Earnings management in public hospitals: The case of Greek state-owned hospitals

BACKGROUND:Today, hospitals need managers who, in addition to having the necessary skills for management and leadership, are accountable to stakeholders, especially the community. Accordingly, the purpose of this study was to evaluate the social accountability of managers of public and private hospitals in Tehran.MATERIALS AND METHODS:The present study is descriptive-analytical and cross-sectional and was performed on 155 managers of selected public and private hospitals in Tehran. The research tools included a demographic characteristic questionnaire and a researcher-made social accountability questionnaire for managers. Data analysis was performed using descriptive and inferential statistics in SPSS 22 software.RESULTS:The situation of social accountability in the managers of public hospitals was at a weak level and in the managers of private hospitals in Tehran was at a good level. In comparing the status of social accountability and its dimensions in the managers of public hospitals with the managers of private hospitals, the status of social accountability in the dimensions of human resource management, quality improvement, executive management, and overall social accountability were significantly different from each other (P ≤ 0.05). However, in terms of governance, the status of social accountability of public hospital managers was not significantly different from private hospitals (P ≥ 0.05). Overall, the results of social accountability in private hospitals were better than in public hospitals.CONCLUSION:The social response status of managers in private hospitals was better than public ones. Lack of attention of managers to social accountability affects the quality of other educational, health, and medical services. This fact raises the need for managers to pay more attention to the issue of social accountability.

The purpose of this paper is to confirm the core competencies required for middle to senior level managers in Victorian public hospitals in both metropolitan and regional/rural areas. This exploratory mixed-methods study used a three-step approach which included position description content analysis, focus group discussions and online competency verification and identification survey. The study validated a number of key tasks required for senior and middle level hospital managers (levels II, III and IV) and identified and confirmed the essential competencies for completing these key tasks effectively. As a result, six core competencies have been confirmed as common to the II, III and IV management levels in both the Melbourne metropolitan and regional/rural areas. Six core competencies are required for middle to senior level managers in public hospitals which provide guidance to the further development of the competency-based educational approach for training the current management workforce and preparing future health service managers. With the detailed descriptions of the six core competencies, healthcare organisations and training institutions will be able to assess the competency gaps and managerial training needs of current health service managers and develop training programs accordingly.

In recent years, human resources management (HRM) in public hospitals has undergone significant changes, influenced by factors such as technological progress, demographic changes, and the challenges brought by the COVID-19 pandemic. This paper examines the new emerging trends in HRM in public hospitals in Romania, highlighting the importance of adapting to the new conditions to maintain the efficiency and quality of healthcare services. Efficient human resources management in public hospitals is essential for optimizing costs and improving healthcare services. By investing in the recruitment and training of healthcare professionals, public hospitals can ensure a skilled workforce, capable of providing high-quality care to patients. Additionally, an adequate level of staff can address the issue of long waiting times and improve emergency response capacity.

Budget management remains a challenge in public hospitals with regard to the delivery of cost effective health services. This article is based on a study undertaken to develop a budget management model for managers in public hospitals in the Limpopo Province of South Africa. The question is: How can the management of the budget in public hospitals be improved? The study investigates budget management in the public hospitals. The research methodology used for this study is both quantitative and qualitative research design to generate data required to achieve its aim and objectives. The targeted population for the study was all public hospitals in the Limpopo Province, which comprises 40 public hospitals. The findings showed that, as there is improvement in budget management, much needs to be done to improve budget management in the public hospitals. In this study a budget management model is recommended for consideration by managers.

Aim: Lean is a set of operating philosophies and methods that help create maximum value for patients by reducing waste and waits. It emphasizes the consideration of the customer's needs, employee involvement, and continuous improvement. The aim of this study was of factors affecting lean management in public hospitals in Kohgiluyeh and Boyerahmad and Bushehr provinces. Materials and Methods: This research was descriptive correlation study. The questionnaire was used to collect the data. Factor analysis and multiple regression analysis were conducted to understand the relationship between these factors and lean implementation success. With using 60 questions questionnaire, the content validity of the method developed by the researchers and expert judgment and Cronbach's alpha and test–retest reliability of the method was investigated, and the opinions of 500 primary health-care practitioners were collected. Then, a two-stage exploratory and confirmatory factor analysis and structural equation modeling with the use of statistical software SPSS for Window 17.0 software (SPSS Inc., lllinois, USA) (Leland Stanford Junior University) and AMOS 20 carried out to review and modify the conceptual model. Results: Exploratory factor analysis identified five factors of human, technology, management, processes, and relational that explains 58.5% of the total variance. Confirmatory factor analysis also showed that among identified factors, technology factor with 0.953 coefficient has greatest impact and management factor with 0.615 coefficient has the lowest impact on the pattern of lean management in public hospitals to improve the quality of services. Conclusions: The factors affecting the deployment of lean management in public hospitals and appropriate strategy for using the lean management to improve the delivery of primary health care and reduce waste. The results represent guidelines for using effective implementation of lean management to increase efficiency and ability to compete in the global market offers.

A systematic review of factors influencing Type 2 Diabetes Mellitus management in Nigerian public hospitals

Budget planning is a challenge regarding the delivery of cost-effective health services in public hospitals. Budget planning is part of broader planning process in the organisations. The purpose of this article is to analyse budget planning in public hospitals in the Limpopo Province of South Africa. The research approach used for the study is quantitative research design. The sample size of 20 public hospitals was drawn from the population of 40 public hospitals. A survey questionnaire was used as the primary data-gathering instrument. The findings of the research show that budget planning is a management challenge for non-finance managers in public hospitals. The result for this is ineffective budget management in public hospitals. The study recommended that non-finance managers be capacitated on the alignment of budget with a strategy to improve budget management in public hospitals.

This study aims to investigate the levels of emotional intelligence for managers in public and private hospitals in Jordan for the purpose of identifying the relative practice of emotional intelligence dimensions by managers in each sector. The research will also look into the differences (gaps) in self- and other-assessed emotional intelligence for managers in both public and private hospitals. As such, the theoretical importance of this research lies in its ability to contribute to filling the missing gap in the literature while forming the basis for or being the object of reference for any future research in the field. The researchers adopted a quantitative research design. Data were collected using a 360-degree questionnaire, in which managers’ self-assessments, and the assessments of two other raters (supervisors, peers, or subordinates), were used to measure the levels of managers’ emotional intelligence in both public and private hospitals. A total of 179 managers and 358 raters participated in our study. The results of the study revealed that differences between managers’ self-assessments and others’ assessments might be an indicator of inflated managers’ self-assessments. Differences between managers’ self-assessments and others’ assessments were larger in public hospitals compared with those in private hospitals. Hence, our study provides valuable recommendations and implications to enhance the practice of emotional intelligence among managers both in public and private hospitals in Jordan.

Portfolio analysis is a business management tool that can assist health care managers to develop new organizational strategies. The application of portfolio analysis to US hospital settings has been frequently reported. In Europe however, the application of this technique has received little attention, especially concerning public hospitals. Therefore, this paper examines the peculiarities of portfolio analysis and its applicability to the strategic management of European public hospitals. The analysis is based on a pilot application of a multi-factor portfolio analysis in a Dutch university hospital. The nature of portfolio analysis and the steps in a multi-factor portfolio analysis are reviewed along with the characteristics of the research setting. Based on these data, a multi-factor portfolio model is developed and operationalized. The portfolio model is applied in a pilot investigation to analyze the market attractiveness and hospital strengths with regard to the provision of three orthopedic services: knee surgery, hip surgery, and arthroscopy. The pilot portfolio analysis is discussed to draw conclusions about potential barriers to the overall adoption of portfolio analysis in the management of a public hospital.

PurposeThe purpose of this paper is to assess the existing facilities maintenance management practices and processes in public hospitals, in accordance with the concession agreement (CA), in order to identify the current performance status.Design/methodology/approachA case study is conducted in one district hospital in Malaysia to assess five key elements: leadership; policies, plans and procedures; training and orientation; monitoring and supervision; and service performance. Data are collected through questionnaires, guided interviews, documentation review and retrieval, archival records review, and direct observations.FindingsThe status of facilities maintenance management in the hospital is categorised as “maturing”, which implies that there has been a good planning and management with all essential requirements and compliance with regulations. Nevertheless, analyses of findings indicate that the maintenance organisations in the hospital still do not realise the importance and benefits of effective facilities maintenance management.Research limitations/implicationsFindings reveal that continuous involvement of all organisations is rudimentary to provide guidance and direction to the maintenance function.Practical implicationsThis research has gained an insight into the management practices and processes exhibited by a maintenance organisation in executing contractual and regulatory requirements of privatised facilities maintenance services in a public hospital. It has also gained an insight into the practice of a maintenance management audit, which was conducted with a view to identifying areas of weakness such that recommendations can be derived to improve the maintenance performance.Originality/valueThis research has introduced a set of key ingredients and effectiveness measures for successful facilities maintenance management. It also explores opportunities for improving facilities maintenance management in public hospitals.

With the continuous progress of modern information technology in the economic and social development, information construction has been widely used in the public medical system. In public hospitals, modern information construction has not only improved the overall medical service level and efficiency, but also strengthened Hospital internal control and management. The application level of information technology is an important factor in the financial management of public hospitals, and the construction of information has a profound impact on the improvement of the financial management of public hospitals. Through the extensive influence and necessity between the financial management and information construction of modern public hospitals, this paper analyzes the main problems existing in the process of financial management and information construction of public hospitals, and studies the suggested measures to solve the problems, in order to optimize the financial management of public hospitals, and provide reference for information construction.

Stakeholders management in public hospitals - from stakeholders management to stakeholders relations Public sector organisations have a sufficient influence to win political legitimization and resources to finance their operations by satisfying their stakeholders. Organizations that adopt stakeholder management principles probably better satisfy their constituent needs and balance their interests, which results in higher capacity of goal achievement. The question of what initiatives were undertaken by public sector organisations to manage different stakeholders, and what were their motivations is still unanswered. The aim of this paper is to understand how stakeholder groups are being recognized in the public hospitals’ decision-making in context of resources.

Purpose: This article aims to investigate the impact of digital transformation on public hospital management in Peru, with a specific focus on enhancing the patient experience through the adoption of digital technologies. Objective: The primary objective is to assess the effectiveness of digital transformation strategies in improving the efficiency and accessibility of health services in public hospitals, ultimately aiming to enhance the overall patient experience. Theoretical Reference: The study is grounded in a mixed-method approach, incorporating elements of qualitative and quantitative research. It includes a comparative analysis of digital transformation strategies implemented in a representative sample of public hospitals at international, regional, and national levels. Method: The research design involves in-depth interviews with healthcare professionals and patients, as well as the analysis of secondary data from national and international health databases. The study encompasses a diverse sample of public hospitals, considering varying technological capabilities and levels of digital development. Results and Conclusion: The findings indicate that the progressive implementation of digital technologies in public hospitals in Peru has shown promise in improving the efficiency and accessibility of health services. However, challenges related to infrastructure, systems integration, and data security remain. The study underscores the need for a comprehensive and coordinated strategy for digital transformation in public hospital management. Implications of Research: The study highlights the importance of greater investment and development of digital health policies at the national level to bridge the gap in the adoption and implementation of digital technologies in hospital management. It emphasizes the significance of a collaborative approach between government, healthcare providers, and technology developers to drive digital transformation in the healthcare sector in Peru. Originality/Value: This research contributes to the understanding of the potential of digital transformation in public hospital management, particularly in developing countries like Peru. It provides insights into the challenges, opportunities, and implications of implementing digital technologies to enhance the patient experience and improve healthcare delivery in public hospitals.

Background Gestational Diabetes Mellitus GDM leads to adverse maternal and foetal health outcomes. There are several benefits of screening pregnant women for GDM including reducing the impact and timing of GDM-associated complications. However there is limited evidence regarding GDM screening and management in public hospitals in low- and middle-income countries. Therefore we aimed to understand the current GDM screening and management practice in public hospitals in South India through the study of pregnant women in Bangalore.Methods We conducted a cross-sectional study in all the six tertiary-level public hospitals of Bengaluru which were providing antenatal services during September 2017. We compared the results of GDM screening in five of these hospitals with a tertiary public hospital wherein a cohort of women were studied during the same time wherein voluntarily consented women were subjected to GDM screening and were followed up through their pregnancy and post-partum.Results Among the 186 pregnant women included in the cross-sectional study 41.4 n77186 had undergone random blood sugar test and 22 n39186 underwent a confirmatory test in the form of either a Glucose Challenge Test GCT or Oral Glucose Tolerance Test OGTT for diagnosis. Similarly pregnant women underwent capillary blood glucose testing 5.1 n9186 fasting blood sugar 1.7 n3186 urine glucose and albumin level 1.7 n3186 testing. The prevalence of GDM in this cross-sectional study obtained via routine screening in public hospitals was 4.3 n8186 while in comparison the prevalence of GDM was 15.4 n1571019 in the ongoing cohort. Furthermore only 22.9 of cohort women diagnosed with GDM received any follow-up treatment in public hospitals. We also found that 12.1 and 7 of women achieved glucose control in the antenatal and postnatal period respectively.Conclusion Our results suggest that most women with GDM attending public hospitals may be ldquomissedrdquo from GDM diagnosis and treatment even in the major public hospitals in Bangalore. Therefore strengthening the GDM screening and management in public hospitals is imperative to avert the adverse risks of GDM among women and their children in urban areas.

Introduction: Crisis management, as one of the areas of consequence management, can increase crisis resilience and reduce the level of organizational vulnerability in times of crises. Therefore, this study was designed and conducted to assess the components of crisis management in private and public hospitals. Method: The present study was conducted in 10 hospitals, in 2020. The sample size was estimated to be 200. The components of crisis management in this questionnaire included: management commitment, taking the blame, learning, awareness, preparedness, flexibility and transparency. Data analysis was performed using Independent samples t-test and Chi-square/Fisher exact test. Results: The results showed that the two groups of public and private hospitals did not have significant differences in terms of individual variables (p<0.05). The crisis management index in the two groups of public and private hospitals was estimated to be 4.11 and 3.22, respectively. The results of comparative assessment of the crisis management components in the two groups revealed that all these components in public hospitals are estimated to be higher than that of the private hospitals, and their differences are also statistically significant (p<0.05). Conclusion: The findings of the study indicated that although the resilience of private hospitals was higher than average, the comparative assessment of the crisis management components revealed that the level of resilience in times of crises in public hospitals was higher than the private ones. Therefore, the components of crisis management in these hospitals should be improved with a proper design and a comprehensive crisis management program.