Efficiency Of Healthcare Services Research Articles

International case studies: success and failure factors for digital transformation in healthcare

Abstract Background The digitalization of healthcare systems is expected to lead to improvements in the quality and efficiency of healthcare services. Despite Germany’s leading economic and technological position, the implementation and utilization of digital health solutions is lagging far behind internationally. A look at other countries shows that the digital transformation in healthcare can be successful, and that financial resources and available technologies are not the only determining factors. Rather, it is a matter of political processes, the interests of different stakeholders and the acceptance of patients and HCPs. Methods While the impression often arises that the selection of countries in case studies is random, eight international case studies were identified using a scientific method. A systematic and multi-stage process was developed to select the case studies, taking into account various relevant criteria (e.g. degree of digitalization, geography, economy). The implementation and use of various digital health tools will be examined in selected countries and healthcare systems, in which the digitalization of the healthcare system is particularly advanced. Semi-structured interviews will be conducted with experts from the international healthcare systems between fall 2024 and summer 2025. The findings will inform the development of recommendations for actions for policymakers in Germany. Conclusions This study aims to provide new insights into the key success and failure factors for the digital transformation of healthcare systems. Recommendations for action, tailored specifically to the German healthcare system and aimed at policymakers, are intended to support decision-makers in setting the course for a successful further transformation towards digital health. Key messages • International case studies will be used to identify factors that contribute to the success or failure of digital transformation in healthcare systems. • Based on the findings of this research, recommendations for action will be developed for policymakers in Germany to set the course for the successful further digitalization of healthcare.

Consanguinity and Occurrence of Monogenic Diseases in a Single Tertiary Centre in Riyadh, Saudi Arabia: A 2 Years Cross-Sectional Study.

Consanguinity, or the practice of marrying close relatives, is a common cultural tradition in Saudi Arabia, with rates among the highest in the world. This practice has significant implications for the prevalence and distribution of major single genetic defects and chromosomal abnormalities within the Saudi population. Herein, using the BESTCare electronic medical record system (designed to streamline hospital operations, enhance patient care, and improve the overall efficiency of healthcare services; bestcare.ezcaretech.com) in a single tertiary centre, King Abdullah Specialized Children Hospital (KASCH) in Riyadh, Saudi Arabia, we performed a cross-sectional study for all patients referred to the hospital from the 1st January 2020 until 1st January 2022. The present study, which included 1100 individuals, found a high prevalence of consanguinity (64%) and a significant proportion of third-degree relatives (69%). The mean age of participants was 12.24 years, and the diagnostic rate using advanced molecular genetics techniques was 45%, with whole exome sequencing (WES) being the most common method (43%). The study also noted a significant delay in diagnosis for more than a year in 16% of cases, with a common neurodevelopmental phenotype (18%). In conclusion, we revealed the prevalence of consanguineous marriages in the KASCH hospital in Riyadh, Saudi Arabia. We also highlighted the most frequently referred phenotype. These findings are consistent with previous research on the prevalence and impact of consanguinity on rare genetic disorders.

Economic Effects of Digitalization: Health Sector Example

Digitalization contribute to reducing costs, as well as many advantages such as increasing efficiency in healthcare services, improving patient outcomes, quality improvement, ease of access to information, and security. Although digitalization have so many advantages and have become widely used, there are very few studies on the economic effects of digital applications in the healthcare sector. In this regard, this study aims to examine the primary economic benefits of digital hospital applications, which are becoming increasingly widespread in Turkey. In the study, paper costs and labor costs were taken as primary costs. Approval for the study was obtained from the ethics committee of a university (dated 19.12.2024 and numbered 34).As a result of the study, it was determined that the economic effects of digitalization on hospitals were positive. It has been determined that digitalization contributes 48494 TL to hospitals in paper saving costs and 7 779 474 TL in labor costs, with an average annual contribution of 7 827 968 TL. In the study, it was determined that 24-hour service availability, patient entry and exit status, the number of personnel working in the unit and the one-minute wages of these personnel are determining factors in labor costs.

Can the digital transformation of pharmaceutical enterprises' finance improve healthcare equity?

Using big data, cloud computing, and blockchain technologies, enterprise finance is gradually transitioning towards digital transformation. Academia has already researched the motivations, efficiency improvements, and ethical impacts of the digital transformation of enterprises' finances. However, there is little research from the social equity perspective to explore the impact of enterprise financial digitization transformation on regional social welfare. As important entities for improving residents' health conditions, pharmaceutical enterprises have not fully studied whether their financial digitization transformation can improve the quality and efficiency of healthcare services and enhance regional healthcare equity. Therefore, this study focuses on listed Chinese pharmaceutical enterprises from 2018 to 2022, empirically examining the impact of pharmaceutical enterprises' digital transformation on regional healthcare equity. Using A Hospital in China as a case study, the process of its financial digitization transformation is deeply analyzed. The results show that the financial digitization transformation of pharmaceutical enterprises has a significant positive impact on regional healthcare equity, and it can be further enhanced by improving financial flexibility and increasing data assets. These findings contribute to accurately assessing the social responsibilities of pharmaceutical enterprises and provide new perspectives and evidence for improving regional social welfare levels.

The significance of personalized medicine in healthcare services of the 21st century: a brief literature review

In modern healthcare services, patient safety is a primary goal. With technological advancements, the complexity of healthcare services increases, which in turn creates increased pressure on health professionals during decision-making processes and can lead to errors worldwide. Communication gaps, human factors, patient-originated issues, technical failures, and inadequate policies have been identified as the main causes of medical errors. While research shows that errors stem from human nature and are inevitable, it is emphasized that it is possible to develop methods that enhance patient safety. Utilizing digital technologies to improve the quality and efficiency of healthcare services is a crucial strategy. Innovations such as wearable technologies, mobile devices, digital media-delivered education and consulting services, telehealth applications, 3D printers, clinical decision support systems, and implantable biosensors encompass advancements in the digital health field. This research aims to analyze the complex and dynamic structure of healthcare services in the 21st century, especially considering the opportunities presented by the integration of artificial intelligence and genomic data, within the scope of the relevant literature.

Machine Learning for Evaluating Hospital Mobility: An Italian Case Study

This study delves into hospital mobility within the Italian regions of Apulia and Emilia-Romagna, interpreting it as an indicator of perceived service quality. Utilizing logistic regression alongside other machine learning techniques, we analyze the impact of structural, operational, and clinical variables on patient perceptions of quality, thus influencing their healthcare choices. The analysis of mobility trends has uncovered significant regional differences, emphasizing how the regional context shapes perceived service quality. To further enhance the analysis, SHAP (SHapley Additive exPlanations) values have been integrated into the logistic regression model. These values quantify the specific contributions of each variable to the perceived quality of service, significantly improving the interpretability and fairness of evaluations. A methodological innovation of this study is the use of these SHAP impact scores as weights in the data envelopment analysis (DEA), facilitating a comparative efficiency analysis of healthcare facilities that is both weighted and normative. The combination of logistic regression and SHAP-weighted DEA provides a deeper understanding of perceived quality dynamics and offers essential insights for optimizing the distribution of healthcare resources. This approach underscores the importance of data-driven strategies to develop more equitable, efficient, and patient-centered healthcare systems. This research significantly contributes to the understanding of perceived quality dynamics within the healthcare context and promotes further investigations to enhance service accessibility and quality, leveraging machine learning as a tool to increase the efficiency of healthcare services across diverse regional settings. These findings are pivotal for policymakers and healthcare system managers aiming to reduce regional disparities and promote a more responsive and personalized healthcare service.

RESNET101 AND GOOGLENET DEEP LEARNING MODELS: COMPARING SUCCESS LEVELS IN THE HEALTH SECTOR

Artificial intelligence (AI) applications in the healthcare sector have revolutionized medical diagnosis and treatment. Advances in this field provide many advantages such as early detection of diseases and increasing the efficiency of healthcare services. In this study, in order to investigate the usability of deep learning models for tuberculosis (TB) detection, the accuracy rates of deep learning models such as ResNet101 and GoogLeNet are compared in terms of TB detection potential in the healthcare sector. The results of the analyses revealed that deep learning networks are successful in classifying chest X-ray images with and without TB. In addition, when the success levels were analyzed, it was determined that the ResNet101 deep learning network, with a success rate of 99.3%, showed a higher score than the other deep learning model considered in the study, GoogLeNet (98.2%). These findings obtained within the scope of the research reveal the importance and functionality of AI applications in order to increase diagnostic accuracy rates.

Patient’s Perception and Satisfaction with Healthcare Professionals at Primary Health Care Facilities in Onelga (Ogba Egbema Ndoni LGA)

Background: This study investigates the patient's perspective and contentment with healthcare professionals at primary health care facilities in Onelga (Ogba Egbema Ndoni LGA). Employing a survey research design, data was collected from 100 healthcare professionals using a structured questionnaire. The study's objectives include assessing patient satisfaction with healthcare services, exploring the correlation between physician behavior and healthcare services, and determining factors influencing satisfaction levels in the study area. Methods: Demographic data analysis reveals the majority of respondents are male, aged above 60, with educational backgrounds ranging from FSLC to MSC/PGD/PHD. Results: Patient satisfaction findings indicate a significant proportion agreeing or strongly agreeing with positive sentiments regarding healthcare services, physician behavior, and facility cleanliness. Additionally, statistical tests affirm a significant relationship between healthcare services and patient satisfaction. The study concludes that patient satisfaction is influenced by efficient service delivery, physician behavior, and facility infrastructure. Conclusion: Recommendations include regular assessment of patient satisfaction, enhancing healthcare service efficiency, and addressing factors influencing patient contentment. This research contributes to the broader understanding of patient perspectives in healthcare settings, facilitating improvements in service quality and overall patient experience

Exploring Telemedicine Usage Intention Using Technology Acceptance Model and Social Capital Theory.

Telemedicine technology has emerged as a pivotal solution to enhance the accessibility and efficiency of healthcare services. This study investigates the factors influencing the acceptance of telemedicine technology among healthcare professionals in Taiwan. Employing a quantitative research approach, we utilized a survey instrument adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Data were collected from 325 healthcare professionals across diverse medical fields. The results indicate that perceived usefulness, ease of use, social influence, and convenience significantly influence intention to use telemedicine. Moreover, age moderates the relationship between perceived usefulness and usage intention. These findings underscore the importance of addressing both technological and social factors in promoting the adoption of telemedicine among healthcare professionals. Policy implications and recommendations for enhancing telemedicine implementation are discussed based on the study findings. Specifically, our findings highlight that perceived usefulness, ease of use, social influence, and convenience significantly impact the intention to use telemedicine technology. Age significantly moderates the relationship between perceived usefulness and usage intention. These results not only theoretically support the UTAUT model but also provide practical strategies to advance the application of telemedicine technology.

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model.

Enhancing the efficiency of primary healthcare services is essential for a populous and developing nation like China. This study offers a systematic analysis of the efficiency and spatial distribution of primary healthcare services in China. It elucidates the fundamental landscape and regional variances in efficiency, thereby furnishing a scientific foundation for enhancing service efficiency and fostering coordinated regional development. Employs a three-stage DEA-Malmquist model to assess the efficiency of primary healthcare services across 31 provincial units in mainland China from 2012 to 2020. Additionally, it examines the spatial correlation of efficiency distribution using the Moran Index. The efficiency of primary healthcare services in China is generally suboptimal with a noticeable declining trend, highlighting significant potential for improvement in both pure technical efficiency and scale efficiency. There is a pronounced efficiency gap among provinces, yet a positive spatial correlation is evident. Regionally, efficiency ranks in the order of East > Central > West. Factors such as GDP per capita and population density positively influence efficiency enhancements, while urbanization levels and government health expenditures appear to have a detrimental impact. The application of the three-stage DEA-Malmquist model and the Moran Index not only expands the methodological framework for researching primary healthcare service efficiency but also provides scientifically valuable insights for enhancing the efficiency of primary healthcare services in China and other developing nations.

Disparities in cancer outcomes: A comprehensive analysis of cancer incidence, mortality, and prevalence in Europe

Cancer poses a substantial challenge in Europe’s public health landscape, contributing significantly to illness burden, diminished productivity, and escalating health-care costs. This article investigates the extent to which disparities in cancer outcomes are associated with factors influencing the performance of cancer control initiatives within the European Union (EU). The characteristics of health-care systems play a pivotal role in shaping cancer outcomes through three key mechanisms: (i) Access to screening programs; (ii) quality and efficiency of health-care services; and (iii) health education and awareness programs. A multifactorial regression analysis was employed, utilizing the GLOBOCAN 2020 projections of cancer incidence, mortality, and prevalence based on the data from the International Agency for Research on Cancer. This analysis was delineated across 36 distinct cancer classifications by both gender and age categories. In countries with incomplete population coverage, patients may face limitations in accessing certain services or contend with significant financial obstacles. Furthermore, disparities in health-care service implementation, including diagnostic procedures, treatment modalities, and follow-up care, significantly affect cancer outcomes. In addition, systematic distinctions in care quality, such as early diagnosis, timely access to specialized care, and the presence of coordinated efforts, contribute significantly to diverse cancer outcomes. In conclusion, this article highlights the variations in cancer care provision across European countries, offering valuable insights for enhancing cancer patient care.

Spatiotemporal dynamics and determinants of medical service efficiency in China

BackgroundMedical service efficiency is an important indicator for measuring the equity of medical services. Therefore, this study primarily focuses on investigating the spatiotemporal domain to explore both spatial and temporal characteristics, as well as influencing factors that affect medical service efficiency across diverse provinces in China.MethodsThe super Epsilon-based Measure (EBM) unexpected model has previously been utilized to quantify energy eco-efficiency, carbon emission efficiency, and green development efficiency. However, limited studies have applied this method to assess the efficiency of healthcare services. Therefore, this study investigates the application of the super-EBM-unexpected model in evaluating medical service efficiency, and further integrates spatial econometric models to explore the influencing factors of medical service efficiency and aims to identify potential avenues for improvement.ResultsThe average efficiency of medical services in the 31 provinces of China ranges from 0.6 to 0.7, indicating predominantly low efficiency values. However, economically developed coastal areas exhibit relatively high efficiency levels above 1. Conversely, regions with relatively lower levels of economic development demonstrate lower efficiency rates at approximately 0.3. Evidently, substantial regional disparities exist. For the influencing factors, the enhancement of residents' living standards can effectively foster the medical service efficiency, while residential living standards of nearby areas can also exert an impact in this region. The influence of educational attainment on medical service efficiency exhibits a significant inhibitory effect.ConclusionsThe majority of China's 31 provinces exhibit suboptimal medical service efficiency, with notable regional disparities. Future policy initiatives should be tailored to address the unique challenges faced by regions with lower levels of economic development, prioritizing enhancements in both the efficacy and quality of their healthcare systems.

Wearable Smart Cardiac Care: Take Vipasyana for Example

The most direct challenge to the healthcare system in Taiwan associated with population aging is the chronic and growing shortfall in medical and nursing practitioners. The integration of artificial intelligence, Internet of Things, and advanced 5G communication technologies is making healthcare more streamlined and intuitive to improve healthcare service efficiency, encourage cross-disciplinary cooperation to improve patient health management, and introduce and mainstream innovative service models such as telecare. To this end, the wearable smart cardiac care system 'Vipasyana', jointly developed by the interdisciplinary research team of the Departments of Electrical Engineering and Computer Science at National Yang Ming Chiao Tung University, not only has an innovative fully functional wireless wearable electrocardiograph but also uses machine learning-based detection/prediction methods to detect and monitor for emergencies such as myocardial infarction, ventricular tachycardia/ventricular fibrillation, and heart failure. To handle the real-time streaming sensing data generated during clinical trials, a big data real-time streaming framework based on Apache Storm and microservices has also been integrated. In addition, a mobile phone app and virtual reality 3D ward round system providing a user-friendly management and monitoring tool for medical staffs were developed and integrated into the system. The 'Vipasyana' system is capable of providing precision medical services to individual patients.

Utilising VSM insights to address health system disconnects: introducing three novel organisational pathologies

PurposeHealth systems worldwide are hampered by disconnects between governance, management, and operations, which negatively impact on their ability to deliver efficient, effective, and safe healthcare services. This paper shows how insights from the Viable System Model (VSM) can help us to conceptualise health system disconnects impacting specialist clinical services and develop solutions to address organisational fragmentation.Design/methodology/approachA case study of a specialist clinical service was undertaken, where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and analysis of findings.FindingsThe VSM provides a coherent way to conceptualise the disconnects and identify their structural underpinnings. Three novel organisational pathologies emerged from the study.Research limitations/implicationsThis New Zealand-based study was undertaken during the COVID-19 pandemic and a period of major health system reform, introducing uncertainty into service provision that may have impacted stakeholders’ views.Practical implicationsThe three novel pathologies affect how health systems define their services, their understanding of the management function, and the importance of coordination. The resulting clarity of functioning could improve service quality, staff and patient satisfaction, and the effectiveness and efficiency of healthcare service delivery.Originality/valueThis study contributes to the VSM literature on organisational pathologies by providing three novel pathologies for a perspective that may be useful beyond healthcare and invites consideration of health system disconnects as a coherent field of study.

An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System.

A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability. We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world. We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement-importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram. Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability.

Symptom experiences and influencing factors in patients undergoing chemotherapy for gastrointestinal cancers: a qualitative study.

To explore the symptom experiences and influencing factors of gastrointestinal (GI) cancer patients on chemotherapy (CTX) in China. Semi-structured interviews were conducted with 13 GI cancer patients undergoing CTX. Following the Colaizzi 7-step analysis method, the interview data were read carefully, meaningful statements related to the research questions were extracted, coded, collected, and described in detail, and the authenticity of the theme was verified. Nine themes were grouped into two main areas including the characteristics of symptom experiences and influences on symptom experiences. The symptom experiences of patients undergoing CTX for GI cancer is poor and influenced by multiple factors. Nurses need to pay attention to the assessment and monitoring of CTX-related symptoms, improve symptom recognition, enhance doctor-patient communication and social support, explore intelligent management methods, and increase the efficiency of healthcare services to improve patients' symptom experience.

Shaping the Future of Healthcare: Integrating Ecology and Digital Innovation

The concept of sustainable healthcare is the subject of an increasingly intense, captivating, forward-looking, yet sometimes still overly theoretical debate. The aim of this contribution is to analyze the current scenarios of ecological and digital transition in the healthcare sector, considering its high energy consumption. In particular, we adopt a holistic and convergent vision of the energy mix and its infrastructure, moving beyond the ideological dichotomy of energy sources. Renewable sources, digital innovations, and the circular economy are seen as playing key roles in the future of the energy sector. In this research, a mixed methodology was employed, combining a questionnaire consisting of 31 questions with semi-structured interviews conducted with the top management of a major player in the private healthcare sector located in southern Italy in 2023. Consequently, we examine the main macro-guidelines of technological development, encompassing enabling technologies, new business models, roles, and professional skills. Based on the analyses conducted, we provide some insights to inform governmental policies and industrial strategies in the near future. Digitalization represents an opportunity to enhance the efficiency of healthcare services, reducing waste and ensuring quality. For instance, digital healthcare solutions enable personalized care on a global scale and offer decision support systems that can enhance overall healthcare performance. However, to maximize the benefits of digital transformation, it is essential to integrate new technologies effectively and sustainably into the existing healthcare ecosystem. A promising example is telemedicine, which can help reduce carbon emissions by decreasing healthcare workers’ travel.

Exploring Iot Embedded Systems Along the Line of Identity Access Management for Enhanced Health Data Security

A. Overview of IoT Embedded Systems The pervasiveness of Internet of Things (IoT) embedded systems in the digital era has significantly transformed numerous industries, including healthcare. These interconnected devices, capable of collecting, transmitting, and analyzing data, offer immense potential to improve healthcare service efficiency, accessibility, and quality. However, the escalating volume of sensitive health data being generated and exchanged necessitates the implementation of robust security measures. A critical element in this regard is Identity and Access Management (IAM), which governs the control of user identities and their access privileges within a specific system [1].

Management Information Systems Towards Improving the Quality of Nursing Care Services: A Literature Review

Background: Many developing countries are striving to further develop health information technology at the healthcare service level, particularly through the implementation of electronic health records (EHR). Objectives: This research aims to evaluate the quality and impact of implementing electronic health records in healthcare services from various perspectives. Methods: The research design employed in this study is a literature review, involving the collection of articles from selected databases, including PubMed and Cochrane. The article search started from the year 2014, and the Boolean operators used were "Electronic Health Record" OR "Electronic Medical Record" OR "EHR" AND "Quality" OR "Documentation" OR "Quality Documentation" OR "Quality Care" AND "Nurs*". The research design incorporated into this study is observational. Results: The use of Electronic Health Records (EHR) has a significantly positive impact on various healthcare service sectors. Hospitals that have fully implemented EHR show a significant improvement in the quality of patient medical records, a decrease in information delivery delays, and a reduction in patient admission costs. Conclusion: Investment in EHR technology can be considered a crucial step in enhancing the quality and efficiency of healthcare services while reducing operational costs. However, it is important to note that EHR implementation is not a straightforward task and requires consideration of various factors mentioned above to achieve optimal results in health information management.

IJCM_376A: Time motion study in Anti Rabies Vaccination OPD in tertiary care Hospital of Central India

Background: Outpatient department is considered a doorway to health services. The outpatient department thus requires a systematic study of its services for its efficient management and functioning. Time-motion study in ARV OPD provides information on how much time it takes for management of animal bite patients at each step. Such a study could prove useful to improve efficiency of health care services. Objective: To assess the average time spent in different service delivery points in ARV OPD Methodology: A hospital based cross0sectional study was conducted in ARV OPD from July 2022 to June 2023 on Patients coming to ARV OPD. A total of 960 patients were included in the study using Systematic Random sampling technique. Data was collected using a pre-designed and pre-tested questionnaire for socio-demographic details and case history of patients and time required for each step in management of animal bite. Stopwatch of smartphone was used to record time at each step of patient management. All the collected data was entered in SPSS software (version 20.0) and was analyzed accordingly. Results: Study results showed that out of 960 patients 613 (63.85%) were male and 347(36.15%) were female. 509 (53.02%) were from urban and 451(46.98%) were from rural area. Out of 960 patients 816 (85 %) were of category III bite and 144 (15%) of category II bite. The most common site for animal bite was lower limb 556 (57.9%) followed by 288 (30%) on upper limb, on trunk 38 (3.96 %) and 78 (8.14%) on head and neck region. Total time required for management of animal bite was 35.15+/- 17.92 minutes. Conclusion: The time spent in transit could be reduced with proper management of logistics. Also reframing of strategies at various steps could help reduced average time needed to attend a patients at ARV OPD.