Hospital Management Research Articles

The influence of policy advocacy and education on medical staff’s adaptation to diagnosis related groups payment reform in China: an analysis of the mediating effect of policy cognition

IntroductionIn recent years, China has been carrying out the Diagnosis Related Groups (DRGs) payment reform, which has an impact not only on payment methods and medical expenses, but also on the behaviors of medical staff. Some of these behaviors are unexpected by policymakers, such as turning away critically ill patients, disaggregating hospitalization costs, setting up disease groups with higher points, and so on. This phenomenon attracted the attention of some scholars, who put forward a few positive intervention measures, mainly including policy advocacy and system improvement. The scholars believed that the former was more feasible. However, there is a lack of research on the effects and influencing processes of these interventions. Therefore, this study aims to explore the influence of policy advocacy and education on medical staff’s adaptation to DRGs payment reform in China and the role of policy cognition in this process, in order to provide experiences for the smooth implementation and sustainable development of DRGs payment system.MethodsA questionnaire survey was conducted among 650 medical staff in five large general hospitals in Zhejiang Province, China, to understand their participation and feedback on policy advocacy and education, their adaptation to the current DRGs payment reform, and their cognition of relevant policies. After descriptive statistical analysis, partial correlation analysis, multiple linear regression models and bias correction Bootstrap sampling method were used to analyze the mediating effect of policy cognition factors.ResultsAll respondents had participated in organized collective policy advocacy and education activities in the past year, but the degree of satisfaction and recognition was not very high. 59.5 percent said their adaptation to the DRGs payment reform was average. Nearly half did not regularly pay attention to and participate in the management of the medical costs of patients with DRGs through compliance. And they had a low understanding of the specific rules of DRGs payment and did not form a high policy identity. The mediating effect values of policy cognition were 0.148, 0.152, 0.108, and 0.057, respectively, when the frequency and quality of policy advocacy and education influenced medical staff’s adaptive perception and adaptive behaviors.DiscussionThe organized collective policy advocacy and education can promote medical staff’s adaptation to DRGs payment reform by improving their policy cognition, and the action paths are diverse. Policymakers and hospital managers need pay attention to this phenomenon, and formulate demand-centered, value-oriented whole-process advocacy and education strategies while constantly improving the DRGs payment system. All of these provided a basis for further research and practice of positive intervention in DRGs payment reform.

Technology evaluation: a systematic review and implications for ethical technology management in tourism and hospitality

Technology evaluation: a systematic review and implications for ethical technology management in tourism and hospitality

Work-family conflict and job stress as predictors of quality of work-life among nurses

This study investigated predictors of quality of work life among nurses in Ipokia Local Government Area in Ogun State, Nigeria. A cross-sectional survey design was adopted to collect data using the Quality of Life Scale, Work-Family Conflict Scale, and Job Stress Scale. A purposive sampling technique was used to select 182 nurses (Females: 123; Males: 59). Data were analyzed using multiple regression analysis, t-test of independent mean, and one-way analysis of variance. Three hypotheses were generated and tested at a 0.001 level of significance. The result revealed that work-family conflict and job stress jointly predicted the quality of work-life among nurses [R2 = 286, F (2,181) = 37.648, p = .002). Also, job stress independently predicted the quality of work-life among nurses (β = .543, p = .001). However, work-family conflict did not independently predict the quality of work-life among nurses (β =-.001, p >.05). It was concluded that work-family conflict was a significant factor when combined with job stress but not an independent predictor of quality of work-life among nurses. Therefore, the Chief Medical Director and Human Resource Department of hospitals should monitor the stress levels of their nurses to ensure continuous productivity and avoid unnecessary breakdown of nurses at Work and home.

Role adaptation of nurses caring for older adults with terminal diseases in geriatric hospitals

AbstractAimTo understand the role adaptation process of nurses caring for older adult patients with terminal diseases in Chinese geriatric hospitals.BackgroundThe Chinese government has been encouraging the conversion of secondary general hospitals and some tertiary hospitals into specialized geriatric hospitals; however, research on nurses’ adaptation to caring for older adult patients with terminal diseases in these hospitals is lacking.MethodsIndividual in‐depth interviews were conducted with 13 registered nurses with a minimum of two years of experience caring for older adults with terminal diseases. Following Glaserian grounded theory, open, selective, and theoretical coding were conducted for data analysis. The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.Results“Guards of the shining sunset” emerged as the core category. Participants experienced three stages: “chaotic me,” “rational me,” and “inclusive me.” They highlighted two causes, three contexts, two intervention conditions, three strategies, and two consequences.ConclusionThe study shows that nurses play a key role in “guarding the shining sunset” of older adult patients with terminal diseases. The observed role adaptation process provides theoretical support for interventions to assist nurses in becoming inclusive “guards of the shining sunset.”Implications for nursing practice and policyNurses play a unique role as guardians protecting the end‐of‐life quality of elderly patients. Their role needs to be expanded and strengthened via effective coping strategies and comprehensive legal, education, welfare, and professional promotion support policies. The substantive theory offered by this study may be applied by nurses, department leaders, geriatric hospital managers, and national‐level institutions to underpin future interventions and improve role adaptation.

“I want to help but customers mistreat me”: the dual moderating role of prosocial motivation on the impact of customer mistreatment

Purpose Based on the stressor-detachment theory, this study aims to investigate the effect of daily customer mistreatment on proactive service performance and ego depletion, mediated by psychological detachment inhibition during the evening. Additionally, this study endeavors to investigate the dual moderating role of prosocial motivation. Design/methodology/approach A time-lagged, diary daily survey involving 74 participants over 8 consecutive workdays was conducted to test the hypotheses. Findings The findings indicate that the psychological detachment inhibition during the evening of Day t mediates the impact of Day t’s customer mistreatment on Day t + 1’s proactive service performance and ego depletion. Furthermore, although prosocial motivation was found to intensify the impact of customer mistreatment on psychological detachment inhibition, it alleviated the negative association between psychological detachment inhibition and proactive service performance. Research limitations/implications When employees experience customer mistreatment, hospitality managers should not only provide emotional reassurance and resolve any related issues promptly but also encourage employees to engage in activities that distract them and help them to relax and recharge, especially for those who exhibit high prosocial motivation. Moreover, hiring employees with high prosocial motivation is recommended for hospitality organizations to enable them to maintain high service performance. Originality/value This study focuses on psychological detachment inhibition during the evening linking within-person design and daily spill-over impact, enriching the mechanisms through which the repercussions of daily customer mistreatment extend beyond the immediate workday and affect individuals’ outcomes. This study also expands upon the existing literature by clarifying the dual aspects – both detrimental and beneficial – of prosocial motivation.

More than words: the role of personality in shaping the timeliness of online reviews

Purpose The purpose of this paper is to investigate the potential influence of the big five personality traits − extraversion, neuroticism, agreeableness, openness and conscientiousness − on the time taken by travelers to submit online reviews after their hotel stay. Design/methodology/approach The study analyzed 83,235 TripAdvisor reviews from 415 hotels in six major US tourism cities using random forest algorithms and Poisson regression. The research investigated the influence of the big five personality traits on the time taken by travelers to submit online reviews post-hotel stay, merging personality psychology with consumer behavior research through a combination of machine learning and statistical analysis. Findings The findings reveal significant correlations between certain personality traits and the time taken to post online hotel reviews. Extraversion, neuroticism and agreeableness were found to be negatively correlated with response time, suggesting that individuals scoring higher in these traits tend to submit their reviews more quickly. Conversely, openness exhibited a positive correlation, indicating that those with higher levels of openness tend to delay their feedback. Conscientiousness showed no significant correlation with response time. Originality/value This study represents a novel approach to understanding the relationship between personality traits and online review behavior in the hospitality industry. By leveraging advanced machine learning techniques, such as random forest algorithms, alongside traditional statistical methods like Poisson regression, this research offers a unique perspective on the influence of personality on consumer behavior. The innovative application of these technologies to a large data set of TripAdvisor reviews provides fresh insights that can inform the development of personalized customer engagement strategies. The findings contribute to the growing body of literature on the intersection of personality psychology, consumer behavior and hospitality management in the digital age.

Abstract 4138603: Adult-onset Kawasaki Disease: An Updated Review of the English-Language Literature from 1980 Through 2023

Introduction: Kawasaki disease (KD) is a pan-vasculitis that primarily affects children and rarely adults. Available data on adult-onset KD are based on case reports and case series, both of which are limited by small sizes. We aimed to characterize the epidemiology, presentation, hospital course, and outcomes of adult-onset KD published in the English literature from 1980 through 2023. Methods: We retrospectively reviewed and included published articles with a diagnosis of KD in patients age ≥18 years. We searched PubMed and Google scholar for case reports/series published in English using the keywords “adult”, “Kawasaki disease”, and “mucocutaneous lymph node syndrome”. We extracted data from individual articles onto an Excel spreadsheet for analysis. Outcomes of interest were the demographic characteristics of patients, clinical presentation and hospital course, management, and complications. Descriptive statistics were used to analyze the data. Results: A total of 137 patients from 29 countries were included in this study. The majority were male (90/137, 64.9%; M:F ratio 1.8) and the median age was 25 years (range, 18-68). The median time to clinical presentation was 5 days (range, 4-60). The main signs and symptoms were fever (95.7%), skin rash (92.9%), conjunctivitis (89.3%), extremity changes (84.3%), oral changes (85.7%), and cervical lymphadenopathy (73.7%). The majority of the patients had no co-morbidities (125/137, 91.2%). EKG changes were not reported in 48 patients (35%). In the remaining 89, 26 (29.2%) had normal EKG or sinus tachycardia, 9 (10.1%) had ST segment elevation, and 9 (10.1%) had arrythmias or abnormal EKGs. Pharmacotherapy included IVIG (80/137, 58.4%), Aspirin (105/137, 76.6%), steroids (31/137, 22.6%) and antibiotics (68/137, 49.6%). For complications, 18.2% (25/137) had aneurysms, 8% (11/137) had myocardial infarction, 10.9% (15/137) had myocarditis, 10% had pericarditis/pericardial effusion, and 10.9% (15/137) had KD shock syndrome. The median length of stay was 14 days (range, 1-60 days). Three patients (2%) died from KD. Conclusion: Adult-onset KD is rare and is associated with significant cardiovascular complications. Clinicians should have high index of suspicion for prompt diagnoses and initiate appropriate treatment to improve outcomes.

Eco-Chic stays: The influence of green communication on guest booking intentions

In this paper, we examine how green communication impacts luxury hotel bookings using data from China. To determine whether green communication has an impact on guests’ decision-making processes, 384 questionnaires were distributed across four major Chinese cities, Beijing, Shanghai, Guangzhou, and Shenzhen. Among the mediators and moderators were perceived brand integrity, intrinsic green motivation, and environmental knowledge. Results indicate that the combinations of perceived brand integrity and green intrinsic motivation affect guests’ booking intentions along with environmental knowledge, according to the results of this study. Luxury hospitality managers can use this research to develop a theoretical framework for sustainable communication with green consumers.

Abstract 4119327: Tyrosine Kinase Inhibitor and Their Cardiotoxic Profile in the African American Population at a Community Safety Net Hospital

Intro: Tyrosine Kinase inhibitors (TKI) have been an effective treatment option for multiple cancer types. Unfortunately, TKIs have shown to have off-target Kinase binding to cardiac tissue. The examination of these cardiotoxic side effects have not been sufficiently explored in minority populations and studies such as DASISION and ENESTnd with high NAA homogeneous demographics reflect this issue. AA tend to have higher rates of HTN and HF at baseline, so further evaluation of TKI cardiotoxicity in this population is warranted. Methods: A total of 181 patients (pts) charts were reviewed in this study, who were exposed to either Ibrutinib, Imatinib and Sorafenib. First, Patients’ demographic data, such as age, gender, race, malignancy type were obtained along with their corresponding exposure to TKIs discussed above. Next, each patient (pt) chart was examined for any cardiotoxic etiologies after starting a TKI, such as arrhythmias, new- onset heart failure (nOHF) , cardiac arrest (CA), and Myocardial infarction (MI). Echocardiography reports were examined for Ejection fraction ( EF). In summary, this is an observational study looking at Cardiotoxicity secondary to TKI use in the AA population. Results: This study's demographics consisted of 149 AA and 32 NAA (non- african american), with the average age of 64.2, and had 128 males and 53 females. A total of 89 pts were on imatinib, 57 on Ibrutinib, 35 on sorafenib. In our population, 64 pts received cardiac echography while on TKIs, with 9 of them demonstrating nOHF. In terms of cardiac arrhythmias, a total of 67 pts experienced this while on TKI, with about 34% (51/149) of AA compared to 50% (16/32) of NAA. A total of 18 pts in the study required hospital management as a sequelae of their cardiotoxicity. Conclusion: There were a few trends that diverged from most studies regarding cardiotoxicity associated with TKIs in our study. When looking at individual items, such as rate of Atrial Fibrillation (AF), seen commonly in patients on Ibrutinib, our rate seen is 4.6% which is lower compared to earlier pooled homogenous population studies (6-7%). Earlier clinical trials of Sorafenib had a 2 % rate of HF in mostly homogenous NAA populations, and our study had 0% rate in total. Overall, several cardiotoxicity trends seen with the TKIs in this observational study warrant need for future studies to enable improved cardiac surveillance strategies post treatment in heterogeneous populations.

Analisis Kepuasan Pengguna Sistem Informasi Manajemen Rumah Sakit Pelni dengan Metode SERVQUAL (Service Quality)

This study aims to analyze user satisfaction with the Hospital Management Information System (SIMRS) implemented at Pelni Hospital using the SERVQUAL (Service Quality) method. The SERVQUAL method is used to measure Service Quality based on five dimensions: tangibles, reliability, responsiveness, assurance, and empathy. The research was conducted by distributing questionnaires to 31 respondents, including patients, medical staff, and administrative staff who actively use SIMRS. The results indicate that, overall, the quality of SIMRS services at Pelni Hospital is categorized as "Good" across all dimensions measured. The reliability dimension scored the highest (4.13), indicating that the system is reliable in providing services as promised. The assurance (4.06) and empathy (3.94) dimensions also received good scores, indicating that users feel safe and well-attended while using the system. However, the responsiveness (3.77) and tangibles (3.87) dimensions showed areas for improvement, such as the speed of response to user requests and improvements in the system's physical appearance, which can affect user comfort. The conclusion of this study is that SIMRS at Pelni Hospital provides adequate and satisfactory services, but improvements in the responsiveness and tangibles aspects are necessary to enhance overall user satisfaction.

Practice in bronchiolitis management in Polish hospitals—a multicenter retrospective cohort study

Bronchiolitis is one of the main reasons for the hospitalization of young children. Based on updated recommendations, only supportive therapy is recommended for treatment. In Poland, many children that are hospitalized with bronchiolitis undergo a treatment that is not supported by current research. The study aimed to assess clinicians’ adherence to the guidelines. This was a multicenter retrospective study of hospitalized infants with bronchiolitis; a cohort study design was utilized. Data were collected in four Pediatric Departments in Poland. All infants aged less than 24 months that had been hospitalized for their first and subsequent episodes of acute bronchiolitis from January 1, 2021, to December 31, 2022, were included. The exclusion criterion was an age over 24 months. A total of 629 infants with a median age of 8.5 months were included in this study. The medical interventions and treatments varied between the four hospitals. Laboratory blood tests were run for almost all children (99.5%), and the percentage of children for which a chest X-ray was performed ranged from 1.3% to 44%. The other measures were the use of intravenous hydration (51.3%-93.3%), use of hypertonic saline nebulization (1.3%-43.6%), use of normal saline nebulization (10%-95.1%), use of oxygen (7.3%-42%), use of beta-mimetics (19.1%-89.4%), use of nebulized steroids (8%-76.9%), use of systemic steroids (0.9%-42%), use of nebulized adrenaline (0%-8.1%), and use of antibiotics (12%-21.8%).Conclusions: In total, 70% of infants who were hospitalized in four hospitals in Poland underwent examinations and treatment methods that are not supported by current guidelines and evidence-based research. This study shows that non-recommended medications are overused in bronchiolitis treatment, and there is a need to take action to implement the guidelines into healthcare providers’ work.What is Known:• Bronchiolitis is a lower respiratory tract viral infection and is one of the main reasons for hospitalization among young children.• Only supportive therapy is recommended in the guidelines.• Bronchodilators, nebulized adrenaline, nebulized or systemic steroids, and antibiotics are not recommended.What is New:• Non-recommended medications are overused in bronchiolitis treatment in Poland.• Up to 70% of hospitalized children in the studied centers underwent treatment that is not supported by guidelines.

Patterns and Predictors of Resilience in Frontline Nurses Before and After Public Health Emergencies: A Latent Transition Analysis

ABSTRACTObjectiveTo explore the stability of resilience among frontline nurses and to analyse the predictive role of internal and external factors on the patterns of resilience transformation in China during public health emergencies.MethodsThe study used a longitudinal design and surveyed 258 frontline nurses at three different time points: February–March 2020 (T1), May–June 2020 (T2) and May–June 2022 (T3). The survey included the 10‐item Connor–Davidson resilience scale, the Emotion Regulation Questionnaire and the Simple Coping Style Questionnaire. Latent profile analysis and latent transition analysis were used to examine the potential classes and changes. Multivariate logistic regression analysis was applied to evaluate the predictors of resilience transitions.ResultsThe resilience of frontline nurses was divided into three categories: fragile group, general group and high resilience group. From T1 to T2, the general group exhibited the least stability, with a probability of maintaining its original latent state at 72.9%. Marriage and positive coping styles significantly impacted the transition between resilience categories. From T2 to T3, the fragile group showed the lowest stability, with a 74.9% likelihood of retaining its initial latent state. In this context, supportive hospital management (including psychological counselling, restful environments, and both spiritual and material incentives) and individuals' emotional regulation and sleep quality significantly affected the transition between resilience categories.ConclusionsThese findings emphasise the necessity for early intervention. For frontline nurses, conducting initial assessments of resilience coupled with sustained hospital support is crucial for maintaining mental health and improving the quality of nursing care in public health emergencies.ImpactThis study offers a fresh perspective for understanding the resilience of frontline nurses during public health emergencies. At the same time, it reveals the factors that promote or hinder the change in resilience among frontline nurses at both individual and organisational levels. This provides a theoretical basis for future resilience interventions and helps us formulate effective crisis management strategies to respond to future public health emergencies. For frontline nurses with diverse resilience characteristics and relevant transformation factors, a personalised multi‐mode resilience improvement plan can be developed to mitigate public health emergencies' potential adverse psychological impact on frontline nurses, especially those in the fragile group.Patient or Public ContributionNo patient or public contribution.

Emotion and cognition in customer experience: a mixed-method study on loyalty formation in the hospitality sector

PurposeThis study investigates the dual roles of emotion and cognition in shaping customer experiences within the hospitality sector, examining their distinct impacts on the formation of customer loyalty.Design/methodology/approachEmploying a sequential exploratory mixed-method design, this research integrates qualitative interviews with eighteen hospitality managers and a quantitative survey involving 595 customers to develop and validate a new instrument measuring affective and cognitive experiential states for general hospitality consumers.FindingsThe study's results reveal that emotional experiences strongly correlate with affective loyalty, while cognitive experiences significantly influence cognitive loyalty. The study contributes to the existing literature by introducing a robust instrument that effectively captures the experiential dimensions, offering insights into customer loyalty formation.Research limitations/implicationsThe reliance on retrospective self-reporting in the quantitative phase may introduce recall bias, potentially limiting the precision of the findings. Future research should seek to mitigate this by employing real-time data capture methods.Practical implicationsThe newly developed measurement tool presents a practical solution for industry professionals aiming to enhance customer experience management by focusing on both affective and cognitive aspects, thus facilitating targeted strategies to cultivate customer loyalty. The implications for service design suggest that both emotional and cognitive elements must be considered to optimize customer experiences and drive loyalty.Originality/valueThis work advances the theoretical understanding of customer experience by distinguishing between its affective and cognitive dimensions and their respective contributions to loyalty. It offers a validated empirical tool, setting a foundation for future investigations.

Themed Restaurant Examination to Improve Student’s Knowledge and Skills in Food and Beverage Management Class

The paper emphasizes the importance of practical knowledge and hands-on experiences in hospitality education, particularly in food and beverage management. Themed events provide a platform for students to apply their theoretical knowledge, develop practical skills, and face real-world challenges. The event, centered around the culinary heritage of Tuscany, showcased student creativity and attention to detail. The event was successful overall, with positive guest feedback and student committee evaluations. However, areas for improvement were identified, including coordination issues, delays, and food quality inconsistencies. These findings highlight the need for better planning, coordination, and attention to detail in future events. In conclusion, the event provided valuable experiential learning for hospitality management students, allowing them to apply knowledge, develop skills, and navigate challenges. While the event showcased student capabilities, areas for improvement were identified, emphasizing the importance of continuous enhancement in execution and attention to detail. This research contributes to understanding the effectiveness of themed events and experiential learning in hospitality education, informing future improvements in preparing students for internships and careers in the industry.

Game Evolution Research on the Choice of Training Strategies between Clinical Departments and Doctors under the Background of Hospital-Provided Training

Objective: This study aims to explore the dynamic game process of training participation strategies among hospitals, clinical departments, and newly recruited doctors, as well as the impact of hospital intervention on this process. By applying game evolution theory, a comprehensive model is constructed to analyze the decision-making logic of training participation and propose new training strategies to promote the professional growth of newly recruited doctors and improve hospital service quality. Methods: The stability of dynamic game equilibrium points was analyzed by constructing Jacobian matrices, considering nine different game scenarios with and without hospital intervention. An empirical study from a hospital was introduced to verify the theoretical model's predictions. Results: The study found that without hospital intervention, clinical departments and newly recruited doctors tend to choose not to participate in training. After hospital intervention, through the provision of resources and incentives, the participation and effectiveness of training significantly improved. Conclusion: The study reveals the crucial role of hospital intervention in promoting the participation of newly recruited doctors in training and proposes a training strategy that combines theory and practice. This strategy not only helps new doctors quickly adapt to the hospital environment but also improves the quality of medical services, providing talent support for the hospital's continuous development. It offers theory-based decision support for hospital managers and provides new ideas for the improvement of future medical education and practice.

Total quality management (TQM) for sustainable growth performance in the private healthcare sector

This study explores the influence of total quality management (TQM) on the sustainable growth performance of companies in the private healthcare sector. A quantitative research method and a purposive sampling method were used. A questionnaire comprising 25 items was spread among 282 administrative employees in private hospitals and healthcare centers in Negeri Sembilan, Malaysia. Structural equation modeling (SEM) via Smart PLS revealed that, except for leadership, all TQM variables exhibit positive and direct interrelationships within the sector. Key findings indicate that customer focus, continuous improvement, and employee involvement positively correlate with company performance, while leadership has a negative direct impact. Collectively, these exploratory TQM factors explain 73% of the variance in healthcare company performance (R² Adj = 0.732, P < 0.01), with employee involvement identified as the most critical component for enhancing performance. These results highlight the importance of prioritizing employee engagement in hospital management to achieve optimal performance outcomes. Additionally, the study suggests a need to reevaluate traditional leadership approaches, as they may hinder performance. This investigation advances the understanding of TQM in healthcare, advocating for a strategic emphasis on employee involvement and a reassessment of leadership practices to drive organizational success. Acknowledgment This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The questionnaire was validated based on studies involving human participants that were reviewed and approved by the social sciences, arts, and humanities ECDA University of Hertfordshire (UK).

Innovations and practices in hospitality management

Intensification of competition and transformation of consumer tastes have determined the constant need for innovations in hospitality management. Companies are constantly looking for new ways to improve the quality of services, reduce costs, and create a segment of regular customers. The optimal combination of technological innovations, customer loyalty management algorithm and online booking platforms in the field of hospitality allow you to build a strategy of competitive advantages and ensure sustainable development. The materials of the presented research are aimed at identifying the impact of technological innovations on the level of customer service and, as a result, an opportunity to influence their loyalty. The concept of integration of the main elements of innovation in management and marketing is proposed, based on the analysis of modern trends and the effectiveness of using online booking platforms in the field of hospitality. The proposed hypothesis is based on several key aspects. The fundamental factors that affect changes in the hospitality sector are due to intensifying competition and the transformation of consumer tastes. In addition, an integral part of successful management in the s hospitality sector is the constant implementation of innovations in management, which allows companies to adapt in accordance with the transformation of the external environment. Effective management of communications with customers has consisted in the optimal combination of technological innovations and algorithms for managing customer loyalty. The proposed hypothesis clearly indicates that the research is aimed at the practical application of the results to improve management and ensure sustainable development in the hospitality sector.

Competition and coordination between traditional and internet hospitals

AbstractMotivated by the recent emergence and rapid growth of online healthcare platforms, this paper investigates its impacts on the healthcare ecosystem by taking into consideration of heterogeneous patients, homogeneous service providers and profit-driven hospitals. A game-theoretical model with a queueing framework is developed, and two healthcare systems are considered, including a monopolistic system with either an offline, traditional hospital, or an online, Internet hospital, and a duopolistic system with both kinds of hospitals. Our study finds that in both systems a large population of patients always increases the healthcare supply and demand and the hospital utilization, which leads to an improvement not only in the hospital profitability, but also in the welfare of both patients and service providers. When considering a monopolistic system only, our study suggests that the monopolistic Internet hospital outperforms its counterpart in hospital utilization only when the wait cost is not high (i.e., patients are less sensitive to wait time), especially when the wait cost is medium and the patient-provider ratio is small. When considering a duopolistic system, this study concludes that the decisions of patients, service providers, and hospital managers of both hospitals are interrelated, and that a large population of service providers increases its hospital’s supply, demand, and wage rate, while decreases its wait times. When comparing the two monopolistic with the duopolistic system, the latter outperforms and improves every entity’s utility (i.e., patients, hospital, and society) when there is abundance of service providers with more being allocated to the Internet hospital, whereas the monopolistic system dominates when the patient population is large, and more providers are allocated to the traditional hospital.

Security Quality Measurement Based on ISO/IEC 25023 Quality Model Case Study: Hospital Management Information System

Hospitals need to protect the security of data assets, where data assets are an important part of the continuity of hospital operations. In connection with the protection of data and information assets in the hospital, it has become a requirement for the hospital information technology team to carry out a security audit of the hospital management information system (HMIS). In this study, we measured the quality of the HMIS software in X Hospital using ISO 25023 which focused on the security aspects of the outpatient service module and drug services in the outpatient pharmacy unit. The security aspect based on the ISO 25023 standard consists of five main characteristics, namely: confidentiality, integrity, non-repudiation, accountability and authenticity. In the early stages, calculations are carried out to find the value of each measurement standard which is denoted by (X). The X value is based on the standard calculation range of values 0 and 1. The threshold value is determined at 0.80 to categorize the point quality whether it is not good or has met the ISO 25023 quality point. The results of software quality measurements show Internal Data Corruption Prevention is worth 0.75 and is at below a predetermined threshold value. Based on these results, it is recommended to improve one of them by replication the database to minimize the possibility of Internal Data Corruption Prevention. In this study, all aspects of software quality have an average value above the threshold, so it can be concluded that HMIS in RS X meets ISO 25023 standards.

Evaluating ChatGPT's Role in Assessing Turkey's Medical Tourism Trends

Background and Aims: The primary objective of this study is to evaluate the performance of the ChatGPT as an expert in the field of medical tourism. Another objective of this study is to assess its evaluations regarding the current state and future prospects of medical tourism in Turkey from an artificial intelligence perspective. Methods: Within the scope of the study's objectives, questions were created for ChatGPT regarding the current state and future prospects of medical tourism in Turkey. First, the draft questions were prepared by the authors of this article using the literature. All questions were evaluated by experts through online interviews. Totally 8 experts have been evaluated the questionnaires. These experts consisted of two tourism professors who had research on medical tourism, three major medical tourism hospital managers, one reconstructive aesthetician clinic owner, and the Turkish Healthcare Travel Council Founding Chairman. The second step of the research questionnaire was applied to the ChatGPT Model 4, which was trained as a medical tourism expert. than test the answers of the AI used the tools “Completeness of content, Lack of false information in the content, Evidence supporting the content, Appropriateness of the content, and Relevance,” referred as CLEAR. All answers were evaluated by 41 experts who had articles and research on medical tourism in Turkey. To explain the methodology appropriately, reporting was conducted using the METRICS checklist, which was prepared for artificial intelligence studies. Results: TThe general answers of ChatGPT 4-o were accurate, informative, and helpful, providing a good overview of medical tourism in Turkey. However, the responses lacked detail, did not provide evidence-based information, and did not always address the nuances and cultural/social impacts of medical tourism. ChatGPT 4-o views the future of Turkey’s medical tourism as shiny and will force the lead in general. Conclusions: This study is important for revealing data on the current and future state of medical tourism through artificial intelligence. However, only a few studies have been conducted on artificial intelligence and medical tourism. To the best of our knowledge, there is no existing literature that systematically evaluates the ChatGPT responses of medical tourism experts. In this regard, it is believed that the study will benefit both academics and practitioners.