background: except in emergency cases, all patients should be seen first by a primary healthcare physician who decides whether a referral to secondary care is necessary. the present study examined the reasons for patient self-referral to specialists. methods: a random sample of 1036 individuals was selected from people attending public outpatient clinics and specialists’ offices in the private ...

background: world health organization (who) defines three goals to assess the performance of a health system: the state of health, fairness in financial contribution and responsiveness. we assessed the responsiveness of health system for patients with diabetes in a defined population cohort in tehran, iran. methods: total responsiveness and eight domains (prompt attention, dignity, communicatio...

background and objectives: quality services delivery in the health settings is contingent on hospital administrative staff organizational commitment. inspired by previous research indicating the prominent role of psychological empowerment in organizational commitment, this study aimed to explore the relationship between the two variables in hospital administrative staff. methods: a random sampl...

introduction: patients are recently more aware and conscious. this is because of the belief that a high level of quality can translate into patient satisfaction. this is critical for healthcare providers as they deal with life. this recognition by both the service provider and service receivers made the government to establish units of service commission (servicom) in each of the governmental a...

In this thought paper, Professor Steven Spear argues that the way to achieve great operational performance and value has often been misunderstood. In order to ensure that good people and good science are facilitated, rather than overwhelmed, by systems, leaders have to expand their attention from ‘what individuals do’ to ‘how the pieces come together’. High quality care and great performance in...

background health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. we evaluated the impact of low health literacy (lhl) on healthcare utilization and healthcare expenditure.   methods database analysis used medical expenditure panel survey (meps) from 2005-2008 which provides nationally representative estimates of healthcare utilization and e...

The economic approach of comparative and historical institutional analysis (Aoki 2001, Greif 2006) has virtually never been used in theoretical studies of healthcare incentives. This paper seeks to help fill this gap by exploring the explanatory power of such an approach for understanding incentives in China’s healthcare delivery system. It focuses on positive analysis of why China’s health sys...

The current healthcare delivery paradigm is defined by integrative care delivery across disparate providers and services. Therefore the ability to deliver efficient and effective healthcare services is dependent on designing and implementing interoperable systems. However, the notion of interoperability is multifaceted and complex. Although the exchange of data is often described as analogous w...

Healthcare policy leaders internationally recognise that people's experiences of healthcare delivery are important, and invest significant resources to monitor and improve them. However, the value of particular aspects of experiences of healthcare delivery - relative to each other and to other healthcare outcomes - is unclear. This paper considers how economic techniques have been and might be ...