Public Hospital Performance - Research Proposal Example

Proposed Environmental factors, the influence and impacts they have on general public hospitals and how they influence the relative performance of general public hospitals. Research interest: Public hospital performance, operation research applications (OR), statistical analysis, performance measurement and management (PMM), efficiency measurement, financial performance. 2. Background or Rationale of the Project Introduction It is true to state that external environmental factors affect the performance of organizations. Organizations all over the world belong to either the public sector or the private sector (Giokas, 2008). Organizations in the public sector form part of the economy that is mainly concerned with the provision of various government services (Afonso & Fernandes, 2008). The composition of services provided vary from state to state or from country to country but mainly include public education, police and military services, public health care, and public transport (Miller, 2012). The private sector is made up of the business sector which is majorly characterised by the making of profits by the owners of enterprises and the voluntary sector, which is mainly interested in charitable organizations (Afonso & Fernandes, 2008). Environmental factors are usually based on particular contexts. Therefore it is better to understand how these factors link with the performance of specific entities in the public sectors, for example, public hospitals and how this affects the overall performance of these public hospitals (Giokas, 2008). Public hospitals, often referred to as general hospitals are usually non-profit organizations. Therefore, profitability or revenue may not contribute much as indicators for their performance. One important characteristic of organizations in the public sector is that they are usually expected to produce a specific amount of output using a limited amount of resources. This is usually quantified using the efficiency measurement approach which is a measurement of performance in the economic production approach. Data envelopment analysis (DEA)(Langabeer, 2008), has been widely used and is verified as a reliable tool that can be used to perfectly measure the efficiency, and financial performance of entities in the public sector (Afonso & Fernandes, 2008). Through this study, the environmental factors affecting the general performance of public hospitals are deeply analysed, which is very beneficial for it gives insight into the general performance which may include financial performance of public hospitals. I have chosen this particular topic of study, because I believe with its critical analysis, it shall easily give us a clear insight of how environmental factors affect the general performance of entities in the public sector (Sherman, 1984). Research Problem Simply because general (public) hospitals are non-profit organizations, the profits they make or revenues they generate are usually not very substantial indicators of their performance either financially or in general terms. Research focused on systems of health care, their management and performance have always given interesting as well as very crucial results. For example, majority of the results show that health care services directly influence sustainable economic as well as social development in a country. Additionally, it is true to state that general hospitals take in a substantially large amount of budget allocated to healthcare; hence, making effort to notice the environmental factors that influence the general performance of public (general) hospitals is an essential element in academics and requires vital attention. There is a lot of literature available across the globe on the appropriate ways to measure hospitals efficiency however, little or no research has been conducted with the intention of noticing the external factors that greatly influence the efficiency of public hospitals (Figueras, Robinson & Jakubowski, 2004). Some of the external factors that affect the efficiency of public hospitals include the established regional health systems, the existing market structures, the ownership structures I.e. whether they belong to the state or county government and this is a contributing factor to its financing , and medical records in use whether electronic or manual (Pidd, 2012). Literature done by Bates is one of the literatures available that examines environmental factors that affect the general performance of public hospitals. This research is mainly interested in trying to note or identify some of the main environmental factors that affect the performance of general hospitals in the public sector (Afonso & Fernandes, 2008). This will further facilitate in the exploration of the possible effects these environmental factors may have on the general performance of public hospitals which includes financial performance, and also offer suggestions to management teams on how they can do modifications on the use of the available resources effectively as well as make structural changes that might compensate for the effects the environmental factors may have on public hospitals general performance (Ancarani, Di Mauro & Giammanco, 2009). Preliminary Review of the Literature Relative efficiency is a ratio system that weights the amounts of outputs gained from the amount of inputs utilized. To measure the efficiency of entities in the public sector, various quantitative techniques are usually employed (Kazandjian & Lied, 1999). These techniques are categorised into two, non-parametric and parametric techniques. Parametric techniques usually require special formation of assumptions about the technology employed and the procedures employed in the production process (Ozcan & Tone, 2014). Non-parametric techniques on the other hand do not impose any characteristics to the various processes involved in production and only utilize the information acquired from inputs and outputs to calculate the effectiveness of decision making units (Giokas, 2008). Analysis of data envelopment is an example of a non-parametric techniques used and was first introduced in 1978. It was fully based on the seminal works of Farrell in the year 1957 referred to as technical efficiency (Zhu, 2009). Over the years, there have been progressive improvements both in application and theory on the effective use of data envelopment techniques. A lot of data envelopment techniques have been developed and put into use in countless contexts that all which experience different conditions. Sherman was among one of the early scholars to use data envelopment techniques to measure the general performance of public hospitals. Very little studies have carried out on environmental factors and their influence on various aspects of an organization. Some of these aspects base their existence and success on proper management, innovativeness, and the use of internet in planning and strategy. When it comes to research, there has been a little amount of research conducted on the effect of environmental factors to the general performance of entities in the public sector, for example, public hospitals. For example, Goikas (2008) examined the effect that location may have on the general performance of banks in Greece. Ancarani, Di Mauro & Giammanco (2009) critically analysed the effect ownership has on the general performance of some of the companies considered as State owned companies in Spain (Ancarani, Di Mauro & Giammanco, 2009). Additionally, Ancarani, Di Mauro & Giammanco (2009) and his colleagues studied the effect that privatization of public entities has on their general performance in Indonesia (Afonso & Fernandes, 2008). Last but not least, Ancarani, Di Mauro & Giammanco (2009) critically analysed the effect that uncontrollable external have on the general performance of entities in the public sector, and their focus was on sewage service rendering entities. Some of the factors they identified include climate, demography, and topography. It’s is importance to note that such environmental factors have effect on general hospitals and in the long run affect their general performance in the public sector. Research Questions (Aims) and Objectives . (a) Research Questions The research questions in this research are meant to help in identifying what kind of relationship exists between environmental factors and the performance of public (general) hospitals in the public sector. 1. What are some of the environmental factors that affect the performance of public (general) hospitals? 2. Why is it advisable to use data envelopment techniques in identifying some of these environmental factors and the intensity of effect they have on the performance of public hospitals? 3. How should the information gathered from the research guide managers in the utilization of the available resources and creation of means and ways that would compensate for the effects the environmental factors have on the public hospitals? (b) Research Objectives The objective of this study is to provide an investigation of the major environmental factors affecting the general performance of general (public) hospitals and whether these environmental factors influence efficiency in performance or not. To reach this goal or aim, the following objectives have been established. 1. To identify and not the most crucial environmental factors that cause variations in the performance of public (general) hospitals. 2. To measure the performance of General (public) hospitals using the applicable data envelopment analysis (DEA) techniques. 3. To determine the degree of intensity of the effects that the various environmental factors have on the relative efficiency of public (general) hospitals. Research Plan This study involves both quantitative as well as qualitative methods of research. In its early stages, it shall seek to unravel and generate the required indices that of the participant populations, i.e. the general hospitals required selected for data analysis. This will make the research deductive and descriptive at those particular stages i.e. the first stage of the research. DEA is the tool that shall be put to use in this research. This is because it does not require the prices or costs to determine the general performance of the entities in the public sector, as in our case public (general) hospitals. Additionally, other quantitative methods may be used as substitutes for the relative performance measurement approach (Brien,n.d). Hence, DEA is the tool that shall be used for this research but other quantitative methods can be used as alternative methods of measuring the performance of public hospitals under the influence of environmental factors. The research will benefit from data retrieved from different sources. This implies that surveys will be conducted, and the data gotten used to relate to what other public hospitals might going through. Historical research will also play a very vital role (Afonso & Fernandes, 2008). This is because the information retrieved will help understand how environmental factors have affected the performance of hospitals in the public sector over the years, and whether technological progress and the influences of globalization, as well as westernization have had any effect in the intensity of the effects (Zhu, 2014). The data collection methods will mainly encompass methods of both quantitative and quantitative data collection; these will include the use of questionnaires, interviews, observation, and review of secondary data. To meet the criteria of validity, iteration on every method of data collection shall be done. This will include repetition of the research techniques until the results obtained are considered valid due to consistency. The research limitations will most likely revolve around surveying, with surveying there shall be the need of relating the survey finding to most of the public hospitals which is a great challenge because not all public hospitals will be subject to the same environmental factors, additionally, finance is never enough, and the financial resources of the project might get depleted and narrow the scope of research Ethical Considerations Ethics constitute part of the guiding principles to every research. They are usually divided to a set of responsibilities by the researcher. For this research, it is important that the researcher get informed consent from the interviewees before interviewing them. This should involve the issuance of a consent form to all interviewees (Oliver, 2010). For the parts of the research that will require the use of questioners, we will be required to have a consent form as well. For instances where these consent forms might not be available, the participant information sheet should come in a perfect substitute (Gregory, 2003). Additionally, it is unethical to provide false information in this research (Miller, 2012). The information should be used with at most truth to influence the development of strategies that would help improve the general performance, for example, financial performance of public hospitals as well as other entities in the public sector (Oliver, 2010). Additionally, the results of the research should be should not be with healed. The research results will be made public for other scholars to use I sharpening their skills, additionally, for critics and reviews that would help draw more elaborate knowledge from the research. 7. Timetable and any special resources required Chapter Topic Words Months 1 Introduction 1,400 2 weeks 2 Literature review 4,000 1 3 Methodologies 4,000 1 4 Analysis of Data 2,500 1 5 Conclusion and research Implications 1,400 2 weeks Total 12,900 4 References ANCARANI, A., DI MAURO, C., & GIAMMANCO, M. D. (2009). The impact of managerial and organizational aspects on hospital wards’ efficiency: Evidence from a case study. European Journal of Operational Research, 194(1), 280-293. AFONSO, A., & FERNANDES, S. (2008). Assessing and explaining the relative efficiency of local government. The Journal of Socio-Economics, 37(5), 1946-1979. BRIEN, JAMES O. Business applivation of information technology. n.d. Top of Form FIGUERAS, J., ROBINSON, R., & JAKUBOWSKI, E. (2004). Purchasing to improve health systems performance editors, Josep Figueras, Ray Robinson & Elke Jakubowski. Maidenhead, Open University Press. GIOKAS, D. I. (2008). Cost efficiency impact of bank branch characteristics and location: an illustrative application to Greek bank branches. Managerial Finance, 34(3), 172-185. Top of Form GREGORY, I. (2003). Ethics in research. London, Continuum. Bottom of Form Top of Form KAZANDJIAN, V. A., & LIED, T. R. (1999). Healthcare performance measurement: systems design and evaluation. Milwaukee, Wis, ASQ Quality Press. LANGABEER, J. R. (2008). Health care operations management: a quantitative approach to business and logistics. Jones & Bartlett Learning. Top of Form MILLER, T. (2012). Ethics in qualitative research. London, SAGE. Bottom of Form Top of Form OLIVER, P. (2010). The students guide to research ethics. Maidenhead, Berkshire, Open University Press. Bottom of Form Top of Form OZCAN, Y. A., & TONE, K. (2014). Health care benchmarking and performance evaluation: an assessment using data envelopment analysis (DEA). Bottom of Form Top of Form PIDD, M. (2012). Measuring the performance of public services: principles and practice. Cambridge, Cambridge University Press. SHERMAN, H. D. (1984). Hospital Efficiency Measurement and Evaluation: Empirical Test of a New Technique. Medical Care, 22(10), 922-938. ZHU, J. (2014). Quantitative models for performance evaluation and benchmarking: data envelopment analysis with spreadsheets (Vol. 213). Springer. Read More