Health Services Case Study

Introduction

This chapter illustrates the proposed modeling approach by investigating the admittance process of a patient to the Athens Hospital (AH), which is a state general hospital that offers a complete range of medical services in central Athens in Greece.

The admittance process starts with the arrival of the patient at the hospital and ends with the patient’s release. The Patient represents the recipient of health and e-health services. Let us suppose for simplicity that this process operates and produces one service, whose name is: Admit to Hospital. It is an important process for:

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  It may be the patient’s first time at the hospital and receives an initial impression of the health service quality.

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  The patient may be in pain and anxiety due to his/her medical condition, therefore any administrative complexities, delays or bureaucratic procedures seem totally useless.

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  It largely provides an assessment of the patient’s condition as well as for it follows the patient from the time of the arrival at the hospital, through patient’s treatment until the patient leaves the hospital. It is also a significant process, since the quick response to patient’s arrival is often translated to a faster commencing of the patient’s treatment program, let alone that in emergency cases agility is critical.

Defining The Service Design Domain For Health Service (Sdd-H)

The SDD-H reflects all stakeholders’ views that are related to health care service design. The SDD-H FCM reflects the four levels of abstraction (as discussed in chapter VI) and its factors reflect areas pertaining to health care domain from different perspectives, such as the health service quality, process performance, the interorganizational effectiveness that reflects the level of co-ordination between the (AH) hospital and other hospitals, the government, insurance companies, etc.

The SDD-H FCM can be developed after interviewing experts and heath care stakeholders, reviewing models found in the literature such as the SERVQUAL (Bowers & Kiefe, 2002) and by applying several approaches such as the fuzzy Delphi method, statistical analysis with structural equation modeling, etc. Factors that constitute parts of the SDD-H also reflect areas that pertain to health service.

For simplicity reasons this case study considers a subset of the SDD-H concepts, which represents only the service characteristics as perceived for example by patients. The SDD-H FCM is shown in Figure 1. The SDD-H FCM is assumed to be part of the electronic Patients’ Health Record (ePHR) system. Customization of services and alternative service scenarios are developed accordingly in order to meet the patient’s needs and priorities as these can be extracted from the ePHR.

Figure 1.

A subset of the Service Design Domain in Health (SDD-H) FCM

This case study examines the Admittance Process which supports the service Admit to Hospital (A).

The Patients’ perceived health care service quality (PQ) is a dependent concept that affects no other concept; instead its performance is influenced by other SDD-H FCM concepts. Let us suppose that, the Patients’ perceived health care service quality (PQ) is assessed in terms of the following factors:

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  Cost (C) of the service, which reduces patient’s perceived service quality. The strength of the reduction is expressed by the weight of the relationship between the cost and the perceived quality of service. The cost is not meant to result from investments, but it rather refers to operational cost.

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  The time to complete admittance (t) that refers to the time that passes from the moment the patient reaches the hospital until the time that the patient leaves the hospital, or he is allocated to a clinic and starts treatment, i.e. until the completion of the process.

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  The number of medical examinations (NEx), which are scheduled in order to evaluate a patient’s medical condition.

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  The diagnosis accuracy (DA).

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  The friendliness of staff (F).

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  The service environment (SE) that refers to the cleanliness, tidiness, and aesthetics of the hospital wards, rooms and corridors.