Asia-Pacific Journal of Health Management (ACHSM)
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Factors Influencing Attrition and Retention of An Allied Health Workforce
No full textObjectives: : Like many countries across Asia Pacific, Australia is facing significant allied health workforce shortages. This study aims to examine factors influencing attrition and retention in an allied health workforce (Nutrition and Dietetics, Orthoptics, Orthotics, Occupational Therapy, Physiotherapy, Podiatry, Psychology, Speech Pathology, Spiritual Care and Social Work) in an Australian public health service.
Methods: A mixed methods study was conducted at a metropolitan, quaternary public healthcare service in Melbourne, Australia. Quantitative and qualitative data was collected and analysed from two online surveys from allied health staff: 1) resigned and completed a voluntary exit survey (group 1); and 2) employed and consented to participate in a workforce survey (group 2).
Results: Eighty-three respondents (group 1, response rate 27%) completed the resignation exit survey and 136 respondents (group 2, response rate 20%) completed the workforce survey. Reasons for resigning included dissatisfaction with the level of involvement in decision making (45%), systems and process (41%) and performance review processes (41%). Respondents currently employed described a positive job satisfaction attributed to enjoyable and interesting work (89%) and feeling valued by others in their profession (80%). Nearly a quarter (23%) were planning to leave their current position in the next six months. Intertwining themes identified job satisfaction, team environment, job flexibility, security and stability, the culture and reputation of the organisation could influence attrition and retention.
Conclusions: The findings from this study adds to the limited but growing understanding of factors influencing attrition and retention of allied health professionals. An allied health professional’s experience of working in public health underpins their desire to stay or leave. Healthcare leaders and managers implementing targeted interventions that focus on improving job satisfaction with greater recognition, professional support, opportunities for career progression, meaningful workload allocation, optimisation of job security and work environments may improve allied health attrition and retention.
Let Us Rethink Prescribing Education Together
No full textPrescribing education is central to patient safety and effective clinical practice, yet it remains fragmented across health professions, often taught in disciplinary silos without sufficient interprofessional integration. Drawing on qualitative and cross-sectional studies in Australian dental prescribing education, including student interviews and national surveys, this paper highlights significant gaps between theoretical learning and clinical application, particularly in areas such as antimicrobial stewardship. These gaps reflect broader systemic issues, where limited collaboration between prescribers, pharmacists, and other healthcare professionals undermines safe prescribing practices. We argue that prescribing should be understood as a shared, patient-centred process requiring intentional, interprofessional education. To address these challenges, internationally aligned frameworks, integrated curricula, and collaborative assessment models that reflect real-world complexity. Preparing students for teamwork rather than isolated competencies will foster safer, more effective prescribing decisions and improve patient outcomes globally
A Call for a Holistic Approach to Measuring Quality in Healthcare Services
No full textQuality in healthcare is a construct whose measurement is vital for quality assurance and improvement purposes. However, achieving a holistic view of quality in healthcare settings can be challenged by having multiple stakeholders involved, such as patients, healthcare providers and managers, with each having different viewpoints and priorities. Whilst service marketing and quality-of-care literature offer a plethora of quality-measuring models that show similarities, each discipline prioritises measuring quality as perceived by one stakeholder (e.g.: patients or service providers), thus offering a partial picture that does not necessarily capture the viewpoints of all stakeholders involved. Moreover, some models evaluate the overall quality of a service, rather than providing a detailed evaluation that captures the quality of different elements of care. Local context and culture are factors to consider as well when measuring quality. Therefore, this paper aims to propose an approach to measuring quality that captures the viewpoints of multiple stakeholders in a service setting. A customised model is constructed, based on comparing the basic elements of models derived from service marketing and quality-of-care literature. The elements are chosen to also reflect the contextual and cultural peculiarities of the service under evaluation, while ensuring that such a detailed approach remains practical upon application
The Influence of Access Barriers on Outpatient Services Use among Low-income Households in Malaysia.
No full textAim: Many people, particularly those from low-income and marginalised communities, face barriers when accessing healthcare services. Therefore, this study examined the influence of household characteristics and perceived access barriers on the utilisation of outpatient services among low-income households living in urban and rural areas.
Methods: This cross-sectional study employed 454 university students as proxies for low-income households. Data on household characteristics, perceived household medical needs and perceived access barriers were collected using online and printed questionnaire forms. The measure of perceived access barriers included items that represented various dimensions, including personal barriers, structural barriers, financial barriers, perceived triviality, accessibility, and time limitations.
Main findings: The distance between household dwellings and public healthcare facilities as well as perceived household medical needs significantly influenced the use of outpatient care for urban and rural households. However, the influence of employment status and household size was only significant among urban households. In terms of perceived access barriers, financial barriers were found to have a negative influence on the use of outpatient services among urban households, while time limitations were strongly associated with reduced outpatient use among rural households. Perceived triviality and accessibility also exhibited statistical significance in influencing the use of outpatient services among urban and rural households, with moderate to large effect sizes.
Conclusion: The findings of this study provided valuable insights into the use of outpatient services, accessibility and barriers encountered by low-income households living in urban and rural areas. Efforts to improve access are crucial in addressing health inequities and promoting a more just and equitable society
Utilization, Demand, And Willingness to Pay for Telehealth Services: A Study of Patients in Selected Vietnamese Provinces
No full textObjective: Telehealth has become essential in healthcare delivery, particularly during the COVID-19 pandemic. It provides solutions to access disruptions and enhances healthcare accessibility and efficiency. This study aimed to describe the utilization, demand, and willingness to pay for Telehealth services in selected provinces in Vietnam.
Methods: A cross-sectional survey involving 438 participants from three Vietnamese provinces was conducted between late 2021 and early 2022. The study assessed telehealth utilization, user preferences, and willingness to pay for different telehealth services.
Results: The study revealed that 58.7% of participants had utilized telehealth services. For lower-cost services (100,000 VND to 500,000 VND), low-income households were 2.7 times more likely to pay (OR: 2.7, 95% CI: 1.41-5.00, p<0.01); familiarity with telehealth services increased the likelihood of spending by 1.6 times (OR: 1.6, 95% CI: 1.10-2.54, p<0.05); and those with less convenient access to healthcare were 1.79 times more likely to pay (OR: 1.79, 95% CI: 1.00-3.13, p<0.05). For higher-cost services (500,000 VND to 1,500,000 VND), wealthier households were 16.67 times more likely to invest (OR: 16.67, 95% CI: 2.04-100.00, p<0.01); insured individuals were 5.88 times more likely to pay (OR: 5.88, 95% CI: 1.92-16.67, p<0.01); and familiarity with telehealth increased the likelihood of payment by 2.3 times (OR: 2.3, 95% CI: 1.20-4.46, p<0.05).
Conclusion: Telehealth is a crucial component of healthcare in Vietnam, with substantial engagement and willingness to pay. The findings underscore the need for investment in telehealth infrastructure and supportive policies to integrate telehealth into the national healthcare system, particularly in underserved regions
The Four Frames for Change Management in Health Services
No full textThe delivery of health services is complex, and this complexity is exacerbated by embedded wicked problems requiring solving through change management initiatives. To create sustainable solutions and improvement healthcare leaders and managers are required to have a well-developed understanding of their complex organisation from several perspectives. The Bolman and Deal framework postulates that organisations can be viewed through four frames: structural, human resource, political and symbolic. This paper presents four real life case studies to show the four frames from the perspective of assessment and intervention, demonstrating ways in which the Frames can be applied to healthcare organisations. A retrospective analysis of the case studies demonstrates that the application of the Frames can lead to identifying areas for improvement and innovation and that they can play a role in creating strategies for evaluating health service improvement initiatives. The full potential of the Frames is only realised when a comprehensive approach is taken by utilising all four frames. Only then a better understanding of complex organisations takes place, helping healthcare organisations to improve and innovate
Attitudes and Familiarity of Hospital Administrative and Medical Staff Towards Artificial Intelligence: A cross-sectional study in Turkey
No full textArtificial intelligence in healthcare holds great promise and continues to advance. Despite the clear potential of its integration into healthcare delivery and management, little has been investigated about the attitudes and familiarity of hospital administrative and medical staff towards artificial intelligence.
In this study, we cross-sectionally surveyed 152 administrative and medical staff who were employed in two private hospitals in the northern region of Türkiye with a structured questionnaire on their attitudes and familiarity regarding artificial intelligence in healthcare delivery and management.
Our results showed that only 8.6% of the 152 participants used AI in their work, and 13.8% followed ongoing AI developments in healthcare. Despite this limited engagement, the majority recognized AI’s potential benefits. For instance, 74.4% (with 23.0% partially agreeing) acknowledged its value in education and research, and similar high percentages supported its potential for workload reduction, learning enhancement, data processing, healthcare delivery, and innovation. In contrast, attitudes were divided regarding AI’s ability to reduce healthcare costs, minimize errors, offer a competitive advantage, assist in decision-making, and optimize healthcare resources. Concerns about job displacement were also prominent, with 45.4% agreeing and 35.5% partially agreeing that AI could lead to unemployment in healthcare. Statistical tests showed significant differences across occupations. Administrative staff demonstrated higher knowledge and optimism about AI applications in competitive positioning (94.2%) and customer relationship management (95.5%) compared to physicians (57.1% and 68.9%) and nurses (77.5% and 74.4%).
Despite general optimism about AI’s potential, both Turkish medical professionals and healthcare managers face notable gaps in familiarity and engagement, as well as concerns about decision-making, healthcare costs, and job displacement. To enhance staff readiness for AI adoption, Turkish hospitals must urgently address these challenges through structured AI training programs
Community Participation in Programme Planning for Universal Health Coverage in India: An exploratory study
No full textHealth can never be adequately protected by health services without the active understanding and involvement of communities whose health is at stake. For attaining Universal Health Coverage, community participation is important, as their active role helps in sustained efforts, collaboration, and a commitment to addressing the underlying social determinants of health, leading to equity in healthcare. Traditional Indian society is cut across by rigid religion and caste lines, and the appropriate role for each caste group has been a serious obstacle in securing complete community participation.
This study employed a quantitative exploratory survey design aimed at understanding public health professionals' perceptions of community participation in healthcare planning. The questionnaire's development included expert consultation and a pilot test to ensure validity and reliability, while the implications of the low response rate on the study's findings was also reported transparently.
This study reflects the opinion on the importance of community participation in healthcare policy and program decisions, identifies the different barriers faced during such vital participation, and recommends measures to enhance community participation for a more equitable healthcare system in the local area
Parents’ Knowledge, Attitudes, And Practices Towards the Utilization Of Healthcare Services for Children with Autism Spectrum Disorder: A cross-sectional descriptive study in Vietnam
No full textObjective: This study aimed to describe knowledge, attitude, practice, and some impact factors regarding the utilization of healthcare services for children with autism spectrum disorder (ASD) among parents in Hanoi, Vietnam, in 2024.
Methods: The cross-sectional descriptive study was conducted on 191 parents of children with ASD who were using care services at five healthcare facilities in Hanoi from October 2023 to March 2024.
Results: Only 23.6% of parents had good knowledge, while up to 67.2% had moderate knowledge regarding ASD. The prevalence of parents with positive attitudes towards childcare services was 84.7%, and only 2.3% had a negative attitude. Special education services and inclusive education support were the most frequently used, with over 70% of parents using them regularly. Parents of first-born children and those whose children were diagnosed immediately after abnormalities were detected had higher knowledge and attitude scores (p<0.05).
Conclusion: Most parents had moderate knowledge about ASD but the majority had a positive attitude with respect for childcare services. First-born children and those who were diagnosed immediately after the detection of abnormalities were associated with higher knowledge and attitudes among parents
Socio-Economic and Demographic Factors Affecting Access to Healthcare Services in Türkiye: A probit model analysis
No full textBackground: Healthcare services aim to meet preventive and therapeutic needs and ensure equal access for all. Despite reforms like the Health Transformation Program in Türkiye, socio-economic and demographic inequalities in healthcare access persist. This study, based on the Grossman model, examines the factors affecting healthcare access in Türkiye.
Method: Data from the Turkish Statistical Institute’s Health Survey (2014, 2016, 2019, 2022) covering 76,196 individuals aged 15 and above were used. Access to healthcare was measured using an index created from observed variables in the survey. The probit model was used to analyze the impact of socio-economic and demographic factors.
Results: Gender, age, income, education, and employment status significantly influence healthcare access. Women have better access than men, and older individuals face more challenges despite growing healthcare needs. Income positively impacts access, while higher education shows an unexpected negative effect, suggesting reliance on alternative healthcare services. Employment status and good health improve access, while obesity and poor health are barriers.
Conclusion: To reduce healthcare inequalities, policies expanding insurance coverage and reducing costs for low-income groups are crucial. Interventions such as awareness programs targeting education and elderly individuals can help mitigate barriers. These findings highlight the role of socio-economic factors in healthcare access and inform the development of sustainable health policies