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Item type:Publication, Inequality in the distribution of resources and health care in the poverty quintiles: Evidence from Peruvian comprehensive health insurance 2018–2019(Modestum LTD, 2024-02-01)In many regions of the world, healthcare is inequitable and limited, affecting poor populations who need greater health opportunities. Given that Peru’s comprehensive health insurance (SIS) seeks to enhance its coverage for the entire population, it is important to know if its coverage benefits the poorest populations. Objectives: To determine the allocation of SIS resources and care to the poorest quintile during 2018 and 2019 in Peru. Methods: We conducted a secondary analysis of data from five Peruvian technical institutions. In 39,8207 Peruvian households, we analyzed the per capita budget assigned to the population affiliated with SIS in microregions of quintile 1 and quintile 2 (poor), and quintile 4 and quintile 5 (non-poor), health coverage, and the level of poverty considering the human development index (HDI) and the regional competitiveness index (RCI). Results: The poorest regions are inversely correlated with HDI and RCI and have an average service of 25.0% affiliates. In poor areas, the allocated budget was lower (approximately $303,000 to $2.2 million), but the proportion of members requiring care was higher (>70.0%). The budget allocated to health was unfair (p<0.05) between poor areas (maximum resources from $96.28 to $108.14) and non-poor areas (maximum resources from $150.00 to $172.43). Low budget allocations and low household per capita income contributed to poverty in quintile 1 and quintile 2 (p<0.01). Conclusions: the poorest regions have greater inequity and the majority of affiliates do not use or do not have access to SIS services, but they have a greater need for health care. In addition, poor regions have a high amount of population without SIS coverage, and low allocated budgets, which affects competitiveness and regional development. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, When extreme work becomes the norm: an exploration of coping strategies of public sector nurses(Taylor and Francis Ltd., 2025-01-01)Drawing on extreme work and transactional stress literature streams; this paper investigates the mechanisms used by public sector nurses to cope with their extreme work conditions in the fragile state context of Egypt. Our findings, which are based on 24 qualitative interviews, show that, to cope with their extreme job duties, nurses engage in the following four strategies–reassertion of professionalism, submission and fatalism, cronyism, and temporalism. Moreover, we found that the low availability of social, physical, and psychological resources and the perceived inadequate provision of entitlements also played a role in this context. Finally, our study is among the first to link the fragile state environment with extreme work conditions in healthcare sector while simultaneously highlighting the related coping mechanisms.1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Grand Societal Challenges Really Matter: How Does the Resilience of Physicians Contribute to That of the Hospital? A Qualitative Exploration(Wiley, 2025-05-01)This paper is one of the few studies to specifically investigate how the physicians' resilience (individual level) can potentially contribute to that of their hospitals (organizational level) in the context of grand societal challenges. The empirical sample comprises semi‐structured interviews with 32 physicians working in four Egyptian public hospitals. Thematic analysis was subsequently used to analyze interviews. The findings show that in the context of grand societal challenges (increased numbers of refugees in this case), physicians can contribute to the resilience of the public hospitals they work in through different practices. In particular, we found contextual practices (prioritizing the main challenges, ensuring a rational use of discretionary power), procedural practices (ensuring the creation of public value, fostering collaboration with private hospitals) and developmental practices (adopting a “work first” approach, exercising routines through learning) to be vital in this concern.1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Between pride and frustration: why committed public healthcare workers consider exiting(Emerald Publishing Limited, 2026-01-01)This study examines why healthcare professionals in public hospitals may still express intentions to leave their organizations despite reporting favorable levels of workplace well-being and affective commitment. It introduces ambivalent identification as a mediating mechanism that helps explain turnover intention in the public sector. Design/methodology/approach Drawing on the job demands–resources model and social identity theory, survey data were collected from 520 administrative and healthcare personnel in two Colombian public hospitals. Partial least squares structural equation modeling (SmartPLS) was used to test the relationships among workplace well-being, affective commitment, ambivalent identification, and turnover intention. Findings Results show that workplace well-being and affective commitment are negatively associated with ambivalent identification, while ambivalent identification is positively related to turnover intention. Mediation analyses confirm that ambivalence transmits the effects of well-being and commitment on turnover intentions. These findings highlight that even committed and engaged employees may consider leaving when organizational identification is marked by unresolved tensions. Originality/value The study advances public management research by integrating ambivalent identification into turnover models, extending the job demands–resources framework, and applying social identity theory to a Latin American public healthcare context. It highlights identity-based mechanisms that help explain why traditional retention resources may be insufficient in public hospitals and offers practical guidance for managers seeking to detect and address ambivalence to strengthen workforce stability. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ambivalent identification: the role of job performance in strengthening organizational identification in healthcare settings(Emerald Publishing Limited, 2025-11-10)PURPOSE: This study examines the direct impact of job performance on organizational identification and the mediating role of ambivalent identification among hospital employees. The aim is to provide a deeper understanding of how high-performing employees influence organizational identification, integrating both positive and negative experiences. DESIGN/METHODOLOGY/APPROACH: Data were collected from employees across three hospitals in Colombia and Argentina. The research utilized regression analysis and structural equation modelling (SEM) to test the proposed relationships between job performance, ambivalent identification and organizational identification. Multigroup SEM was used to assess differences by control variables. FINDINGS: The study reveals that job performance significantly influences organizational identification, a relationship scarcely explored in prior research. Ambivalent identification serves as a crucial mediator, offering a novel perspective on how employees' mixed feelings towards their organization impact their overall identification. This dual role of ambivalent identification highlights the complex interplay between job performance and organizational outcomes, emphasizing the importance of managing both positive and negative employee experiences. Including ambivalent identification as a mediator increases explained variance in organizational identification by 18%. ORIGINALITY/VALUE: This research breaks new ground by investigating the relatively unexplored pathway from job performance on organizational identification, incorporating ambivalent identification as a mediating variable. The use of the JD-R model to frame this relationship offers a comprehensive understanding of the dynamics involved, demonstrating the dual effects of job demands and resources on organizational outcomes. This study not only expands the theoretical understanding of these constructs but also provides practical implications for managing employee performance and organizational identification in the healthcare sector.2