Bibliometric Analysis of Outsourcing in Healthcare

Year 2022, Volume: 12 Issue: 3, 417 - 431, 20.09.2022

Mehmet Nurullah Kurutkan , Melek Terzi

https://doi.org/10.33631/sabd.1072053

Cited By: 3

Abstract

Aim: The main purpose of the research is to examine how the discussed themes have been improved and interrelated in the publications made in the field of health service’s outsource usage between 1992-2021, with a bibliometric analysis. Material and methods: The data used in the research, which attributed as a secondary data, were obtained from the Web of Science (WoS) Core Collection database. After the inclusion and exclusion criteria on the subject, 680 publications were reached and those publications was analyzed. SciMAT, one of the software that provides bibliometric analysis, was used in the analysis. Strategic diagrams, cluster networks and thematic development map were analyzed as 4 periods, (1992-2000, 2001-2010, 2011-2016, 2017-2020) covering the last 29 years.
Results: While "cost" was the motor theme in the first period (1992-2000), in the following periods "cloud computing, access control, public key encryption, privacy preserving, big data, electronic medical record, technology" were motor themes. Themes obtained by using the thematic development map; cloud computing in healthcare, risks based on outsourcing, general operational problems and cost issues. The results regarding to the cost are far from certain.
Conclusion: It is important for hospital managers to be aware of cloud computing and to pay attention to the quality level of services while aiming to reduce costs with outsourcing. In order to keep the risks that may arise from outsourcing at a minimum level, it is beneficial to take precautionary measures for risks in outsourcing agreements between health institutions and companies.

Keywords

Outsourcing, cloud computing, cost, bibliometrics

Sağlık Hizmetlerinde Dış Kaynak Kullanımının Bibliyometrik Analizi

Abstract

Amaç: Araştırmanın temel amacı 1992-2021 yılları arasında sağlık hizmetlerinde dış kaynak kullanımı alanında yapılmış yayınlarda ele alınan temaların, günümüze kadar nasıl geliştiğini ve birbirleri ile olan ilişkisini bibliyometrik bir analiz ile incelemektir.
Gereç ve Yöntemler: Araştırmada kullanılan veriler ikincil veri niteliğinde olup, Web of Science (WoS) Core Collection veri tabanından elde edilmiştir. Konu ile ilgili dahil etme ve hariç tutma kriterleri sonrası 680 yayına ulaşılmış ve bu yayınlarla analiz yapılmıştır. Analizde bibliyometrik analiz sağlayan yazılımlardan biri olan SciMAT kullanılmıştır. Stratejik diyagramlar, küme ağları ve tematik gelişim haritası son 29 yılı kapsayacak şekilde 4 periyot (1992-2000, 2001-2010, 2011-2016, 2017-2020) olarak analiz edilmiştir.
Bulgular: İlk dönemde (1992-2000) “cost” motor tema iken, sonraki dönemlerde motor temalar “cloud computing, access control, public key encryption, privacy preserving, big data, electronic medical record, technology”dir. Tematik gelişim haritasından yararlanarak elde edilen temalar; sağlık hizmetlerinde bulut bilişim, dış kaynak kullanımına dayalı riskler, genel işleyişle ilgili problemler ve maliyet konularıdır. Maliyet ile ilgili sonuçlar kesinlikten uzaktır.
Sonuç: Hastane yöneticilerinin bulut bilişim konusunda bilinçlenmeleri, dış kaynak kullanımı (DKK) ile maliyetlerin azaltılmasını hedeflerken aynı zamanda hizmetlerin kalite düzeylerine dikkat etmeleri önem arz etmektedir. DKK’dan kaynaklı oluşabilecek risklerin minimum düzeyde kalabilmesi için sağlık kurumları ve firmalar arasında gerçekleşen DKK anlaşmalarında risklere yönelik ihtiyati tedbirlerin alınmasında fayda vardır.

Keywords

Dış kaynak kullanımı, bulut bilişim, maliyet, bibliyometri

References

• 1. Antucheviciene J, Lashgari S, Delavari A, Kheirkhah O. The Impact of Outsourcing in Terms of Access and Quality of Health Services from Participants Attitude. Eng Econ. 2013;24(4):356–63.
• 2. Bozdemir E, Terzi M. Dış Laboratuvar Hizmet Alımının Maliyet Karlılık Analizi: Bir Üniversite Hastanesi Örneği. Gümüşhane Üniversitesi Sos Bilim Enstitüsü Elektron Derg. 2021;12(1):110–7.
• 3. Ketler K, Walstrom J. The outsourcing decision. Int J Inf Manage. 1993;13(6):449–59.
• 4. Hsiao C-T, Pai J-Y, Chiu H. The study on the outsourcing of Taiwan’s hospitals: a questionnaire survey research. BMC Health Serv Res. 2009;9:78:1-9.
• 5. Tribble DA, Kastango ES. Key Considerations in Pharmacy Outsourcing: Understanding Risks and Managing Liability: http://dx.doi.org/101310/hpj4702-112. 2012;47(2):112–7.
• 6. Avery G. Outsourcing Public Health Laboratory Services: A Blueprint for Determining Whether to Privatize and How. Public Adm Rev. 2000;60(4):330–7.
• 7. Bowers JA. A cost benefit analysis of outsourced laboratory services. J Healthc Resour Manag. 1995;13(11):13–7.
• 8. Freinberg B, Kaden PA. Pros and Cons of Outsourcing Laboratory Services. J Oncol Pract. 2006;2(4):162–3.
• 9. Shinkman R. Outsourcing on the upswing. Health providers are farming out more services to spend less money. Mod Healthc. 2000;30(37):46–50, 52.
• 10. Yiğit V, Tengilimoğlu D, Kisa A, Younis MZ. Outsourcing and its implications for hospital organizations in Turkey - PubMed. J Heal Care Financ. 2007;33(4):86–92.
• 11. Ikediashi DI, Ogunlana SO, Odesola IA. Service quality and user satisfaction of outsourced facilities management (FM) services in nigeria’s public hospitals. Built Environ Proj Asset Manag. 2015;5(4):363–79.
• 12. Magnezi R, Kedem R, Reuveni H. Outsourcing of primary care: Satisfaction level in the Israeli Defense Forces. Mil Med. 2004;169(5):379–84.
• 13. Roberts V. Managing strategic outsourcing in the healthcare industry - PubMed. J Heal Manag. 2001;46(4):239–49.
• 14. Lee J. Strategic risk analysis for information technology outsourcing in hospitals. Inf Manag. 2017;54(8):1049–58.
• 15. Lee J. Evaluating lab outsourcing. Hospitals seek savings but have to consider quality, service and staff issues. Mod Healthc. 2014;44(35):22-4.
• 16. Komatsu M. Advantages and disadvantages of outsourcing hospital microbiological testings. Rinsho Byori. 2011;59(10):944–6.
• 17. Rahimi B, Mizrahi R, Magnezi R. The challenges and opportunities of implementing outsourcing in private and public hospitals in Israel. Harefuah. 2011;150(1):56–66.
• 18. Young E, Vissapragada R, Bulamu NB, Raju DP, McDonald CR. Outsourcing robotic-assisted operations to private hospitals: Cost analysis of a retrospective cohort. ANZ J Surg. 2021;91(11):2352-2359.
• 19. Hagen TP, Holom GH, Amayu KN. Outsourcing day surgery to private for-profit hospitals: the price effects of competitive tendering. Heal Econ Policy Law. 2017;1–18.
• 20. Dalton CM, Warren PL. Cost versus control: Understanding ownership through outsourcing in hospitals. J Health Econ. 2016;48:1–15.
• 21. Menachemi N, Burkhardt J, Shewchuk R, Burke D, Brooks RG. To outsource or not to outsource: Examining the effects of outsourcing IT functions on financial performance in hospitals. Health Care Manage Rev. 2007;32(1):46–54.
• 22. Omrani A, Delgoshaei B, Gorgi HA. Identifying factors affecting about outsourcing in paraclinical services: a systematic review of literature. J Fundam Appl Sci. 2018;9(2S):1290-1308.
• 23. Kasemodel MGC, Makishi F, Souza RC, Silva VL. Following the trail of crumbs: A bibliometric study on consumer behavior in the Food Science and Technology field. Int J Food Stud. 2016;5(1):73–83.
• 24. Cobo M. SciMAT: Software Tool for the Analysis of the Evolution of Scientific Knowledge. Proposal for an Evaluation Methodology. University of Granada; 2011.
• 25. Cobo MJ, Lõpez-Herrera AG, Herrera-Viedma E, Herrera F. SciMAT: A new science mapping analysis software tool. J Am Soc Inf Sci Technol. 2012;63(8):1609–30.
• 26. Cobo MJ, López-Herrera AG, Herrera-Viedma E, Herrera F. An approach for detecting, quantifying, and visualizing the evolution of a research field: A practical application to the Fuzzy Sets Theory field. J Informetr. 2011;5(1):146–66.
• 27. Niknam, Gorji HA, Langarizadeh M. The challenge of outsourcing of hospital services in Iran: A qualitative study. J Educ Health Promot. 2020;9(1):294.
• 28. Olofsson PT, Aspelin P, Bohlin J, Blomqvist L. The impact of contracts on outsourcing computed tomography examinations from a Swedish public university hospital to a private radiology unit. Radiography. 2019;25(2):148–54.
• 29. Loh L, Venkatraman N. Determinants of information technology outsourcing: A cross-sectional analysis. J Manag Inf Syst. 1992;9(1):7–24.
• 30. Low C, Hsueh Chen Y. Criteria for the Evaluation of a Cloud-Based Hospital Information System Outsourcing Provider. J Med Syst. 2012;36(6):3543–53.
• 31. Yang X, Li T, Xi W, Chen A, Wang C. A blockchain-assisted verifiable outsourced attribute-based signcryption scheme for EHRS sharing in the cloud. IEEE Access. 2020;8:170713–31.
• 32. Liu J, Huang X, Liu JK. Secure sharing of Personal Health Records in cloud computing: Ciphertext-Policy Attribute-Based Signcryption. Futur Gener Comput Syst. 2015;52:67–76.
• 33. Li M, Yu S, Zheng Y, Ren K, Lou W. Scalable and secure sharing of personal health records in cloud computing using attribute-based encryption. IEEE Trans Parallel Distrib Syst. 2013;24(1):131–43.
• 34. Guo C, Zhuang R, Jie Y, Ren Y, Wu T, Choo KKR. Fine-grained Database Field Search Using Attribute-Based Encryption for E-Healthcare Clouds. J Med Syst. 2016;40(11):235.
• 35. Washer P, Joffe H. The “hospital superbug”: Social representations of MRSA. Soc Sci Med. 2006 Oct 1;63(8):2141–52.
• 36. Johnson AP. Methicillin-resistant Staphylococcus aureus: the European landscape. J Antimicrob Chemother. 2011;66(suppl_4): iv43-iv48.
• 37. Wang V, Maciejewski ML, Patel UD, Stechuchak KM, Hynes DM, Weinberger M. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers. BMC Heal Serv Res. 2013;13(1):1–9.
• 38. Sugimoto K, Ogata Y, Kashiwagi M. Factors promoting resident deaths at aged care facilities in Japan: a review. Health Soc Care Community. 2018;26(2):e207–24.
• 39. Wakefield BJ, Tripp-Reimer T, Rosenbaum ME, Rosenthal GE. Veterans’ Use of Department of Veterans Affairs Care and Perceptions of Outsourcing Inpatient Care. Mil Med. 2007;172(6):565–71.
• 40. Liu X, Deng RH, Yang Y, Tran HN, Zhong S. Hybrid privacy-preserving clinical decision support system in fog-cloud computing. Futur Gener Comput Syst. 2018;78(2):825.
• 41. Yang Y, Zheng X, Guo W, Liu X, Chang V. Privacy-preserving fusion of IoT and big data for e-health. Futur Gener Comput Syst. 2018;86:1437–55.
• 42. Thirumalai CS, Viswanathan P. Modelling a side channel resistant CHAN-PKC cryptomata for medical data security. Multimed Tools Appl. 2019;78(18):25977–97.
• 43. Potluri S, Rao KS, Mohanty SN. Cloud security: techniques and applications. Walter de Gruyter GmbH & Co KG; 2021.
• 44. Joha A, Janssen M. Design choices underlying the software as a service (SaaS) business model from the user perspective: Exploring the fourth wave of outsourcing. J Univers Comput Sci. 2012;18(11):1501–22.
• 45. Purtova N. eHealth Spare Parts as a Service: Modular eHealth Solutions and Medical Device Reform. Eur J Heal Law. 2017;24:463–86.
• 46. Zhu Y, Hu H, Ahn GJ, Yau SS. Efficient audit service outsourcing for data integrity in clouds. J Syst Softw. 2012;85(5):1083–95.
• 47. Khan I, Anwar Z, Bordbar B, Ritter E, Rehman HU. A protocol for preventing insider attacks in untrusted infrastructure-as-a-service clouds. IEEE Trans Cloud Comput. 2018;6(4):942–54.
• 48. Kibiwott KP, Zhao Y, Kogo J, Zhang F. Verifiable fully outsourced attribute-based signcryption system for IoT eHealth big data in cloud computing. Math Biosci Eng. 2019;16(5):3561–94.
• 49. Aazam M, Zeadally S, Harras KA. Offloading in fog computing for IoT: Review, enabling technologies, and research opportunities. Futur Gener Comput Syst. 2018;87:278–89.
• 50. Kara O, Kurutkan MN. Applications of Blockchain Technologies in Health Services: A General Framework for Policymakers. In: Bozkuş Kahyaoğlu, editor. The Impact of Artificial Intelligence on Governance, Economics and Finance. Singapore: Springer, Singapore; 1st ed. 2021.
• 51. Heart T, Ben-Assuli O, Shabtai I. A review of PHR, EMR and EHR integration: A more personalized healthcare and public health policy. Heal Policy Technol. 2017;6(1):20–5.
• 52. Deng F, Wang Y, Peng L, Xiong H, Geng J, Qin Z. Ciphertext-Policy Attribute-Based Signcryption with Verifiable Outsourced Designcryption for Sharing Personal Health Records. IEEE Access. 2018;6:39473–86.
• 53. Shi H, Guo R, Jing C, Feng S. Efficient and unconditionally anonymous certificateless provable data possession scheme with trusted kgc for cloud-based emrs. IEEE Access. 2019;7:69410–21.
• 54. Deng J, Xu C, Wu H, Chen J. Analysis and improvement of a fair remote retrieval protocol for private medical records. Concurr Comput Pract Exp. 2016;28(6):1918–29.
• 55. Ramu G, Eswara Reddy B. Secure architecture to manage EHR’s in cloud using SSE and ABE. Health Technol (Berl). 2015;3–4(5):195–205.
• 56. Zhang H, Yu J, Tian C, Zhao P, Xu G, Lin J. Cloud storage for electronic health records based on secret sharing with verifiable reconstruction outsourcing. IEEE Access. 2018;6:40713–22.
• 57. Liu Z, Weng J, Li J, Yang J, Fu C, Jia C. Cloud-based electronic health record system supporting fuzzy keyword search. Soft Comput. 2016;20(8):3243–55.
• 58. Ramu G. A secure cloud framework to share EHRs using modified CP-ABE and the attribute bloom filter. Educ Inf Technol. 2018;23(5):2213–33.
• 59. Kahn JS, Aulakh V, Bosworth A. What it takes: characteristics of the ideal personal health record. Health Aff (Millwood). 2009;28(2):369–76.
• 60. Qian H, Li J, Zhang Y, Han J. Privacy-preserving personal health record using multi-authority attribute-based encryption with revocation. Int J Inf Secur. 2014;14(6):487–97.
• 61. Liu X, Liu Q, Peng T, Wu J. Dynamic access policy in cloud-based personal health record (PHR) systems. Information Sciences journal. 2017;10;379:62–81.
• 62. Guo R, Li X, Zheng D, Zhang Y. An attribute-based encryption scheme with multiple authorities on hierarchical personal health record in cloud. J Supercomput. 2020;76(7):4884–903.
• 63. Xhafa F, Wang J, Chen X, Liu JK, Li J, Krause P. An efficient PHR service system supporting fuzzy keyword search and fine-grained access control. Soft Comput. 2014;18(9):1795–802.
• 64. Ying Z, Jang W, Cao S, Liu X, Cui J. A lightweight cloud sharing PHR system with access policy updating . IEEE Access. 2018;6:64611–21.
• 65. Myers FB, Henrikson RH, Bone J, Lee LP. A Handheld Point-of-Care Genomic Diagnostic System. PLoS One. 2013;8(8):e70266.
• 66. Hasan MZ, Mahdi MSR, Sadat MN, Mohammed N. Secure count query on encrypted genomic data. J Biomed Inform. 2018;81:41–52.
• 67. Ma X, Zhu Y, Li X. An efficient and secure ridge regression outsourcing scheme in wearable devices. Comput Electr Eng. 2017;63:246–56.
• 68. Ikediashi DI, Ogunlana SO. Significant risk factors associated with facilities management (FM) outsourcing: A study on Nigeria’s public hospitals. Eng Constr Archit Manag. 2015;22(6):771–96.
• 69. Bjerrum SS, Kiilgaard JF, Mikkelsen KL, Cour M la. Outsourced cataract surgery and postoperative endophthalmitis. Acta Ophthalmol. 2013;91(8):701–8.
• 70. Delory T, Seringe E, Antoniotti G, Novakova I, Goulenok C, Paysant I, et al. Prolonged delay for controlling KPC-2-producing Klebsiella pneumoniae outbreak: the role of clinical management. Am J Infect Control. 2015;43(10):1070–5.
• 71. Set Litwin A, Avgar AC, Becker ER. Superbugs versus outsourced cleaners: Employment arrangements and the spread of health care-associated infections. ILR Rev. 2017;70(3):610–41.
• 72. Toffolutti V, Reeves A, McKee M, Stuckler D. Outsourcing cleaning services increases MRSA incidence: Evidence from 126 english acute trusts. Soc Sci Med. 2017;174:64–9.
• 73. Streja E, Kovesdy CP, Soohoo M, Obi Y, Rhee CM, Park C, et al. Dialysis Provider and Outcomes among United States Veterans Who Transition to Dialysis. Clin J Am Soc Nephrol. 2018;13(7):1055.
• 74. Wang V, Coffman CJ, Stechuchak KM, Berkowitz TSZ, Hebert PL, Edelman D, et al. Survival among Veterans Obtaining Dialysis in VA and Non-VA Settings. J Am Soc Nephrol. 2019;30(1):159.
• 75. Wang V, Swaminathan S, Corneau EA, Maciejewski ML, Trivedi AN, O’Hare AM, et al. Association of VA Payment Reform for Dialysis with Spending, Access to Care, and Outcomes for Veterans with ESKD. Clin J Am Soc Nephrol. 2020;15(11):1631–9.
• 76. Turpin RS, Canada T, Rosenthal V, Nitzki-George D, Liu FX, Mercaldi CJ, et al. Bloodstream Infections Associated With Parenteral Nutrition Preparation Methods in the United States. J Parenter Enter Nutr. 2012;36(2):169–76.
• 77. Ikediashi D, Ekanem AM. Outsourcing of facilities management (FM) services in public hospitals: A study on Nigeria’s perspective. J Facil Manag. 2015;13(1):85–102.
• 78. Lippi G, Plebani M. Cost, profitability and value of laboratory diagnostics: in God we trust, all others bring data. J Lab Med. 2019;43(1):1–3.
• 79. Beaulieu M, Roy J, Landry S. Logistics outsourcing in the healthcare sector: Lessons from a Canadian experience. Can J Adm Sci / Rev Can des Sci l’Administration. 2018;35(4):635–48.
• 80. Alvarez MR, Kerr BJ, Burtner J, Ledlow G, Fulton L V. Effects of outsourced nursing on quality outcomes in long-term acute-care hospitals. J Nurs Adm. 2011;41(3):138–43.
• 81. Thouin MF, Hoffman JJ, Ford EW. The effect of information technology investment on firm-level performance in the health care industry. Health Care Manage Rev [Internet]. 2008;33(1):60–8.
• 82. Bondurant KL, Wheeler JG, Bursac Z, Holmes T, Tilford JM. Comparison of Office-Based Versus Outsourced Immunization Recall Services. Clin Pediatr (Phila). 2016;56(6):555–63.
• 83. Huang C-Y, Chen S-S, Chen L-K. Comparison of two different running models for the shock wave lithotripsy machine in Taipei City Hospital: self-support versus outsourcing cooperation. Urological Research. 2009;37(5):247–51.
• 84. Skipworth H, Delbufalo E, Mena C. Logistics and procurement outsourcing in the healthcare sector: A comparative analysis. Eur Manag J.2020;38(3):518–32.
• 85. Khatri N, Gupta V. Effective implementation of health information technologies in U.S. hospitals. Health Care Manage Rev. 2016;41(1):11–21.