Intellectual capital for recovering patient centrality and ensuring patient satisfaction in healthcare sector
| DOI | https://doi.org/10.1108/JIC-04-2020-0116 |
| Published date | 12 November 2020 |
| Date | 12 November 2020 |
| Pages | 461-478 |
| Subject Matter | Information & knowledge management,Knowledge management,HR & organizational behaviour,Organizational structure/dynamics,Accounting & finance,Accounting/accountancy,Behavioural accounting |
| Author | Fabio Fiano,Marco Sorrentino,Francesco Caputo,Margherita Smarra |
Intellectual capital for recovering
patient centrality and ensuring
patient satisfaction in
healthcare sector
Fabio Fiano
Saint Camillus International University of Health and Medical Sciences (UniCamillus),
Roma, Italy
Marco Sorrentino
Department of Law and Economic Sciences, Pegaso Telematic University,
Napoli, Italy
Francesco Caputo
Department of Economics, Management, and Institutions (DEMI),
University of Naples “Federico II”, Naples, Italy, and
Margherita Smarra
Dipartimento di Economia, Universit
a degli Studi del Molise, Campobasso, Italy
Abstract
Purpose –With the aim to enrich the ongoing debate about healthcare management, the paper has a twofold
intent: [1] to emphasise the interpretative contribution that intellectual capital can provide to a better
understanding of the relevant role of patients in the healthcare sector and [2] to investigate the relationships
between the three main dimensions of intellectual capital –human capital, relational capital and structural
capital –and patient satisfaction in the healthcare sector.
Design/methodology/approach –The intellectual capital framework is contextualised in the healthcare
sector, and the relationships among patient evaluations of human capital, relational capital and structural
capital and patient satisfaction are tested via structural equation modelling (SEM) using primary data collected
with reference to a sample of 561 Italian patients involved in post survey treatments in three Italian hospitals.
Findings –The role of intellectual capital in supporting a better understanding of processes and dynamics of
patient satisfaction in the healthcare sector is underlined. The empirical research provides possible guidelines
for recovery patients centrality in healthcare management.
Originality/value –The paper shows how an intellectual capital framework can support a better
understanding and management of dynamics and processes through which patient centrality and satisfaction
in healthcare management can be enforced.
Keywords Healthcare sector, Intellectual capital, Human capital, Relational capital, Structuralcapital, Patient
satisfaction
Paper type Research paper
1. Introduction
Since the beginning of modern social and managerial sciences, multiple researchers have
underlined the relevance of the healthcare sector as a central node around which it is possible
to plan safe, longevous and productive societies (Faulkner, 2008;McLaughlin and Olson,
2008;Walshe and Smith, 2011).
Several researchers and practitioners have spent their time investigating the multiple
dimensions upon which healthcare is founded in order to identify possible paths through
which to ensure alignment between health providers and patients (Lambert et al., 1997)
support advancements in knowledge and innovativeness (Aronson, 2008;Papa et al., 2018;
Usai et al., 2018) and enforce health accessibility for all (Buchanan et al., 2006;Saviano
et al., 2019).
Intellectual
capital in
healthcare
sector
461
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/1469-1930.htm
Received 11 April 2020
Revised 7 July 2020
7 September 2020
Accepted 1 October 2020
Journal of Intellectual Capital
Vol. 23 No. 3, 2022
pp. 461-478
© Emerald Publishing Limited
1469-1930
DOI 10.1108/JIC-04-2020-0116
In the last few decades, a challenging debate has been stimulated around the possibility of
“better use of available resources”(Hall, 2012;Taboada et al., 2013). Multiple contributions
have been provided about the so-called “health corporation”as a way to optimise the total
amount of resources spent in healthcare (Braithwaite et al., 2011;Feinglass and Salmon, 1990).
Unfortunately, the health corporation has progressively become a way for “reducing”the
expenses without adequately considering the effects and consequences of this saving of
money on patient satisfaction and health service quality (Andaleeb, 2001;Alrubaiee and
Alkaa’ida, 2011;Barile et al., 2014a). As a consequence, an increasing cognitive distance
between providers and users in healthcare sectors has appeared and the survival of
healthcare domains in multiple countries is nowadays under discussion (Barile et al., 2014b;
Caputo, 2018;Caputo et al., 2018b).
The central role of the patient in the healthcare domain has been progressively
underestimated and increasing patient dissatisfaction has compromised consolidated health
organisational and managerial models (Conway, 2011;Polese et al., 2018). Accordingly, the
healthcare domain is stalled because it must respect two opposing directions. On the one
hand, the use of resources must be “optimising”through the reduction of expenses; on the
other hand, actions are required to increase health satisfaction and the willingness to actively
collaborate to healthcare management and survival.
Reflecting upon the state of the art, the paper tries to investigate elements and conditions
with respect to which actions can be taken to improve the quality of the relationship between
health providers and users without an increase in the expenses of the health system.
Accordingly, an intellectual capital framework is adopted for depicting the three main areas
related to the intangible assets upon which any kind of organisation can act to improve the
quality of its value proposition: human capital, relational capital and structural capital (Firer
and Williams, 2003;Lerro et al., 2014;Teece, 2000). These three domains are analysed with
specific reference to the healthcare sector in order to emphasise their role in affecting patient
satisfaction. The depicted conceptual model has been tested through an exploratory study to
verify via structural equation modelling (SEM) the relationships among patient evaluations
of human capital, relational capital and structural capital and patient satisfaction based on
the perceptions of 561 Italian patients involved in post survey treatments.
The study confirms evidence related to the relevant role of intangible assets in the
healthcare sector and it also underlines the centrality of human resource and relational
dimensions as ways to influence user perspectives and evaluations in high cognitive
involvement domains.
The paper is structured as follows: section 2 provides a brief literature review about
human capital, relational capital and structural capital in the healthcare domain on which the
research hypotheses are based; section 3 traces the main elements of the research path;
section 4 summarises the main results of the research path; section 5 contains the main
discussions related to the research outcomes; section 6 approaches the theoretical and
practical implications of the research; section 7 depicts preliminary conclusions and section 8
summarises possible future directions for the research.
2. Literature overview and hypotheses development
Intellectual capital (IC) has been defined as “the sum of everything everybody in a company
knows that gives it a competitive edge. Unlike the assets with which business people and
accountants are familiar –land, factories, equipment, cash –intellectual capital is intangible”
(Stewart, 2010, p. I). Klein and Prusak (1994, p. 12) enlarged the previous view of IC by
referring to “intellectual material that has been formalised, captured, and leveraged to
produce a higher-valued asset”. Building upon this extended view, human, relational and
structural dimensions of IC are briefly discussed in this section with the aim to identify their
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