Co-production and Japanese Healthcare Work Environment, Governance, Service Quality and Social Values

01 Mar 2021

Co-production and Japanese Healthcare. Work Environment, Service Quality, Governance and Social Values (Routledge, 2021)

By Victor Pestoff

What kind of healthcare systems will emerge after the COVID-19 Pandemic? Will they continue to emphasize economics and market mechanisms, or will the response facilitate expanding public provision to guarantee adequate service before the next pandemic? Perhaps there is another way to provide healthcare, based on collaboration and partnership between patients and professional providers? If so, can it provide the synergies that the theories of co-production promise?

Japan has a unique system of two user-owned healthcare providers with nearly 200 hospitals, 500 clinics and 50,000 beds (i.e., more hospital beds than Denmark and Sweden combined). However, they differ from each other and from public hospitals, in terms of their work environment, service quality, governance models and social values. This volume compares cooperative and public healthcare providers at ten hospitals across Japan and analyzes survey data from the staff, as well as from the patients and volunteers at four of them. It compares three models of governance, i.e., ‘command and control’, stewardship and participatory governance. It also contrasts two divergent approaches to co-production, i.e., aspirational and transformative co-production. It demonstrates that participatory governance promotes a partnership between patients and professional healthcare providers that results in more satisfied staff, better service quality, more engaged patients, robust health literacy outreach and a unique, coherent set of social values. However, both the aspirational and transformative approach have their advantages, and hopefully, they can learn from each other.

This volume will be of interest to researchers, academics, and students in the fields of public and non-profit management, healthcare management and human resource management. Forthcoming from Routledge in 2021, it has 12 chapters, 58 tables and 15 figures.

Victor Pestoff is Guest Professor in Political Science at Ersta Sköndal Bräcke University College in Stockholm, Sweden and former Guest Professor at the Faculty of Human Sciences, Osaka University, Japan. His recent book was Co-production and Public Service Management, Routledge, 2018.


Table of contents

1. Introduction: Co-production and Japanese Healthcare.

Part 1 Background.

2. Third Sector and Cooperative Services – An alternative to privatization.

3. Democratizing Medical and Healthcare – The Japanese example.

4. Co-production in Public Service Delivery and Healthcare.

Part 2 Co-production and Japanese Healthcare.

5. Research on Japanese Healthcare – Background, data and methods.

6. Work Environment and Service Quality in Japanese Healthcare.

7. Two Patterns of Patient Participation in Japanese Healthcare - Aspirational and transformative co-production.

8. Volunteering and Co-production in Japanese Healthcare.

9. Participatory Governance and Japanese Healthcare.

10. The Social Values and Mission of Cooperative and Public Healthcare Providers in Japan – Comparing the perspective of the staff, patients and volunteers.

11. Co-production at the Crossroads and Organizational Logics in Japanese Healthcare.

Part 3. Summary and Conclusions.

12. Lessons Learned and Implications for Research on Co-production and Healthcare.