Governance Design and Rehabilitation Efficiency in Small Private Health-Care Facilities: A Markov-Based Health Planning Model for Psychiatric Halfway Houses

Governance Design and Rehabilitation Efficiency in Small Private Health-Care Facilities: A Markov-Based Health Planning Model for Psychiatric Halfway Houses | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 9 February 2026 V1 Latest version Share on Governance Design and Rehabilitation Efficiency in Small Private Health-Care Facilities: A Markov-Based Health Planning Model for Psychiatric Halfway Houses Authors : Han-Wei Chou 0009-0007-5923-5284 [email protected] and Chin-Tsai Lin Authors Info & Affiliations https://doi.org/10.22541/au.177066379.90080219/v1 90 views 52 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Effective governance in psychiatric halfway houses requires a delicate balance between regulatory compliance (upward accountability) and patient-centered service quality (downward accountability). Although financial sustainability and formal compliance are often prioritized in practice, the role of downward accountability mechanisms in shaping long-term rehabilitation planning remains insufficiently examined. This study develops a strategic planning model to assess how institutional transparency and grievance mechanisms influence recovery trajectories among residents of psychiatric halfway houses. Using a Markov chain modeling approach, we analyzed state-transition probabilities across 21 psychiatric halfway houses in Taiwan between January and December 2023. Governance data were integrated from facility managers (n = 21) and staff surveys (n = 83) to operationalize three core dimensions of downward accountability: information disclosure, complaint procedures, and patient participation. The Markov analysis indicates that robust downward accountability is significantly associated with improved rehabilitation outcomes. In particular, higher levels of institutional transparency through information disclosure (p < 0.01) and structured grievance mechanisms (p < 0.05) were linked to increased recovery rates and successful community reintegration, whereas passive forms of patient participation showed no significant association with recovery outcomes. These findings suggest that sustainability in small-scale mental health facilities requires a shift from compliance-oriented governance toward patient-centered accountability structures. Health planners and accreditation bodies should therefore incorporate downward accountability indicators—especially transparency and complaint resolution—into standardized quality assessment frameworks. The proposed Markov-based monitoring model offers a practical, real-time decision-support tool to assist administrators in optimizing service delivery and enhancing patient-centered rehabilitation outcomes. Supplementary Material File (ijhpm v1.docx) Download 157.27 KB Information & Authors Information Version history V1 Version 1 09 February 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords downward accountability health system governance markov decision model quality management small healthcare providers Authors Affiliations Han-Wei Chou 0009-0007-5923-5284 [email protected] Ming Chuan University School of Management View all articles by this author Chin-Tsai Lin Ming Chuan University School of Management View all articles by this author Metrics & Citations Metrics Article Usage 90 views 52 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Han-Wei Chou, Chin-Tsai Lin. Governance Design and Rehabilitation Efficiency in Small Private Health-Care Facilities: A Markov-Based Health Planning Model for Psychiatric Halfway Houses. Authorea . 09 February 2026. DOI: https://doi.org/10.22541/au.177066379.90080219/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. 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