International study of technology investment decisions at hospitals
Abstract
Purpose
Healthcare costs have increased considerably over the past decades around the world. Major contributors to this trend are expensive medical technologies. The purpose of this paper is to use a case study approach to understand how organizational and country level factors influence hospital investment behavior.
Design/methodology/approach
The paper developed a conceptual framework based upon decision theory and institutional theory from which key questions were derived. The paper conducted semi-structured group interviews with relevant stakeholders in six hospitals located in five countries (Germany, India, Thailand, South Korea, USA).
Findings
The paper found that the investment decisions of the interviewed hospitals are primarily affected by the healthcare system, the socio-economic and cultural context, and the organization's mission. Most of the interviewed hospitals consider multiple criteria in their decision-making framework and share similar organizational processes.
Practical implications
The paper identified an international best practice approach to investment decision making at one of the hospitals. The other hospitals, despite being leading institutions in their respective countries, do not have sufficiently advanced and objective assessment approaches and would benefit from a more data-driven and systematic decision process.
Originality/value
Prior research has documented that investment decisions at hospitals are driven by organizational factors. This paper shows how, in addition, country level factors – in particular healthcare system and cultural aspects – affect hospital decision-making behavior.
Keywords
Acknowledgements
This research has been funded in part by AHRQ grant R03HS021800, NSF grant CMMI-1335407 and by the Virginia Tech Institute of Critical Technology and Applied Science (ICTAS) grant JFC-11-130.
Citation
Wernz, C., Zhang, H. and Phusavat, K. (2014), "International study of technology investment decisions at hospitals", Industrial Management & Data Systems, Vol. 114 No. 4, pp. 568-582. https://doi.org/10.1108/IMDS-10-2013-0422
Publisher
:Emerald Group Publishing Limited
Copyright © 2014, Emerald Group Publishing Limited