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Article
Publication date: 18 March 2024

Graeme Newell and Muhammad Jufri Marzuki

Healthcare property has become an important alternate property sector in recent years for many international institutional investors. The purpose of this paper is to assess the…

Abstract

Purpose

Healthcare property has become an important alternate property sector in recent years for many international institutional investors. The purpose of this paper is to assess the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French healthcare property in a French property portfolio and mixed-asset portfolio over 1999–2020. French healthcare property is seen to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. Drivers and risk factors for the ongoing development of the direct healthcare property sector in France are also identified, as well as the strategic property investment implications for institutional investors.

Design/methodology/approach

Using annual total returns, the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French direct healthcare property over 1999–2020 are assessed. Asset allocation diagrams are used to assess the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. The role of specific drivers for French healthcare property performance is also assessed. Robustness checks are also done to assess the potential impact of COVID-19 on the performance of French healthcare property.

Findings

French healthcare property is shown to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. French direct healthcare property delivered strong risk-adjusted returns compared to French stocks, listed healthcare and listed property over 1999–2020, only exceeded by direct property. Portfolio diversification benefits in the fuller mixed-asset portfolio context were also evident, but to a much lesser extent in a narrower property portfolio context. Importantly, this sees French direct healthcare property as strongly contributing to the French property and mixed-asset portfolios across the entire portfolio risk spectrum and validating the property industry perspective of healthcare property being low risk and providing diversification benefits in a mixed-asset portfolio. However, this was to some degree to the loss or substitution of traditional direct property exposure via this replacement effect. French direct healthcare property and listed healthcare are clearly shown to be different channels in delivering different aspects of French healthcare performance to investors. Drivers of French healthcare property performance are also shown to be both economic and healthcare-specific factors. The performance of French healthcare property is also shown to be different to that seen for healthcare property in the UK and Australia. During COVID-19, French healthcare property was able to show more resilience than French office and retail property.

Practical implications

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio, with French healthcare property having different investment dynamics to the other traditional French property sectors. The strong risk-adjusted performance of French direct healthcare property compared to French stocks, listed healthcare and listed property sees French direct healthcare property contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. French healthcare property’s resilience during COVID-19 was also an attractive investment feature. This is particularly important, as many institutional investors now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries and the need for effective social infrastructure. The importance of French direct healthcare property sees direct healthcare property exposure accessible to investors as an important alternate real estate sector for their portfolios going forward via both non-listed healthcare property funds and the further future establishment of more healthcare REITs to accommodate both large and small institutional investors respectively. The resilience of French healthcare property during COVID-19 is also an attractive feature for future-proofing an investor’s portfolio.

Originality/value

This paper is the first published empirical research analysis of the risk-adjusted performance, diversification benefits and performance dynamics of French direct healthcare property, and the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of French direct healthcare property in a portfolio; particularly where the strategic role of direct healthcare property in France is seen to be different to that in the UK and Australia via portfolio replacement effects. Clear evidence is also seen of the drivers of French healthcare property performance being strongly influenced by healthcare-specific factors, as well as economic factors.

Details

Journal of European Real Estate Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1753-9269

Keywords

Article
Publication date: 26 April 2024

Edoardo Trincanato and Emidia Vagnoni

The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the…

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Abstract

Purpose

The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.

Design/methodology/approach

The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.

Findings

Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.

Social implications

By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.

Originality/value

This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.

Details

International Journal of Entrepreneurial Behavior & Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1355-2554

Keywords

Article
Publication date: 31 January 2024

Margit Malmmose and Mai Skjøtt Linneberg

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate…

Abstract

Purpose

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Design/methodology/approach

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

Findings

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Originality/value

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

Details

Accounting, Auditing & Accountability Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 19 February 2024

Manjeet Kharub, Himanshu Gupta, Sudhir Rana and Olivia McDermott

The objective of this study is to systematically identify, categorize and assess the driving factors and interdependencies associated with various types of healthcare waste. The…

Abstract

Purpose

The objective of this study is to systematically identify, categorize and assess the driving factors and interdependencies associated with various types of healthcare waste. The study specifically focuses on waste that has been managed or is recommended for treatment through the application of Lean Six Sigma (LSS) methodologies.

Design/methodology/approach

To accomplish the study’s objectives, interpretive structural modeling (ISM) was utilized. This analytical tool aided in quantifying the driving power and dependencies of each form of healthcare waste, referred to as “enablers,” as well as their related variables. As a result, these enablers were classified into four distinct categories: autonomous, dependent, linkage and drivers or independents.

Findings

In the healthcare sector, the “high cost” (HC) emerges as an autonomous variable, operating with substantial independence. Conversely, variables such as skill wastage, poor service quality and low patient satisfaction are identified as dependent variables. These are distinguished by their low driving power and high dependency. On the flip side, variables related to transportation, production, processing and defect waste manifest strong driving forces and minimal dependencies, categorizing them as independent factors. Notably, inventory waste (IW) is highlighted as a salient issue within the healthcare domain, given its propensity to engender additional forms of waste.

Research limitations/implications

Employing the ISM model, along with comprehensive case study analyses, provides a detailed framework for examining the complex hierarchies of waste existing within the healthcare sector. This methodological approach equips healthcare leaders with the tools to accurately pinpoint and eliminate unnecessary expenditures, thereby optimizing operational efficiency and enhancing patient satisfaction. Of particular significance, the study calls attention to the key role of IW, which often acts as a trigger for other forms of waste in the sector, thus identifying a crucial area requiring focused intervention and improvement.

Originality/value

This research reveals new insights into how waste variables are structured in healthcare, offering a useful guide for managers looking to make their waste-reduction strategies more efficient. These insights are highly relevant not just for healthcare providers but also for the administrators and researchers who are helping to shape the industry. Using the classification and ranking model developed in this study, healthcare organizations can more easily spot and address common types of waste. In addition, the model serves as a useful tool for practitioners, helping them gain a deeper, more detailed understanding of how different factors are connected in efforts to reduce waste.

Details

International Journal of Quality & Reliability Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 5 March 2024

Susanna Pinnock, Natasha Evers and Thomas Hoholm

The demand for healthcare innovation is increasing, and not much is known about how entrepreneurial firms search for and sell to customers in the highly regulated and complex…

Abstract

Purpose

The demand for healthcare innovation is increasing, and not much is known about how entrepreneurial firms search for and sell to customers in the highly regulated and complex healthcare market. Drawing on effectuation perspectives, we explore how entrepreneurial digital healthcare firms with disruptive innovations search for early customers in the healthcare sector.

Design/methodology/approach

This study uses a qualitative, longitudinal multiple-case design of four entrepreneurial Nordic telehealth firms. In-depth interviews were conducted with founders and senior managers over a period of 27 months.

Findings

We find that when customer buying conditions are highly flexible, case firms use effectual logic to generate customer demand for disruptive innovations. However, under constrained buying conditions firms adopt a more causal approach to customer search.

Practical implications

Managers need to gain a deep understanding of target buying environments when searching for customers. In healthcare sector markets, the degree of flexibility customers have over buying can constrain them from engaging in demand co-creation. In particular, healthcare customer access to funding streams can be a key determinant of customer flexibility.

Originality/value

We contribute to effectuation literature by illustrating how customer buying conditions influence decision-making logics of entrepreneurial firms searching for customers in the healthcare sector. We contribute to entrepreneurial resource search literature by illustrating how entrepreneurial firms search for customers beyond their networks in the institutionally complex healthcare sector.

Details

International Journal of Entrepreneurial Behavior & Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1355-2554

Keywords

Article
Publication date: 27 May 2024

Martin Beaulieu, Salomée Ruel and Olivier Dupouet

This article investigates how the healthcare sector can reorganize its procurement network to better balance its resilience and cost-minimization objectives.

Abstract

Purpose

This article investigates how the healthcare sector can reorganize its procurement network to better balance its resilience and cost-minimization objectives.

Design/methodology/approach

A single case study was conducted on the procurement of personal protective equipment (PPE) during the first COVID-19 pandemic wave in the Quebec public healthcare network. Interviews were conducted with stakeholders from the supply chain management (SCM) departments at eight public healthcare institutions.

Findings

Two major challenges in the early months of the pandemic impacted the development of resilience in the healthcare network. First, peripheral actors’ decisions, which orient procurement objectives, limited the deployment of resilience measures in the supply chain (SC). Second, SC resilience included hundreds of products other than PPE that are critical to the delivery of care. The article illustrates the challenges of SCR, which will inevitably be accompanied by additional costs when purchasing in the public healthcare sector is often focused on the lowest price.

Originality/value

Drawing from the network perspective model, this article examines the actions of Quebec supply network stakeholders through the three phases of SCR: anticipation, response to disruption, and recovery. Finally, the article suggests that decision-makers remove the cost of resilience measures from the purchase price of products, in order to maintain these measures over the long term.

Details

International Journal of Public Sector Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0951-3558

Keywords

Open Access
Article
Publication date: 6 February 2024

Matthew Quayson, Eric Kofi Avornu and Albert Kweku Bediako

Blockchain technology enhances information management in healthcare supply chains by securing healthcare information and providing medical resource traceability. However, there is…

Abstract

Purpose

Blockchain technology enhances information management in healthcare supply chains by securing healthcare information and providing medical resource traceability. However, there is no decision framework to support blockchain implementation for managing information, especially in emerging economies’ healthcare supply chains. This paper develops a hierarchical decision model for implementing blockchain technology for information management in emerging economies’ healthcare supply chains.

Design/methodology/approach

This study uses 20 health supply chain experts in Ghana to rank 17 decision criteria for implementing blockchain for healthcare information management using the best-worst method (BWM) multi-criteria decision technique.

Findings

The results show that “security” and “privacy,” “infrastructural facility” and “presence of training facilities” are the top three critical factors impacting blockchain adoption in the health supply chain for healthcare information management. Other sub-factors are prioritized.

Practical implications

To implement blockchain effectively to enhance information management in the healthcare supply chain, health institutions, blockchain technology providers and state authorities should concentrate on the highly critical factors extracted from the study.

Originality/value

This is the first study that develops a hierarchical decision model for implementing blockchain technology in emerging economies' health supply chains.

Details

Modern Supply Chain Research and Applications, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2631-3871

Keywords

Article
Publication date: 28 February 2023

Gutama Kusse Getele and Xiong Ruoliu

The study research aims to examine the effects of supply chain management practices on risk mitigating (RM) by studying the correlation between social ties, institutional support…

Abstract

Purpose

The study research aims to examine the effects of supply chain management practices on risk mitigating (RM) by studying the correlation between social ties, institutional support, interagency cooperation and external flexibility in public healthcare sectors. Moreover, this research examines the impact of RM on supplier trust, and also the authors examine the relationship among supplier trust and logistics performance.

Design/methodology/approach

The authors used a structural equation model (SEM) based on 539 quantitative data from Ethiopian healthcare organizations. The model included control variables like company size and position to understand better how employees perceive risk mitigation.

Findings

The study's findings indicate that interagency collaboration and external flexibility positively affects RM. On the other hand, RM positively impacts supplier trust and also the supplier trust has a positive effects on performance dimensions. This study also shows that RM has not positively impacting institutional support and social ties.

Practical implications

The study investigation may help the pharmaceutical industry, healthcare service SC agencies and other stakeholders better understand the effects of supply chain management practices on RM and obtain information on progress made thus far.

Originality/value

This research helps managers and their organizations to manage the risk associated with their organizations. Though, this study focuses on Ethiopian healthcare SCM. The authors expect the findings might apply to other countries organizations with comparable demographic or SCM features.

Details

International Journal of Emerging Markets, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-8809

Keywords

Article
Publication date: 27 March 2024

Sunil Kumar Yadav, Shiwangi Singh and Santosh Kumar Prusty

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within…

Abstract

Purpose

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

Design/methodology/approach

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

Findings

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

Research limitations/implications

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Practical implications

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Originality/value

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

Keywords

Open Access
Article
Publication date: 16 January 2024

Federica Bosco, Chiara Di Gerio, Gloria Fiorani and Giulia Stola

This paper aims to identify the key issues that healthcare knowledge-intensive organizations (KIPOs) should focus on to define themselves as socioenvironmentally and governance…

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Abstract

Purpose

This paper aims to identify the key issues that healthcare knowledge-intensive organizations (KIPOs) should focus on to define themselves as socioenvironmentally and governance responsible for integrating environmental, social, and governance (ESG) logic into their business strategy. At the same time, this provides an understanding of how healthcare KIPOs contribute to achieving the Sustainable Development Goals of the 2030 Agenda.

Design/methodology/approach

Taking a cue from the model developed by the World Economic Forum, an “ESG Processing Map” was constructed to identify qualitative disclosures that a healthcare company should consider when implementing sustainability logic. The aspects investigated were processed, considering national and international standards, frameworks and disclosures. The social network analysis technique was used to systemize and combine the outcomes of these processes and analyze their consistency with sustainable development.

Findings

Through the “ESG Processing Map,” 13 areas of action and 27 topics specific to the health sector were defined on which to intervene in sustainability in order to concretely help HCOs to place specific corrective and improvement actions over time concerning socioenvironmental and governance aspects.

Originality/value

The paper provides contribute, on the one hand, to enriching and updating the academic literature on ESG logic in a still underexplored field and, on the other hand, to provide these types of organizations with a “compass” to guide and orient their business strategies towards sustainability.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1096-3367

Keywords

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