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Book part
Publication date: 19 December 2013

Commentary on “Horizontal and Vertical Integration of Physicians: A Tale of Two Tails” By Lawton Robert Burns, Jeff C. Goldsmith, and Aditi Sen

Stephen M. Shortell

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Abstract

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000015010
ISBN: 978-1-78350-715-3

Keywords

  • physician organizations
  • hospital–physician integration
  • payment incentives
  • integrated delivery systems

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Book part
Publication date: 11 August 2014

Horizontal and Vertical Integration of Physicians: A Tale of Two Tails

Lawton Robert Burns, Jeff C. Goldsmith and Aditi Sen

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of…

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Abstract

Purpose

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

Design/Methodology Approach

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

Findings

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

Research Limitations

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Research Implications

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Practical Implications

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

Originality/Value

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000015009
ISBN: 978-1-78350-715-3

Keywords

  • Physicians
  • group practice
  • horizontal integration
  • vertical integration

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Book part
Publication date: 19 December 2013

List of Contributors

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Abstract

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000015003
ISBN: 978-1-78350-715-3

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Book part
Publication date: 19 December 2013

Preface

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Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000015006
ISBN: 978-1-78350-715-3

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Book part
Publication date: 30 September 2020

Just Work: Sex Work at the Intersections

Gowri Vijayakumar

Examining paths into and out of sex work followed by three women in Bangalore, India, this essay argues that the struggles of sex workers to secure a livelihood highlight…

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Abstract

Examining paths into and out of sex work followed by three women in Bangalore, India, this essay argues that the struggles of sex workers to secure a livelihood highlight the interlocking relationships of caste, class, and gender, as well as forms of autonomy and agency within these systems. Interview narratives reveal how gendered marginalization leads to precarious work; and precarious work leads to sexual stigma. They show how intersectionality theory can be placed in conversation with Marxist feminisms and Indian feminist scholarship on caste, class, and gender to illuminate patterns of gendered economic marginalization in urban India. Such an analysis offers a way to articulate the relationships of caste, class, and gender in the lives of sex workers and to illustrate how intersectionality theory can be extended when engaged transnationally.

Details

Rethinking Class and Social Difference
Type: Book
DOI: https://doi.org/10.1108/S0198-871920200000037007
ISBN: 978-1-83982-020-5

Keywords

  • Sex work
  • sexuality
  • intersectionality
  • feminism
  • India
  • social reproduction

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Book part
Publication date: 18 October 2016

Conceptualization of Social Entrepreneurship: Narratives on Avant Garde Social Entrepreneurs from India

Roopinder Oberoi

This chapter primarily aims to revisit and explore the theoretical underpinnings of social entrepreneurship and dwell into what unfolds while amalgamating the…

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Abstract

This chapter primarily aims to revisit and explore the theoretical underpinnings of social entrepreneurship and dwell into what unfolds while amalgamating the conventionally considered to be dissimilar design of business entrepreneurship and the social impact? Can the prefix “social” of social entrepreneurship transform the innate characteristics of entrepreneurship? Is social entrepreneurship an essentiality in a ground-breaking playing field in the business research to facilitate new theories and concepts or a rehash of the corporate responsibility debate? Is it just an appellation or does the underscored social label and its construct allow for new possibility to be explored into the sociality of entrepreneurship along with the new-fangled entrepreneurialism in society? The chapter attempts to decode these more germane and interwoven issues like do we have to tell apart between a capitalist entrepreneurship and a non-capitalist one? Or between pioneering and replicative entrepreneurs. Can we sanctify the political in the social spheres and who (which actors) actually sets the discourse of social needs. The chapter also tracks multiple cases in the Indian locale to determine the robust application of the concept while unpacking the Indian context of social entrepreneurship. These cases are randomly selected from assorted sectors and are wide in its sweep and scope. These cases highlight on the lived experiences, where the task is truly played out. This adds to the sensibilities of new entrepreneurs and policy framers who face the challenges.

Details

Corporate Responsibility and Stakeholding
Type: Book
DOI: https://doi.org/10.1108/S2043-052320160000010014
ISBN: 978-1-78635-626-0

Keywords

  • Social entrepreneurship
  • sustainability
  • business model
  • bottom of pyramid
  • social entrepreneurs in Indian

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Article
Publication date: 11 March 2019

Sustainable development goals and reproductive healthcare rights of internally displaced persons in India

Madhulika Sahoo and Jalandhar Pradhan

The internally displaced persons (IDPs) are often overlooked population, falling between the cracks of international and national commitments. Displaced women and children…

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Abstract

Purpose

The internally displaced persons (IDPs) are often overlooked population, falling between the cracks of international and national commitments. Displaced women and children go through more hardship than the male counterpart, as they are frequently at greater risk and do not get adequate access to the reproductive healthcare rights; they suffer from poor health amid threats of eviction. The purpose of this paper is to look into the IDPs reproductive healthcare situation in India and sustainable development goal (SDG) role in addressing the reproductive healthcare rights of the IDPs in India.

Design/methodology/approach

This paper is based on the available literature on reproductive rights of IDPs in India, analysis of the SDGs 3 and other legal safeguards.

Findings

The newly arrived IDPs in the camps have complex needs and health problems. They are susceptible to a number of health problems due to the exposure to physical and environmental threats, violence and trauma. Many of them face a loss of social networks and assets, knowledge and information in the new environment, and lack food security. They have inadequate shelter, healthcare services, sanitation and access to safe water.

Research limitations/implications

This is a viewpoint paper and most of the information in this paper are taken from different sources which are cited in the reference section. There is a lack of sufficient data on IDPs in India. Most of the IDPs figures/data are quoted from Internal Displacement Monitoring Centre and other literature.

Practical implications

To achieve the SDGs by 2030, India needs to take account of all people’s vulnerabilities to address their humanitarian and sustainable development needs. It is important that the development, humanitarian actors, along with the local communities, work collectively to respond to the health needs of the IDPs. Moreover, the active role of the government can provide the necessary assistance to guarantee the rights of IDPs health, adequate standard of living and to social security.

Originality/value

This paper highlights the reproductive healthcare rights of the IDPs in India and the challenges faced by them. It has analyzed the policy gaps. The paper also suggests few measures that can be undertaken to address those challenges under the SDGs.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/IJHRH-12-2017-0074
ISSN: 2056-4902

Keywords

  • India
  • IDP
  • SDGs
  • Reproductive health
  • Women

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