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Purpose – Research on hospital system organization is dated and cross-sectional. We analyze trends in system structure during 2000–2010 to ascertain whether they have become more centralized or decentralized.

Design/Methodology/Approach – We test hypotheses drawn from organization theory and estimate empirical models to study the structural transitions that systems make between different “clusters” defined by the American Hospital Association.

Findings – There is a clear trend toward system fragmentation during most of this period, with a small recent shift to centralization in some systems. Systems decentralize as they increase their members and geographic dispersion. This is particularly true for systems that span multiple states; it is less true for smaller regional systems and local systems that adopt a hub-and-spoke configuration around a teaching hospital.

Research Limitations – Our time series ends in 2010 just as health care reform was implemented. We also rely on a single measure of system centralization.

Research Implications – Systems that appear to be able to centrally coordinate their services are those that operate in local or regional markets. Larger systems that span several states are likely to decentralize or fragment.

Practical Implications – System fragmentation may thwart policy aims pursued in health care reform. The potential of Accountable Care Organizations rests on their ability to coordinate multiple providers via centralized governance. Hospitals systems are likely to be central players in many ACOs, but may lack the necessary coherence to effectively play this governance role.

Originality/Value – Not all hospital systems act in a systemic manner. Those systems that are centralized (and presumably capable of acting in concerted fashion) are in the minority and have declined in prevalence over most of the past decade.

This chapter reviews some of the technical background relating to the designs of digital infrastructures for financial services. Such technical background could be useful to the understanding of the design choices that the central banks and pertinent regulators face when developing or promoting open digital infrastructures for financial services. First, the chapter reviews modularity and interoperability in the design of digital infrastructure. The chapter then examines three broad architectural models of open digital infrastructures: decentralized, centralized and distributed. The chapter ends with some lessons learnt from the different architectural models that have been implemented in practice.

This chapter introduces what a digital ID is, why it is important, how it works, the design choices, as well as how central banks can collaborate with other stakeholders in promoting digital ID infrastructures for use in digital financial services.

This chapter proposes a reconceptualization of educational formalization. By formalization I broadly mean when school attendance ceases to be voluntary, and state authority is elevated over local controls. Although these twin processes tend to parallel each other, there is sufficient variation that while both conditions may obtain, countries can be located on a distribution measuring centralized to decentralized control over educational dimensions (see e.g., Baker & Letendre, 2005, p. 139). Very different social origins may indeed matter as the primary source of subsequent centralized or decentralized controls, and yet countries may adopt broadly similar forms of national authority in spite of very different social origins. The former takes the more historicist strategy, concentrating on national differences that elaborate into different organizational outcomes (see especially Vaughan & Archer, 1971; Archer, 1979). The latter argues that transnational, global forces exert defining influences on countries, producing educational patterns that are visible at the global level and are independent of national differences (see especially Boli, Ramirez, & Meyer, 1985; Ramirez & Boli, 1987; Astiz, Wiseman, & Baker, 2002; Werum & Baker, 2004). Nonetheless, there is no straightforward causality that links social origins to formalization, for it is clear that each strategy needs and incorporates elements of the other. At minimum, the characterization of an educational system as centralized or decentralized remains conceptually risky. This chapter suggests an alternative conceptualization that may lighten this conceptual risk, and bridge the distance between the historicist and institutional approaches to comparative educational systems.

The mechanistic-organic assumptions of SF address those organizational factors related to structural arrangements, contextual factors, job-task work activities, and human resources management policies. Organizations adopt structures and procedures in search of legitimacy and institutionalization (Riebero & Scapens, 2006, p. 96). Structures manifest themselves in centralized (mechanistic) and/or decentralized (organic) forms. These structures can be loose or tightly controlled; they can involve independent or interdependent tasks. These conditions have a direct impact on the operation of management information and control systems that will, in turn, impact organizational learning and process innovations, which, ultimately, affects organizational performance.

This chapter integrates current Chinese education reform into the unique socioeconomic context of China in a transitional time and explores the complexity of education decentralization in China through an in-depth analysis on changes in education finance, administration, and curriculum development. Mark Hanson's theory of education decentralization is cited to build a conceptual framework for examining education decentralization in China. Previous studies, government documents, laws, and regulations related to the current wave of Chinese education reform are reviewed to capture a true picture of education decentralization in China. In investigating the background, actual actions, and motive of the current Chinese education reform, the chapter demonstrates that the on-going Chinese education reform is moving toward a centralized decentralization. Linking education with the unified national goal of economic modernization, the paradoxical mixture of centralization and decentralization is a strategic means to avoid loss of centralized control. Literature on decentralization reform in Chinese education primarily concentrates on changed Chinese education policies in the reform. This chapter places the focus on the contextual factors that shape the decentralization trend in current reform.

Despite the seminal works of authors like Bartlett, Ghoshal, Nohria, Doz, Williamson, among others, because they focused on mature multinationals, newcomers in international markets find scarce information about the design and implementation of international operations networks. In this paper we analyze the internationalization process of Brazilian and Chinese firms to understand the evolution of their networks, a process influenced by factors inexistent in studies about developed country multinationals, namely global production networks (GPNs) and country-of-origin effects. The key characteristics of their international operations networks seem to be well described by a stage-based approach where emerging country multinationals start as local optimizers and then evolve by taking different strategic positions within the GPN to which they are connected. That upgrading is possible when the implementation of the international operations network reaches a certain level of maturity.

This paper examines the evolution of Intellectual Property (IP) commercialization in historical perspective. IP Law imposes an incentive structure that determines the extent of societal investment in those assets. From their inception at the dawn of the Industrial Revolution, IP has expanded due to the introduction of new technologies. Property rights allocation over these assets has traditionally been assigned to governments centralizing the recognition of such property. For a long period of time, government intervention was critical to allow IP commercialization; hence, the political economy of IP was dictated by the prevailing ideology of policymakers in favor or against market transactions. The resulting clash of ideologies has marked the position of developing countries seeking exclusions from open IP commercialization to obtain temporary relief from foreign competition of technology producing countries, as well as that of industrialized countries, seeking to export their technologies overseas. The emergence of blockchain technology, as a decentralized transaction exchange protocol that makes intermediary centralized institutions (i.e. governments) certifying IP irrelevant over a large portion of intellectual property (i.e., trade secrets and copyrights) will create revolutionary institutions facilitating IP commercialization, such as NFTs. We examine this historical evolution in the context of legal institutions governing intellectual property transactions and technology transfer.

Purpose: Cryptocurrency technology has improved fast in the social economy and growth. Because cryptocurrency has many good qualities, it is initially employed for Bitcoin transactions.

Methodology: With the advent of Bitcoin, the link between distributed ledger technology (DLT) and the banking market has become stronger and more integrated. As more banking institutions understood the relevance of DLT, they began experimenting with using it in financial activities, such as R3CEV, Hyperledger, and Qiwi.

Findings: Many commercial organisations are beginning to experiment with DLT to reduce transactional costs and boost operational effectiveness, particularly in financial notes, cross-border payments, and asset-backed financing.

Practical Implications: DLT has many potential applications in banking domains in the upcoming years.