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This study aims to determine the barriers hindering the incorporation of blockchain technology (BCT) in two key service industries – hotel and health care – as well as to assess their readiness for implementing BCT after overcoming the barriers.

The barriers of this study are determined through two phases: a review of prior literature and obtaining expert opinions, which are then analyzed to identify specific barriers that are impeding the incorporation of BCT. Moreover, to generate a blockchain implementation reluctance index (BIRI), this study presents an interval-valued intuitionistic fuzzy set (IVIFS) that uses graph theory and matrix approach (GTMA). The permanent function in the GTMA approach is computed using the PERMAN algorithm. Finally, to compare the readiness of the hotel and health-care industries to adopt BCT, the BIRI values are plotted and evaluated.

The barriers identified by this study are listed under five major headings, namely, financial, operational, behavioral, technical and legal. This study revealed that the operational and technical barriers of BCT are critically hindering its widespread integration in hotel and health-care industries. Furthermore, on comparing the BIRI values of both industries, the result suggested that the hotel industry needs to work more on these barriers to effectively incorporate BCT. Besides the comparison, the BIRI values clearly indicate that both industries have to put a lot of effort into the mitigation of the barriers found by this study to successfully integrate BCT.

The experts’ opinions are used to evaluate the identified barriers, which raises the chance that the opinions are prejudiced based on the experts’ perspectives and ideologies. The sensitivity of decision-maker loads toward preference outcomes is not analyzed in this manuscript. Therefore, any recent sensitivity analysis may be considered a prospective field for future research. This study applies a multicriteria decision-making (MCDM) approach, IVIFS–GTMA, which limits the evaluation of the influence caused by individual barriers on the integration of BCT in the hotel and health-care industries. Henceforth, in future investigations, alternative MCDM methods may be used to analyze individual barriers.

According to the findings, if the hotel or health-care industry aims to incorporate BCT in its supply chain operations, it is recommended to emphasize more on the operational barriers along with the technical and behavioral barriers. The barriers mentioned in this manuscript can be used as guidance for developers in their development activities, such as scalability concerns, establishment costs, the 51% attack and the inefficient nature of BCT. Furthermore, they may address the potential users’ negative perceptions about security, privacy, trust and risk avoidance through creatively developed blockchain solutions to promote BCT implementation.

To the best of the author’s knowledge, this is the first study that identifies barriers toward BCT incorporation in the major service industries, i.e. hotel and health care. Moreover, this is the first study that compares the preparedness of the hotel and health-care industries to determine the industry that requires more work to implement BCT.

The purpose of this paper is to investigate the absolute and risk-adjusted stock return performance of the US health care industry conditional upon the presidential administration’s political party and the Federal Reserve’s monetary policy stance. It evaluates this return behavior across the 60-year time period from 1954 to 2013, and sub-divides this entire period into the pre-Medicare period (1954-1964), Medicare period (1965-1984), and Medicare-plus-high-health-care-inflation period (1985-2013).

The study uses monthly returns to the health care industry and overall market, characterizing each sample month as either having a Republican or Democratic president and either a contractionary or expansionary monetary policy regime determined by whether the Federal Reserve is increasing or decreasing interest rates, respectively. It incorporates univariate and multivariate analysis to quantify the return behavior of both the health care industry and the overall market during the entire period and all three sub-periods. Additionally, it utilizes a common four-factor multivariate regression model and associated hypothesis testing to characterize risk-adjusted excess returns (i.e. α) to the health care industry during the entire period and all three sub-periods.

The health care industry has earned robust, positive risk-adjusted returns with the magnitude of the returns sensitive to the political party of the administration and the monetary policy regime. The authors find that prior to 1965 (1954-1964), when the president was a Republican, during times of monetary contraction, health care earned an excess risk-adjusted return. There was no association between Democratic administrations and excess health care returns prior to 1965. In contrast, the authors find that after 1965 this relationship changes. The authors find that returns to health care were positive for Republicans during times of monetary expansion and positive for Democrats during monetary contraction. The authors also find this relationship has become more pronounced after 1984.

The study extends prior literature, which has shown that the health care industry is a priced factor in the US stock market and that it provides significant risk-adjusted returns in the recent past. Uniquely, this study shows that the excess returns to health care vary considerably over the past 60 years, and that these excess returns are quite sensitive to political policy, proxied by the presidential administration party, and monetary policy, as measured using Fed discount rate changes. These findings have implications for management and shareholders of highly regulated and subsidized industries and firms.

The purpose of this paper, on Portugal, is to determine the economic effects of public and private capital spending on health.

The authors use a vector autoregressive model to estimate the elasticities and marginal products of health care investments in Portugal on investment, employment and output.

Every €1m invested in health care yields significant positive spillover effects, boosting investment and GDP by €24.74 and €20.45m, respectively, creating 188 net jobs. Adversely, net exports deteriorate, as new capital goods are imported. While only 28.2 percent of the total accumulated increase in GDP occurs within a year, investment is front loaded with a corresponding 73.8 percent. Over this period, 68 workers are displaced for every €1m invested. At a disaggregated level, real estate, construction, and transportation and storage are industries where output shares increase the most. Employment shares increase the most in professional services, construction and basic metals.

This paper adds to the empirical literature, corroborating, for example, Rivera and Currais (1999a) and McDonald and Roberts (2002) in that health care spending can have a very significant effect on macroeconomic aggregates. In addition to the analysis of the tradable/non-tradable divide, it adds two further novelties by discussing industry-specific effects on economic performance and the distinction between effects on impact and those over the longer term.

As policy implications, health investments have very significant long-term economic performance effects, but are unhelpful counter cyclically. Also, they will change the industry mix: construction and professional services are the non-traded industries that will benefit the most, while the traded industries of non-metallic minerals, basic metals, and machinery and equipment benefit much less.

Given that capital spending on health boosts economic performance, especially in the long run, it ought to be a part of Portugal’s medium-to-long-term growth strategy. Also, if these projects depress economic activity in the short run, and are thus unhelpful counter cyclically, the timing of when they are launched matters. Furthermore, following a health investment, policies that boost net exports will be required to ensure trade balance.

The originality of this paper is to estimate, in a dynamic framework, the aggregate and industry-specific elasticities and marginal products on investment, employment and output, allowing the identification of effects both on impact and over the long term. Although health care investments are expected to have important macroeconomic effects, they need not be evenly distributed across industries.

The purpose of this study was to undertake a diagnostic investigation of the international health care logistical environment to determine if regulatory policies or industry procedures have hindered the implementation of just‐in‐time systems. The analysis was conducted in a systematic manner and compared the anticipated benefits with those validated in other industries from the implementation of just‐in‐time. The study also compared the health care industry environments of the USA, UK, and Germany with the manufacturing industry. The author focussed on answering: first, why has the health care industry not implemented just‐in‐time; second, is it feasible for a healthcare provider to implement a just‐in‐time logistical system; and third, what benefits will a health care provider achieve by implementing just‐in‐time. Concludes that controlling health care pricing requires reducing product cost or continues to place limits on product prices, quantities of services, or both. An alternative approach to controlling prices is to restructure the market for health services to encourage greater price competition among providers.

The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.

This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.

The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).

A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.

Industry 4.0, artificial intelligence and digitalization have got a momentum in health care. However, scholars and practitioners do not agree on their implications on health services' quality and effectiveness. The article aims at shedding light on the applications, aftermaths and drawbacks of industry 4.0 in health care, summarizing the state of the art.

A systematic literature review was undertaken. We arranged an ad hoc research design, which was tailored to the study purposes. Three citation databases were queried. We collected 1,194 scientific papers which were carefully considered for inclusion in this systematic literature review. After three rounds of analysis, 40 papers were taken into consideration.

Industry 4.0, artificial intelligence and digitalization are revolutionizing the design and the delivery of care. They are expected to enhance health services' quality and effectiveness, paving the way for more direct patient–provider relationships. In addition, they have been argued to allow a more appropriate use of available resources. There is a dark side of health care 4.0 involving both management and ethical issues.

Industry 4.0 in health care should not be conceived as a self-nourishing innovation; rather, it needs to be carefully steered at both the policy and management levels. On the one hand, comprehensive governance models are required to realize the full potential of health 4.0. On the other hand, the drawbacks of industry 4.0 should be timely recognized and thoroughly addressed.

The article contextualizes the state of the art of industry 4.0 in the health care context, providing some insights for further conceptual and empirical developments.

The primary purpose of this study is to undertake a diagnostic investigation of the international health care logistical environment and determine whether regulatory policies or industry procedures have hindered the implementation of just‐in‐time (JIT) systems and then to recommend operational improvements to be achieved by implementing JIT Systems.

The analysis was conducted in a systematic manner and compared the anticipated benefits with benefits validated in other industries from the implementation of JIT. An extensive literature review was conducted.

In this particular study the cost and benefit outcomes achieved from a health care JIT implementation were compared with those achieved by the manufacturing, service, and retail industries. Chiefly, it was found that the health service market must be restructured to encourage greater price competition among priorities. A new standardization process should eliminate duplication of products and realize substantial savings.

The analysis was conducted in a systematic manner and compared the anticipated benefits with benefits validated in other industries from the implementation of JIT.

In this paper, we argue that the opportunities created from the recent transformational change in the health care industry have provided the environment for entrepreneurship to thrive. As a result, new and innovative organizational forms have flourished particularly when embedded in communities of entrepreneurial activity where networks of experience, access, and social/work relationships exist. The major purpose of this paper is to initiate a theoretical dialogue in which entrepreneurship is introduced as a field of research that can be used to explain how and why health care organizations have emerged and changed into their present forms. First, we present the basic elements for understanding the process of entrepreneurship and how entrepreneurial activity is important to the innovation of new organizational forms. Second, we relate this to the field of health care by focusing on the three stages in the entrepreneurial model: creation, discovery, and exploitation of entrepreneurial opportunities. Third, we argue that the degree of entrepreneurial activity within a given community is the outcome of a dynamic process involving social networks along with positive economic and legal activities that reduce transaction costs and encourage entrepreneurship. To demonstrate this, we focus on the area known as the “health care business capital” in the U.S. – Nashville, Tennessee – and describe the entrepreneurial activity in that city beginning in the 1960s and relate this to the existing theory. We believe this research represents a juxtaposition of the practical and theoretical, so critical in understanding entrepreneurial activity and new organizational forms in health care.

Drawing on closed and open-ended interview data (n=79), this paper explores the health care experiences of a purposive sample of sex industry workers in a medium-sized metropolitan area of British Columbia, Canada. The respondents reported high average health care utilization and many reported satisfactory access to health care, including a positive relationship with a regular health provider. However, several respondents reported feeling intimidated and shamed in health care settings (felt stigma) and many choose to withhold information relevant to their health care due to fear of discrimination (enacted stigma) by health professionals.

The purpose of this paper is to explore how large, public companies in the health industry communicatively engage in employer branding on career homepages.

An exploratory content analysis of the career homepages (N = 42; 8,500) was conducted to analyze the communication of successful organizations in four realms of the public health-care industry to include Biotech (n =10), Managed Health Care (n = 8), Medical and Equipment Supplies (n = 12) and Pharmaceuticals (n = 12).

The analysis revealed the following ten major themes of content: Worldview, Stakeholders, Environment, Excellence, Dedication, Aid, Unity, Advancement, Distinctiveness and Industry/Organization. Additionally, the results revealed that health-care employer branding often communicated about Stakeholders, Industry/Organization and Advancement.

The results of this study aid researchers in understanding the foundational content of employee branding efforts in the health industry.

The results assist practitioners in understanding how different health-care industries and organizations engage in employer branding on career homepages.

The results of this study function to both confirm previous findings related to employer branding and extend research on employer branding into the career homepages of organizations in the health-care industry.