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Amongst the alternate property sectors, healthcare property has recently become an important property sector for major investors such as pension funds in the global property landscape; particularly in the UK, and being driven by the ageing population demographics. The purpose of this paper is to assess the significance, risk-adjusted performance and portfolio diversification benefits of UK healthcare property in a UK property and mixed-asset portfolio over 2007–2016. Both healthcare property and listed healthcare property channels are assessed. Drivers and risk factors for the on-going development of the healthcare property sector are also identified.

Using annual total returns, the risk-adjusted performance and portfolio diversification benefits of UK healthcare property over 2007–2016 is assessed. An asset allocation diagram is used to assess the role of both healthcare property channels in a UK property portfolio and in a UK mixed-asset portfolio.

Both UK healthcare property and listed healthcare property delivered superior risk-adjusted returns compared to UK property, stocks and listed property over 2007–2016, with portfolio diversification benefits in the fuller mixed-asset portfolio context, but not in a narrower property portfolio context. Importantly, this sees both UK healthcare property channels as strongly contributing to the UK 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 not to the loss or substitution of traditional direct property exposure.

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of both healthcare property channels in a UK property portfolio and in a UK mixed-asset portfolio. The strong risk-adjusted performance of both UK healthcare property compared to UK property, stocks and listed property sees both UK healthcare property channels contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. This is particularly important, as many investors (e.g. pension funds) now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries. The importance of both healthcare property channels sees healthcare property exposure accessible to both small investors and large investors.

This paper is the first published empirical research analysis of the risk-adjusted performance of UK healthcare property, and the role of healthcare property in a UK property portfolio and in a UK mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of both healthcare property and listed healthcare property in a portfolio.

As the prolonged effect of the COVID-19 pandemic has materially impacted investment returns significantly, it is more crucial than ever for institutional investors to redefine their property portfolios using assets with better investment management potential and meaningful diversification benefits. The “alternative asset revolution” is gaining traction in the property investment space internationally among institutional investors due to the shifting investment attitudes towards the alternative property sectors. Australia's $205bn healthcare property sector is at the forefront of this revolution due to its societal significance, as well as its attractive investment qualities. This paper investigates the institutional investor management of the Australian healthcare property sector via both the direct and listed channels and empirically analyses its investment attributes.

Using the unique Morgan Stanley Capital International/Property Council of Australia quarterly data set for Australian direct healthcare property over 2006–2020, the risk-adjusted performance and portfolio diversification potential direct healthcare property and listed healthcare were assessed. A constrained mean-variance portfolio optimisation framework was used to develop a six-asset portfolio scenario to analyse the portfolio added-value benefits of both direct healthcare property and listed healthcare in a mixed-asset investment strategy. A similar set of analysis was performed using the post-global financial crisis (GFC) quarterly time series of 2009–2020 to investigate the healthcare asset class' performance dynamics in the post-GFC investment timeframe.

The results indicate that direct healthcare property and listed healthcare offer two key advantages for institutional investors in managing their property portfolios: (1) a stable yet superior risk-adjusted performance and (2) significant portfolio diversification potential in managing their property portfolios. Importantly, both direct healthcare property and listed healthcare provided valuable contributions in strengthening an investment portfolio's performance. The post-GFC sub-period analysis revealed a consistent conclusion regarding the healthcare asset class's performance attributes.

This is the first research that provides an independent empirical examination of the strategic importance of Australian healthcare property as a maturing alternative property sector that can serve both investment and environmental, social and governance goals of investors. This research presents a positive investment prognosis for the Australian healthcare property sector to achieve its institutionalised status as a mainstream asset class of the future.

Population ageing is fast becoming a major social concern across the globe. This ageing trend unavoidably fuels elders’ demand for healthcare services. As the main users of health care service, whether the healthcare is geographically approachable in local areas is more imperative to senior residents with restricted mobility. This paper proposes to examine the effect of elders’ healthcare accessibility on property prices of Taipei Metropolis, Taiwan.

Luo and Qi’s (2009) enhanced two-step floating catchment area method – taking both healthcare demand and supply into account – was used to measure three types of healthcare services: “physician-to-elder ratio”, “hospital bed-to-elder ratio” and “ambulance-to-elder ratio”. Spatial quantile regression (SQR) model was then used to examine the spatial effect of healthcare accessibility on different property price ranges.

The “physician-to-elder ratio” and “hospital bed-to-elder ratio” demonstrated expected consistent positive effects across all quantiles of property prices (p < 0.01) in SQR, and its effects aggravated as the quantiles of property prices rose. The “ambulance-to-elder ratio” demonstrated a non-linear influence on property prices (i.e. a negative effect on lowest quantile prices but a positive on higher quantile prices) possibly due to the semi-obnoxious characteristic of the ambulance. That is, residents living in lower priced neighbourhoods may dislike ambulances’ annoying sound of sirens (i.e. ambulances’ disamenity), while residents living in higher valued neighbourhoods may on the contrary appreciate ambulances’ healthcare services (i.e. amenity).

These findings are expected to offer some insights for government’s policies in providing elders in their later years with good residential quality and easy access to healthcare resource.

This paper is one of the few studies that consider the capitalization of the spatial healthcare accessibility to elders into property prices. In this ageing trend across the globe, although all the accessibility to medical resources should be equally critical, the application of spatial quantile regression revealed residents’ inconsistent tendency against semi-obnoxious ambulances. It provides a different perspective in defining the importance of healthcare accessibility in neighbourhoods.

The purpose of this paper is to investigate a particular type of property market, that of funeral homes, of which little is known, despite the fact that it is an expanding market, reflecting a social and cultural change in Italy.

A qualitative analysis of the funeral property market was carried out. Information and data were collected from funeral companies, with reference to their market strategy, and from institutional investors, in order to gauge their knowledge of that specific sector and their willingness to invest in this specific property type. The instruments used were questionnaires, telephone interviews and on-site visits.

The results of this study suggest that Italian funeral companies identified a new property market, responding to the demands of a changing social context, especially in Northern Italy. Limited experience in the management of this asset and the lack of a clear and uniform legislative regulation at the national level appear to be among the main difficulties. From the investors’ point of view, the main problems in investing in this property were the lack of adequate knowledge in the sector and moral qualms about the specific type of assets.

The small sample restricts generalization beyond the companies that participated in the research. Furthermore, the research only focused on the private sector related to niche market strategy and property investments.

The paper could raise awareness of a specific and not well-known property market among the real estate operators.

The originality of the analysis lies in investigating a relevant phenomenon from the social point of view that has been little or not at all addressed from the point of view of real estate, particularly in Italy.

It is typical of public real estate benchmarking reports to show only highly aggregated benchmarks based on buildings’ floor areas. They hardly provide disaggregated benchmarks for usage clusters. The aim of this study is to show the caveats from highly aggregated benchmarking without consideration of cluster-specific characteristics.

Based on the parameters of the German facility management association 812 standards, cleaning costs and costs for the surfaces of seven hospitals have been collected and allocated to specific room clusters. Using these basic data, a calculation and simulation conducted with the aim of simulating facilities that are comparable in the sum of costs yet feature varying sub-clusters as cost drivers. In particular, during this simulation, area ratios were varied randomly and the average cleaning costs per cluster were held constant for all hospitals. Therefore, the costs per square meter in the clusters of all simulated hospitals are identical and the full costs only depend on the area ratios.

The simulation shows that highly aggregated cleaning costs lead to large spans, and thus, to misinterpretations in the field of action. In the case, the aggregate benchmark ranges from 40.6 to 66.5 EUR/m², although, for all hospitals the same costs per square meter had been used. Thus, the bias results only from varying the share of area across the clusters. This finding is caused by a well-known statistical problem: the Simpson’s paradoxon, which currently receives little attention in real estate benchmarking.

The results show, that the regular benchmarking with high aggregated data, often used in practice, cannot be recommended. The author consider using a detailed benchmarking as meaningful and purposeful. To be able to make a detailed benchmarking, it is essential to identify and collect the influencing factors. Only if all important factors, in this case, the clusters will be regarded in the benchmarking, a reasonable benchmarking and useful interpretation can be given. Using a simple benchmarking to get a rough overview is refused steadfastly.

The study highlights that a comparison with public benchmarking reports (operation costs) must be taken with great caution. The author has quantified the bias from the aggregated benchmarking and have shown, that the Simpson’s paradox fully explains the consequences.

There are some 487,000 places in long-stay residential care and nursing homes in the UK representing an industry worth some £15.2 billion per annum. Creating leases with guaranteed rental uplifts, a property bond in all but name, now attracts significant investment into healthcare. This is argued to be unsustainable, as evidenced by the collapse of Southern Cross Healthcare. The purpose of this paper is to provide insight into institutional investment for sustainable healthcare provision.

It is carried out via a range of unstructured and semi-structured interviews with a purposive sample of a small elite of professionals involved at the summit of this investment market and analysis of secondary literature concerning the wider international property market regarding the way in which advisers and investors view the security and value of these new instruments.

It is found that the differentiation between rental growth and indexed rental uplifts reveal a misunderstanding of the nature of the investment vehicles currently being marketed.

The implication of the research, is that much modern private healthcare provision is financially unsustainable, as has begun to be recognised in recent government regulation and guidance.

This research provides new and original insight into institutional investment for sustainable healthcare provision

Interorganizational business process standards (IBPS) are IT-enabled process specifications that standardize, streamline, and improve business processes related to interorganizational relationships. There has been much interest in IBPS as organizations from different industries implement these process standards that lead to successful organizational outcomes by integrating and standardizing intra- and inter-organizational business processes. These process standards enable data analytics capabilities by facilitating new sources of interorganizational process data. The purpose of this paper is to unearth employees’ reactions to a new type of supply chain process innovations that involved an implementation of new IBPS, a supply chain management (SCM) system, and associated analytics capabilities.

The authors gathered and analyzed qualitative data for a year from the employees of a healthcare supplier, a high-tech manufacturing organization, during the implementation of a SCM system and RosettaNet-based IBPS.

In what the authors termed the initiation stage, there was quite a bit of confusion and unrest among employees regarding the relevance of the new process standards and associated analytics capabilities. With the passage of time, in the institutionalization stage, although the situation improved slightly, employees found workarounds that allowed them to appropriate just part of specific processes and the analytics capabilities. Finally, once routinized, employees felt comfortable in the situation but still did not appropriate the new supply chain processes faithfully. Overall, employees’ reactions toward the SCM system and associated analytics capabilities were different from their reactions toward the new business processes.

The paper contributes to the literature by offering novel insights on how employees react to and appropriate process innovations that change their work processes.

This paper aims to increase understanding on how co-locating in a multi-firm campus setting could be of value to healthcare organizations.

The paper presents a qualitative case study of two health campuses in Finland. The data comprises interviews with different organizations operating on the campuses, complemented by onsite observations, and analysis of archival data.

Based on the empirical analysis, the value of co-locating as perceived by the organizations operating on campus is grouped into four categories: connectivity, cost-efficiency, community and collaboration (or the “four Cs”).

The study does not aim at statistical genaralizability but rather seeks to draw analytical generalizations based on identified empirical regularities. The developed value framework, the four Cs, contributes to current scholarly knowledge on location strategies.

Furthermore, the managerial implications of the four Cs entail a new twofold role for property management: the traditional facilitator role, which is suitable for delivering the two tangible values of connectivity and cost-efficiency, and the modern era integrator, a community builder that is able to deliver community and collaboration.

Previous literature on healthcare facilities has focused on the technical performance of the buildings, while previous literature on the collaborative value of co-location has studied mainly single-firm corporate campuses. This study uniquely explores the potential value of health campuses, where different private, public and third sector organizations co-locate.

The aim of this paper is to evaluate the use of blockchain for identity management (IdM) in the context of the Internet of things (IoT) while focusing on privacy-preserving approaches and its applications to healthcare scenarios.

The paper describes the most relevant IdM systems focusing on privacy preserving with or without blockchain and evaluates them against ten selected features grouped into three categories: privacy, usability and IoT. Then, it is important to analyze whether blockchain should be used in all scenarios, according to the importance of each feature for different use cases.

Based on analysis of existing systems, Sovrin is the IdM system that covers more features and is based on blockchain. For each of the evaluated use cases, Sovrin and UniquID were the chosen systems.

This paper opens new lines of research for IdM systems in IoT, including challenges related to device identity definition, privacy preserving and new security mechanisms.

This paper contributes to the ongoing research in IdM systems for IoT. The adequacy of blockchain is not only analyzed considering the technology; instead the authors analyze its application to real environments considering the required features for each use case.

Background: The ageing population is generating increasing concern over the occurrence and associated costs of falls in healthcare settings. Supplementary to the investigation of strategies to prevent falls, is the consideration of ways to reduce the number of injuries resulting from falls in these settings.Aims: This overview assesses the status of research on flooring in healthcare settings to reduce the incidence of injury resulting from falls.Methods: A comprehensive literature search, carried out in conjunction with a Cochrane Systematic Review on hospital environments for patient health‐related outcomes, identified the available evidence. Searches were also conducted in Medline and Scopus specifically to identify studies on flooring types, falls, and injuries. Reference lists of relevant studies and reviews were scanned and relevant authors were approached for further information.Conclusions: Flooring should be considered as a possible intervention for reducing injuries from falls, however, more rigorous and higher quality research is needed to identify the most appropriate materials for use.