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Service firms that successfully develop new methods for distributing their products will have a clear competitive advantage. This article provides a guide for firms exploring uncharted territory.

This study aims to develop a hierarchical model that uncovers the relationships between challenges confronting Africa's organ transplant supply chain systems.

Eleven challenges (variables) were identified after a comprehensive review of the existing literature. The contextual interactions among these variables were analysed from the perspectives of health-care stakeholders in two sub-Saharan Africa (SSA) countries (Nigeria and Uganda), using Delphi-interpretive structural modelling-cross-impact matrix multiplication applied to classification (MICMAC) techniques.

The findings reveal that weak regulatory frameworks, insufficient information systems and a lack of necessary skills make it challenging for critical actors to perform the tasks effectively. The interaction effects of these challenges weaken organ supply chains and make it less efficient, giving rise to negative externalities such as black markets for donated organs and organ tourism/trafficking.

This paper establishes a solid foundation for a critical topic that could significantly impact human health and life once the government or non-profit ecosystem matures. The MICMAC analysis in this paper provides a methodological approach for future studies wishing to further develop the organ supply chain structural models.

The study provides valuable insights for experts and policymakers on where to prioritise efforts in designing interventions to strengthen organ transplantation supply chains in developing countries.

This study is one of the first to empirically examine the challenges of organ transplant supply chains from an SSA perspective, including theoretically grounded explanations from data collected in two developing countries.

Organ donation and transplantation services represent a microcosm of modern healthcare organisations. They are complex adaptive systems. They face perpetual problems of matching supply and demand. They operate under fierce time and resource constraints. And yet they have received relatively little attention from a systems perspective. The purpose of this paper is to consider some of the fundamental issues in evaluating, improving and policy reform in such complex systems.

The paper advocates an approach based on programme theory evaluation.

The paper explains how the death to donation to transplantation process depends on the accumulation of series of embedded, institutional sub-processes. Evaluators need to be concerned with this whole system rather than with its discrete parts or sectors. Policy makers may expect disappointment if they seek to improve donation rates by applying nudges or administrative reforms at a single point in the implementation chain.

These services represent concentrated, perfect storms of complexity and the paper offers guidance to practitioners with bio-medical backgrounds on how such services might be evaluated and improved. For the methodological audience the paper caters for the burgeoning interest in programme theory evaluation while illustrating the design phase of this research strategy.

Hematopoietic stem cell transplant (HSCT) patients can suffer from long-term transplant-related complications that affect their quality of life and daily activities. This study, a narrative review, aims to report the impact of HCT complications, the benefits of rehabilitation intervention, the need for long-term care and highlights the research gap in clinical trials involving rehabilitation.

A comprehensive search strategy was performed on several databases to look for relevant articles published from 1998 to 2018. Articles published in English with the following terms were used: hematopoietic stem cell transplant, chronic graft-versus-host disease, rehabilitation, exercise, physical therapy, occupational therapy. A patient/population, intervention, comparison, and outcomes (PICO) framework was employed to ensure that the search strategies were structured and precise. Study year, design, outcome, intervention, sample demographics, setting and study results were extracted.

Of the 1,411 records identified, 51 studies underwent title/abstract screening for appropriateness, 30 were reviewed in full, and 19 studies were included in the review. The review found that, for the majority of patients who underwent HSCT and developed treatment-related complications, rehabilitation exercises had a positive impact on their overall quality of life. However, exercise prescription in this patient group has not always reflected the scientific approach; there is a lack of high-quality clinical trials in general. The review also highlights the need to educate healthcare policymakers and insurance companies responsible for rationing services to recognise the importance of offering long-term follow-up care for this patient group, including rehabilitation services.

A large number of HSCT patients require long-term follow-up from a multidisciplinary team, including rehabilitation specialists. It is important for healthcare policymakers and insurance companies to recognise this need and take the necessary steps to ensure that HSCT patients receive adequate long-term care. This paper also highlights the urgent need for high-quality rehabilitation trials to demonstrate the feasibility and importance of rehabilitation teams.

Healthcare policymakers and insurance companies need to recognise that transplant patients need ongoing physiotherapy for early identification of any functional impairments and appropriate timely intervention.

The debate over whether or not to allow the sale of human organs is compelling enough to warrant discussion. A literature review revealed much ethical discussion, but little discussion was found on economic outcomes related to donors and selling human organs. It was demonstrated in the literature how an increased organ supply will benefit recipients. If allowing the sale of organs is the way to increase the organ supply for the benefit of recipients, then, in order to demonstrate that donors will not be exploited, it must be demonstrated how, and if, such sales would benefit those donors. This study explores whether or not one should sell human organs. Using basic models, this study develops economic scenarios and outcomes related to the selling of human organs with particular focus on pricing and profitability in relation to donor benefit. Theoretical outcomes show that the donor will not benefit in the long run.

Tissue engineering (TE) offers treatments for chronic, life threatening, degenerative illnesses and possibilities for restoring cellular or organ functions that have been lost due to injuries or hereditary conditions. However, a prerequisite for the use of TE products as part of future therapies is the development of strategies for safe and efficient supply chain management and versatile services spanning from product development to a follow‐up period of possibly decades. The present study aims to explore the future needs for services and extended supply chains for safe delivery of health care, procurement, distribution and long‐term follow‐up of TE products and therapies.

Studies in operational disciplines and coordination systems for different types of supply chains and service networks are used to formulate a framework for developing services throughout product lifecycle. Case examples of TE products are presented to demonstrate complexity, microbial risks, services and long‐term follow‐up. The role of logistics and the necessary services are identified for products classified into experimental, therapy and standard products.

The paper finds that, through the stages, the importance of logistics increases from an enabler to becoming a strategic tool, emphasizing logistics requirements in establishing a viable TE supply chain. New dimensions to existing service operations frameworks are needed where proactive tissue sourcing, long follow‐up periods, short shelf life and biological risks call for enforcing flexible services with tissue banks, detailed tracing, authorization and regulation.

The paper presents the discovery of the logistics services and service institutions that will become imperatives for the future success of TE products and therapies.

This study aims to understand whether and how the use of performance measures in the context of healthcare organizations facilitates the dynamics of compromise or whether it creates moral struggles among a wide variety of actors. It offers novel insights into the concept of hybridity by investigating its underlying moral dimension. Drawing upon the sociology of worth theory (Boltanski and Thévenot, 1991, 2006), this paper examines how actors negotiate and compromise over time concerning issues of justice, involving the use of performance measures on a day-to-day basis.

The article presents a single case study of a medical unit in a French public hospital. Data were obtained through the ethnographic method, semi-structured interviews and internal financial and accounting documents.

Unlike earlier accounting studies, the authors analyze whether, and how, accounting, on one hand, contributes to the dynamics of compromise between actors with divergent values that characterize hybrid organizations, and, on the other hand, increases tensions among actors with convergent values involved in caregiving. This offers practical insights into three relational mechanisms underlying the dynamics of compromise and their limits through the time dimension.

The authors use a single case study in a country-specific context.

This study helps managers of healthcare organizations to understand the relationships between the use of performance measures and their impact on the evaluation of worth in practice.

In terms of theoretical contribution, the authors show how the sociology of worth (Boltanski and Thévenot, 1991, 2006) complements the analysis of hybridity and develop an original approach to understanding the ambivalent role of performance measures in bringing together divergent values within French public hospitals.

There is a significant body of literature explaining how a free market for kidneys would eliminate both the economic and the medical shortage of kidneys and thus, in addition to supplying sufficient kidneys for those who become needy in the future, remove the entire backlog of 40,000+ patients waiting for a kidney transplant in the United States. This article is an attempt to fathom the financial and market processes that would evolve were a free market for kidneys to be permitted. Issues addressed include the types of institutions that would likely develop, how transactions would be facilitated, and what would happen to the price of kidneys both in the short and long term.

The purpose of this paper is to explore the demand-side factors that influence the inbound medical tourists’ (MTs) decision to travel abroad for medical treatment/surgery.

The researchers conducted thematic analysis of in-depth interviews in India with 24 foreign MTs’ to generate the themes, identify factors and propose a model with hypothesis for future quantitative survey.

The findings conclude that patients ranked in ascending order less waiting time for surgery, healthcare quality and accreditation, staff/surgeons expertise, healthcare information, hospital facilities and services, patient safety, travel risk, surgical costs and holiday opportunity as important factors that influence the decision to travel abroad for medical treatment/surgery.

Foreign patients from six private hospitals were willing to be interviewed with the permission of the hospital. Due to confidentiality and privacy policy, many hospitals declined interviews with foreign patients.

The findings are generalised in case of foreign patients as MTs and all private hospitals treating foreign patients in India and other global healthcare destinations. Policy implications suggest that private hospitals in developing countries need to provide first-class quality of healthcare as foreign patients look for internationally accredited quality, no waiting time, patient safety, qualified and experienced surgeons, healthcare workers education and experience hospital facilities and post-surgery care with positive healthcare outcomes.

There is little empirical research on the views of inbound MTs, about factors influencing their decision to travel abroad for surgery to India.