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1 – 10 of over 4000Antti Peltokorpi, Juri Matinheikki, Jere Lehtinen and Risto Rajala
To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency…
Abstract
Purpose
To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.
Design/methodology/approach
A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.
Findings
Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.
Research limitations/implications
Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.
Practical implications
Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.
Social implications
For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.
Originality/value
This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.
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Debbie Isobel Keeling, Michael Rigby, Ko de Ruyter, Liliana L. Bove and Philip Stern
Orlando Troisi, Anna Visvizi and Mara Grimaldi
Digitalization accelerates the need of tourism and hospitality ecosystems to reframe business models in line with a data-driven orientation that can foster value creation and…
Abstract
Purpose
Digitalization accelerates the need of tourism and hospitality ecosystems to reframe business models in line with a data-driven orientation that can foster value creation and innovation. Since the question of data-driven business models (DDBMs) in hospitality remains underexplored, this paper aims at (1) revealing the key dimensions of the data-driven redefinition of business models in smart hospitality ecosystems and (2) conceptualizing the key drivers underlying the emergence of innovation in these ecosystems.
Design/methodology/approach
The empirical research is based on semi-structured interviews collected from a sample of hospitality managers, employed in three different accommodation services, i.e. hotels, bed and breakfast (B&Bs) and guesthouses, to explore data-driven strategies and practices employed on site.
Findings
The findings allow to devise a conceptual framework that classifies the enabling dimensions of DDBMs in smart hospitality ecosystems. Here, the centrality of strategy conducive to the development of data-driven innovation is stressed.
Research limitations/implications
The study thus developed a conceptual framework that will serve as a tool to examine the impact of digitalization in other service industries. This study will also be useful for small and medium-sized enterprises (SMEs) managers, who seek to understand the possibilities data-driven management strategies offer in view of stimulating innovation in the managers' companies.
Originality/value
The paper reinterprets value creation practices in business models through the lens of data-driven approaches. In this way, this paper offers a new (conceptual and empirical) perspective to investigate how the hospitality sector at large can use the massive amounts of data available to foster innovation in the sector.
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Alejandro Godino and Oscar Molina
The paper aims to analyze collective bargaining in the facility management business of these six countries to explore similarities and differences between them. The analysis…
Abstract
Purpose
The paper aims to analyze collective bargaining in the facility management business of these six countries to explore similarities and differences between them. The analysis serves to test the differential impact of the national institutional setting on the protection provided by collective agreements to facility management workers.
Design/methodology/approach
The paper adopts a case study methodology to approach a facility management multinational company providing services in six European countries (France, Italy, The Netherlands, Poland, Spain and the UK) that represent different industrial relations systems with variance in key dimensions of collective bargaining, including its structure, coverage and extension of agreements.
Findings
The extension of the facility management business model has not always adopted a high-road strategy aimed at enhancing the quality and efficiency through the integrated management and delivery of services, which is expected to positively impact employment conditions. Rather, it has, in many cases, been a deliberate, low-road attempt to undercut working standards, taking advantage of the multiple services provided by the company in a context of growing de-centralization in collective bargaining. The results point to an important role of industrial relations institutions in shaping facility management strategies and outcomes.
Originality/value
Similar to other forms of outsourcing, facility management leads to fragmented employment relations. However, the concentration of outsourced workers under the same supplier organization introduces opportunities to ensure the protection of workers, depending on the adoption of a high- or low-road competitive strategy. This paper provides for the first time comparative evidence about industrial relations in facility management businesses, a largely under-researched area.
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John Olsson, Daniel Hellström and Yulia Vakulenko
The success of last-mile delivery is dependent on consumer acceptance of such services, yet little is known about unattended delivery experience. This paper's purpose is to…
Abstract
Purpose
The success of last-mile delivery is dependent on consumer acceptance of such services, yet little is known about unattended delivery experience. This paper's purpose is to provide empirically based understanding of customer experience dimensions in unattended home delivery.
Design/methodology/approach
Using an engaged scholarship approach, this field study investigated nine households that actively used an unattended delivery service for a period of six to nine months. Empirical data were collected primarily from in-depth interviews.
Findings
The study demonstrates that unattended delivery experience is a multidimensional construct that comprises consumers' cognitive, emotional, behavioral, sensorial, physical and social responses to the service. The empirical evidence provides rich descriptions of each customer experience dimension, and the research offers a framework and propositions on unattended delivery experience.
Practical implications
The results guide and support managers in assessing and developing delivery services using a consumer-centric approach to enhance customer experience.
Originality/value
This research is one of the first to address unattended delivery experience by providing a comprehensive, empirically grounded framework. The results provide a foundation for future investigations of last-mile delivery experience dimensions.
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The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This…
Abstract
Purpose
The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This paper describes a three-year service journey of an elderly person from home to a nursing home through home care, specialized hospital and inpatient care. The aim of this viewpoint paper is to consider how customer orientation and integration are realized when an older lady living an active life becomes seriously ill and loses the ability to conduct daily functions.
Design/methodology/approach
The service path will be described from the perspective of a relative.
Findings
The paper raises questions related to governance as well as multidisciplinary and customer orientation in integrated care.
Originality/value
The paper discusses a real-life experience of an elderly care journey from active senior life to a nursing home in Finland. When making visible an elderly care journey, this gives real-life information about the challenges and the needs for development. Better practical understanding helps to remove inter-organizational barriers toward more integrated and patient safe care.
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Therese Dwyer Løken, Marit Kristine Helgesen, Halvard Vike and Catharina Bjørkquist
New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service…
Abstract
Purpose
New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service integration. Integration of municipal services is important for people with complex health and social challenges, such as concurrent substance abuse and mental health problems. This article explores the conditions for service integration in municipal health and social services by studying how public management values influence organizational and financial structures and professional practices.
Design/methodology/approach
This is a case study with three Norwegian municipalities as case organizations. The study draws on observations of interprofessional and interagency meetings and in-depth interviews with professionals and managers. The empirical field is municipal services for people with concurrent substance abuse and mental health challenges. The data were analyzed both inductively and deductively.
Findings
The study reveals that opportunities to assess, allocate and deliver integrated services were limited due to organizational and financial structures as the most important aim was to meet the financial goals. The authors also find that economic and frugal values in NPM doctrines impede service integration. Municipalities with integrative values in organizational and financial structures and in professional approaches have greater opportunities to succeed in integrating services.
Originality/value
Applying a public management value perspective, this study finds that the values on which organizational and financial structures and professional practices are based are decisive in enabling and constraining service integration.
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Shane Dunlea, Geoff McCombe, John Broughan, Áine Carroll, Ronan Fawsitt, Joe Gallagher, Kyle Melin and Walter Cullen
Throughout the world, healthcare policy has committed to delivering integrated models of care. The interface between primary–secondary care has been identified as a particularly…
Abstract
Purpose
Throughout the world, healthcare policy has committed to delivering integrated models of care. The interface between primary–secondary care has been identified as a particularly challenging area in this regard. To that end, this study aimed to examine the issue of integrated care from general practitioners’ (GPs) perspectives in Ireland.
Design/methodology/approach
This multimethod study involved a cross-sectional survey and semi-structured interviews with GPs in the Ireland East region. A total of 1,274 GPs were identified from publicly available data as practising in the region, of whom the study team were able to identify 430 GPs with email addresses. An email invite was sent to 430 potential participants asking them to complete a 34-item online questionnaire and, for those who were willing, an in-depth interview was conducted with a member of the study team.
Findings
In total, 116 GPs completed the survey. Most GPs felt that enhancing integration between primary and secondary care in Ireland was a priority (n = 109, 93.9%). Five themes concerning the state of integrated care and initiatives to improve matters were identified from semi-structured interviews with 12 GPs.
Originality/value
The uniqueness of this study is that it uses a multimethod approach to provide insight into current GP views on the state of integrated care in Ireland, as well as their perspectives on how to improve integration within the Irish healthcare system.
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Corey Burke, John Broughan, Geoff McCombe, Ronan Fawsitt, Áine Carroll and Walter Cullen
“Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC…
Abstract
Purpose
“Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC literature, whilst valuable, has become extensive and wide-ranging to such a degree that knowing what is most important in IC is a challenge. This study aims to address this issue.
Design/methodology/approach
A scoping review was conducted using Arksey and O'Malley's framework to determine IC priority areas.
Findings
Twenty-one papers relevant to the research question were identified. These included studies from many geographical regions, encompassing several study designs and a range of populations and sample sizes. The findings identified four priority areas that should be considered when designing and implementing IC models: (1) communication, (2) coordination, collaboration and cooperation (CCC), (3) responsibility and accountability and (4) a population approach. Multiple elements were identified within these priorities, all of which are important to ensuring successful and sustained integration of care. These included education, efficiency, patient centredness, safety, trust and time.
Originality/value
The study's findings bring clarity and definition to what has become an increasingly extensive and wide-ranging body of work on the topic of IC. Future research should evaluate the implementation of these priorities in care settings.
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