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The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to elucidate the challenges of vertical policy coordination between non-political actors at the national and regional levels regarding this policy issue, using Sweden as our case.

Interviews with key actors at the national and regional levels were analyzed using an adapted version of a conceptualization by Adam et al. (2019), depicting barriers to vertical policy coordination.

Our results show that the main issues in the Swedish context were related to parallel sovereignty and a vagueness regarding responsibilities and mandates as well as complex governmental structures and that this was exacerbated by the unfamiliarity and uncertainty of the policy issue. We conclude that understanding the interaction between the comprehensiveness and complexity of the policy issue and the institutional context is crucial to achieving effective vertical policy coordination.

Many studies have focused on countries’ overall pandemic responses, but in order to improve the outcome of future pandemics, it is also important to learn from more specific response measures.

Payments to healthcare providers create incentives that can influence provider behaviour. Research on unit-level incentives in primary care is, however, scarce. This paper examines how managers and salaried physicians at Swedish primary healthcare centres perceive that payment incentives directed towards the healthcare centre affect their work.

An interview study was conducted with 24 respondents at 13 primary healthcare centres in two cities, located in regions with different payment systems. One had a mixed system comprised of fee-for-service and risk-adjusted capitation payments, and the other a mainly risk-adjusted capitation system.

Findings suggested that both managers and salaried physicians were aware of and adapted to unit-level payment incentives, albeit the latter sometimes to a lesser extent. Respondents perceived fee-for-service payments to stimulate production of shorter visits, up-coding of visits and skimming of healthier patients. Results also suggested that differentiated rates for patient visits affected horizontal prioritisations between physician and nurse visits. Respondents perceived that risk-adjustments for diagnoses led to a focus on registering diagnosis codes, and to some extent, also up-coding of secondary diagnoses.

Policymakers and responsible authorities need to design payment systems carefully, balancing different incentives and considering how and from where data used to calculate payments are retrieved, not relying too heavily on data supplied by providers.

This study contributes evidence on unit-level payment incentives in primary care, a scarcely researched topic, especially using qualitative methods.

The purpose of this paper was to study the unfolding of an urgent and extensive decommissioning program in Sweden, focusing on the public’s reactions and their arguments when opposing the decommissioning activities.

The public’s responses were studied through local media. Its content was surveyed and divided into actions and arguments. The arguments were further analyzed and categorized into inductively developed themes.

Protest activities, such as demonstrations, meetings and petitions, were not coordinated, but mostly carried out for withdrawals of unique services and services in remote areas. The public questioned the decision makers’ information, calculations and competence, the adequacy of the consequence analyses and whether the decommissioning activities would lead to any real savings. Patient and public safety, the vulnerable in society, and effects on the local areas were important topics. Thus, it seems the decision makers did not fully succeed in communicating the demonstrable benefits or create clarity of the rationales for decommissioning the particular services. Furthermore, it seems the public has a more inclusive approach to health services and their value compared to decision makers that need to keep the budget.

Decommissioning is an emerging field of research, and this study of the unfolding of an urgent and extensive decommissioning program contributes with evidence that may improve decommissioning policy and practice. The study illustrates that it may be possible to implement a decommissioning program despite public protest, but that the longer-term effects on the health system’s legitimacy need to be studied.

Labour came to power in 1997 and immediately transferred many features of its party political news management style into government, overseeing the departure of most of the civil service communications leadership within two years, and developing the media management role of politically appointed special advisers. The purpose of this paper is to empirically examine the changes in custom and practice that operated behind the scenes in government communications between 1997 and 2015, asking to what extent such changes challenge public trust in government in a liberal democracy.

This study takes a longitudinal, qualitative approach through in-depth interviews with former civil servants, journalists and special advisers, together with documentary and archival evidence. The data were analysed thematically through the text-processing software, NVivo.

The paper finds that although the controversy over the 2002 dossier on Iraq’s Weapons of Mass Destruction was an extraordinary episode, the creative approach to news management that characterised this case still operates within UK Government communications: the bypassing of civil servants, a partial approach to the facts, selective briefing of favoured journalists, a lack of due process in the management of information and a disregard for the letter and spirit of propriety codes. This has implications for public trust and confidence in the workings of liberal democracy.

The study adopts a mediatisation approach to the study of public relations, using the concept of the “cross field” to demonstrate how PR professionals share media management responsibilities with a number of different promotional actors. PR professionals in government must therefore navigate between the hidden, competitive and demanding worlds of politics, the media and bureaucracy, working with journalists, politicians and political operatives to craft the narratives that seek to drive public opinion.

The purpose of this paper is to analyze which key financial factors are appropriate for measuring a credit rating score for family firms. In the recent literature, there exists a vast number of studies which evaluates performance differences between family and non-family firms (NFF). However an analysis with regards to a distinction between credit rating scores of family-orientated businesses compared to their counterparts in Austria has not been examined so far.

In order to bridge this research gap, an empirical model based on Moody’s credit rating methodology is used to address these issues. Therefore, the relevant data were taken from the 600 largest, both listed and non-listed, companies of Austria. The statistical measurements refer to a comparison of the means resulting from quantitative rating categories (profitability, leverage structure, liquidity development and firm size).

The results of this empirical research show that family firms achieve better values in profitability, leverage structure and liquidity development based on credit rating scores. Only firm size represents no significant differences between family and NFF.

This study will contribute to the existing literature in the academic area of family business research and offers a framework for future empirical analysis in this field. Furthermore, this paper provides important information that will help both family and NFF accomplish their financial strategies related to credit rating transitions.

The aim of this paper is to analyze and measure the effects of intellectual capital (IC), i.e. human capital (HC), relational capital (RC) and structural capital (SC), on healthcare industry organizational performance and understanding the role of data analytics and big data (BD) in healthcare value creation (Wang et al., 2018). Through the assessment of determined variables specific for each component of IC, the paper identifies the guidelines and suggests propositions for a more efficient response in terms of services provided to citizens and, specifically, patients, as well as predicting effective strategies to improve the care management efficiency in terms of cost reduction.

The study has a twofold approach: in the first part, the authors operated a systematic review of the academic literature aiming to enquire the relationship between IC, big data analytics (BDA) and healthcare system, which were also the descriptors employed. In the second part, the authors built an econometric model analyzed through panel data analysis, studying the relationship between IC, namely human, relational and structural capital indicators, and the performance of healthcare system in terms of performance. The study has been conducted on a sample of 28 European countries, notwithstanding the belonging to specific international or supranational bodies, between 2011 and 2016.

The paper proposes a data-driven model that presents new approach to IC assessment, extendable to other economic sectors beyond healthcare. It shows the existence of a positive impact (turning into a mathematical inverse relationship) of the human, relational and structural capital on the performance indicator, while the physical assets (i.e. the available beds in hospitals on total population) positively mediates the relationship, turning into a negative impact of non-IC related inputs on healthcare performance. The result is relevant in terms of managerial implications, enhancing the opportunity to highlight the crucial role of IC in the healthcare sector.

The relationship between IC indicators and performance could be employed in other sectors, disseminating new approaches in academic research. Through the establishment of a relationship between IC factors and performance, the authors implemented an approach in which healthcare organizations are active participants in their economic and social value creation. This challenges the views of knowledge sharing deeply held inside organizations by creating “new value” developed through a more collaborative and permeated approach in terms of knowledge spillovers. A limitation is given by a fragmented policymaking process which carries out different results in each country.

The analysis provides interesting implications on multiple perspectives. The novelty of the study provides interesting implications for managers, practitioners and governmental bodies. A more efficient healthcare system could provide better results in terms of cost minimization and reduction of hospitalization period. Moreover, dissemination of new scientific knowledge and drivers of specialization enhances best practices sharing in the healthcare sector. On the other hand, an improvement in preventive medicine practices could help in reducing the overload of demand for curative treatments, on the perspective of sharply decreasing the avoidable deaths rate and improving societal standards.

The authors provide a new holistic framework on the relationship between IC, BDA and organizational performance in healthcare organizations through a systematic review approach and an empirical panel analysis at a multinational level, which is quite a novelty regarding the healthcare. There is little research focussed on healthcare industries' organizational performance, and, specifically, most of the research on IC in healthcare delivered results in terms of theoretical contribution and qualitative analyzes. The authors even contributed to analyze the healthcare industry in the light of the possible existence of synergies and networks among countries.