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The United States devotes a larger share of its GDP to health care and spends more on health care per capita than any other country. The sheer size of the total spending on health care, at approximately $3.5 trillion in 2017, puts significant pressure on all payers and crowds out other forms of public and private spending.

In this brief commentary the authors suggest that, as part of the effort to deal with this pressure, the United States should look at borrowing a cost containment strategy from other countries: the use of hard caps on spending growth. The authors draw on our their experience of working with decision-makers over the last 20 years on the topic of priority setting to put forward some ideas on whether there is potential for application of trade-offs in the United States.

As hard caps force choices to be made, a necessary condition for successful implementation of this policy is the presence of an effective priority-setting framework to ensure that the right choices are made in operationalizing spending limitations. Work on this topic elsewhere can provide some insight into the use of a criteria-based framework for priority setting that purports transparency in decision-making to achieve value-based decisions.

Other countries still have much work to do, but there is a substantial track record of using formal priority-setting approaches that could potentially inform practice in the United States. We suggest that there are key segments of the US healthcare system where the adoption of formal priority-setting frameworks to guide trade-off decisions is feasible. Piloting such activity in these contexts is the next natural step in this line of inquiry.

In order to create sustainable health systems, many countries are introducing ways to prioritise health services underpinned by a process of health technology assessment. While this approach requires technical judgements of clinical effectiveness and cost effectiveness, these are embedded in a wider set of social (societal) value judgements, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritisation and the resulting decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritisation process.

Through a multidisciplinary collaboration involving a series of international workshops, ethical and political theory (including accountability for reasonableness) have been applied to develop a practical way forward through the creation of a values framework. The authors have tested this framework in England and in New Zealand using a mixed-methods approach.

A social values framework that consists of content and process values has been developed and converted into an online decision-making audit tool.

The authors have developed an easy to use method to help stakeholders (including the public) to understand the need for prioritisation of health services and to encourage their involvement. It provides a pragmatic way of harmonising different perspectives aimed at maximising health experience.

All health care systems are facing increasing demands within finite resources. Although many countries are introducing ways to prioritise health services, the decisions often face legal, political, commercial and ethical challenge. The research will help health systems to respond to these challenges.

This study helps in increasing public involvement in complex health challenges.

No other groups have used this combination of approaches to address this issue.

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

How can joint open innovation (OI) projects between small and medium-sized enterprises (SMEs) and large companies (LCs) be effectively managed? This study aims to try to answer this research question with a focus on the critical success factors (CSFs) of such cooperation.

Based on 40 semi-structured interviews with Italian SMEs and LCs engaged in various industries, 20 open OI projects involving SMEs and LCs are investigated using a reflexive thematic analysis, a methodology involving both deductive and inductive approaches.

Fifteen CSFs grouped into seven categories emerge from the analysis of joint OI projects between SMEs and LCs. Among them, shared leadership, dynamic decision-making and priority setting emerge as essential elements at the basis of the proposed SMEs–LCs cooperation in joint OI projects that were not sufficiently addressed by prior studies.

To the best of the authors’ knowledge, this study is the first to provide an evidence-based framework for managing joint OI projects between SMEs and LCs. Relatedly, this study links the practices and most recurring CSFs that facilitate such cooperation.

This research priority setting partnership (PSP) aims to collaboratively identify the “top ten” research priorities relating to communication and swallowing for children and adults with learning disabilities, across the lifespan in the UK, using a modified James Lind Alliance approach.

A steering group and reference group were established to oversee the PSP. A survey of speech and language therapists (SLTs) resulted in 157 research suggestions. These were further developed into 95 research questions through a multi-stakeholder workshop. Questions were prioritised via an online card-sort activity completed by SLTs, health-care or education professionals and carers. Research questions were analysed thematically. Ten adults with learning disabilities were supported to assign ratings to themes reflecting their prioritisation. The top ten research priorities were identified by combining results from these activities.

The top ten research priorities related to intervention, outcome measurement and service delivery around communication and dysphagia.

To the best of the authors’ knowledge, this is the first UK-wide research PSP on learning disabilities and speech and language therapy across the lifespan. It uses a novel approach to incorporate the preferences of people with learning disabilities in the prioritisation.

This paper aims to estimate the determinants of the intensity of use of financial inclusion by households in Ghana.

Due to the reality of a household using one or more financial products or services, this study uses the generalised Poisson model applied to GLSS6 and GLSS7 data collected in 2012/2013 and 2016/2017 respectively, to estimate the determinants of the intensity of use of financial inclusion. To deepen the analysis, a multinomial probit model is also applied.

Results show that infrastructural variables such as roads, public transport and banks stimulate the intensity of financial inclusion. In addition, agricultural development characteristics such as markets and cooperatives are essential for the intensity of inclusion.

There is a need to incorporate how many services or depth of services that people use as part of the conceptualisation of financial inclusion, as this can provide more policy-relevant evidence to enhance priority setting in financial inclusion policies. Also, micro-level financial inclusion studies in agrarian economies should consider exploring agricultural development and infrastructure variables in the modelling framework. As lead to further studies, count models of financial inclusion should consider exploring cross-country analysis, the use of panel data, or other methodological approaches to provide more robust evidence.

Previous studies have not modelled financial inclusion based on a count model as a means of measuring intensity though conceptualisations highlight the fact that people use varied financial products or services. Following from this angle, to the best of the authors’ knowledge, this study provides the first attempt at analysing the underlying determinants of the number of financial products or services used by households.

The purpose of this paper is to investigate how a substantial organization gradually builds a management accounting system from scratch, changing its accounting routines by learning processes. The paper uses the experiential learning theory and the concept of learning style to investigate the learning process during management accounting change. The study aims to expand the domain of management accounting change theory to emphasize the learning-related aspects that can constitute it.

The paper provides an interpretation of management accounting change based on the model of problem management proposed by Kolb (1983) and the theory of experiential learning (Kolb, 1976, 1984). The study is based on a 14-year longitudinal case study (1994‐2007). The case examined can be considered a theory illustration case. Data were obtained from a broad variety of sources including interviews, document analysis and adopting an interventionist approach during the redesign of the costing system.

The paper contributes to two important aspects of management accounting change. First, it becomes apparent that the costing information change was not a discrete event but a process of experience and learning conducted through several iterations of trial-and-error loops that extended over the years. Second, the findings reveal that the learning process can alter management accounting system design in a radical or incremental way according to the learning style of the people involved in the process of change.

Because of the adopted research approach, results could be extended only to other organizations presenting similar characteristics. Several further areas of research are suggested by the findings of this paper. In particular, it would be of interest to investigate the links between learning styles and communication and its effect on management accounting change.

The paper includes implications for the management of learning during management accounting change, to improve the efficiency and effectiveness of this process.

This paper is one response to the call for an interdisciplinary research approach to the management accounting change phenomena using a “method theory” taken from the discipline of management to provide an explanation of the change in management accounting. In respect of the previous literature, it provides two main contributions, namely, the proposal of a model useful both to interpret and manage learning processes; the effect of learning style on management accounting routines change.

This study aims to investigate the effects of open innovation (OI) and big data analytics (BDA) on reflective knowledge exchange (RKE) within the context of complex collaborative networks. Specifically, it considers the relationships between sourcing knowledge from an external environment, transferring knowledge to an external environment and adopting solutions that are useful to appropriate returns from innovation.

This study analyzes the connection between the number of patent applications and the amount of OI, as well as the association between the number of patent applications and the use of BDA. Data from firms in the 27 European Union countries were retrieved from the Eurostat database for the period 2014–2019 and were investigated using an ordinary least squares regression analysis.

Because of its twofold lens based on both knowledge management and OI, this study sheds light on OI collaboration modes and highlights the crucial role they could play in innovation. In particular, the results suggest that OI collaboration modes have a strong effect on innovation performance, stimulating the search for RKE.

This study furthers a deeper understanding of RKE, which is shown to be an important mechanism that incentivizes firms to increase their efforts in the innovation process. Further, RKE supports firms in taking full advantage of the innovative knowledge they generate within their inter-organizational network.

The purpose of this paper is to identify the productivity improvement potentials from maintenance planning practices in manufacturing companies. In particular, the paper aims at understanding the connection between machine criticality assessment and maintenance prioritization in industrial practice, as well as providing the improvement potentials.

An explanatory mixed method research design was used in this study. Data from literature analysis, a web-based questionnaire survey, and semi-structured interviews were gathered and triangulated. Additionally, simulation experimentation was used to evaluate the productivity potential.

The connection between machine criticality and maintenance prioritization is assessed in an industrial set-up. The empirical findings show that maintenance prioritization is not based on machine criticality, as criticality assessment is non-factual, static, and lacks system view. It is with respect to these finding that the ways to increase system productivity and future directions are charted.

In addition to the empirical results showing productivity improvement potentials, the paper emphasizes on the need for a systems view for solving maintenance problems, i.e. solving maintenance problems for the whole factory. This contribution is equally important for both industry and academics, as the maintenance organization needs to solve this problem with the help of the right decision support.

Identifying the qualities of primary care that have the potential to produce optimal health outcomes is only half the story. The Models of Child Health Appraised (MOCHA) project has not only explored how to transfer these to other national contexts, but also which successful components should be transferred. It is important to assess the population criteria of the identified sociodemographic, cultural and social characteristics and the population perspectives on a care system’s components. The project analysed public experiences and perceptions of the quality of primary care for children from a representative sample of the general public in five European Union member states. The public perception of children’s primary care services, in particular the perceived quality of care and expectations with regard to care for children, is important to understand before MOCHA lessons can be effectively adopted in a country. We found that the socio-cultural characteristics of a country inform the population perceptions and preferences with regard to the care system. In the five countries surveyed, there was agreement about aspects of quality of care – such as accessible opening hours, confidential consultations for children and timeliness of consultation for an illness, but there was a difference in opinion about giving priority to items such as making an appointment without a referral, or a child’s right to a confidential consultation. The cultural context of transferability and the means of addressing this such as defining the target audience and the different means of disseminating important messages to the wider community to address contextual factors can act as barriers or facilitators to the introduction of new components of primary care models.