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Article
Publication date: 1 April 1996

Peter Littlejohns, Carol Dumelow and Sian Griffiths

The NHS Executive expects purchasers and providers to base their agreed patterns of care on evidence of clinical effectiveness. If this approach is to be successful it is…

Abstract

The NHS Executive expects purchasers and providers to base their agreed patterns of care on evidence of clinical effectiveness. If this approach is to be successful it is necessary to reconcile conflicting published information about effectiveness and local professional opinion. In this study we have identified the type of interactions that occur when purchasers and providers were brought together to discuss how this policy could be implemented locally. Three geographically‐based multidisciplinary workshops were structured around three case studies: coronary artery disease, diabetes, and the management of clinical depression in general practice. The proceedings were transcribed and analysed using content analysis methods. Structured observation techniques were used to examine the interaction between providers and purchasers in the three groups that discussed coronary artery disease. While the overall pattern of interactions between purchasers and providers was similar among the workshops, there were significant differences within them. In two of the workshops providers dominated the discussions on clinical effectiveness, which may affect the purchaser's ability to implement a policy of clinical effectiveness. If a local policy of clinical effectiveness is to be successful there is a need to strengthen purchasers' ability to match the provider's knowledge and enthusiasm.

Details

Journal of Clinical Effectiveness, vol. 1 no. 4
Type: Research Article
ISSN: 1361-5874

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Article
Publication date: 1 June 2002

MiYoung Lee and Kim K.P. Johnson

We investigated whether differences existed among Internet apparel purchasers, browsers, and non‐purchasers in terms of their attitudes about Internet shopping and…

Abstract

We investigated whether differences existed among Internet apparel purchasers, browsers, and non‐purchasers in terms of their attitudes about Internet shopping and retailers, willingness to provide credit card information, Internet use behavior, and demographic characteristics. Data were obtained from an Internet survey conducted by the Graphic, Visualization, and Usability (GVU) Center from the Georgia Institute of Technology. Internet apparel purchasers were significantly different both from the Internet apparel browsers and non‐purchasers, but browsers were not significantly different from non‐purchasers.

Details

Journal of Fashion Marketing and Management: An International Journal, vol. 6 no. 2
Type: Research Article
ISSN: 1361-2026

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Article
Publication date: 1 January 2006

Janet Carruthers, Nicholas J. Ashill and Michel Rod

The purpose is to examine the bases of positive relations between suppliers and purchasers of healthcare services. In doing so, the paper examines the nature of…

Abstract

Purpose

The purpose is to examine the bases of positive relations between suppliers and purchasers of healthcare services. In doing so, the paper examines the nature of cooperation between the providers of healthcare services (hospitals) and those who commission and purchase healthcare on behalf of patients (regional health authorities).

Design/methodology/approach

The paper employs a qualitative interview approach for gathering and analysing major stakeholder (provider and purchaser) perceptions of their interorganisational relations and how these interactions impact on the quest of the healthcare provider to meet the needs of the community they serve.

Findings

The paper identifies group relevant variables into four major themes or “core categories” that characterise purchaser‐provider stakeholder cooperation. These themes represent provider and purchaser views on those factors characterising stakeholder relationships within the purchaser‐provider dyad.

Practical implications

The paper suggests that extending practitioners' understanding of the nature of these interrelated factors may lead to better insights of how interorganisational relations and partnerships might be managed more proactively throughout the healthcare value chain.

Originality/value

In the extant literature, there is a paucity of research that has illustrated multi‐stakeholder perspectives in the public sector. This paper explores the perceptions of two main stakeholders in public healthcare to map and assess management issues influencing purchaser‐provider cooperation.

Details

Qualitative Market Research: An International Journal, vol. 9 no. 1
Type: Research Article
ISSN: 1352-2752

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Article
Publication date: 1 June 2003

John Øvretveit

Much has been written about quality in patient care and clinical support services, but very little about the quality of purchasing. This paper gives an overview of quality…

Abstract

Much has been written about quality in patient care and clinical support services, but very little about the quality of purchasing. This paper gives an overview of quality issues in purchasing, and offers guidelines and practical steps for purchasers to improve service quality – both their own and their providers’. It defines quality in purchasing and considers how purchasers can influence markets and work with providers to improve health services quality. The paper gives practical guidance for improving quality, which recognises the limited resources and skills which purchasers have for the task. It addresses some issues raised by purchaser/managers: How does a purchasing organisation measure and improve quality? Is there a better way of specifying and monitoring quality than the “shopping‐list of standards” approach – what should be asked of providers? How can information about clinical quality, outcome and costs, be obtained in a form in which reliable comparisons can be made? Is quality accreditation or registration a good predictor of future quality?

Details

International Journal of Health Care Quality Assurance, vol. 16 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 10 April 2007

Janet Carruthers, Michel Rod and Nicholas J. Ashill

The purpose of this paper is to examine the bases of positive relations between suppliers and purchasers of healthcare services. In doing so, it examines the nature of…

Abstract

Purpose

The purpose of this paper is to examine the bases of positive relations between suppliers and purchasers of healthcare services. In doing so, it examines the nature of cooperation between the providers of healthcare services (hospitals) and those who commission and purchase healthcare on behalf of patients (regional health authorities) and makes specific recommendations as to how cooperation can be better realized.

Design/methodology/approach

The paper employs a qualitative interview approach for gathering and analyzing major stakeholder (provider and purchaser) perceptions of their interorganizational relations and how these interactions impact on the quest of the healthcare provider to meet the needs of the community they serve.

Findings

The paper identifies and groups relevant variables into four major themes or “core categories” that characterize purchaser‐provider stakeholder cooperation. These themes represent provider and purchaser views on those factors characterising stakeholder relationships within the purchaser‐provider dyad. This is followed by a number of suggestions as to how to improve the nature of cooperation between these stakeholders.

Practical implications

Extending practitioners' understanding of the nature of these inter‐related factors may lead to better insights of how interorganizational relations and partnerships might be managed more proactively throughout the healthcare value chain. Strategies to foster stakeholder cooperation are also suggested.

Originality/value

In the extant literature, there is a paucity of research that has illustrated multi‐stakeholder perspectives in the public sector. This paper explores the perceptions of two main stakeholders in public healthcare to map and assess management issues influencing purchaser‐provider cooperation.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 1 no. 1
Type: Research Article
ISSN: 1750-6123

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Article
Publication date: 1 January 1976

The Howard Shuttering Contractors case throws considerable light on the importance which the tribunals attach to warnings before dismissing an employee. In this case the…

Abstract

The Howard Shuttering Contractors case throws considerable light on the importance which the tribunals attach to warnings before dismissing an employee. In this case the tribunal took great pains to interpret the intention of the parties to the different site agreements, and it came to the conclusion that the agreed procedure was not followed. One other matter, which must be particularly noted by employers, is that where a final warning is required, this final warning must be “a warning”, and not the actual dismissal. So that where, for example, three warnings are to be given, the third must be a “warning”. It is after the employee has misconducted himself thereafter that the employer may dismiss.

Details

Managerial Law, vol. 19 no. 1
Type: Research Article
ISSN: 0309-0558

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Article
Publication date: 1 August 2006

Jayoung Choi and Jihye Park

To examine shopping orientation, information search, and demographics of multichannel customers in comparison to traditional single channel customers.

Abstract

Purpose

To examine shopping orientation, information search, and demographics of multichannel customers in comparison to traditional single channel customers.

Design/methodology/approach

A questionnaire was used to assess research variables and mailed out to 10,000 individuals in South Korea who were randomly selected from a purchased national database. A total of 2,926 usable questionnaires were returned for a 29 percent response rate.

Findings

Shopping orientation, information search, and demographics differentiated shopper groups: single‐channel offline users, single‐channel online users, multichannel offline users, and multichannel online users.

Research limitations/implications

A lack of theoretical approaches, a direct self‐assessment for store choice behavior, and duplicated measures for independent and dependent variables perhaps limit its usefulness.

Practical implications

Provides guidance to global retailers who plan to pioneer new markets with multichannel retailing strategies. Shopping orientations, perceived usefulness of information sources, and demographics can be effectively used to identify target markets in Korea.

Originality/value

This study first explored Korean consumer profiles in the context of multi‐shopping channels and added valuable empirical findings to the current limited literature in multichannel retailing in the international market and to help global retailers identify consumer segments based on channel choice behavior.

Details

International Journal of Retail & Distribution Management, vol. 34 no. 8
Type: Research Article
ISSN: 0959-0552

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Article
Publication date: 1 January 1975

Håkan Håksansson and Björn Wootz

Examines a study carried out on three large Swedish firms examining the effects of education, experience and the environment on ways in which decisions are made. Studies…

Abstract

Examines a study carried out on three large Swedish firms examining the effects of education, experience and the environment on ways in which decisions are made. Studies, in particular, purchasing behaviour in an international context with the central theme and analysis of how purchasers evaluate suppliers located in different countries. Acknowledges, surprisingly, both knowledge of foreign language and experience of foreign countries seemed to be unimportant. Concludes that the results are on a tentative level requiring further research.

Details

European Journal of Marketing, vol. 9 no. 1
Type: Research Article
ISSN: 0309-0566

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Article
Publication date: 5 June 2007

Lynda Andrews, Geoffrey Kiel, Judy Drennan, Maree V. Boyle and Jay Weerawardena

Purpose – This paper compares the experiential consumption values that motivate consumer choice to purchase online for both male and female purchasers and non‐purchasers

Abstract

Purpose – This paper compares the experiential consumption values that motivate consumer choice to purchase online for both male and female purchasers and non‐purchasers. Design/methodology/approach – Using the theory of consumption value the study examines gendered perceptions of the functional, social and conditional value of using a virtual consumption setting for purchasing. Data was collected through an online survey and analysed using multiple discriminant analysis to determine meaningful differences between male and female purchasers and non‐purchasers. Findings – The findings show that male online purchasers are discriminated from female purchasers by social value and from male non‐purchasers by conditional value. Female purchasers are discriminated from male purchasers by functional value and from female non‐purchasers by social value. Female non‐purchasers are discriminated from female purchasers by conditional value. Male non‐purchasers are discriminated from male purchasers by functional and social value. Research limitations/implications – Limitations include using an Internet survey and an Australian sample which may impact the generalisability of the findings to a wider population of Internet users. Future research should involve replication of the study in a country more or less developed in terms of gender composition of internet users to extend the generalisability of the findings. Additionally, researchers should examine whether other dimensions of consumption value, such as social influence through on‐ and off‐line communication networks, may influence consumer choice to purchase online. Practical implications – The study provides practical implications for marketers to leverage consumption values that influence male and female consumers' choice to purchase online and then drive their behaviour online through integrated marketing campaigns that involve both on‐ and offline strategies. Originality/value – The research makes an original contribution to the consumer behaviour literature as to date, no research has been found that undertakes such a comprehensive gender‐based comparison of the perceived value of using a virtual consumption setting for purchasing.

Details

European Journal of Marketing, vol. 41 no. 5/6
Type: Research Article
ISSN: 0309-0566

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Book part
Publication date: 11 June 2009

Winnie Yip and Kara Hanson

Objectives – Purchasing has been promoted as a key policy instrument to improve health system performance. Despite its widespread adoption, there is little empirical…

Abstract

Objectives – Purchasing has been promoted as a key policy instrument to improve health system performance. Despite its widespread adoption, there is little empirical evidence on how it works, the challenges surrounding its implementation, its impact, and the preconditions for it to function effectively, particularly in low- and middle-income settings. The objective of this chapter is to analyze critically the extent to which purchasing could be, and has been used strategically in China and to identify modifications that are needed for purchasing to be effective in assuring that the government's new funding for health care will result in efficient and effective health services.

Methods – We present a conceptual framework for purchasing, which identifies three critical principal–agent relationships in purchasing. We draw on evidence from secondary data, results of other research studies, interviews, and the impact evaluation of a social experiment in rural China that explicitly used purchasing to improve quality and efficiency. This information is used to examine purchasing relationships in urban social health insurance (SHI), the rural medical insurance scheme, and purchasing of public health services.

Findings – To date, use of strategic purchasing is limited in China. Both the urban and the rural health insurance schemes act as passive third-party payers, failing to take advantage of the opportunities to strengthen incentives to improve quality and efficiency. This may be because as government agencies, the extent to which the Ministries of Health and Labor and Social Security can act independently from provider interests, or act in the best interest of the population, is unclear. Other important challenges include ensuring adequate representation of the population's views and preferences and making better use of the leverage provided by purchasing to create appropriate provider incentives, through better integration of financing and improved coordination among purchasers.

Implications for policy – In designing purchasing arrangements, attention needs to be paid to all three principal–agent relationships. Successful purchasing appears to require mechanisms to mobilize and represent community preferences and more strategic contracting with providers. More research is needed to strengthen the evidence on which purchasing arrangements work, which do not work, and under what conditions different purchasing configurations can work most effectively.

Details

Innovations in Health System Finance in Developing and Transitional Economies
Type: Book
ISBN: 978-1-84855-664-5

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