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The present study discusses the benefits and importance of sociotechnical thinking for the integration of industry 4.0 (I4.0), and their subsequent usefulness in analyzing the value-added activities and related quality issues, and their implications in the quality 4.0 (Q4.0), product-service systems (PSS) in the organization level/complex systems in the era of I4.0. I4.0 pushed the traditional manufacturing models toward product-service systems; for this transition, social and economic factors influence more, and technological advancements are going more rapidly than the social developments needed for the transition. The integration of social-technical system perspective with I4.0 technologies adoption would improve the value cocreation of PSS. The balance among the sociotechnical systems theory (STST) and I4.0 technologies are necessary for production and logistics organizations. This can be attained by sociotechnical systems thinking because it gives a comprehensive overview for integrating I4.0 and related quality issues in the production and logistics service systems.

A common observation is that both single- and multi-payer health care systems will achieve lower overall costs if they use primary care gatekeeping. Questioning this common wisdom, we focus on the health care access system, that is, the way in which patients gain access to health care. Gatekeeping, the use of primary care providers to control access to more specialized physician and hospital services, has come under intense scrutiny in the United States and in Europe. The few international comparative studies that have focused on the issues of quality of care, cost containment, and patient satisfaction find weak or no support for common assumptions about gatekeeping. Hence, we examine the institutional environments in seven countries in order to: (a) define and categorize health care access systems; (b) identify the components of a health care access system; (c) explore the notion of a strategic fit between health care financing systems and access system configurations; and (d) propose that the health care access system is a key determinant of process-level cost efficiency. Drawing upon institutional and governance theories, we posit that the structure and organization of an access system is determined by how it addresses six essential questions: Who is covered? Which services are included? What are the points of access? How much time elapses before access? What are the ways of selecting among points of access? and Are services and their quality the same for everyone? This analytical framework reveals that national health care access systems vary the most in their points of access, access times, and selection mechanisms. These findings and our explanations imply that access systems are one of the only tools for demand management, that any lasting change to an access system typically is implemented over an extended time period, and that managers of health care organizations often have limited freedom to define governance structures and shape health care service production systems.

The concept of Industry 4.0 emerged in Germany in 2011 for the first time causes production processes to be increasingly interconnected and to be more effective owing to its economic and social benefits. The structure of international trade is getting changed due to Industry 4.0. Manufacturing sector is one of the leading sectors in international trade. Manufacturing sector which has remarkable share of exports brings up against significant challenges aiming to competitively design and manage modern products, which are changing and accelerating the complicated multi-domain systems. That producing is more innovatively due to advantages provided by Industry 4.0 impact, positively international trade. The reason is that use of advanced robotic machines and automatization in production process reduces labour costs and thus increases competitiveness of a country in the international markets. The aim of this study is to exhibit a theoretical framework between the digitalization and international trade and to examine how Industry 4.0 impacts international trade in Turkey.

The implemented European Union Services Directive aimed at creating a unified European market for trade in services. However, the implementation of the institutions was not fully successful as to the characteristics of international services caused challenges in the ratification of the Directive. Research on international services is facing similar challenges based on the fragmented, inconclusive, and at times even contradictory findings of international services literature with regard to service characteristics. Thus, each academic field of international business, economic geography, and service management has tried to identify international service characteristics, but no unified characterization is found. The challenges in defining the different types of services, difference in the levels of analysis, and various impacts of policies and institutional environments on the service, cause these differences. The authors see the need for a unified framework that combines the different literatures and considers the policy implications. The authors develop a framework consisting of four components of international service characteristics, that is, the connectivity of service actors to the environment, the configuration of service activities within organizational set-ups, the dyadic collaborative interaction between service actors, and the created value by the services. The authors specifically consider policy and institutions as well as a vast variety of literature streams to support the arguments.