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Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

This chapter reviews and integrates the empirical literature on the influence of organizational factors on hospital financial performance. Five categories of organizational characteristics that research has addressed are identified and examined as part of the review: ownership, governance, integration, management strategy, and quality. With some exceptions, our review reveals a general lack of consistency and conclusiveness across studies in each area. Exceptions were found in the areas of governance (e.g., physician participation and board processes) and integration (e.g., horizontal system centralization). Despite the lack of conclusive findings across studies, our review suggests substantial opportunities for future work, including opportunities for qualitative and exploratory work. Additional implications for theory and management are discussed.

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.

The contemporary dynamics impose companies to both innovate and internationalize at the same time while remaining competitive in the international marketplace. With this context in mind, Industry 4.0 technologies have the potential to increase the competitiveness of companies, leading to a new era of “Manufacturing Renaissance.” Recently, conceptual studies have speculated on possible impacts of the adoption of Industry 4.0 technologies in terms of international business. However, empirical studies on this topic are still lacking. Through a multiple case study approach, this study presents exploratory qualitative research investigating the relationship between Industry 4.0 and the internationalization of companies. The analysis of 16 Italian manufacturing exporting companies, which have adopted some of these technologies, has revealed a more intriguing relationship compared to the one presented in current literature, and thus has opened avenues for future research on this issue.

Activist criminology advocates for social change by acting beyond the role of the academic, mainly through first-hand involvement in the field (Goyes, 2016). In this chapter, the author offers a longitudinal reflection on the researcher’s positionality, epistemology and methodology from the personal experience since their first research project, in 2019. During this project, the author started having cooperation with the Liberi Nantes migrants’ sports centre, now a community centre in Rome’s working-class suburb. This sparked her first reflections on activist criminology and how to embed it in her research approach and practice. The initial cooperation evolved in the ongoing and evolving collective ‘conversational integration’ project, which aims at overcoming the notion of integration as one-sided assimilation, working on addressing the diverse needs of the local community through a bottom-up governance initiative. This chapter is to be intended as a checkpoint in their growth within activist criminology and it hopefully serves to spark questions, suggestions and a push to form a solid network of activist academics that can help in fostering social change outside of the neoliberal agendas of academia.

The Balanced Scorecard (BSC) emphasizes on the of information system to track a limited number of balanced metrics (measures and indicators) that are closely aligned with organization's goals. This study investigates how system integration in different forms is related to the success of using the BSC for performance measurement. The use of a BSC in performance evaluation is considered in five contexts: determining cost, measuring efficiency, ensuring quality and customer satisfaction measure, promoting continuous innovation and monitoring contract negotiation. The findings indicate that system integration defined in the study positively relates to the success of using the BSC in all five decision perspectives. The findings conclude that hospitals need a streamlined, information integration across the continuum of care to better assess the operation results, in both organizational and technical perspectives.

This chapter investigates the impact of coordination and control mechanisms on the orientation to performances, looking at the relation between Corporate Foundations and their Founder Firms. The research starts from the consideration that the relationship between CFs and Founder Firms can be considered similar to the relationship between headquarter and subsidiaries in large corporations, as the ties are very strong and significant.

In order to address the impact of control and coordination mechanisms on CFs’ orientation to performance, we managed a survey addressed to 188 CFs from six European countries, representing the most significant context for corporate philanthropy in Europe.

The results of a linear regression show that only selected mechanisms are effective for boosting CFs’ orientation to performance, and that these tools must be adapted to the specific nature of the CFs.

The study can help Founder Firms to identify the more effective mechanisms to improve the performance of the CFs they support, in order to ensure the possibility for both the parties to pursue the shared value creation.

The research has put in evidence that CFs must be explored taking into consideration their close tie to Founder Firm, which differentiates them from other interdependent foundations.