供应链伙伴信息共享的博弈与激励

针对产销双方对供求信息掌握的不对称性,分析了实现供应链合作伙伴信息共享的条件,从保证供应链合作伙伴信息共享的实现出发,建立了信息共享的博弈模型,分析了共享需求信息和成本信息前后期望利润变化,提出了在制造商与分销商信息共享的激励机制。通过激励机制,改变Nash均衡解的利润分配,在价格优惠和一次性补贴下,使供应链伙伴均获得信息共享带来的收益增加。     

数字化时代银行与多边平台开放合作策略研究

数字化打破了产业边界，推动传统金融业向开放、共享的场景生态迈进，同时也带来了银行与数字平台间如何共生、如何协调的难题.基于此，本文结合消费者的感知风险和感知价值，构建了考虑转移支付策略行为的多阶段动态博弈模型，分别研究了垄断和竞争情形下，银行与多边平台开放合作的约束条件及均衡策略，并进一步探讨了平台端口开放的最优数量决策.研究发现，开放性均衡状态下，银行的最优数据共享程度和平台的最优可变费用随网络效应强度、消费者兴趣度、麻烦和合作成本以及伙伴关系的变化而变化.相比于分散决策，联合决策下基于监控的固定收益转移增加了数据不共享或共享程度较弱时的开放动机，但也导致其结果出现类似的双重边缘化效应.数值实验表明，当可变费用较低或极高时，联合开放是实现双方绩效均改进的占优机制；否则，分散开放可能要优于联合开放.此外，在弱网络效应下，强强联手、弱弱结盟的伙伴关系更能提高开放效率；而极强的网络效应或数据共享程度则会导致垄断合作机会的产生.     

分级诊疗服务系统中协调医疗转诊的政府补贴机制研究

本文研究协调医疗转诊制度运作的政府补贴机制设计问题。通过构建分级诊疗服务系统中政府、三级医院、社区医院及患者之间的一个四阶段博弈理论排队模型,本文给出各方参与主体的均衡决策和均衡绩效;评估有限财政补贴预算情形下影响补贴社区医院与补贴下转患者两种协调机制引导患者自愿下转进而促使医疗服务运营效能与社会福利提升及等待时间降低效率的影响机理。研究发现:对较低、中高、高等的运营利润关切度,或较高的社区能力成本,或足够少的预算,补贴社区更有助于患者下转的运行、患者效益与社会福利的提高以及等待时间的降低;对于较中低的运营利润关切度,或足够低的社区能力成本,或较中等的预算,补贴下转患者反而更优;对于较中等的运营利润关切度与社区能力成本,而预算较多时,补贴社区医院尽管对患者下转率及其效益提高、等待时间降低更有效,但对社会福利的提升的效率反而更低。     

基于信号博弈模型的公立医院利益补偿机制

针对医疗服务市场的特点,讨论了医药分业后政府补贴公立医院的利益补偿机制,以优化资源配置为目标建立医院与政府的信号博弈模型并进行均衡分析,发现市场的均衡效率随作假的伪装成本和期望风险成本减少而降低;实现市场完全成功的分离均衡的关键条件为保持较高伪装成本和期望风险成本;相应的政策应集中于建立医疗服务行业规范和提升医疗监察效率.     

基于交货期库存协调的供应链转移定价研究

在将缺货成本和延期惩罚成本纳入决策模型的前提下,对供应商—制造商两阶供应链在转移定价、安全库存,以及总成本之间的相互作用进行了探讨:首先探讨基于 Stackelberg 收益共享定价机制的最优决策;然后,以一体化供应链为参照系,探讨对供应链各成员的行为进行优化的两部制(two-part scheme)收益共享转移定价决策在实践中的运用;最后,探讨模型中部分变量变化对最优决策所产生的影响.通过分析发现,承诺的交货期、延期惩罚成本与缺货成本将会影响供应链的总成本和转移定价决策,进而影响供应商的最优库存决策,而制造商则可以通过适当的激励机制设计,激励供应商按照供应链整体最优的方式进行转移定价、安全库存及相关决策.     

考虑战略消费者行为风险的动态定价策略

本文研究的是存在战略消费者行为风险的动态定价问题,垄断厂商在需求不确定的有限时间内销售定量易逝商品,追求既定风险下的期望收益最大化;战略消费者在动态定价下基于参考价格安排购买时机.研究表明,厂商和消费者的行为策略间存在完美博弈均衡;在均衡价格范围内,战略购买行为改变了各交易主体的收益或支付,扩大了厂商收益不确定性风险;风险敏感的厂商定价趋于保守;交易信息透明是厂商实现预定目标的引导条件.     

DRGs与DIP的对比研究：基于医院运营的视角

打包预付方式将控制医疗费用的责任转移至医方，能激励医院做好成本管控，会对医院的日常运营产生重大影响.本文主要研究按疾病相关组付费(DRGs)和按病种分值付费(DIP)两种支付方式，通过构建排队和竞争博弈模型探讨两种支付方式下的医院间服务速率决策问题以及相同医疗预算下的医疗服务质量、医院利润和社会福利的对比研究，并通过数值方式探讨了医院数量和服务成本系数对系统性能的影响.研究发现：1)DIP与DRGs相比，医院的服务速率相对降低，服务的病人数量较少，但医院利润更大.2)从社会福利来看，患者损失的成本较高时，DRGs较优；反之，DIP较优，且此时DIP是帕累托改进策略.3)只有当医院数量适中、服务成本系数较大时，DIP的优势才更明显.     

互补品制造供应链的集团采购与需求信息共享

研究了集团采购中信息共享的激励问题.考虑两个互补品制造商通过一个集团采购组织(group purchasing organization,GPO)集中采购某种部件,制造商分别观测到不完美需求预测信息,并可选择向GPO共享任意水平信息量.通过建立不完全信息下的动态博弈模型和求解博弈均衡,分析互补性、信息精度和信息共享水平等因素对于系统绩效的影响,揭示制造商的信息共享激励问题,进而设计基于收益共享契约的信息共享激励机制.研究发现,批发价格契约下,各制造商不愿共享任何信息,信息共享会加剧双重边际效应,削弱互补效应和预测效应,从而降低系统利润;收益共享契约下,各制造商愿意共享全部信息,且所有参与者实现帕累托改进,而进一步消除制造商间的信息不对称可使系统达到最优.     

非对称信息下供应链融资优化决策研究

本文提出供应链融资的概念框架,并对非对称信息条件下供应链内部融资存在的信息优势及其对供应链价值的影响进行分析。基于供应链内部融资的信息优势和收益来源,构建出供应链融资基本模型,并分别考虑信息成本和不考虑信息成本情形建立供应链融资优化决策模型。研究表明,不考虑信息成本情形下,供应链内部融资的价值增加表现为融资主体间的利率套利和融资外部收益;考虑信息成本情形下,受资方向出资方转换信息增加的边际成本与出资方降低的边际报酬相等时的均衡解是出资方信息转换的最优决策点,此时将实现供应链价值最大化。     

供应链成员信息共享技术策略博弈分析

运用博弈论分析不确定条件下供应链成员的信息共享技术策略。首先建立基于需求不确定和供应不确定两种参数的"供应商+零售商"的期望收益模型,证实在不确定条件下的存在双方期望收益的最优解;建立三阶段博弈模型,探讨双方信息共享技术策略的博弈关系;分析四种的均衡状态:探讨初始需求不确定性、供应商的信息推测能力与零售商收益的不同关系对双方信息共享技术策略的影响,结论显示:当初始需求不确定性较大时,零售商以拒绝策略为先,进一步的策略取决于供应商的信息推测能力及其对零售商收益的影响,如果该能力较强,零售商将采取接受策略,反之则反。     

Solving physician-hospital administration conflicts: a physician strategy for the '90s

Today's health care climate creates increased potential for conflict between hospital administrators and hospital-based physicians. Voluminous regulations, increasing operating costs, professional liability exposure, changing methods of reimbursement, constraints on capital expenditures, and similar constraints on bed expansion have caused hospitals to explore new and innovative sources of revenue. Hospitals have become more eager to provide "bundled" services and health care "packages" in order to compete for discounted reimbursement contracts demanded by large-volume purchasers. While the impact of these changes is clearly felt in the private sector, similar fiscal constraints also may require university hospitals to modify their traditional role as leaders in education, research, and community service. In short, all hospitals are under intense pressure to increase revenues, reduce operating costs, and maintain the scope and quality of services provided.     

Bringing IT Back: An Analysis of the Decision to Backsource or Switch Vendors

Whereas the decision to outsource information systems (IS) has been an important focus in IS research and practice, the decision to switch vendors or to backsource has received little attention. Evidence suggests that in practice, however, the decision to backsource or to switch vendors is becoming increasingly common as firms vie for ways to continue to cut information technology (IT) costs and improve IT service levels. This research specifically examines the factors associated with the decision to backsource or to switch vendors. Based on a sample of 160 IT managers involved with application development, we compare and contrast the perceptions of those who switched vendors, backsourced, or continued in an outsourcing relationship for application development. Our findings suggest that product quality, service quality, relationship quality, and switching costs are related to the decision to backsource application outsourcing. However, service and product quality did not influence the decision to switch vendors. Rather, firms that made the decision to switch vendors reported high levels of service and product quality but low levels of relationship quality and switching costs.     

A Study of Online Auction Sellers’ Intention to Switch Platform: The Case of Yahoo!Kimo Versus Ruten_eBay*

The study of consumers’ switching from one service provider to another has a long tradition in economics, information systems, and marketing. The emergence of electronic commerce presents new challenges in understanding consumers’ switching intentions in the context of e‐commerce in general and online auctions in particular. With the abundance of literature on online auctions, there is a surprising lack of research on auction sellers’ intentions to switch from one online auction platform to another. Using the competition between Yahoo!Kimo and Ruten_eBay, two leading auction platforms in Taiwan, as the backdrop, we developed a research model and collected empirical data based on this real case to study what factors influence auction sellers to switch to a competing service provider. We find that the higher the procedural switching costs, financial switching costs, relational switching costs, site design quality, or interaction quality, the lower the intention of an auction seller to switch to a competing auction service provider. A higher perceived transaction fee, however, leads to a higher switching intention.     

Measuring the logistics performance of internal hospital supply chains – A literature study

The patient care processes in hospitals are supported by a range of operational activities including inventory management and distribution of supplies to point-of-care locations. Hospitals carry large amounts and a great variety of items, and the issues of storing and distributing these items throughout the hospital supply chain are of great importance to providing high-quality patient service. Healthcare logistics encompasses the process of handling physical goods (e.g. pharmaceuticals, surgical medical products, medical equipment, sterile items, linen, food, etc.) and the associated information flows, from the reception of the goods within a hospital to their delivery at patient care locations. The medical supply costs constitute the second largest expenditure in hospitals, after personnel costs. A high-performing supply chain may realize improved outcomes (e.g. safe and quality patient service) and greater efficiency. Logistics managers need to identify opportunities to improve the logistics processes in order to lower costs and to improve patient care quality. However, in order to improve the logistics processes, you must understand how the healthcare supply chain is currently performing. Measuring the performance of the supply chain is fundamental to identify and address deficiencies in the logistics activities, and it serves as a good input for managerial decision-making. The purpose of this article is to present existing research on performance measurement at the internal hospital supply chain (e.g. inventory management, distribution activities), and more specifically in the operating theatre since it is among the most critical resources for a hospital. At the operating theatre, the requested items should be available at the right time at the right place, in the right condition, at the lowest cost possible. Furthermore, we will also discuss literature on multi-criteria decision-making techniques. It enables researchers to build a performance measurement framework and to prioritize between multiple performance indicators since a diverse group of stakeholders with conflicting interests is involved in the internal operating room supply chain.     

IT Governance Characteristics,Electronic Medical Records Sophistication,and Financial Performance in U.S. Hospitals: An Empirical Investigation

As a result of a recent federal government mandate, an increasing number of hospitals have decided to adopt electronic medical record (EMR) systems. This initiative is expected to lead toward more efficient and higher quality health care; however, little is known about governance characteristics and organizational performance for EMR adopters. Our goal is to inform theory and practice by examining hospitals with a sophisticated EMR and comparing those hospitals to similar hospitals (with a less sophisticated EMR) to understand the association between information technology (IT) governance characteristics and the implications on financial performance. Leveraging elements of the upper echelon theory, we posit that hospitals in which the chief information officer (CIO) reports to the chief executive officer, CIO turnover is low, and an IT steering committee is present are more likely to have a sophisticated EMR. We argue that EMR sophistication leads to improved financial performance. Our results underscore the importance of continuity in the CIO position on successful EMR implementations. Results also show that hospital size and financial performance are strongly associated with EMR sophistication. In addition, we find that a sophisticated EMR appears to be a fundamental element in improving hospitals’ revenue cycle management. Moreover, we find that hospitals with a sophisticated EMR appear to be more profitable. Finally, we observe that total payroll expense adjusted by total discharges drops among the sophisticated hospitals, potentially due to an increase in employee productivity. These insights can serve as a basis for tempering expectations relative to the financial impact of EMR adoption.     

考虑信息平台优化的医疗服务系统决策研究

微信、支付宝等手机应用上预约挂号和智能分诊的实现,实质上是信息平台优化。而信息平台优化投入对患者就医偏好的影响具有不确定性。通过分析信息平台优化投入对患者就诊选择影响,本文构建了考虑信息平台优化的医疗服务系统。与以往研究不同的是,系统中的期望等待时间为更精确的等待队列等待时间。另外,服务提供者的最优化决策变量创新地由医疗服务能力转为信息平台优化的投入,同时资金提供者的决策目标为最小化社会医疗成本。本文研究了医疗服务系统的均衡策略与均衡状态的性质。其次,对不同医疗服务规模的医疗服务系统的均衡状态进行了对比。研究发现,对于公共医疗系统,信息平台优化的最优投入与患者自付率无关,而这有助于实现基本医疗服务均等化。本文从数理上证明了,在均衡状态下,当患者的医疗需要增加时,划拨到公立医院的预算会减少。患者自付率与医疗服务的复杂度无关,即患者负担的医疗费用与医疗服务的复杂度无关。     

Innovation, cultural values, and the management of change in British hospitals

This paper describes the results of a study of innovation in the management teams of 27 UK hospitals. It is argued that the content of innovations provides an accurate representation of the underlying cultural values of the management teams, and the cultural values which they seek to purvey within the wider organizational settings. The authors propose that values in action (as opposed to espoused values) are manifest in the range of innovations introduced by top management within organizations. Using a typology of organizational culture, they categorize the innovations introduced by the management teams, in order to map their underlying cultural values. The results indicate predominant orientations of hospital management teams towards rational goal and hierarchical values in the current context of health care in Britain. Internal climate and service innovations were relatively infrequent, suggesting that the hospitals were dominated by management concern for control rather than flexibility. The costs of such cultural strategies in health service settings are discussed.     

Public hospitals: an assessment and plan for the future.

We are currently living in very difficult times for most health care providers. Even though we have always known it, the fact that resources for health care are limited is now abundantly apparent to consumers, health care providers, fiscal intermediaries, government (local, state, and federal), health care planners, and policy makers. Hospitals, especially, are being severely pressured to reduce resource consumption and costs. Conditions that are difficult for nonpublic hospitals are critical for public hospitals in general and nearly fatal for rural public hospitals. Fortunately, nonpublic hospitals are beginning to realize for the first time that their future depends, to a significant degree, on a strong and financially healthy public hospital system. If the public hospital, the hospital of last resort, closes, medically indigent patients will have to be treated in nonpublic hospitals, with the resultant medical, financial, economic, political, and social consequences. Therefore, the importance of public hospitals has to be even better recognized and appreciated and these institutions actively supported in order for the private and total health care systems to be successful.     

Strategically integrating hospital/home care services for improved profitability

Because hospitals and home health agencies have been predominantly separate organizations, coordination of their efforts has not been optimized. However, with the recent proliferation of hospital-based home health agencies, opportunities to integrate these health care service delivery systems have increased. Bethesda Memorial Hospital, Boynton Beach, Fla., is a 362-bed not-for-profit community hospital with a Medicare-certified home health agency organized as a department of the hospital. Until recently, the home health agency was generally perceived as a separate entity whose services were distinct from hospital services. Progress toward integration of hospital and home care services was given impetus through collaboration of the home health agency administrator and a newly appointed director of medical affairs who was given the responsibility as medical director of the home health agency. A prime responsibility of the director of medical affairs was to reduce length of stay and hospital costs through appropriate resource management.     

The Role of Clinical and Process Quality in Achieving Patient Satisfaction in Hospitals

Managers constantly struggle with where to allocate their resources and efforts in managing the complex service delivery system called a hospital. In the broadest sense, their decisions and actions focus on two important aspects of health care—clinical or technical medical care that emphasizes “what” the patient receives and process performance that emphasizes “how” health care services are delivered to patients. Here, we investigate the role of leadership, clinical quality, and process quality on patient satisfaction. A causal model is hypothesized and evaluated using structural equation modeling for a sample of 202 U.S. hospitals. Statistical results support the idea that leadership is a good exogenous construct and that clinical and process quality are good intermediate outcomes in determining patient satisfaction. Statistical results also suggest that hospital leadership has more influence on process quality than on clinical quality, which is predominantly the doctors' domain. Other results are discussed, such as that hospital managers must be mindful of the fact that process quality is at least as important as clinical quality in predicting patient satisfaction. The article concludes by proposing areas for future research.