Planning health services with explicit geographical considerations: a stochastic location–allocation approach

This paper is concerned with modeling for planning health services when geographical considerations in the location of services and in the locations of patients who need services are important. Examples of geographical distribution and organization of health services are the location of hospital outpatient departments within a city, and the provision of hospital-based specialist services, such as cardiac and dental surgery, across a region. Important issues in the provision of services include the location of the service centers, service capacities, geographical distribution of patients, and ease of access to the health services. This paper describes the development of a discrete-event geographical location–allocation simulation model for evaluating various options for the provision of services. Real-life case studies will illustrate the practical importance of the modeling approach.     

中国生产服务业与制造业共生演化模型实证研究

本文从共生理论视角来研究生产服务业与制造业的互动发展,基于生态学种群Logistic共生演化模型,对生产服务业与制造业互动阶段进行划分并给出具体特征表现,生产服务业与制造业的共生动态演化过程可由分段Logistic曲线叠加进行描述,建立最大环境容量模型,对中国1983-2007年的生产服务业和制造业共生演化进行了实证分析。结果表明,生产服务业和制造业都处于成长期,二者之间互动发展属于非对称互惠共生模式, 生产服务业对制造业的影响大于制造业对生产服务业的影响。     

PRODUCTION FACTORS IN POLICING SERVICES*

The demand for increased public protection has become a major public issue of our times. The usual American response of increased resources has been applied but has had less than the desired effects. This paper analyzes the existing production factors in the provision of policing services in terms of the efficiency with which these services are delivered. The efficiency analysis occurs on a number of levels: (1) the use of existing resources, (2) alternative allocation at the existing resource level, (3) alternative technologies, and (4) the tasks and services which should be undertaken. The effects and implications of exogenous changes upon crime and policing services are considered and the problems and needs for change in the production factors for policing services are presented.     

New opportunities in global services

This article calls attention to macroenvironmental changes and competitive factors affecting the international distribution of services and addresses some options and implications for corporate strategy. It provides a conceptual framework for understanding and evaluating services trends, cites examples of services that are expanding internationally and explores the interrelationships between production and services trade.     

Foundations and Implications of a Proposed Unified Services Theory

Diverse businesses, such as garbage collection, retail banking, and management consulting are often tied together under the heading of “services”, based on little more than a perception that they are intangible and do not manufacture anything. Such definitions inadequately identify managerial and operational implications common among, and unique to, services. We present a “Unified Services Theory” (UST) to clearly delineate service processes from non‐service processes and to identify key commonalities across seemingly disparate service businesses. The UST defines a service production process as one that relies on customer inputs; customers act as suppliers for all service processes. Non‐services (such as make‐to‐stock manufacturing) rely on customer selection of outputs, payment for outputs, and occasional feedback, but production is not dependent upon inputs from individual customers. The UST reveals principles that are common to the wide range of services and provides a unifying foundation for various theories and models of service operations, such as the traditional “characteristics of services” and Customer Contact Theory. The UST has significant operational corollaries pertaining to capacity and demand management, service quality, services strategy, and so forth. The UST provides a common reference point to which services management researchers can anchor future theory‐building and theory‐testing research.     

Legal issues in accepting capitation

The effort to reduce the cost of medical, hospital, and ancillary services increasingly focuses on shifting the financial risk for the cost of these services to those who provide them. Shifting arrangements include capitation for physicians classified as "primary care" physicians; capitation arrangements that include primary and specialty services; risk shifting to medical groups, IPAs, and other physician organizations; as well as the packaging of physician and hospital services on a "full risk," "per case," or other basis. Accepting financial risk for the cost of medical and other health care services, as well as the responsibility for managing the provision of services, may very well be the only remaining opportunity for providers to maximize reimbursement and maintain administrative and clinical self-direction. However, physicians must work with managed care organizations (MCOs) through negotiation of contracts and throughout the relationship to make sure: Unnecessary financial and legal risks to the MCO and physicians are eliminated. Risks that cannot be eliminated are apportioned between the MCO and physicians. All risks are managed in a coordinated fashion between the MCO and physicians.     

How should managed care physicians be paid?

When paying a physician for medical or surgical services, most patients expect the traditional bill or charge for that encounter or visit. While most people also pay health insurance premiums, few patients expect to prepay for their health care. But that is the foundation of most managed health care systems-prepaid medicine. PPOs, IPAs, and HMOs are typically health care providers linked together to provide services to a set population for a specific prepaid fee or "capitation" payment. Other providers contract with these managed care insurers to receive a predetermined and often "discounted" professional fee for services. These managed care organizations have already gone through a number of stages in determining how physicians are to be compensated for their services, and further changes loom on the horizon.     

Models for investment in electronic commerce—financial perspectives with empirical evidence

Electronic Commerce (“eCommerce”) is a concept for trade based upon products and services that are being marketed, contracted, and paid for over the Internet. Consequently, electronic commerce demands for the investment in computer systems, marketing, logistics and payments.This paper will develop conditions for profitable investments in eCommerce with a special focus on outlays for information technology systems and sales management. If the services are made more standardized, if they do not change that often, or if they are well known to the customers so that there is little need for supplementary information, then the less costly will the information technology system become. The investment in marketing depends on how well known the brand name is to the customer. eCommerce firms “Born on the Net” have to spend substantially more resources on marketing than firms that “Move to the Net”.These investments may be seen as parts of a process, which aims to generate larger revenues to the firm, better services to the customers, a more efficient logistic system, and lower payment costs. A financial perspective is taken, where investment outlays for web services and marketing are balanced to cost savings when serving existing customers and net revenues from the generation of new customers. This financial approach is applied to five case studies from the sectors of capital goods, financial services, food, ornamental horticulture, and books and stationeries, where the given background from practice and conditions for success are developed in terms of a customer-base, margins, and sales growth. It is demonstrated that an existing customer base offline reduces the need for a marketing that is costly. It is also shown that a combination of services online and offline improves customer services and increases the extension of repeat purchases.     

Diagnosis related groups: product line management within hospitals.

The hospital is viewed as a human service enterprise whose primary function is the provision of diagnostic and therapeutic medical services. Its products are the specific sets of services provided to individual patients. A system for defining hospital products based on the characteristics of patients receiving similar sets of services has been developed and is referred to as Diagnosis Related Groups (DRGs). The system is described, and its implications for improved hospital management are discussed.     

Service Architecture and Modularity*

An understanding of the nature of service architecture and modularity is crucial to service design and innovation. Two sets of approaches are developed that further our understanding and support decision making. First is a systematic decomposition approach to architecture modeling that allows organizations to understand their current architecture, evaluate alternative architectures, and identify key interfaces between different parts of the service. Second, the article develops a service modularity function (SMF), a mathematical model indicating the degree of modularity deriving from unique services and the degree to which the modules can be replicated across a variety of services. Three areas are identified that can contribute to competitiveness: the possession of unique service modules or elements not easily copied in the short term by competitors; the ability to exploit these through replication across multiple services and/or multiple sites; and the presence of a degree of modularity, which in turn supports both customization and rapid new product development. The SMF can support decision making in the design of services and the exploitation of service innovation. In particular, the relationship between architecture and modularity and the roles of service contact personnel in the customization of services is shown to be complementary. It is proposed that service customization can be either combinatorial (the combination of a set of service processes and products to create a unique service) or menu driven (the selection of one or more services from a set of existing services/products to meet customer needs).     

'90s may be decade for physician payment reform

The '80s in health care were characterized by reform of Medicare payment for hospital services. The '90s are likely to be characterized by reforms in the manner in which physicians are paid for services to Medicare beneficiaries. In this article, the authors examine the steps that are already under way or proposed for reforms in the payment for physician services under Medicare.     

Measuring servitization progress and outcome: the case of ‘advanced services’

The purpose of this paper is to establish a framework for assessing the progress and outcome of a manufacturer’s transformation towards becoming a provider of ‘advanced services’ – a complex bundling of products and services, whereby manufacturers offer capabilities and outcomes instead of products alone. ‘Advanced services’ represent the most complex offering in the current servitization trend amongst manufacturers. However, current performance measures lack the breadth and focus to assess progress or outcomes, and so support research and practice of organisational transformation efforts required. To address this gap the paper investigates how a manufacturer’s efforts to become an ‘advanced services’ provider can be comprehensively measured, and develops a framework for assessing the transformation journey towards becoming an ‘advanced services’ provider. The research method is based on (1) a systematic literature review process to create a comprehensive set of service-related performance measures that are available to assess a manufacturer’s servitization efforts, followed by (2) an engagement with an expert panel to synthesise the identified measures and create a set of ‘advanced services’ performance measures. The proposed framework is presented as a scorecard that can be used in practice to assess the progress and outcome of a manufacturer’s transformation towards becoming a provider of ‘advanced services’.     

Services culture: A matrix to measure diversity

Services culture differs from goods manufacturing in that customer and employee subcultures are more relevant inputs. The cultural model appears to be structurationist and bottoms-up rather than monolithic and corporate. Analogies with international business suggest adaptation of the Farmer-Richman matrix as a “culture scale” for services. The paper discusses organizational culture, services “differentness,” and the matrix. A hypothetical example drawn from the Citibank case illustrates application of the matrix to a services firm.     

Shared services--a recipe for cost-cutting in hospitals

This article is derived from a study the authors conducted during 1978–1979 to determine the extent of shared services participation by a group of metropolitan hospitals, the problems that occurred, and the recommendations that appeared realistic. It appeared from a survey of the literature that most writers on shared services had merely introduced the concept and some of its possible applications. Little had been done to study the actual incorporation of shared services into the management structure of the organization. This study is an attempt to look closer at the real, long-term acceptance of the idea by hospital administrators and to provide a clearer picture of the way in which shared services are being used or misused.     

虚拟顾客服务系统排队模型

通过对虚拟企业售后服务部门的顾客排队网络的分析 ,确定了一种顾客具有优先权的多级顾客服务排队模型 .以顾客满意度为条件计算出了稳定平衡状态下排队系统的主要指标 ,并从收益、成本和效率等方面建立了排队系统的优化问题 ,从而可得到服务部门最优基准服务能力 .基准服务能力的确定 ,对服务能力的有效安排和组织具有重要的指导意义     

Coaching- und Beratungsanliegen von Hochschullehrenden

In the last few years, there has been an increase in coaching and training for teaching staff at institutions of higher education??universities and colleges??to provide them with the skills to develop their roles and meet professional demands upon them. These services are usually provided by the institution??s own human resource department or external higher education institutions with teaching services. This article focuses on the typical concerns of the target group of lecturers teaching at academic institutions about teaching and the higher education system. It has been structured chronologically, to provide a frame of reference for coaching and guidance counseling services and serves as a guideline for such services in general.     

International offshoring of services: A parity study

Conventional wisdom suggests that firms engage in international offshoring of services primarily to reduce wage costs associated with a given service activity. Drawing on international business research on the costs of doing business abroad (CODBA), liability of foreignness (LOF), and institutional theory, we investigate the factors that contribute to the location choices for services offshoring activity, including wage differentials between the home and host countries. We find that consistent with a parity perspective but contrary to conventional expectations, a country is more likely to be a destination of services offshoring as the average wage of a country increases. We also find that education level and cultural similarity are significant drivers of offshoring location choices, again consistent with a parity perspective. This study contributes to debates about the economic impact of services offshoring by showing that firms locate offshoring facilities in destinations that are closer in wages to the home country and those with higher education levels and cultural similarity.     

Headquarter Services in the Global Integration of Production

This study examines knowledge management within multinational enterprises (MNEs) by analyzing whether greater interdependence of production between U.S. parent firms and their foreign subsidiaries increases the provision of headquarter (HQ) services from the home country. The findings suggest that U.S. parents provide more assistance to their foreign subsidiaries that are linked in a global value chain than to those that are not involved in production sharing. This study builds on the earlier studies of the relationship between intra-MNE product flows and knowledge flows in multiple ways. First, it separately examines the relationship for high-tech and low-tech manufacturing industries, and finds that knowledge services from HQ that could be combined with knowledge of the subsidiary, such as R&D services, are primarily associated with production sharing with subsidiaries in high-tech manufacturing industries, which are assumed to be more technologically capable. Likewise, it finds that knowledge services from HQ that might be considered to be more passively received from the parent, such as industrial-type maintenance and design, are primarily associated with subsidiaries in low-tech manufacturing industries, which are assumed to be less technologically capable. Second, this study is the first one, to our knowledge, that gauges intra-firm knowledge flows using dollar-denominated measures of HQ services provided by parents to their subsidiaries.     

Focus on a necessary benefit

More than 9,000 home health agencies provide services to Medicare beneficiaries. In 1996, 10 percent of Medicare beneficiaries received home health services at a total cost of +18 billion. Rapid growth has forced changes in the structure of the benefit payment system and has made home health an attractive area for fraudulent activities which are now being targeted. Collectively, this important benefit and relatively new industry will face changes in the way they do business and deliver services.