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。     

The Impact of Service Quality and Service Characteristics on Customer Retention: Small Businesses and their Banks in the UK1

The recent developments in relationship marketing have increasingly focused attention on the beneficial effects of customer retention. The notion of building relationships and delivering quality service in order to encourage loyalty is perhaps of particular importance in the service sector where it is often argued that customer attraction costs are significantly higher than retention costs. Central to the idea of investment in the development of service quality and customer relationships is the belief that such investments will enhance loyalty, retention and profitability. Empirical evidence on the extent to which such links exist is still partial. This paper explores the relationship between service qualitylcustomer relationships and customer loyalty and retention using evidence from the UK banking sector and its small business customers.     

The Impact of a Task Clarification and Feedback Intervention on Restaurant Service Quality

Customer service is a key aspect of restaurant success, as performance has shown a reliable positive relationship with customer retention. However, waitstaff performance may deteriorate, as income from gratuities is often unrelated to service quality. The present study investigated the effectiveness of an intervention consisting of task clarification and task-specific feedback on restaurant service tasks and observed the relationship between task completion and gratuities. Three adult women servers participated during their regular working shifts at a local dine-in restaurant. Initially customer service task completion was low (36% on average across participants). Performance increased immediately following the introduction of the intervention, and all participants maintained 87.5%–100% task completion. Correlational analyses found that gratuities were unrelated to performance and may thus pose a problem for performance maintenance. Implications relating to feedback and payment schedules are discussed.     

文化差异对顾客服务质量感知影响的实证研究

顾客感知服务质量的度量是服务管理理论中最具前沿性的问题,而服务质量评价方法跨文化适用性的界定,无疑对借鉴国外先进的评价方法和提高中国服务企业服务质量水平具有积极的意义。本文通过对服务质量评价最重要的评价方法SERVQUAL跨文化适用性的研究,提出了不同文化背景的顾客在服务质量感知方式等方面存在着差异等一系列结论。     

服务失败情境下面子丢失对顾客抱怨倾向的影响

作者基于中国文化中特有的面子理论对消费者在服务失败中的心理反应机制进行了详尽的探讨,提出了以顾客损失、面子丢失和情绪为核心的顾客抱怨倾向模型。该文采用真实录像情景实验法进行了实证研究,证实了面子机制在服务失败下是真实存在的,消费者的面子损失会影响失败后情绪,进而影响其抱怨倾向。     

Health Care Supply Chain Design: Toward Linking the Development and Delivery of Care Globally*

This article is motivated by the gap between the growing demand and available supply of high‐quality, cost‐effective, and timely health care, a problem faced not only by developing and underdeveloped countries but also by developed countries. The significance of this problem is heightened when the economy is in recession. In an attempt to address the problem, in this article, first, we conceptualize care as a bundle of goods, services, and experiences—including diet and exercise, drugs, devices, invasive procedures, new biologics, travel and lodging, and payment and reimbursement. We then adopt a macro, end‐to‐end, supply chain–centric view of the health care sector to link the development of care with the delivery of care. This macro, supply chain–centric view sheds light on the interdependencies between key industries from the upstream to the downstream of the health care supply chain. We propose a framework, the 3A‐framework, that is founded on three constructs—affordability, access, and awareness—to inform the design of supply chain for the health care sector. We present an illustrative example of the framework toward designing the supply chain for implantable device–based care for cardiovascular diseases in developing countries. Specifically, the framework provides a lens for identifying an integrated system of continuous improvement and innovation initiatives relevant to bridging the gap between the demand and supply for high‐quality, cost‐effective, and timely care. Finally, we delineate directions of future research that are anchored in and follow from the developments documented in the article.     

医疗信息共享对患者转移数量和服务质量水平影响研究

当前我国医院间存在严重的"信息孤岛",医院参与医疗信息共享意愿不高,患者的诊疗信息被静态碎片化储存而无法充分有效地利用。考虑到医院进行医疗信息共享将降低患者转移成本,本文构建一个多阶段双寡头动态博弈模型研究医疗信息共享对医院竞争过程中患者转移数量和服务质量水平决策的影响。首先,根据是否存在转移成本,将患者分为新患者和经验性患者,借助Hotelling模型刻画患者的效用函数,分析患者就诊决策。然后,在政府价格规制和不考虑医院利他性情景下,构建了医院累积期望收益目标函数,使用动态规划方法,求解实现医院累积期望收益最大化的服务质量水平,获得了实现患者相互转移且医院在市场中共存的马尔可夫完美均衡。最后,根据医院参与医疗信息共享后患者转移成本降为零,分析与比较信息共享前后患者转移数量和服务质量水平变化。研究发现：在不同医院间本身存在患者转移背景下,医院参与信息共享后,患者转移数量增加但存在一个上限,增加的转移量与患者在医院间的转移成本呈正相关,与初始感知效用的差值范围呈负相关;医院参与信息共享后,均衡状态下的医院服务质量水平高于信息共享前的服务质量水平。因此,在不改变当前医保支付方式下,要加快推进医疗信息共享,政府部门可以根据医院的患者数量和服务质量水平变化对其进行定期补贴,以激励医院积极参与医疗信息共享,本文给出了这个补贴的量化表达。     

3PL企业融资服务模式下考虑损失规避零售商的供应链运营和协调策略

针对第三方物流（3PL）企业融资服务模式,研究了具有损失规避行为的零售商面临资金约束情形的供应链运营策略和协调问题。在本文中,分析了分散情形下3PL企业的最优融资策略和损失规避零售商的最优订货策略。以及集中情形下供应链的最优订货策略,通过比较两种情形下的最优订货量,得到了可以使资金约束供应链实现整体协调的转移支付契约。研究结果表明：当零售商初始资金较高时,3PL企业融资服务模式下零售商的订货量超过其在资金充足时的订货量;当零售商初始资金满足在一定范围内时,3PL企业融资服务模式可以使3PL企业和零售商获得帕累托改善,但不能直接协调资金约束供应链;当3PL企业和零售商签订的转移支付契约满足一定条件时,供应链可以实现整体协调。     

公仆型领导、员工集体和个人的工作态度对服务质量的影响

作者在13家宾馆和餐馆进行了一次实证研究,探讨饭店管理人员的公仆型领导风格、员工集体和个人的工作态度对员工的服务质量的影响.多层次线性模型分析结果表明,部门的公仆型领导氛围会直接影响员工集体的工作满意感,并通过集体情感性归属感,间接影响员工的服务质量.部门的公仆型领导氛围会调节员工感知的部门负责人的公仆型领导风格对他们的服务质量的影响;员工集体的情感性归属感会调节员工个人的工作满意感和情感性归属感对服务质量的影响.     

员工情绪表现结构维度及对感知服务质量影响初探

根据文献总结,情绪劳动分为员工和消费者视角,对员工视角的情绪劳动已经有了相当丰富的研究,而对消费者视角情绪表现研究还处于起步阶段。文章通过日记观察法和问卷调查法来探讨:(1)情绪表现的结构;(2)情绪表现对感知服务质量的影响。在25篇观察日记和564份有效问卷的基础上,采用SPSS和SmartPLS进行数据处理。结果显示,情绪表现分为负向情绪表现,包括假装表情、冷漠表情、轻视表情;正向情绪表现包括持久表情、真诚表情和自然表情共六个维度;基于总体数据,负向表情对感知服务质量的负向作用不显著,正向表情对感知服务质量的正向作用显著;基于不同背景样本之间的路径作用存在差异,学生样本的显著路径远远多于在职样本,男性样本的显著路径多于女性样本,专科样本的显著路径远远多于本科和硕士样本,小于30岁样本的显著路径远远多于大于30岁样本。     

银行卡的替代效应及其对狭义货币需求的影响分析

本文首先研究了我国银行卡支付额对现金的替代效应,并进一步分析了银行卡支付额对狭义货币需求的影响。研究发现:随着近年来我国银行卡产业的蓬勃发展,银行卡支付总额猛增,银行卡支付额与现金流通量之间呈指数替代关系,并建立了银行卡支付额对现金替代效应的非线性模型;银行卡支付额对狭义货币需求量的影响也是非线性的,并利用非参数局部多项式拟合建立了部分线性回归模型。这两个模型在这类研究中是首次提出,并有很好的解释作用。     

服务失败情境下顾客损失、情绪对补救预期和顾客抱怨倾向的影响

由于服务行业高交互性和同步性特征,服务失败不可避免,重新赢得顾客的有效途径就是通过成功的服务补救.从国内外对于服务失败和补救的研究成果上看,绝大多数采用以认知为主的范式(归因、公平、满意、期望等),很少有研究关注服务失败和补救中给消费者带来的情绪变化.本文在充分回顾服务失败文献的基础上,提出在多年的研究成果中并未充分重视消费者的情绪反应过程.作者基于资源交换理论对消费者在服务失败中的心理反应机制进行了系统而科学的探讨,提出了以顾客损失、情绪为核心的服务失败模型.根据研究目的和研究模型,本文采用情景模拟法进行了实证研究,正式研究进行了严格的实施控制,包括对访问人员的访前培训和问卷复合,研究所用量表从国外相关研究的研究量表选择有效测项形成,按照事件严重程度和服务员情绪展示程度对情景进行2×2设计,选择在校大学生作为被试,最终获得有效问卷261份.数据采用了ANOVA、回归和PLS进行分析,并对各研究假设进行了验证.研究成果证实了服务失败本身和服务员处理失败时的情绪都会影响到消费者功利损失和象征损失,并进而影响消费者失败后的情绪,补救预期和抱怨倾向是认知和情绪综合影响的结果.     

Impact of Absenteeism on Assembly Line Quality and Throughput

Assembly lines function best when every worker is present. When a worker is absent, management must scramble to quickly find a replacement. Usually, the replacement will not be as proficient as the absent worker. This can reduce quality and throughput. We present two assembly line work‐systems models (one for lines with Andon and one for lines without Andon) that show one mechanism whereby absenteeism could impact quality and throughput. We exercise these models to provide insights into absenteeism's impact on quality and throughput. While the paper is written in the concrete terms of automotive assembly, the concepts and results apply to manual assembly lines in general.     

The Impact of Nonagility on Service Level and Project Duration*

“Why projects are late” is a fundamental issue in theory and in practice. One well‐established explanation is that a project's network structure can be a significant factor—the “fatter” or more parallel the project, the later the project completion. Herein we show that a lack of agility, which may frequently arise in projects when there are external resources, can also be a significant factor in project delays—both in more serial‐like projects as well as more parallel ones. Specifically, this article formally characterizes the concept of agility in projects, shows how a lack of agility can have a significant impact on a project, and gives some general properties on agility with respect to a project's structure.     

The Impact of Variability and Patient Information on Health Care System Performance

In the delivery of health care services, variability in the patient arrival and service processes can cause excessive patient waiting times and poor utilization of facility resources. Based on data collected at a large primary care facility, this paper investigates how several sources of variability affect facility performance. These sources include ancillary tasks performed by the physician, patient punctuality, unscheduled visits to the facility's laboratory or X‐ray services, momentary interruptions of a patient's examination, and examination time variation by patient class. Our results indicate that unscheduled visits to the facility's laboratory or X‐ray services have the largest impact on a physician's idle time. The average patient wait is most affected by how the physician prioritizes completing ancillary tasks, such as telephone calls, relative to examining patients. We also investigate the improvement in system performance offered by using increasing levels of patient information when creating the appointment schedule. We find that the use of policies that sequence patients based on their classification improves system performance by up to 25.5%.     

Paper Versus Electronic Medical Records: The Effects of Access on Physicians' Decisions to Use Complex Information Technologies*

This study examines physicians' responses to complex information technologies (IT) in the health care supply chain. We extend individual‐level IT adoption models by incorporating a new construct: system accessibility. The main premise of the study is, when faced with a decision between alternate IT systems, individual users tend to select and make use of the technology or system that is most readily accessible. We discuss both physical and logical dimensions of accessibility as they relate to adoption of electronic medical records (EMR). Physical accessibility refers to the availability of computers that can be used to access EMR, while logical accessibility refers to the ease or difficulty of logging into the system. Using data from a survey of 199 physicians practicing in a large U.S. hospital, we show that, when deciding between the paper chart and EMR, accessibility is an important consideration in a physician's decision to use the system. Both dimensions of accessibility act as barriers to EMR use intentions through their indirect effect on physicians' perceptions of EMR usefulness and ease of use. Logical access also has a direct effect on EMR use intentions. We conclude that accessibility is an important factor that limits acceptance of complex IT such as EMR.     

网络能力、关系学习对服务创新绩效的影响研究

基于服务科学、网络能力理论、关系学习理论,结合已有文献深入剖析服务创新内涵、服务创新绩效。本文构建了包含中介变量的结构方程模型,并通过对华南地区243家企业样本的实证研究,得出以下研究结果:(1)网络能力对服务创新绩效有正向影响关系;(2)网络能力对关系学习存在显著的正向影响;(3)关系学习对服务创新绩效有正向影响;(4)在网络能力对服务创新绩效的影响中,关系学习起部分中介作用。本文研究结论可以为服务业创新活动提供有益的指导和借鉴,进而强化服务业的竞争优势。     

服务质量决定要因顾客满足和行动意图的影响--在中国服务产业的应用

为维持现有顾客和创造新顾客,服务企业必须知道怎样实施服务质量战略来增加顾客满足和行动意图,因为服务质量、顾客满足和顾客行动意图之间存在着因果关系.本研究把整体服务质量分解为相互作用质量、物理环境质量、结果质量三个决定要因,并对服务质量决定要因对顾客满足和行动意图的影响进行了研究,实证检验在中国服务产业中进行.对研究模型的验证结果支持本研究提出的所有因果假设,即构成整体服务质量的三个决定要因对顾客满足具有显著的正向影响,顾客满足对行动意图具有显著的正向影响.而且,对于中国顾客来说,服务质量决定要因对顾客满足的相对影响力依次为结果质量＞相互作用质量＞物理环境质量.     

Offshoring Business Process Services and Governance Control Mechanisms: An Examination of Service Providers from India

As emerging markets increasingly rely on service businesses through offshore outsourcing, we examine the role of governance control mechanisms in improving performance among business process outsourcing (BPO) service providers in India. Using data collected from 205 emerging market‐based BPO service providers in India, we examine the antecedents and consequences of establishing governance control mechanisms in BPO service providers. Specifically, we examine how structural (use of contracts with the client), administrative (effective allocation and demarcation of responsibilities within the firm), and relational (collaboration and information sharing with the client) mechanisms drive the performance of a BPO service provider operating in an emerging market. We also examine how key task‐related (task connectivity and task security) and client‐related (end customer orientation and global control) antecedents influence the use of different governance control approaches in this environment. Our analysis finds that both task connectivity and task security significantly impact use of structural and administrative mechanisms, whereas end customer orientation is significantly associated with the strength of the relational mechanisms governing the emerging market‐based BPO service provider and its client. Further global control significantly influences the strength of the structural mechanisms between the client and the BPO service provider. Finally, the three mechanisms have a complementary influence in driving the BPO service provider's performance.     

服务补救中顾客情绪对顾客满意之影响的实证研究

在顾客服务补救满意的研究中,本文引入情绪变量,提出了包含服务失败、服务补救整个过程的研究模型,采用情景模拟的方法进行了实证研究。研究表明:顾客在服务补救后的满意,受顾客服务补救后情绪的影响,而不是受顾客服务失败时的初始情绪的影响。其中,补救后积极情绪对补救满意有显著的正向影响;补救后外在归因消极情绪对补救满意有显著的负向影响。