Towards an understanding of health care purchasing: The purchasing behaviour of general practice fundholders 1

In the last few years there have been considerable changes in the National Health Service. Perhaps the most significant of these has been the introduction of competition into health care, that is the split of the health service into purchasers and providers of care. Central to this development has been the introduction of general practice fundholding, whereby practices are able to purchase health care for their patients directly from competing suppliers. Those pradices which have become fundholders have faced considerable challenges in developing their purchasing function. At the same time, provider units in areas where fundholding has become established face an increasingly fragmented purchasing base.

Building on existing theoretical work into the nature of organizational purchasing behaviour and current knowledge of the health care market in Britain, this paper attempts to develop an understanding of the dynamics of GP fundholder purchasing behaviour.     

Purchasing health care services: Information sources and decisional criteria

The introduction of a market mechanism into the National Health service in the UK was underpinned by the belief that decentralised purchasing would both improve the quality of health care provision and restrain spiralling costs, through purchasers exercising their ability to choose between alternative providers. Focusing on budget holding General Practitioners, that is those practices responsible for purchasing hospital services for their practice populations, this paper explores the evolving purchasing behaviour of these professional intermediaries. Drawing on empirical evidence gathered as part of a broader study of the purchasing behaviour of GP Fundholders in Scotland, specifically it examines the key information sources and decisional criteria utilised by these professional intermediaries in selecting health care providers for their practice population. Utilising relational models of market behaviour, it addresses both the contextually specific issue of whether the market mechanism within the NHS is achieving the twin objectives of improving health care provision and restraining cost pressures, and the broader conceptual issue of the purchasing behaviour of professional intermediaries within a service sector environment.     

Understanding the drivers of organic foods purchasing of millennials: Evidence from Brazil and Spain

This paper examines the antecedents of millennials' organic food purchasing. A conceptual framework, based on product characteristics, and consumers' concerns and consciousness, is proposed. Data collection was conducted through a survey in two culturally and socioeconomically distinct countries (Brazil vs. Spain) to increase the robustness and generalizability of the results. The results show that product characteristics and consumer concerns improve millennials’ health consciousness and increase their social consciousness, which, in turn, increase their willingness to pay a price premium and their purchase frequency of organic foods. The findings show that the proposed model has high validity, with only one significant difference between the two countries. Theoretical contributions and managerial implications are discussed.     

Innovation sourcing excellence: Three purchasing capabilities for success

Innovation sourcing has become more critical across many industries. As global value chains have become more fragmented, change and opportunity comes from all sides. As a result, companies need to excel at capturing innovation opportunities with existing and potential supply chain members. This article describes a simple framework with three essential innovation sourcing capabilities needed to excel in purchasing: (1) Purchasing needs to explore unmet needs and anticipate future competitive advantages by working closely with other functions and clients; (2) it needs to explore external opportunities beyond first-tier suppliers; and (3) it needs to involve suppliers in innovation projects that consistently deliver results over time. Our framework has been developed based on a combined qualitative and quantitative research methodology that takes into account practices and results at the purchasing and company levels. The framework will help C-level managers and purchasing teams benchmark their progress in innovation sourcing and understand what steps need to be taken to achieve excellence.     

A story to sell: The influence of storytelling on consumers' purchasing behavior

Storytelling can arouse consumers' emotions and affect purchasing behavior through desires and attitudes. While the marketing literature discusses storytelling, there is a lack of consensus because of the diverse conceptual and operational definitions used. To untangle the complexities and consolidate the fragmented knowledge about storytelling in marketing, this research examines how the marketing literature has addressed the influence of storytelling on consumers' purchasing behavior. The findings aid in understanding how the topic has been discussed from a marketing perspective in consumer behavior studies. Through a systematic literature review using a bibliometric analysis, we demonstrate that the marketing literature features four strands about the uses of storytelling to influence consumers' purchasing behavior. First, storytelling stimulates the consumer's identification with the brand. Second, storytelling allows consumers to experience emotional value. Third, storytelling supports engagement behaviors. Finally, storytelling has a downside in that it also propagates harmful speech. This study concludes with a roadmap for future research about how storytelling impacts consumers' purchasing behavior.     

Ethical perceptions of Asian managers: evidence of trends in six divergent national contexts

Global link building is having a substantial impact in every sphere of Asian managerial activity. The economic upheavals of the Asian ?nancial crisis have cast a long shadow, and ethical clarity has become a social issue. For instance, corporate performance in terms of long-term survival, growth and global competency is seen to depend to a considerable extent upon the ethical infrastructur of managers and emerging managerial culture in Asia. One ?eld in which Asian managers and their managerial practices are often considered weak is the area of ethical clarity. Corporate managerial leaders in Asia need to develop new responses to the ethical complexities arising out of the increasing global interfaces. In spite of a growing awareness of the importance of ethical centrality in an intensely competitive international business arena, very little empirical work has been conducted to strengthen the relevant management literatures. The purpose of the research reported in this paper was to examine the perceptions of ethical probity among managers in six Asian countries. The results of the study indicate interesting convergences and divergences across countries and organisational demographies. The ?ndings lead to observations of the apparent similarities of ethical conceptualisation in global, societal and often in the organisational arena while revealing noticeable divergences in the domain of individual ethical perceptions.     

Consumer preferences for sustainable production methods in apple purchasing behaviour: a non‐hypothetical choice experiment

Increasing concern for potential risks on human health related to the overuse of chemicals in farming has promoted the research of alternative production methods. This paper contributes to the current literature by presenting a non‐hypothetical choice experiment study that investigates apple consumers' preferences for alternative production systems moving from a conventional to organic production, passing through an integrated pest management and an innovative technique that uses biocontrol agents. Other investigated attributes are appearance, origin and low greenhouse gas emission practices. The non‐hypothetical choice experiment was carried out in supermarkets by asking respondents to pay out of their own pocket for the chosen product. Most of interviewed people stated to have cut‐off values in mind when purchasing apples and their choices have been modelled according to the Swait soft cut‐off approach. Non‐compensatory model estimations confirm previous evidence that ignoring thresholds in data sets that contain them leads to significant errors in terms of willingness to pay. Results suggest that respondents, besides preferring organic production, seem to not perceive the potential benefits of other sustainable production methods.     

Social media celebrities and new world order. What drives purchasing behavior among social media followers?

Social media celebrities (SMCs) and social media platforms (SMPs) have become indispensable in today's business and marketing settings. Drawing on the celebrity influence model (CIM), this study examines the impact of SMCs on their followers' purchase intention and the moderating influence of SMP usage on the relationships between (a) SMCs and their followers' purchase intention, (b) para-social relationships (PSR) and purchase intention, and (c) identification and purchase intention. We collected 665 valid responses via an online questionnaire in China and then employed partial least squares structural equation modelling (PLS-SEM) to examine the proposed relationships between the variables. The findings revealed that SMCs do not significantly influence their followers' purchase intention directly; however, they do exert such influence through PSR and identification. The results further indicated that SMP usage moderates the effect of PSR and identification on purchase intention. Our study offers both theoretical and managerial contributions. Theoretically, the incorporation of CIM into this study's model augments the PSR and identification literature in the context of SMCs. Again, the moderating effect of SMP usage that we reveal is novel in the social media literature. In practice, marketers in China should consider the credibility and rapport a particular social media celebrity has with his or her followers before contracting that particular celebrity to endorse their products.     

What's inside matters: The impact of ingredient branding on consumers' purchasing behaviours in services

Ingredient branding has been widely used as a marketing strategy to create added value and enhance market competitiveness in a variety of durable and non-durable product categories. Despite its prevalence in practice, current research into ingredient branding offers little guidance for the services sector and is, in any event, limited to studies that analyse intentions rather than actual behaviours. This paper contributes to the literature by using scenario-based and field experiments to examine the impact of ingredient branding on consumers' purchasing behaviours in a service context. The scenario-based experiments highlight the mediating role of quality perception on willingness to pay, which increases by up to 9 % for a food item that is ingredient branded. The results of the field experiment show that the actual sales of an item increase by 40 % when it is ingredient branded. Consequently, this paper provides both theoretical and managerial insights into the favourable impact of ingredient branding on consumers’ purchasing behaviour. This paper concludes by proposing an agenda for future research.     

The role of cultural values in green purchasing intention: Empirical evidence from Chinese consumers

Environmental problems, especially in the case of water and air pollution, are the harmful result of the overconsumption of fossil fuels as well as various forms of industrial sewage water discharge. Recently, growing environmentally friendly purchasing behaviour of consumers has become regarded as an effective method for alleviating such environmental problems. Due to concerns regarding the natural environment, consumers have increasingly begun to exhibit favourable attitudes towards environmentally friendly products, and as a result, are more likely to purchase “green” products. However, green purchasing behaviour of consumers varies across different nations and cultures. This study aims to reveal how Chinese cultural values (specifically, the Doctrine of the Mean) influence green purchasing intention of Chinese consumers. As the lifestyles of consumers will be deeply affected by their cultural values, this study examines the mediating effects of the four dimensions of Chinese lifestyle have on consumers. At the same time, environmental knowledge is considered as a moderating variable in order to investigate the relationship between the Doctrine of the Mean and green purchasing intention. The study’s data were collected from Chinese consumers. Empirical results reveal that such Chinese cultural values are positively associated with green purchasing intention, and that three dimensions of consumer lifestyle (namely leadership, cost consciousness and development consciousness), are all found to play mediating roles in the relationship between the Doctrine of the Mean and green purchasing intention in Chinese consumers. The moderating effects of environmental knowledge are exhibited in the influence of leadership as well as development consciousness on green purchasing intention. The study’s findings have theoretical implications for understanding green purchasing intention as well as behaviour of Chinese consumers further. The study’s findings also present practical implications for how to promote green purchasing intention in Chinese consumers better.     

Strategic changes in purchasing: Two main tracks

Purchasing is going through an extensive process of change, and facing several challenges. In this study two important strategic tracks are identified and the underlying causes analysed. The first track entails an increased degree of purchasing, following from make-or-buy decisions: so-called outsourcing. The second tract entails decentralization of and coordination within the purchasing function. In three case studies, these two tracks have been found to be dominant aspects of change. They can be implemented simultaneously, but their driving forces are different. The companies examined have been chosen to make comparisons between a company within the automobile industry and two prominent companies within other engineering industries. Comparisons show that automobile manufacturers have unique prerequisites for going very far along the outsourcing track, owing to a combination of mass production and an end-product that contains many modules or subsystems. In terms of decentralization of and coordination within the purchasing function, the companies have more similar conditions and changes are more alike.     

Measuring Purchasing Groups Performance in the Health Care sector

For many decades, governments in Western countries have attempted to control health costs. One of the strategies used is through purchasing groups, since consolidated needs generate additional savings. Although various aspects of purchasing groups have been studied, performance measurement has been neglected; due to the lack of proper measures, tensions between the purchasing group and its members can't be addressed with more objective information. However, appropriate performance indicators are considered a prerequisite to successful collaboration. Using the in‐depth case of a Canadian purchasing group in the health care sector, this article suggests a set of performance indicators to measure results considering dimensions of the purchasing process and the interactions between the purchasing group and its members (who are also its customers). © 2018 ASAC. Published by John Wiley & Sons, Ltd.     

Genetic Testing and the Demand for Cancer Insurance

There has been an expansion of the availability of disease-specific insurance policies in the United States over the past decade. At the same time, recently developed medical tests are providing consumers with new information regarding their risk of contracting particularly serious diseases. This exploratory study makes use of data from two groups of women to examine the demand for one type of disease-specific policy, cancer insurance. Members of the first group have been tested for a BRCA1 gene mutation that is associated with an 88% risk of contracting breast and/or ovarian cancer by age 70. The other group consists of women from the general population who have not been tested for any BRCA1 gene mutation.The study results indicate that women who have been tested for the BRCA1 gene mutation are more likely than untested respondents to have purchased cancer insurance and to have recently thought about purchasing cancer insurance. The results also indicate that older women and women who have modest household incomes are more likely to have purchased cancer insurance. Women who have minor children, who are more highly educated, who have no health insurance, who have had cancer, or who report that they are in poor health are more likely to have recently contemplated purchasing cancer insurance. Our discussion of the findings highlights several issues that merit further consideration on the part of consumer policy makers working in the area of insurance regulation.     

An exploration of the influence of food labels on South African consumers' purchasing behaviour

New labelling legislation in South Africa is expected to help consumers sustain a healthy lifestyle through the food choices they make. This study was undertaken to explore a sample of South African consumers' reasons for reading labels and the influence of food labels on their purchasing behaviour. The study was conducted using focus group discussions held with label reading consumers in Potchefstroom in the North West Province of South Africa. Findings suggested that these participants read food labels to assess the nutritional value, personal benefits, health attributes and product quality. Various purchasing influences were also identified, suggesting that consumers are in some cases motivated by food labels to purchase a product, or may be unresponsive to the label or indifferent by being aware of the information but not reluctant to buy a product that does not indicate essential information. Several indirect consideration factors such as situational factors (e.g. family), extrinsic (e.g. price) and intrinsic (e.g. taste) may contribute to the purchasing behaviour of some consumers. These findings are useful to propose a perceptual model of the way in which food labels influence purchasing behaviour of a sample of South African consumers and explain the role of food labels in the purchasing decision of label‐reading consumers. This information is especially significant for new packaging and labelling initiatives as it highlights the reasons why label‐reading South African consumers read label information.     

Cocreative customer practices: Effects of health care customer value cocreation practices on well-being

Drawing on three studies using data from six separate samples of 1151 health care customers, the authors investigate cocreative customer practices, modeling the effects of customer value cocreation practices on well-being. Results highlight that while positive interactions with medical staff (doctors) lead to increased well-being through engaging in coproducing treatment options, interactions with friends and family and their associated cocreated activities have an even greater positive effect on well-being. Furthermore, several other customer-directed activities have positive indirect effects. Interestingly, activities requiring change can have a negative effect on well-being, except in psychological illnesses, where the opposite is true. The authors conclude with theoretical and managerial implications, highlighting that if interactions and activities with medical professionals are supplemented with customer-directed activities, the positive effect on well-being is significantly enhanced.     

Influences on member commitment to group purchasing organizations

Group purchasing organization (GPOs) have become an important part of some sectors of our economy, such as health care. To be successful at obtaining favorable purchase terms, a GPO must be able to foster and maintain the commitment of its members. Four positive influences on member commitment are hypothesized: (1) satisfaction with the GPO; (2) the perceived commitment of other GPO members; (3) the degree of information exchange between member and GPO; and (4) trust in the GPO. The suitability of alternatives to membership in the GPO was predicted to negatively influence member commitment. These hypotheses were tested with data from a mail survey returned by 249 (49.8%) retail pharmacies. A multiple regression analysis identified significant positive associations between member commitment and commitment of other members, information exchange, and trust. Also, the suitability of alternatives showed a significant negative relationship with commitment. Implications of the findings for managers and researcher are discussed.     

Fear appeals and coping appeals for health product promotion: Impulsive purchasing or psychological distancing?

The prevalence of online health communities (OHCs) motivates health product companies to manipulate persuasion-based marketing strategies, including fear appeals and coping appeals, to promote health products. However, whether such a practice is effective remains unclear. Respondents may either impulsively purchase the recommended health products or simply distance themselves psychologically from the information. Building on protection motivation theory (PMT), this study uncovers the mechanisms behind these two coping responses to persuasive messages, namely, the impulsive purchasing and psychological distancing of OHC users. Correspondingly, we evaluated 366 valid questionnaires, and the results reveal that (1) when encountering fear appeals, perceived health threat can evoke cyberchondria, leading to psychological distancing; and (2) when encountering coping appeals, perceived response efficacy leads to product affection, fostering impulsive purchasing. This study provides new insights into the effects of persuasive messages for health product promotion in social commerce. Marketers should design appropriate persuasive messages to foster impulsive purchasing by generating individuals’ product affection and avoiding cyberchondria.     

Continental differences in purchasing strategies and tools

This article focuses on the similarities and differences between the continental purchasing strategies and tools of companies in Western Europe and North America. The main question examined here is the strategic priorities and tools that European and North American buyers use (at the category level) for direct purchases and how they differ. The analysis is based on an empirical study of 224 companies from 10 countries. The results suggest that Europeans emphasise a reduction in prices and total cost of ownership as strategic objectives, while North Americans place greater emphasis on compliance with social and ethical guidelines. Both groups place surprisingly little emphasis on environmental objectives. In terms of tools, North American buyers have higher utilisation of electronic tools in purchasing and in communicating with suppliers, while European buyers appear to more extensively use purchasing tools associated with rating and auditing suppliers. Overall, it appears that a majority of purchases take place in home countries and close-by regions. Accordingly, we argue that practices adopted there offer interesting insights for international purchasing of the companies.     

Environmental purchasing: a framework for theory development

This paper examines environmental research in the supply chain management literature in order to establish a framework for current and future development of environmental purchasing theory. As the purchasing function takes on a more strategic role in forming trading partnerships with others in their supply chains, it is in a critical position to influence responses to concerns about the natural environment. Definitions of environmental supply chain management and environmental purchasing are offered and the literature is reviewed. Linkages of environmental purchasing with transaction cost analysis are established and future research is described to enhance the study of purchasing's ability to effect the natural environment.