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.     

Marketing Performance and Business Risk in Acutecare Health Trusts - A New Comparative Approach

The introduction of an internal market to the NHS in April 1991 has created a vastly different structure for the delivery of healthcare throughout the UK. This paper investigates the relationship between the changing income structure of acute care Trusts and their use of marketing as a tool to manage an increasingly complex operating environment. Primary data from a postal questionnaire to Trust Chief Executives (or their representatives) has been used to classify the 51 responding Trusts according to their performance within an acute care market that accounts for some £3.57 billion of the annual NHS spend.This is the first time that this type of marketing risk analysis as been attempted within the UK Health Service.

An innovativepositional matrix has been developed, categorising all the acute healthcare Trusts into four categories according to theirMarketing Index (MI) and Perceived Future Income Instability (INS) scores. The study suggests that about 24 per cent of all the Trusts are excessively exposed to future business risk as evident by their rather high income instability scores and low useof marketing tools and therefore more attention to marketing has to be given by these Trusts. Closer analysis of the results ofthe data indicates that those Trusts with a high marketing index (i.e. those more likely to be able to handle income instability),place market analysis, marketing strategy, demand forecasting and personal contact with purchasers, as top priorities. ThoseTrusts with low marketing indexes give priority to pricing analysis and personal contact with purchasers only.     

The more business owners, the merrier? The role of tertiary education

Policy in developed countries is often based on the assumption that higher business ownership rates induce economic value. Recent microeconomic empirical evidence may lead to a more nuanced view: Especially the top-performing business owners are responsible for the value creation of business owners. Other labor market participants would contribute more to economic value creation as an employee than as a business owner. The implied existence of an “optimal” business ownership rate would thus replace the dictum of “the more business owners, the merrier.” We attempt to establish whether there is such an optimal level, i.e., a quadratic relation between the business ownership rate and economic output rather than a linear or higher-order relationship, while investigating the role of tertiary education. Two findings stand out. First, by estimating extended versions of traditional Cobb–Douglas production functions on a sample of 19 OECD countries over the period 1981–2006, we indeed find robust evidence of an optimal business ownership rate. Second, the relation between business ownership and macroeconomic productivity is steeper for countries with higher participation rates in tertiary education. Thus, the optimal business ownership rate tends to decrease with tertiary education levels. This is consistent with microeconomic theory and evidence showing that business owners with higher levels of human capital run larger firms.     

Business Performance in the UK Hotel Sector - Does it Pay to be Market Oriented?

This article reports the findings ofa postal survey of 200 of the UK's largest hotel groups. The results clearly indicate that many organisations have yet to achieve a market orientation and that a focus on competitors is frequently absent. Thirty five per cent of hotels remain sales oriented, although no adverse effects on performance would yet appear to be evident. This study found no link between the degree o f market orientation attained and the performance o f the business as measured by profitability and turnover.     

Political and Economic Arguments for Corporate Social Responsibility: Analysis and a Proposition Regarding the CSR Agenda

Different perspectives on corporate social responsibility (CSR) exist, each with their own agenda. Some emphasise management responsibilities towards stakeholders, others argue that companies should actively contribute to social goals, and yet others reject a social responsibility of business beyond legal compliance. In addition, CSR initiatives relate to different issues, such as labour standards and corruption. This article analyses what types of CSR initiatives are supported by political and economic arguments. The distinction between different CSR perspectives and CSR issues on the one hand and between political and economic arguments on the other could help to advance the debate on the justification and welfare impact of CSR. It is argued that ordinary boundary conditions for business behaviour in a market economy provide support for some, but not all, CSR initiatives. This has implications for policy priorities. Building on the analysis, it is proposed that more attention should be paid to the behaviour of large multinational enterprises in their normal business operations and to CSR issues with a potentially large impact on market functioning.     

Can Ethical Behaviour Really Exist in Business

Our soft survey reveals that the assumption underlying much of the business ethics literature -- that the conduct of business can and ought to support the social good -- is not accepted within the workplace. This paper considers an apparent dichotomy, with companies investing in ethical programs whose worth their employees and managers question. We examine the relationship between work, bureaucracy and "the market" and conclude that employees often question the existence of business ethics because there is no good and bad between which to choose. The choice is between success and failure. A common view of success and the "good life" is one determined by hard work in a well-organised company operating in a free market. Analysing the three aspects of this view (the free market, hard work, bureaucracy) we suggest these are mere fictions. A major problem we identify in business is that organisations are designed as profit making mechanisms and have no interest in the good of society. The challenge is to convince such organisations that a direct benefit accrues to them through their own ethical behaviour. In order to do this organisations must first be shown the importance of long termism. Executives, managers and other employees can be expected to attain high ethical standards only when they feel they are a integral part of an organisation and the organisation itself respects those standards. One of the keys to unravelling the undesirable situation of a perceived absence of ethics in business is in encouraging a greater identity community, company and workforce. We provide some examples of ways companies can meet the challenge of encouraging more ethical, long-sighted behaviour. In addition, we highlight ways in which the expectations of the organisations of the organisation can be communicated more strongly through corporate structures that foster ethical action that benefits the long term interests of the individual and the organisation. Overall implementing a successful ethical program is shown to parallel that of the implementation of a quality program.     

Value-oriented brand positioning

The objective of brand positioning is to place a brand that is clearly distinguishable from competitors' brands on the market. The principal aim is to ensure that the brand occupies a unique position on the market and that it is endowed with a precisely defined profile with clear-cut contours. The basic idea underlying this analysis is that consumers' perceptions of the various brands can be conceived as a multidimensional space in which individual brands are positioned. A product's positioning is determined from its position on the relevant dimensions of the perceptual space, its position on the various product attribute vectors and its position with respect to other brands. This paper uses correspondence analysis to reconstruct a space, in order to connect the relevant brand attributes with the drivers of behaviour, such as utility components and individual values. An empirical investigation shows the usefulness of this approach for product and advertising policy.     

Theoretical milestones in international business: The journey to international entrepreneurship theory

For many decades global business was considered the preserve of large multinationals and traditional international business theory was developed to explain the behaviour of these firms. However, increasingly there is a realization that the small entrepreneurial firm has an important role to play in international business especially given that there are strong globalization pressures that both pull and push the small firm into international markets to ensure its very survival. On the questions of how and why international business takes place, several theoretical approaches have been developed that appear to run parallel to each other. However, this paper posits that the point of convergence is international entrepreneurship.     

Creating the Customer: The Influence of Advertising on Consumer Market Segments – Evidence and Ethics

For over half a century market segments have been considered objective groupings of individuals which marketers identify, understand, and target with advertising messages. The process of market segmentation has, therefore, occupied a position of moral neutrality. An increasingly popular method of segmentation is by consumer personality, with advertisers targeting messages to specific personality types. This paper explores personality segmentation, and presents empirical evidence to support the proposition that personality metrics that are used to assign individuals to segments may, in fact, be manipulable by advertising executions themselves. Quite apart from the implications that this has for the business efficacy of the segmentation process, the ethical implications – particularly as applied to children – are considerable.     

A systems perspective on markets – Toward a research agenda

This paper addresses the implications of an emerging, increasingly important way of thinking about markets: systems thinking. A market is one of the most founational abstractions in marketing and business research; yet, it often receives too little attention. As a result, the taken-for-granted assumptions about markets spur from over-simplified conceptualizations of neoclassical economics that depict markets as static and mechanistic. Systems thinking represents a major change in perspective that involves transcending this mechanistic worldview and thinking instead in terms of wholes, relationships, processes, and patterns. We argue that building a theory of markets based on systems thinking, would enable scholars to develop more realistic models that correspond with fast-changing business environment and therefore, increase both the rigor and relevance of future research. To further this aim, we identify the main implications of systems thinking and formulate them into a research agenda to further the systemic understanding of markets.     

The Governance of Corporate Sustainability: Empirical Insights into the Development,Leadership and Implementation of Responsible Business Strategy

This article explores how corporate governance processes and structures are being used in large Australian companies to develop, lead and implement corporate responsibility strategies. It presents an empirical analysis of the governance of sustainability in fifty large listed companies based on each company’s disclosures in annual and sustainability reports. We find that significant progress is being made by large listed Australian companies towards integrating sustainability into core business operations. There is evidence of leadership structures being put in place to ensure that board and senior management are involved in sustainability strategy development and are then incentivised to monitor and ensure implementation of that strategy through financial rewards. There is evidence of a willingness to engage and communicate clearly the results of these strategies to interested stakeholders. Overall, there appears to be a developing acceptance amongst large corporations that efforts towards improved corporate sustainability are not only expected but are of value to the business. We suggest that this is evidence of a managerial shift away from an orthodox shareholder primacy understanding of the corporation towards a more enlightened shareholder value approach, often encompassing a stakeholder-orientated view of business strategy. However, strong underlying tensions remain due to the insistent market emphasis on shareholder value.     

Corporate Social Responsibility in Chinese Law——On the Section 5 of the Company Law of China

The Principle of Corporate Social Responsibility in Chinese Law
In China, a lot of ill-formed business activities exist, the good market order hasn＇t realized and the commerce hasn＇t reached the perfoect operating status. In addition to those, the personal and corporate credit systems haven＇t been completely established yet, the merchants still place their profit in primary position without considering the public interest or with less consideration, and the social problems caused by many companies with bad faith are more outstanding, so it is necessary to supplement and strengthen corporate social responsi.bility in Chinese Law.     

Cognitive Maps and a Hyperknowledge Support System in Strategic Management

Strategic management is defined as the system of action programs which form sustainable competitive advantages for a corporation, its divisions, and its business units in a strategic planning period.We have developed a system called Woodstrat to serve as a support system for these action program activities on both the corporate, the divisional, and the business unit levels. The system is modular and is built around the logic of strategic management, i.e., the main modules cover the market position; the competitive position; the production position; and the profitability, investment, and financing positions. The innovation in Woodstrat is that these modules are linked together, i.e., when a strong market position is built into some market segment, it will have an immediate impact on profitability through links running from the assumptions on an expected development to the projected profit/loss statement. There are similar links making the competitive position interact with the market position, and the production position interact with both the market and the competitive positions, and with the profitability and financing positions.The intermodular links are based on expert knowledge of strategic management; expert knowledge is also worked into the modules such that the logic of strategic management guides the user through the process of working out sustainable competitive advantages. The process is made user-supportive with a hyperknowledge user interface. The support is made intuitive and effective with the use of object-oriented expert system technology. The basis for this is rather unusual: the Woodstrat system was built with Visual Basic, in which the objects to create a hyperknowledge environment were built.It is shown that the conceptual constructs which form strategic management can be described with cognitive maps, and that these can be adequately represented with our hyperknowledge objects. It is also shown that the knowledge formation which takes place in a management team when strategic plans are formed can be described and validated with a hyperknowledge support system. It is finally shown that a support system with hyperknowledge features, which are close to the cognitive maps of a management team, will have a profound impact on the depth and the structure of its strategic management processes.     

Latvia

Situated on a trading crossroads between Western Europe and Russia, Latvia has emerged as one of the most successful countries in Central Europe. This article provides a comprehensive review of Latvia's historical development, political structure, economy, investment, and foreign‐trade environment. It aims to be a useful source of information for foreign businessmen and investors interested in doing business in Latvia. In the fall of 1991, when the Baltic States separated from the Soviet system, no one predicted that these countries would make the transition to a market‐based economy as quickly and as effectively as they have. However, 11 years later, with notable growth and rising standards of living, such thinking is no longer considered overly optimistic. “It is the biggest, most complicated, and most promising piece of the new Europe,” wrote The Economist (1998) in reference to the Baltic region. Wherever there is new growth, there are many business opportunities to be found. Latvia's position in the center of this region is one indication of the business potential for those with the capacity to do business there. © 2003 Wiley Periodicals, Inc.     

Uncharted territory: investigating individual business ethics in Cyprus

The research purpose of the study is to investigate and identify correlates of ethical behaviour and attitudes of individuals currently working or pursuing a business‐related graduate degree in Cyprus. Analysis of the quantitative questionnaire revealed that the majority of the respondents had a concept of ‘ethical behaviour’, consider ethics important, and hold attitudes that are conducive to ethical behaviour in business. In addition, findings revealed significant differences in three correlates: age, gender and position. Finally, reflecting the findings, the authors suggest specific actions that aim to improve ethical decision making in the Cyprus business environment.     

Cooperation and Competition in the Context of Organic and Mechanic Worldviews – A Theoretical and Case based Discussion

In this study we argue that there is an interconnection between; the mechanistic worldview and competition, and the organic worldview and cooperation. To illustrate our main thesis we introduce two cases; first, Max Havelaar, a paradigmatic case of how business might function in an economy based upon solidarity and sustainability. Second, TINE, a Norwegian grocery corporation engaged in collusion in order to force a small competitor out of the market. On the one hand, in order to encourage market behaviour that integrates economic, societal and environmental values we find that transparent cooperation within a context of an organic worldview takes care of important intrinsic as well as instrumental values. On the other hand, we find evidence for asserting that cooperation based upon a mechanistic worldview, typically leads to group egotistical consequences undermining the long term common good.     

Establishing Moral Business Culture in Newly Formed Democracies

Business Ethics is often regarded as a low priority in newly formed democracies, because it seems there are more urgent demands that have to be dealt with first. In this paper it is argued that this perception is not only wrong, but also dangerous. A lack of morality in business can undermine exactly those priorities that newly formed democracies regard as most urgent.It starts by indicating why morality in business is a precondition for the legitimacy of a market economy as well as for excellence in a global market economy. It continues to argue that ethics in business is also a precondition for establishing a legitimate political democracy. Once the necessity of moral business behaviour has been argued, the focus shifts to the main stumbling blocks that impede the development of moral business culture in newly formed democracies such as South Africa.In the final part of the paper, measures are discussed that can be taken to foster the development of moral business culture in these countries. The role that business leaders, politicians, civil society and the media can play in this regard are highlighted.     

Business policy,ethics and society

This section will cover (a) definition of business policy: strategic decisions in the enterprise; (b) ethical behaviour above and beyond the requirements of the law: what might this involve e.g. in respect of products and markets in which the business is prepared to operate? (c) does business have a responsibility towards ‘society’? For example, should businesses decide without being legally required to do so, to undertake activities which they think are in the national interest even if this may appear to conflict with strictly commercial interests? (d) if ethical/social decisions are required, who is to make them — at what levels of an enterprise — e.g. does the board make them all or are they also expected below board level? This section will also cover: (e) practical examples in the light of changing attitudes towards business and market behaviour in the 1980's and 1990's; (f) implications of attitudes towards corporate crime and of behaviour which may not be illegal but which may be regarded as ‘unacceptable’: this will be discussed with examples from experience in Australia and other countries. The section will first explain the meaning of the phrase ‘business policy’ and will briefly outline the kinds of strategic decision which have to be made in business enterprises. It will go on to consider whether there are things a business ‘ought’ or ‘ought not’ to do even if they are within the law. The section will illustrate these problems with examples in the light of changing attitudes towards business policy and market behaviour in the 1980's and 1990's. It will take into account some recent cases of corporate crime in Australia and elsewhere and also of behaviour which while neither against the law or outside the power of the board, might be thought ‘inappropriate’.     

Bending the rules,breaking the rules: How corruption and lobbying affect the investment market selection of Swedish firms

There is stark evidence that many policies which influence firm gains from engaging in FDI (such as tax and trade policies) are targeted by lobbying groups and that corruption can be an important determinant of market attractiveness. The scarce research that exists on firm behaviour, corruption and lobbying shows that these activities can be regarded as alternative, and interdependent, influence forms. This paper provides the novel contribution of investigating how the market infiltration of corruption and lobbying affects the firm's investment decision. We identify the interdependent effects using census data for Swedish manufacturing firms that allows a complete identification of the firm's market selection. Our results reveal that these private–public sector links influence the firm's investment decision differently, as market selection is deterred by corruption and stimulated by lobbying, and that they function as substitutes. We show that the stimulating lobbying effect largely can be attributed to its interdependency with corruption, which suggests that firms are more shielded from corruption in lobbying environments. Further investigation reveals that the corruption and lobbying effects are not always representative of larger firms: The largest firms are undeterred by corruption in markets where lobbying forms an integral part of the business environment and larger firms are not stimulated by lobbying in markets largely void of corruption.     

Sources of opportunities used by growth minded owner managers of small and medium sized enterprises

The purpose of this paper is to investigate the sources and nature of opportunities used by owner-managers of small and medium size (SMEs) firms in order to grow their businesses. In addition to the owner-manager's desire for growth, clearly there needs to be both opportunities to pursue and sufficient management activities that will discover such opportunities, so that a business can grow. These opportunities may originate through some form of environmental change such as advances in technology or by exploiting changes in the marketplace, for example, the exit of a competitor.Research was carried out within twenty SMEs whose owner-manager's aimed to grow their businesses. The focus of the research was on the sources of opportunities they encountered and how and why opportunities were recognized by these firms.The key findings of this research illustrate that the majority of sources for business opportunities for SMEs in this study lie in the market place and are not a direct consequence of environmental change. Traditional marketing analysis tools can, therefore, identify significant sources and scope for growth opportunities for SMEs.