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.     

Gender differences in the impact of banking services: evidence from Mexico

This paper examines the effects of providing financial services to low-income individuals on entrepreneurial activity, employment, and the income levels of men and women. We exploit cross-time and cross-municipality variation in the opening of Banco Azteca in Mexico to measure these effects with a difference-in-difference strategy. This bank opened over 800 branches simultaneously in 2002, focusing on low-income clients. Our results show that this led to an increase in the number of informal business owners among men and to an increase in wage-earning opportunities for women. Average income levels also increased, with this increase being twofold higher for women than for men.     

Privatization of health care services in Canada: Reform or regress?

The emergence of the privatization of health care services as one of the dominant health policy issues in many western industrialized countries is no doubt related to a number of factors, including rising health care costs, fiscal crisis in the form of budgetary deficits, charges of public waste and mismanagement and underfunding, the onset of a new era of political and fiscal conservatism, and professional and corporate antipathy to certain aspects of publicly financed health insurance schemes. The paper discusses the meaning of privatization and stresses the importance of recognizing the different forms of privatization and the need to assess these forms against well specified health policy objectives. Current and proposed forms of privatization in Canada are described and evaluated. It is concluded that there are sound arguments against privatization through user fees for insured physician and hospital services. As for the other forms of privatization there are confusing and inconsistent findings that preclude a definitive conclusion as to the wisdom of a general push for privatization. It is stressed that there are not many empirically established facts about the likely effects of privatization and the many claims about the virtues of privatization are far from substantiated by careful research. In the absence of such evidence the push for reprivatization seems, as some critics have pointed out, ideologically motivated.     

Customer participation to co-create value in human transformative services: a study of higher education and health care services

Previous studies on customer participation have mainly focused on its outcome benefits. The current study investigates the effect of various participation behaviors on both process and outcome value in human transformative services. Based on the data surveyed from health care and higher education services in Vietnam, the results show that active and relevant participation behaviors are crucial to co-create value. Information sharing, responsible behavior, and voluntary in-role feedback have different roles in process and outcome value. Voluntary in-role feedback is more important in health care service, while responsible behavior is critical in higher education. Moreover, distinction should be made between passive provision of information and voluntary feedback of customers to the firm.     

Ethical banking: The case of the Co-operative bank

The aim of this paper is to present a significant current British case of the application of an ethical approach to banking practice — it relates to issues of stakeholder dialogue, corporate strategy, and marketing.The Co-operative bank traces its organisational origins to the 1870s, and its founding principle to the beginnings of the co-operative movement in the 1830s.In today's fiercely competitive and rapidly changing financial services market, dominated by four major players, the bank has only a 2% share and its advertising spend and marketing profile have been low.Against this background, the bank searched for a positioning statement which would counter its low profile; express where it wanted to be; and give direction to its necessarily limited marketing and communications budget.What slowly evolved was an ethical banking strategy which built on the bank's differences from the others, and which benefited from an opportunity which was being ignored by them. The key concept was a commitment to the responsible sourcing and distribution of funds. A quantitative research project was undertaken with 30 000 customers which revealed major support for the overall strategy, and which was used to prioritise the practical issues of greatest concern. The outcome was an ethical banking policy which communicated what we are and what we stand for and strict guidelines on who we will, or will not do business with.Professor Brian Harvey is The Co-operative Bank Professor of Corporate Responsibility at Manchester Business School, University of Manchester and Honorary Secretary of the European Business Ethics Network. His books have been published by Prentice Hall, Macmillan & Kluwer, of whose series Issues in Business Ethics he is joint Editor.     

Efficiency in banking services: a comparative analysis of Internet-primary and branching banks in the US

This paper investigates the provision of financial services by banks as a two-stage production process involving three different basic activities. The first stage includes service activities, while the second stage comprises both investment-related and risk management activities. Financial services performance is assessed in terms of service efficiency and investment and risk management efficiency for years 2002–2010. The major empirical findings are that the Internet-primary bank is more efficient than most branching banks in deposit-raising activities, but with regard to investment and risk management activities, there are many brick-and-mortar banks that match the online bank performance.     

Exploring mobile banking services for user behavior in intention adoption: using new hybrid MADM model

Service Business - Mobile banking services are one of the most promising recent technological innovations. In this study, we developed a conceptual model to explore mobile banking services for user...     

A framework for strategy formulation in sustainable supply chains: a case study in the electric industry

The aim of a sustainable supply chain is the strategic integration of all social, environmental and economic goals within an organization, through a systematic coordination of key business processes in order to improve the long-term economic performance of a company and its value chain. This paper describes a new methodological approach to support the strategy formulation process in sustainable supply chains. The proposed methodology combines three analytical tools (analytic hierarchical process, fuzzy multi-objective optimization, and clustering methods) within a strategy formulation process, integrating the competitive and corporative strategies with the supply chain strategy on the basis of sustainability. A case study in the Mexican Federal Commission of Electricity Gulf-Center Distribution Division shows the capability of our proposed framework. This company is large and complex enough to encompass the whole issue of the supply chain. Results indicate that our methodology is a valid decision support tool to formulate a set of sustainable supply chain strategies, and it is able to generate a coordinated strategy for the management of a sustainable supply chain.     

The GATS negotiations: Implications for health and social services

Health and social services have so far attracted fewer commitments than virtually all other large sectors covered by the GATS. What are the reasons behind the low level of negotiating interest? What impact would GATS-bound reforms have on the provision of health and social services?     

Consumer behaviour in the credit card market: a banking case study

This paper analysed the demographic, socio‐economic and banking‐specific determinants that influence the choice of credit cards. A multinomial logit model was run on a recent portfolio of banking customers based in Italy. The model incorporates the type of credit cards as the dependent variable and a set of explanatory variables. The empirical results provided useful insight into the structural characteristics of the card payment system and offered a microeconomics perspective to analyse consumers' behaviour and preferences. Overall, women, older people, residents in the centre of Italy and secondary card owners are more likely to acquire a classic card. Gold cards are preferred by older customers, whereas younger clients have a higher probability to choose a revolving card, which is also preferred by the residents in the North‐east. The analysis on the continuous variables highlighted that Italy can be regarded as a ‘conservative’ market with room for credit card upgrading and expansion into more sophisticated products.     

e-banking culture: A comparison of EU 27 countries and Portuguese case in the EU 27 retail banking context

The aim of this research is two-fold. Firstly we conducted a wise comparative analysis of EU 27 countries and secondly we identified distinct e-banking user segments of Portuguese citizens. We used a questionnaire for data collection (n=2358) and Latent Class Models (LCM) for data analysis. LCM revealed three segments in EU 27 (Portugal is in the poorest cluster, concerning the indicators used, with Greece, Spain and Cyprus) and two e-banking user segments in Portuguese citizens: Those who do not risk (49%), and Those who risk (51%). Our findings enable e-banking managers for taking appropriate strategic decisions.     

Cross-cultural entrepreneurship research: Current status and framework for future studies

Although cross-cultural research in the field of entrepreneurship is still in its infancy as a research stream, it offers important inferences for both theory and practice. Some have criticized the relative immaturity of previous survey-based studies’ methodology. In order to address this flaw, we analyze existing survey-based studies in the field of cross-cultural entrepreneurship to identify research gaps in content and methodology and then derive the most appropriate analytical approach to fill the gaps for this type of research. Finally, we present a practical framework in which to conduct sound and prudent future studies, integrating the most appropriate analytical approach, general methodological insights, and the particularities of entrepreneurship research in a cross-cultural setting.

The interplay of counter-conformity motivation,social influence,and trust in customers' intention to adopt Internet banking services: The case of an emerging country

The aim of this paper is to shed light on the roles of counter-conformity motivation, social influence, and trust in explaining customers' intention to adopt Internet banking services. Data is collected from 245 respondents and analyzed using SmartPLS 2.0 M3. Results show that the intention to adopt Internet banking is mainly influenced by trust in the Internet banking services, followed by customers' counter-conformity motivation and performance expectancy. Social influence and trust in the physical bank, however, have indirect impacts on customers’ intention to adopt Internet banking. Effort expectancy has no effect on it.     

Issues of health services for the consumer in Third World countries

This article deals with the issues of health services for poor consumers in Third World countries. The health services in these countries have been modelled on the systems available in developed countries and meet the needs of the affluent sections of the population who control government policy. But these services are beyond the reach of the poor. There are wide disparities between the health indicators of the rich and poor consumers in the Third World. To provide adequate health services to the poor, there should be a re-allocation of resources away from high technology and hospital based curative services to preventive and promotive health services. It is often argued that low income countries cannot expect to improve the health of all their inhabitants without first increasing productivity. Evidence from selected Third World countries indicates, however, that visible improvements in the health status of the poor are quite feasible with low per capita GNPs if there is the political will to implement progressive policies in health and certain non-health sectors. The latter include policies on land reform and education, particularly education of women.

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Verbraucherprobleme bei Gesundheitsdiensten in Drittweltländern

Zusammenfassung Der Aufsatz befaßt sich mit Problemen von Gesundheitsdiensten für arme Konsumenten von Drittweltländern. Die gesundheitliche Versorgung der Bevölkerung ist dort nach Vorbildern von Industrieländern eingerrichtet worden. Sie kommt den Bedürfnissen der wohlhabenden Oberschicht entgegen, die die Regierungspolitik kontrollieren. Die dieserart angebotenen Gesundheitsdienstleistungen sind jedoch für die Armen unerreichbar und unerschwinglich. Es zeichnen sich erhebliche Unterschiede in den Gesundheitsindikatoren zwischen den wohlhabenden und den armen Verbrauchern in Ländern der Dritten Welt ab. Um wirklich die Armen gesundheitlich zu versorgen, müßte eine Umverteilung der Resourcen weg von Hochtechnologie und stationärer Behandlung und hin zu präventiven und unterstützend-helfenden Maßnahmen erfolgen. Es wird oft behauptet, daß Länder mit geringem Volkseinkommen den Gesundheitsstand ihrer Bevölkerung nicht wesentlich verbessern können, bevor sie nicht erst ihre Produktivität steigern. Beweismaterial von Drittweltländern zeigt jedoch an, daß erkennbare Verbesserungen des Gesundheitszustandes der Armen in Ländern mit geringem Volkseinkommen möglich sind, wenn der politische Wille besteht, fortschrittliche Politiken in Gesundheitsdientsen und einigen verwandten Nichtgesundheitssektoren umzusetzen. Zu letzteren gehören Bodenreform und Erziehung, vor allem für Frauen.

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Kumariah Balasubramaniam is pharmaceutical advisor to IOCU (International Organization of Consumers Unions), P.O. Box 1045, 10830 Penang, Malaysia.     

Ethics in organizations: A framework for theory and research

In a climate of increasing interest and activity within the field of business ethics, as yet there exists no coherent conceptual framework for organizational theory and research. From a review of current thinking and previous writings a framework of concepts is suggested to help set an agenda for empirical research. The elements of this are, first, a taxonomy of ethical domains: the foci of organizations' and their agents' ethical concerns and conduct. Second, it is considered how ethical functioning might be analysed in terms of causal relationships between expressive forms, voluntary action and instituted forms. Third is discussed ethical process, the means by which ethical awareness is aroused. Fourth and last, the paper examines how normative evaluations might apply to the ethical condition of organizations and their agents, meaning change or stability in reputation and integrity. At each stage of the argument possible objectives for research are developed.Professor Nigel Nicholson is Chairman of the Organisational Behaviour Group and Director of the Centre for Organisational Research at London Business School. Previously, he led investigations into Individual and Organisational Change at Sheffield University's Social & Applied Psychology Unit, and has also held visiting appointments at American, Canadian and German universities. He has published 8 books and over 65 articles on a wide range of topics, and been honoured with an award from the Academy of Management for his contribution to theory.     

Development banking and technological development: a case study of industrial development banks in the GCC countries

This article explores the important role of Industrial Development Banks in promoting the quality of technological development. It is argued that the historical experiences of the developed economies and several developing economies during recent times support the need and potentials of a more pro-active role by Industrial Development Banks. Against this background, the specific experiences of Industrial Development Banks in the Gulf Co-operation Council Countries are examined and the results of a select field survey are reported. This exploratory study suggests that some fundamental steps are needed in order to develop Industrial Development Banks from being comparatively passive conduits of technological aid to more active promoters of technological development.     

Consumer problems in the public sector: A framework for research

Studies of consumer problems to date have largely focused on the private marketplace. The purpose of this paper is to delineate the nature of problems faced by consumers of government services, and to set forth a research agenda for studying these problems. Public sector consumer problems are attributed to two basic sources of governmental ineffectiveness: organizational failure which stems from internal bureaucratic factors, and political failure which stems from conflicts in the body politic. These sources are seen to lead to four categories of consumer problems: disappointing goods, problems of awareness and coping, consumer preference problems, and problems of access and location.

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Zusammenfassung Die wissenschaftliche Beschäftigung mit Verbraucherproblemen ist bislang auf die private Versorgung über den Markt konzentriert. Der vorliegende Beitrag stellt erstmals systematisch die Frage nach den Problemen, die aus einem Ungenügen der öffentlichen Versorgung von Verbrauchern mit Waren und Dienstleistungen erwachsen. Er lokalisiert die Ursachen für solche Probleme einerseits in der Bürokratie, andererseits in der politischen Willensbildung. Auf diese Faktoren werden vier Kategorien von Verbraucherproblemen zurückgeführt: Probleme der mangelhaften Gestaltung öffentlicher Leistungen, Probleme der begrenzten Zugänglichkeit angebotener Leistungen aus Gründen reduzierter Wahrnehmungs- oder Bewältigungsmöglichkeit, Probleme die mit differierenden Präferenzen unterschiedlicher Verbrauchergruppen zusammenhängen, und schließlich Probleme der räumlichen Versorgung mit öffentlichen Leistungen. Abschließend werden für jede der vier Problemgruppen die den jeweils zugrundeliegenden Ursachen gemäßen Lösungsmöglichkeiten abgeleitet.

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Dennis R. Young is an Associate Professor at the W. Averell Harriman College for Urban and Policy Sciences, State University of New York at Stony Brook, Stony Brook, New York 11794, U.S.A. He wishes to thank Richard Zeckhauser, Charles Perrow, and Ed Ames for their particular comments and suggestions. The author is also grateful to his research assistant, Neil Katz, for diligent search of both the academic and popular literature.     

Foreign direct investment in the banking sector: the case of Italian banks in the '90s

The present paper addresses the issue of the determinants of the growth of multinational banks upon foreign markets at a micro individual level. Theories and approaches suggested so far about globalisation of the banking sector basically relate banks' international growth to the theory of the multinational enterprise. Accordingly, this paper relies on the eclectic paradigm, which views the foreign direct investment decision to be a combination of ownership, internalisation and location advantages. Empirical evidence is provided through an econometric model based on count data techniques, with reference to the Italian case in the decade 1989–1999. Results show that the availability of resources and international experience already gathered by the parent banks have positive effects on their decision to undertake direct investments abroad. Multinational banks are also proved to grow internationally in order to internalise their pre-existing bank–client relationships, and to locate their foreign units where they can exploit positive externalities related to the presence of important international financial centres.     

A revised framework of global strategy: Extending the coordination-configuration framework

Although there have been significant efforts in conceptualizing global strategies, few frameworks have been developed to measure the relative globalness of firms. Porter proposed a specific framework of coordination and configuration for this purpose. This article proposes a new framework of global strategy by extending Porter's original framework. The conceptual clarification of this article will be useful in understanding different types of firms that are pursuing a global strategy. © 1995 John Wiley & Sons, Inc.