Role conflict and ambiguity confronting transnational business networkers: Contrasting social stigma and relational risks for Chinese and Western boundary spanners

Our research explores the role conflict, ambiguity and resulting social stigma and relational risks that transnational B2B networkers face when facilitating the formation of new exchange dyads between firms from distinct and distant cultures, i.e. Chinese and Western. We integrate literature from institution theory and role theory to establish the comparative framework. This allows us to explore: (1) what stigma and relational risks guanxi brokers assume when facilitating transnational business connections; (2) if Western brokers encounter similar stigma and negative consequences that threaten their professional standing and the formation process; and, (3) the lessons from both that transnational firms can learn and incorporate into best practices. We conclude our paper with managerial implications and suggestions for further research.     

Why the public thinks natural resources public participation processes fail: A case study of British Columbia communities

This study examines the experiences and opinions of a “public” which became involved in a government driven comprehensive land use and natural resource planning exercise in British Columbia, Canada during the 1990s. While it is generally assumed to be an inherently good thing, or at least a politically necessary thing, to involve the public in natural resources or land use planning, few studies have examined the experiences of the public or examined perceived failures from the public's perspective. This study examines British Columbia's CORE and LRMP planning processes, their successes and failures, as determined by residents of six communities that participated in these processes. Lessons on improving public processes from the viewpoint of that public are discussed.     

Distribution and drivers of costs in type 2 diabetes mellitus treated with oral hypoglycemic agents: a retrospective claims data analysis

Objective:

To describe the distribution of costs and to identify the drivers of high costs among adult patients with type 2 diabetes mellitus (T2DM) receiving oral hypoglycemic agents.

Methods:

T2DM patients using oral hypoglycemic agents and having HbA1c test data were identified from the Truven MarketScan databases of Commercial and Medicare Supplemental insurance claims (2004–2010). All-cause and diabetes-related annual direct healthcare costs were measured and reported by cost components. The 25% most costly patients in the study sample were defined as high-cost patients. Drivers of high costs were identified in multivariate logistic regressions.

Results:

Total 1-year all-cause costs for the 4104 study patients were $55,599,311 (mean cost per patient?=?$13,548). Diabetes-related costs accounted for 33.8% of all-cause costs (mean cost per patient?=?$4583). Medical service costs accounted for the majority of all-cause and diabetes-related total costs (63.7% and 59.5%, respectively), with a minority of patients incurring >80% of these costs (23.5% and 14.7%, respectively). Within the medical claims, inpatient admission for diabetes-complications was the strongest cost driver for both all-cause (OR?=?13.5, 95% CI?=?8.1–23.6) and diabetes-related costs (OR?=?9.7, 95% CI?=?6.3–15.1), with macrovascular complications accounting for most inpatient admissions. Other cost drivers included heavier hypoglycemic agent use, diabetes complications, and chronic diseases.

Limitations:

The study reports a conservative estimate for the relative share of diabetes-related costs relative to total cost. The findings of this study apply mainly to T2DM patients under 65 years of age.

Conclusions:

Among the T2DM patients receiving oral hypoglycemic agents, 23.5% of patients incurred 80% of the all-cause healthcare costs, with these costs being driven by inpatient admissions, complications of diabetes, and chronic diseases. Interventions targeting inpatient admissions and/or complications of diabetes may contribute to the decrease of the diabetes economic burden.