Technologies in caregiving: professionals’ strategies for engaging with new technology

This article explores the adoption of new technology in organisations that provide senior citizen care. Inspired by Niklas Luhmann’s systems theory, we study how technology reduces complexity by identifying client needs and ensuring predictability in service delivery. However, how technologies are adopted in practice is not determined by technology since it is also structured by care-workers' continuous decision-making. Against this backdrop, we explore how technologies alter the conditions for decision-making in two settings of elderly care, and we describe how care workers seek to adapt technologies to their practical needs as well as conception of care ethics. Developing a systems theory approach, the article eschews a priori assumptions of technological constraint on care-workers’ professional autonomy, offering a more open-ended exploration of diversified strategies for coping with new technology. Our case studies show that employees develop diversified strategies for technology adoption, including both non-usage, heated resistance, excessive embrace, and creative adaption.     

智慧居家养老服务协同供给的优化路径研究——以广西钦州市智慧居家养老项目的实践经验为例

智慧居家养老服务的协同供给可以形成社会联动效应，降低公共服务成本。运用公共服务协同供给分析框架，通过交叉分类方法从协同主体的利益与目标两个变量的耦合性出发分析广西钦州市智慧居家养老项目中养老服务主体间不同种类的协同关系，可以从加强政府领导、形成合作联盟、建立市场标准、创新扶持政策4个方面完善政府、企业、社会组织之间不同类型的协同供给，实现社会资源的高效利用以及向智慧居家养老服务的发展和转变。     

Consequences of a green image of drone food delivery services: The moderating role of gender and age

Drone food delivery services play a significant role in protecting the environment, because the services are operated by batteries that can be charged with electricity. Therefore, this study tried to examine a green image in the context of drone food delivery services. More specifically, this study proposed that a green image of drone food delivery services plays an important role in the formation of attitude toward using the services. In addition, it was hypothesized that the attitude has a positive influence on behavioral intentions including intentions to use, word‐of‐mouth intentions, and willingness to pay more. Lastly, the moderating role of gender and age was proposed during the theory‐building process. A theoretical model, which included 12 hypotheses, was developed and tested using a total of 427 samples collected in Korea. The data analysis results showed that a green image of drone food delivery services has a positive influence on attitude toward using the services, which in turn positively affects three subdimensions of behavioral intentions. Furthermore, gender and age played partly as a moderator. The current paper was the first to study the green image of drone food delivery services, so the findings of this study mean a lot to the theoretical aspect.     

New development: China renews reform of central–local fiscal relations and provides for basic national public services

China’s reform on central–local fiscal reform has slowed down in recent years. The appointment of a new finance minister experienced in local government affairs is expected to renew the reform affirmed by the Chinese Communist Party (CCP) congress in late 2017. China has unprecedentedly identified a comprehensive list of 81 national basic public services as entitlements. Eighteen of them are subject to national and local standards, and co-financed by central and local governments. A new cost-sharing method for 10 of these services classifies sub-national jurisdictions into five tiers, in which the central government’s share declines from 80% to 10%. These measures, effective in 2019, aim at creating a ‘harmonious and moderately prosperous society’.     

Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries

Healthcare reforms have long been advocated as a cure to the increasing healthcare expenditures in advanced economies. Nevertheless, it has not been established whether a market solution via private financing, rather than public financing, curb aggregate healthcare expenditures. To our knowledge, this paper is the first that quantifies the impact of reforms that significantly increases (decreases) the private (public) share of healthcare financing on total healthcare expenditures relative to income in 20 OECD countries. Our reform measure is based on structural break testing of the private share of total expenditures, and verification using evidence of policy reforms. To quantify the effect of these reforms we apply Propensity Score Matching and Inverse Probability Weighted regression analysis. Over a 5-year evaluation period the reforms lead to an accumulated cost saving 0.45 percentage points of GDP. The yearly effects of the reforms are largest in the first years in the post-reform period and decreases in size as a function of time since the reform. Our findings suggest that the investigated healthcare reforms have a relatively short-lived effect on aggregate health spending relative to GDP. The findings are robust to various sensitivity tests.     

“Going natural”: Black women’s identity project shifts in hair care practices

Hair care, a seemingly mundane consumption practice, is packed with sociocultural meanings and constitutes an important realm of identity work for consumers. Drawing upon existing literature on consumer identity projects, this paper investigates the experiences of urban, Black women in Kenya as they disengage from the normative practice of altering their natural hair texture using chemical straighteners (a practice that conforms to Eurocentric beauty ideals of straight, flowing hair), and adopt the non-normative hair care practice of “going natural,” in which they embrace their natural hair texture and hairstyles. This paper traces the historical, sociocultural, and political events that underpin the normative ideology associated with the identity marker of natural Black hair, and how this ideology influences the women’s “going natural” experience. Findings reveal tensions that emerge in the women’s identity project disengagement and reconstruction process, and how the women navigate their position as they reimagine their embodied identity quest.     

An exceptional development pattern

This paper investigates India's exceptional development pattern, specifically the major importance of information technology services (ITS), and compares it with China's development pattern. Both countries want to develop capabilities for carrying out the innovation of technologies that compete at the state-of-the-art in the world market. The paper posits that technological/economic success in the contemporary world market requires the ability to innovate complex technologies and complex technology-related services. The share of trade represented by complex technologies is compared with the “high-tech” share. The trading patterns of the two countries are compared using United Nations data. Two case studies of Indian ITS companies are then compared with two case studies of Chinese manufacturing companies. Historical and cultural differences appear to explain some of the differences in the development patterns of the companies located in the two countries.     

Efficiency outcomes of market concentration and managed care

The paper examines how hospital cost efficiency has reacted to extensive horizontal integrations of hospitals and rapid growth of managed care in the US health care industry. Cost efficiency is estimated by using panel data approaches to relax the assumptions for the hospital effects imposed in earlier studies. The paper shows that higher managed care penetration over time is associated with greater hospital efficiency, and higher market concentration is positively associated with efficiency when markets are highly competitive or highly concentrated.     

Violations of Service Fairness and Legal Ramifications: The Case of the Managed Care Industry

Adapted from Chan's (2000) model depicting success of litigation, this paper argues that with the application of various legislation, health maintenance organizations' (HMOs') violations of service fairness to each group: enrollees, physicians, and hospitals give rise to each group's lawsuits against the HMOs. Various authors (Bowen et al., 1999; Seiders and Berry, 1998) indicate that justice concepts such as distributive, procedural, and interactional justice can be applied to the area of service fairness. The violation of these underlying justice principles with HMOs' service unfairness to enrollees, physicians, and hospitals is examined. A general synopsis of the ethical issues in the managed care industry is provided. The various lawsuits launched by each group: enrollees, physicians, and hospitals together with the key statutes used are discussed. This paper also highlights the provisions and ramifications of the 11 April 2000 landmark agreement that Aetna made with Texas Attorney General John Cornyn to settle the 1998 lawsuit brought against the company. Lastly, the current ethical issues in the managed care industry are further discussed. The value of this paper can be adapted to the study of organizations' service fairness violations in other industries or in the educational, governmental, and not-for-profit sectors both nationally and internationally.     

A note on “Bed allocation techniques based on census data”

Capacity planning and resource allocation are crucial to the cost-effective delivery of health care services. In this paper, we present an analytic approach based on a modified version of the Holt-Winters multiplicative seasonality forecasting model to determine the frequency distribution associated with a hospital care unit's census. This paper is a follow-up to the census frequency distribution simulation model described in Lapierre et al. (Socio Econ. Plan. Sci. 33 (1999) 25). We demonstrate that our model can provide census frequency distributions equivalent to the simulation model of Lapierre et al. [1], but without the computational effort common to simulation models.