Suchergebnisse

Cover -- Title Page -- Copyright Page -- Contents -- Acknowledgments -- About the Authors -- Remembering -- About the Companion Website -- List of Exhibits -- List of Acronyms -- Preface -- Chapter 1 The Healthcare Supply Chain Environment-Here's the Big Picture -- 1.1 The Healthcare Supply Chain: Evolving Recognition and Importance -- 1.2 Healthcare System Challenges and Strategies -- 1.3 Supply Chain as a System of Systems within Healthcare as a System -- 1.4 What Is (Healthcare) Supply Chain Management? -- 1.5 Supply Chain Processes and Functions -- 1.6 The Supply Chain Stakeholders -- 1.6.1 Primary Actors: Buying and Selling Organizations -- 1.6.2 Supporting Actors -- 1.6.3 Influencers -- 1.6.4 Fusion Organizations -- 1.7 FISCO Functions and Supply Chain Maturity -- 1.8 From Cost Center to Strategic Asset -- 1.8.1 Clinician Centrality and the Customer -- 1.8.2 Who Is the Customer? -- 1.8.3 Advancing Capabilities -- 1.8.4 Lessons from Other Industries -- 1.8.5 Clockspeed -- 1.9 Chapter Summary -- Notes -- Chapter 2 Building a Strategy for Healthcare Supply Chain Management-Creating the Vision -- 2.1 Introduction -- 2.2 Vision Statements -- 2.3 Mission Statements -- 2.4 Corporate Objectives -- 2.5 Business Process Strategies -- 2.6 Technology Framework Strategies -- 2.7 Distribution Network Strategy -- 2.8 Action Initiatives/Strategies -- 2.9 Chapter Summary -- Notes -- Chapter 3 Risk Management Strategies-Healthcare Is Risky, So Is Supply Chain Management -- 3.1 Introduction -- 3.2 The Nature of Supply Risk -- 3.3 Risk Categories -- 3.3.1 Strategy Risk -- 3.3.2 Market Risk -- 3.3.3 Demand Risk -- 3.3.4 Implementation Risk -- 3.3.5 Cost Risk -- 3.4 Response and Resilience to Risks -- 3.4.1 Mitigating Risks -- 3.4.2 Reducing Risk Through Technology -- 3.5 Chapter Summary -- Notes.

ABSTRACTAn implicit assumption in distributing and coordinating work among independent organizations in a supply chain is that a focal organization can use financial or contractual mechanisms to enforce compliance among the other organizations in meeting desired performance objectives. Absent contractual agreement or financial gain, there is little incentive for independent organizations to coordinate their process improvement activities. In this study, we examine a health care supply chain in which the work is distributed among independent organizations. We use a detailed case study and anabductive reasoningapproach to understand how and why the independent organizations choose to coordinate and collaborate in their work. Our study makes two contributions to the literature. First, we use well‐established lean principles to explain how independent organizations achieve superior performance despite highly uncertain and variable customer demand—a context considerably different from the origins of lean principles. Second, we forward relational coordination theory to explain why the organizations in this decentralized supply chain coordinate their work. Relational coordination includes the use of shared goals, shared knowledge, and mutual respect for one another's work as primary mechanisms to explain process improvement in the absence of any contractual incentives. Our study constitutes a first step in generating theory for work design and its improvement in decentralized supply chains.

Purpose
In the context of the debate on ensuring health-care efficiency, this study aims to identify and prioritize factors and subfactors that influence organizational effectiveness (OE) in the health-care supply chain.


Design/methodology/approach
For the purpose of this qualitative study, triangulation was applied to identify, explore and systematically analyze the OE-related practices used by diverse stakeholders along the health-care supply chain. Sixty-two OE practices were thus identified. Subsequently, these were grouped in six different nodes before the analytical hierarchical process (AHP) was used to identify the weightings of specific practices (and related factors) and their impact on OE.


Findings
The findings suggest that external factors associated with government regulation, including government directives and branding, are the most critical factors that influence OE-related practices, while cost-related factors are the least important.


Originality/value
The originality of this study derives from the introduction of system theory supported by a modified supplier-input-process-output-customer (SIPOC) framework. Two important factors – government regulation and branding – have been introduced to the existing SIPOC chart as a valuable process structure for the health-care chain.

ABSTRACTRecent articles in the Wall Street Journal summarize the state of business practice in American hospitals by shedding light on the state of supply chain management practices and foci in today's health care supply chains. In health care, the single largest cost after labor is materials, and it has been documented that health care facilities can reduce the environmental impacts of the products and services they consume before regulatory problems arise or waste disposal costs increase by focusing on their upstream activities. Health care systems around the country consume significant quantities and varieties of products within the health delivery processes. Solving these environmental problems requires a much broader view involving collaborative efforts of professionals from different areas of health care to meet these challenges. The purchasing function bridges the gaps by providing a healthy dialogue on key environmental attributes within the health care supply chain. The concept of bundling new with refurbished products is gaining a lot of attention in the health care supply chain. This research describes a health care purchasing problem for bundling new and refurbished products of the type facing a growing number of large health care providers, and then proposes a methodology for evaluating the complex tradeoffs involved in bundling decisions for refurbished health care products. By exploiting some useful properties of the problem structure, our results provide buyers with useful insights for examining and selecting suppliers who are willing to offer bundles of new and refurbished products.

ABSTRACTThis article is motivated by the gap between the growing demand and available supply of high‐quality, cost‐effective, and timely health care, a problem faced not only by developing and underdeveloped countries but also by developed countries. The significance of this problem is heightened when the economy is in recession. In an attempt to address the problem, in this article, first, we conceptualize care as a bundle of goods, services, and experiences—including diet and exercise, drugs, devices, invasive procedures, new biologics, travel and lodging, and payment and reimbursement. We then adopt a macro, end‐to‐end, supply chain–centric view of the health care sector to link the development of care with the delivery of care. This macro, supply chain–centric view sheds light on the interdependencies between key industries from the upstream to the downstream of the health care supply chain. We propose a framework, the 3A‐framework, that is founded on three constructs—affordability, access, and awareness—to inform the design of supply chain for the health care sector. We present an illustrative example of the framework toward designing the supply chain for implantable device–based care for cardiovascular diseases in developing countries. Specifically, the framework provides a lens for identifying an integrated system of continuous improvement and innovation initiatives relevant to bridging the gap between the demand and supply for high‐quality, cost‐effective, and timely care. Finally, we delineate directions of future research that are anchored in and follow from the developments documented in the article.

Due to the diversity of its players, the American healthcare sector has experimented with different types of integrated supply chain management systems for medical supplies. In the 1980s, US distributors were offering customers the so‐called stockless replenishment method, whereby the distributor picks and packs products according to the particular needs of each patient care unit and, in most cases, delivers them directly. By the late 1990s, stockless agreements had run out of steam, as distributors sought to optimize the balance between their efforts expended in hospital replenishment and the hospitals' inventory savings. Among the various reflections and initiatives aimed at finding such a new balance, we focused on the experience of a Quebec (Canada) hospital adopting a hybrid version of the stockless system, under which the distributor supplied high‐volume products for the patient care unit in case quantities, leaving the institution's central stores to break down bulk purchases of low‐volume products into point‐of‐use format (eaches). The study reveals marginal benefits from the hybrid method for both the institution and the distributor. However, it also reveals the importance of the manufacturer's role with respect to packing formats, and demonstrates that the rearrangement of storage areas can generate substantial savings, opening the way to means for improving the healthcare sector supply chain.

Purpose
Due to the rapid surge in the number of COVID-19 cases in India, the health-care supply chain (HCSC) disruptions and uncertainties have increased manifold posing severe challenges to health-care facilities and significantly hampering the functioning of the health industry. This study aims to propose a hierarchical structural model of enablers of HCSC in the COVID-19 outbreak and identifies inter-relationships among them in the health-care market.


Design/methodology/approach
Enablers of emergency HCSC have been identified through extensive literature review and experts' opinions. Subsequently, total interpretive structural modeling (TISM) and cross-impact matrix-multiplication (MICMAC) analysis have been implemented to determine the hierarchical inter-relationships among enablers and classify them according to their contribution to the overall system.


Findings
The research has identified and validated 15 enablers of the emergency supply chain in health-care businesses. The study resulted in a seven-level hierarchical structural model based on enabler's driving and dependence powers. Further, the application of MICMAC analysis resulted in the classification of enablers into four groups, namely, autonomous, dependent, linkage and independent group.


Research limitations/implications
This study would help health professionals, policymakers and academia to implement the theoretical model constructed to alleviate the effect of COVID-19 by improving the HCSC performances in pandemic situations. This study has social and economic implications in terms of cost-effective and efficient delivery of care services in health emergencies.


Originality/value
The proposed theoretical model constructed is a new effort addressing the issues of HCSC in the COVID-19 crisis. Procedural implementation of TISM and MICMAC analysis in this study would help researchers to grasp concepts in a very lucid manner. The present study is one of the very few studies analyzing enablers in pandemic situations by implementing the TISM approach.

This article examines the effect of access to health infrastructure, personnel and services on children's nutritional status in rural Nepal. Data for the study come from the 1996 Nepal Living Standards Survey, which includes individual- and household-level information on children's nutritional status and its environmental and socioeconomic determinants, and community-level information on the availability of health care infrastructure, personnel and services. The study uses a structural modelling approach to assess the relative contributions of the health care supply environment on children's anthropometric status via the pathway of maternal and child health (MCH) service use. The findings suggest that improvements in the availability of outreach clinics and the structural quality of the closest public facility would be expected to have statistically significant and large effects on the use of MCH services, and that increases in MCH service use would have a statistically significant impact on weight-for-age, but not weight-for-height or height-for-age. The overall impact of the heath care supply environment on nutritional status is assessed through a series of policy simulations.

Die Studie analysiert die gesundheitliche Versorgungssituation des Landkreises Fulda vor dem Hintergrund der demografischen Transition und des sich in ländlichen Regionen abzeichnenden Hausärztemangels. Kontrastiert wird die alle Leistungsanbieter umfassende kleinräumige Bestandsaufnahme der Versorgung mit Sichtweisen von relevanten regionalen Akteuren der Versorgung und politischen Entscheidungsträgern zur aktuellen und perspektivischen Versorgungssituation und deren Entwicklungsperspektiven. Der "Versorgungsatlas" zeigt auf Basis der verfügbaren Regionaldaten aktuell ein starkes Stadt-Land-Gefälle, eine ausgeprägte Heterogenität bei den Angebotsdichten sowie eine sich im kommenden Jahrzehnt abzeichnende Versorgungslücke im (haus-)ärztlichen Bereich. Die interviewten Akteure und Stakeholder schätzen die gesundheitliche Versorgungssituation in Übereinstimmung mit den aktuellen Bedarfszahlen derzeit noch weitgehend gut ein, sehen jedoch die zukünftige Entwicklung deutlich skeptischer. Die künftig veränderte Nachfrage nach Gesundheitsleistungen, Probleme bei der Praxisnachfolgesuche bei Hausärzten, der Fachkräftemangel bei nicht-ärztlichen Gesundheitsberufen sowie die sich daraus ergebenden Konsequenzen für andere Versorgungsteilnehmer werden von den Interviewpartnern als brisante Problemlagen genannt. Zur langfristigen Sicherstellung der gesundheitlichen Versorgung formulieren die Interviewpartner eine Vielzahl von teils übereinstimmenden, teils kontroversen Ansätzen und Maßnahmen. Im Zentrum stehen hier die Einrichtung kooperativer Versorgungsformen und -modelle, neue Formen der ärztlichen Berufsausübung, fachübergreifende Behandlungseinrichtungen, die Delegation und Substitution ärztlicher Leistungen, Aspekte der Nachwuchsförderung von Ärztinnen und Ärzten, Unterstützungsangebote durch Kommunen und Landkreis sowie die Förderung ehrenamtlicher Tätigkeiten. Die Studie schließt mit zusammenfassenden Handlungsempfehlungen, die sich auf die in den Interviews formulierten Vorschlägen stützen. Dem erhöhten ...

Health spending as a percentage of gross domestic product in the U.S. economy is growing, from 5% in 1960 to about 16% in the current period, and it is predicted to grow to as much as 30% in 2050. Then why is the supply of health care in the United States so insensitive to steeply rising prices? This paper conducts an econometric study to show that high health‐care costs have an adverse impact on labor productivity, causing a negative production externality in all industries. So, can the rising cost of health‐care affect the U.S. comparative advantage? The paper seeks answers to these questions in a general equilibrium model and finds that the labor productivity shock is responsible for the sluggish or declining supply of health care. Consumers are able to afford less health care due to a possible decline in real wages. U.S. comparative advantage becomes a nonissue, provided that the equilibrium is stable in spite of a negatively sloped health‐care supply curve. Negative externality, leading to market failure, may be addressed in two alternative ways. (JEL F11, I11, I12, I18)

PurposeThe purpose of this paper is to provide, first, an explication of the interconnectivity of logistics as an element of health care disaster posturing and second, to use a context of strategic‐level planning, for supply chain management's inclusion in health care emergency management planning.Design/methodology/approachUsing a review of existent literature, this work examines and expounds upon the impact of effective supply chain management processes in disaster mitigation and planning.FindingsThis paper presents a discourse in health care supply chain management's involvement in disaster mitigation by clarifying the role of logistics in strategic‐level planning.Practical implicationsOptimally, for a health care organization to be truly prepared for disaster, leaders must first have a sound logistics platform from whence support and sustainment are received. For an organization to be truly prepared logistically, however, there must exist a basic understanding of principles related to emergency management and health care operations.Social implicationsArguably, a critical path to success in health care supply chain readiness posturing involves evidence‐based, critically applied insight into disaster mitigation and preparations across multiple echelons of managerial responsibilities.Originality/valueA key recurring problem is that little research is available or related specifically to health care logistics management. Few works can be found concerning health care supply chain management's involvement in disaster posturing. In an applied sense, the paper provides health care managers with concepts related to effective crisis mitigation.

"Investigates relationships among labor force participation, health outcomes, and quality of health care in Jamaica. Develops an econometric model linking demand for health care, health status outcomes, and labor force participation"--Handbook of Latin American Studies, v. 57