The process of hospital consolidation: a case study in Anhui Province, China

JEL: I11, I18, M1, M54Hospital consolidation is an important topic both in theoretical research and practical exploration in the healthcare sector as it allows for the improvement of the utilization efficiency of medical resources and for the optimization of cost reduction. Based on the strategic management theory, especially the resource-based theory, this thesis makes an in-depth analysis of the strategic choices of the First People‘s Hospital group of Hefei City, Anhui Province, China. Combining with the process of China‘s health system reform, the motivating factors of establishing hospital groups, the basic concept of hospital groups and modes are reviewed while the reasons and background for public hospitals consolidation in China are introduced. Under this setting, the thesis studies the motivations behind strategic choices and incentives towards consolidation as well as the environment and the strengths and weaknesses of the internal resources of the hospital. Based on the case study method, 25 semi-structured interviews to 25 experts and participants and field visits were conducted for data collection. The research shows that the consolidation strategy followed by the hospital allows for its sustainable development. However, in identical situations, for positive results to be achieved, a core member of the group should be selected to lead the consolidation process during the transition period and to balance the relationship between centralization and decentralization while respecting each specific situation The analysis of the strategic consolidation of the hospital studied allowed for the identification of difficulties and challenges, which may serve as a theoretical base for the practice of other organizations undergoing a similar processA consolidação de unidades hospitalares é um tópico de investigação importante para a teoria e para a prática, pois permite reorganizar os recursos médicos através da sua utilização eficiente e da optimização da redução de custos. Com base na teoria da gestão estratégica e em especial na teoria dos recursos, esta tese analisa em profundidade as escolhas estratégicas com que se debateu um grupo hospitalar da cidade de Hefei, província de Anhui na China: o First People‘s Hospital Group. Tendo como base o processo de reforma do sistema de saúde na China, a tese estuda as motivações inerentes à tomada de decisão, bem como os incentivos à consolidação. São analisados os pontos fortes e fracos do hospital, os seus recursos principais e a envolvente procurando-se entender as escolhas estratégicas que levaram à consolidação. A tese utiliza o método do estudo de caso tendo sido realizadas 25 entrevistas semiestruturadas a peritos e participantes no processo bem como diversas visitas que permitiram observação direta. A investigação demonstra que a estratégia de consolidação permite assegurar o desenvolvimento sustentado do hospital mas, para isso, a melhor opção é escolher um dos membros do grupo para assumir um papel de liderança durante o período de transição e cuidar do equilíbrio da relação entre centralização e descentralização sem descurar a especificidade da situação local. A análise da consolidação estratégica do hospital estudado permitiu ainda identificar as dificuldades do processo contribuindo com uma base teórica que poderá ser útil ao desenvolvimento de outras organizações em idêntica situação

The Evolution of the Internet of Things Industry and Market in China: An Interplay of Institutions, Demands and Supply

This paper seeks to provide some explanation as to how demand-, supply- and institutions-related factors in China have affected the creation and diffusion of Internet of Things (IoT)-related products and services. Concerning demand side factors the paper demonstrates how potential market size and existing technology trajectory work in favor of IoT diffusion. As a related demand side factor the paper argues that, in terms of the technological trajectory, China has started farther from the frontier than most industrialized countries. The degree of incremental benefit from the IoT is thus higher in the country. As to the supply side factors, the article promotes an understanding of how Chinese technology companies have capitalized on a huge user base to develop IoT-based applications. It also suggests that technologies and expertise provided by foreign multinationals have also played crucial roles. Regarding formal institutions, the government's proactive policies have been a major factor in the IoT's evolution. It is also in the Chinese government's interest to develop IoT products to make censorship and surveillance more effective. Regarding informal institutions, Chinese consumers are less concerned than Westerners about being tracked and monitored, which provides a favorable condition for the adoption of IoT-enabled devices. Nonetheless, this condition is changing due to increasing abuse of consumer privacy. China and the U.S. are compared in terms of diffusion, key determinants, performance indicators and impacts of the IoT in order to understand the areas that China outperforms—and underperforms—the U.S. Some indicators are proposed to gauge the IoT-related performance and the impacts of the IoT

Core competitiveness strategic thinking in China's maternal and child healthcare hospitals: an exploratory study

In recent years, China has achieved rapid economic and social development. To keep up with the economic growth, China adopted two-child policy and started to reform the medical system. Against such backdrop, there is a huge increase in the demand for women and children's health services. However, the overall service capacity of the maternal and child care service centers in China cannot satisfy the growing demand. Therefore, it is necessary to update development strategies so as to achieve a sustainable and healthy development. Based on the resource-based view, this thesis studies the core competitiveness of the hospitals. First, we conducted three rounds of Delphi consultation with 32 hospital managers and research experts in public health from eight different institutions to finalize the evaluation index for the core competitiveness specially developed for Chinese maternal and child care service centers. In order to validate the evaluation index, we have proceeded with correlation analysis of core competitiveness with five other maternal and child care service centers of same level in China. An in-depth the case study of Shunde Maternal and Child Healthcare Hospital. and through SWOT analysis, we have proposed strategies for improving the core competitiveness of Shunde Maternal and Child Healthcare Hospital to adapt to new situations. Last but not least, through analysis of the key influencing factors of the hospital’s development in the past decade, we have proved the importance of improving the core competitiveness so as to adapt to changes of the environment. This study found that VRIO resources and capabilities, dynamic capabilities and unique hospital culture are the three key factors to ensure excellent performances for Shunde Maternal and Child Healthcare Hospital. To be more specific, hospitals should adopt specialization strategies, develop a talent team, improve management and service abilities, develop cooperative medical service system, improve abilities to treat critical and difficult diseases and establish a culture that encourages innovation and people-oriented.Nos anos mais recentes, assistiu-se na China, um acelerado desenvolvimento socioeconómico. A par disso, assistiu-se à introdução da política de “dois filhos” bem como de outras medidas públicas reformativas do sistema de saúde que estão a ser implementadas com grande sucesso. Porém, a capacidade total das maternidades e hospitais pediátricos está, no entanto, longe de ser capaz de satisfazer toda a procura nesta nova era. Consequentemente, é necessário repensar as estratégias de desenvolvimento de modo a atingir um desenvolvimento sustentado da saúde. Com base na teoria de recursos, a presente tese promoveu uma análise sobre as competências nucleares dos hospitais. Em primeiro lugar, aplicou-se o método Delphi com três fases de consulta onde intervieram 32 gestores hospitalares e peritos em saúde pública de oito diferentes instituições para a construção de um índice de avaliação de competências nucleares de centros de maternidade e de pediatria. Para validação do índice de avaliação realizaram-se análises de correlação de competências nucleares com outros cinco centros de maternidade do mesmo nível que o "Shunde Maternal and Child Healthcare Hospital". Elaborou-se um estudo de caso aprofundado do Shunde Maternal and Child Healthcare Hospital e, com base neste e na aplicação da análise SWOT foram formuladas estratégias para a melhoria das capacidades organizacionais nucleares do hospital. Por outro lado, a análise de fatores essenciais de desenvolvimento do hospital nos últimos 10 anos, este estudo demonstrou, ainda, a importância da relevação das capacidades organizacionais nucleares na adaptação do hospital às variações da envolvente global. O presente estudo permitiu concluir que os recursos e capacidades organizacionais VRIO, o domínio das capacidades dinâmicas e a cultura específica do hospital são os três fatores chave de estratégia para que os hospitais pediátricos e de maternidade possam ter um desempenho superior. As medidas mais importantes no quadro das capacidades organizacionais nucleares a reter são a estratégia de especialização, a construção do um sistema de retenção de talentos, melhoria de competências de gestão, a construção de um sistema médico integrado e o estabelecimento de uma cultura de inovação e cuidado com as mães e progénitos

Economic and Social Transformation in China

The Center for China Studies is among China’s most influential think-tanks, and its China Studies Reports are read at the highest levels of government. Now for the first time, the most important of these reports is collected in book form in Eng, providing a fascinating insight into the challenges and opportunities for Chinese development and the government’s thinking on economic and social issues. Including comparative studies with developed and developing nations, analysis of past economic performance and future trends, and effects of demographic shifts such as population ageing and urbanization, this book is an essential collection of research and includes notes made by central party leaders. Compiled by the founder of the Center for China Studies, one of the country’s leading economists, this book is key to understanding Chinese development and the likely future path of government policy

Emergency management competence needs: Education and training for key emergency management personnel in a maritime Arctic environment MARPART2-(MAN), Project Report 2

This report focuses on competence demands among key management personnel responsible for maritime emergency response. The report has a special focus on competence challenges related to operations in an Arctic environment

"Internet Plus" medical services based on total quality management theory: an empirical research in public hospital outpatient services in Guangzhou, China

China is a large country with a population of more than 1.3 billion people, so public places are always full of people. The large public hospitals in China are even more overcrowded with a widespread medical treatment dilemma of "three longs and one short" in outpatient departments, which refers to “long waiting time of registration and payment, long waiting time of fetching medicine, long waiting time of treatment and short time of diagnosis”. This medical dilemma has long plagued medical workers as well as patients seeking treatment in outpatient departments and their families. Based on the theory of total quality management, this research is carried out in accordance with the Juran Trilogy –"Quality Planning – Quality Control – Quality Improvement" and the “European Quality Award Logical Model”. With the prevalent phenomenon of “three longs and one short” as the orientation, this research reviews the relevant literature, illustrates the historical reason for the occurrence of the dilemma and the practical significance of solving it, proposes the hypothesis to improve outpatient medical experience through the “Internet + medical service” model, achieves outpatient treatment process reengineering through empirical research on the “WeChat + outpatient medical service” platform developed by T hospital, and realizes the goal of improving satisfaction of patients and the medical staff with quality as the key and the medical staff participating from the beginning to the end to work continuously to improve outpatient service quality. Through practice, combined with methods such as questionnaire, interview, expert consultation, and group discussion, it has been proven that the “WeChat + outpatient service” platform can effectively alleviate or solve the dilemma of "three longs", but there is no improvement for the “one short”. Through the five dimensions of service quality (tangibles, reliability, responsiveness, assurance, and empathy) and service quality gap analysis, it can be seen that the construction of "WeChat + outpatient service" platform has improved the patient’s medical experience, increased satisfaction of patients and the medical staff, and promoted employees’ awareness of active service.A China é um país de grande dimensão, com uma população de mais de 1,3 mil milhões de habitantes, e por isso os lugares públicos estão sempre cheios de pessoas. Os grandes hospitais públicos na China estão ainda mais superlotados com um dilema de tratamento médico generalizado de "três longos e um curto" em departamentos ambulatoriais, que se refere a “longo tempo de espera de registro e pagamento, longo tempo de espera de busca de medicamentos, longo tempo de espera de tratamento e tempo curto de diagnóstico". Este dilema médico há muito atormenta o pessoal médico, bem como os pacientes que procuram tratamento em departamentos ambulatoriais e suas famílias. Com base na teoria da gestão da qualidade total, esta pesquisa é realizada de acordo com a Trilogia Juran - "Planeamento da Qualidade - Controlo da Qualidade - Melhoria da Qualidade" e o "Modelo Lógico do Prêmio Europeu da Qualidade". Com o fenómeno prevalente de "três longos e um curto" como a orientação, esta pesquisa revisa a literatura pertinente, ilustra a razão histórica para a ocorrência do dilema e o significado prático de resolvê-lo, propõe a hipótese de melhorar a experiência médica ambulatorial por meio o modelo "Internet + serviço médico", realiza a reengenharia do processo de tratamento ambulatorial através da pesquisa empírica sobre a plataforma "WeChat + outpatient service" desenvolvida pelo hospital T, e realiza o objetivo de melhorar a satisfação dos pacientes e equipa médica com qualidade, tendo como chave a equipa médica que participa do começo ao fim para trabalhar continuamente para melhorar a qualidade do atendimento ambulatorial. Através da prática, combinada com métodos como questionário, entrevista, consulta com especialistas e discussão em grupo, foi provado que a plataforma "WeChat + outpatient service" pode efetivamente aliviar ou resolver o dilema de "três longos", mas não há melhoria para o "um curto". Através das cinco dimensões de qualidade de serviço (tangibilidade, confiabilidade, responsabilidade, garantia e empatia) e análise de lacunas de qualidade de serviço, pode ser visto que a construção da plataforma "WeChat +outpatient service" melhorou a experiência médica do paciente, aumentou a satisfação de pacientes e equipa médica, e promoveu a consciencialização dos funcionários sobre o serviço ativo

Success Factors Impacting Artificial Intelligence Adoption --- Perspective From the Telecom Industry in China

As the core driving force of the new round of informatization development and the industrial revolution, the disruptive achievements of artificial intelligence (AI) are rapidly and comprehensively infiltrating into various fields of human activities. Although technologies and applications of AI have been widely studied, and factors that affect AI adoption are identified in existing literature, the impact of success factors on AI adoption remains unknown. Accordingly, the main study of this paper proposes a framework to explore the effects of success factors on AI adoption by integrating the technology, organization, and environment (TOE) framework and diffusion of innovation (DOI) theory. Particularly, this framework consists of factors regarding the external environment, organizational capabilities, and innovation attributes of AI. The framework is empirically tested with data collected by surveying telecom companies in China. Structural equation modeling is applied to analyze the data. The results indicate that compatibility, relative advantage, complexity, managerial support, government involvement, and vendor partnership are significantly related to AI adoption. Managerial capability impacts other organizational capabilities and innovation attributes of AI, but it is indirectly related to AI adoption. Market uncertainty and competitive pressure are not significantly related to AI adoption, but all the external environment factors positively influence managerial capability. The study provides support for firms\u27 decision-making and resource allocation regarding AI adoption. In addition, based on the resource-based view (RBV), this article conducts study 2 which explores the factors that influence the firm sustainable growth. Multiple regression model is applied to empirically test the hypotheses with longitudinal time-series panel data from telecom companies in China. The results indicate that at the firm level, the customer value and operational expenses are significantly related to sustainable growth. Also, at the industry level, industry investment significant impacts sustainable growth. Study 2 provides insights for practitioners the way to keep sustainable growth

E-Governance: Strategy for Mitigating Non-Inclusion of Citizens in Policy Making in Nigeria

The Nigerian federation that currently has 36 states structure adopted the Weberian Public Administrative system before now as an ideal way of running government, which was characterized with the traditional way of doing things without recourse to the deployment of Information Communication Technology (ICT). Today e-governance is seen as a paradigm shift from the previous way of governance. Research has shown that, the adoption and implementation of e-governance is more likely to bring about effective service delivery, mitigate corruption and ultimately enhance citizens’ participation in governmental affairs. However, it has been argued that infrastructure such as regular electricity power and access to the Internet, in addition to a society with high rate of literacy level are required to effectively implement and realize the potentials of e-governance for improved delivery of services. Due to the difficulties currently experienced, developing nations need to adequately prepare for the implementation of e-governance on the platform of Information Communication Technology (ICT). Hence, this study seeks to examine whether the adoption and implementation of e-governance in the context of Nigeria would mitigate the hitherto non-inclusion of citizens in the formulation and implementation of government policies aimed at enhanced development. To achieve the objective of the study, data were sourced and analyzed majorly by examining government websites of 20 states in the Nigerian federation to ascertain if there are venues for citizens to interact with government in the area of policy making and feedback on government actions, as a way of promoting participatory governance. The study revealed that the adoption and implementation of e-governance in the country is yet to fully take place. This is due to lack of infrastructure, low level of literacy rate and government inability to provide the necessary infrastructure for e-governance to materialize. The paper therefore, recommends among others the need for the Federal Government to involve a sound and clear policy on how to go about the adoption and implementation of egovernance through deliberate effort at increasing budgetary allocation towards infrastructural development and mass education of citizens