How German hospitals govern IT - An empirical exploration

Health care services in German hospitals are causing immense expenses. Successful IT Governance might help to support specific challenges for every organization with an adequate use of IT. The market structure of hospitals in Germany is very heterogeneous, e.g. in size and sponsorship. This paper analyses the state of the art of IT Governance based on a survey among 220 IT executives in German hospitals. The quantitative analyses of collected survey data reveal that hospitals govern their IT differently according to size and sponsorship. In addition, our analyses show that decision-making authority for the IT budget rises with hospital size and is positively correlated with the fraction of IT projects in the overall IT budget. We also show that the investments in innovative IT projects increase with hospital size. Our study revealed that a high number of private and larger hospitals lack a systematic IT Governance approach within the decision domain on IT projects. This study is the first to shed light into the empirical situation of IT Governance in German hospitals. Creativity-intensive processes such as the development of marketing campaigns or the production of visual effects increasingly find their way into the agenda of process managers. Such processes often comprise of both well-structured, transactional parts and creative parts that often cannot be specified in terms of their process flow, required resources, and outcome. Moreover, the processes’ high variability sets boundaries for the possible degree of automation. In this paper we introduce the concept of pockets of creativity as an analytic device which is hoped to support process managers in their efforts to identify and describe creative sections in business processes. We argue that this step of identifying and describing is imperative to successfully allocate resources, integrate creativity into the overall process, and introduce process automation for those parts that are well-structured and can actually be automated. Our argument rests in the examination of existent literature as well as in findings from exploratory case studies that were conducted in the film and visual effects industry in order to study processes that rely on creativity

owards a reference model for grassroots enterprise mashup environments

Health care services in German hospitals are causing immense expenses. Successful IT Governance might help to support specific challenges for every organization with an adequate use of IT. The market structure of hospitals in Germany is very heterogeneous, e.g. in size and sponsorship. This paper analyses the state of the art of IT Governance based on a survey among 220 IT executives in German hospitals. The quantitative analyses of collected survey data reveal that hospitals govern their IT differently according to size and sponsorship. In addition, our analyses show that decision-making authority for the IT budget rises with hospital size and is positively correlated with the fraction of IT projects in the overall IT budget. We also show that the investments in innovative IT projects increase with hospital size. Our study revealed that a high number of private and larger hospitals lack a systematic IT Governance approach within the decision domain on IT projects. This study is the first to shed light into the empirical situation of IT Governance in German hospitals

Institutionalized Bailouts and Fiscal Policy: The Consequences of Soft Budget Constraints

States have soft budget constraints when they can expect a bailout by the federal government in the event of a financial crisis. This gives rise to incentives for unsound state fiscal policy. We test whether states with softer budget constraints have higher debt and deficits, receive more bailouts funds, spend funds less efficiently, and are more likely to allocate funds to programs benefiting special interests. Exogenous variation in soft budget constraints across states and over time allows the identification of budget constraint softness on state fiscal policy. We take advantage of the fact that in Germany, states’ political influence is exogenous because voting weights differ in the upper chamber of the German parliament. The stronger the political influence of states, the softer their budget constraints. We show that states with softer budget constraint have higher deficits and debts, and receive more bailouts funds. Further, overrepresented states are less efficient in spending public funds and are more prone to respond to rent seeking by interest groups.

A pied-piper situation : do bureaucratic researchers produce more science?

¿Puede un científico confiar en que el gobierno le va a pagar honestamente? En la relación entre la ciencia y el Estado, el gobernante sale ganando si no paga (o si no paga honradamente). Todo científico público, así, afronta el riesgo de que tras una carrera larga y difícil el gobernante cambie las reglas del juego. A pesar de que la solución a este problema de credibilidad es lo que da forma a las instituciones de la ciencia pública el problema ha sido rara vez estudiado teórica o empíricamente en los estudios de la ciencia. En este trabajo proponemos un modelo de esa relación entre gobiernos y científicos de acuerdo con la teoría de juegos que muestra la importancia del tipo de contrato que los vincula, el que sea más o menos burocrático en un sentido weberiano. Hasta cierto punto, los contratos burocráticos —como los de los funcionarios— protegen a los científicos contra el mal comportamiento de los gobernantes. Mediante esas reglas burocráticas, los contratos atan las manos del gobierno con lo que se hace creíble su compromiso a la vez que se protege el delicado sistema de recompensas de la ciencia. De esta manera se estimula la productividad tanto en calidad como en cantidad. Sin embargo, cuando se da el caso de gobiernos fiables los contratos burocráticos limitan los sistemas de incentivos y van en contra tanto de la receptividad de los científicos a las demandas de los gobiernos o de la sociedad como, al final, al interés de los gobiernos por el producto que ofrecen. En este trabajo utilizamos evidencia comparada entre países que confirma las proposiciones del modelo teórico y muestra cómo los contratos burocráticos estimulan la productividad científica en el caso de gobiernos poco confiables —como en el caso de las dictaduras— pero limitan esa productividad con gobiernos más fiables — como las democracias—

European Governance, or Governmentality? Reflections on the EU‘s System of Government

This paper offers a critical exploration of the term ‘governance’, its rise to prominence within EU political discourse, and the new forms of authority and expertise it has come to be associated with within the EU’sevolving political regime. Its argues that a critical understanding of EU governance might be advanced ifscholars look beyond the conventional political science literature (where governance is often ontologizedas that form of politics and authority which reflects the social reality of administering complex societies),and interpret it instead in terms of recent debates about neoliberal governmentality. I ask, what does theCommission’s appropriation of this ambiguous concept reveal about the way EU politicians, experts andpolicy makers are re-conceptualising Europe and the problem of European government?

Tourism and Economic Growth in Latin American Countries: A Panel Data Approach

We consider the relationship between tourism and economic growth for Latin American countries since 1985 until 1998. The analysis proposed is based on a panel data approach and the Arellano-Bond estimator for dynamic panels. We obtain estimates of the relationship between economic growth and growth in tourists per capita conditional on main macroeconomic variables. We show that the tourism sector is adequate for the economic growth of medium or low-income countries, though not necessarily for developed countries. We then invert the causality direction of the analysis. Rather than explaining economic growth, we try to explain tourism arrivals conditional on GDP and other covariates such as safety, prices and education level, and investment in infrastructures. We employ a generalised least squares AR(1) panel data model. The results provide evidence that low-income countries seem to need adequate levels of infrastructures, education and development to attract tourists. Medium-income countries need high levels of social development like health services and high GDP per capita levels. Finally, the results disclose that price of the destination, in terms of exchange rate and PPP is irrelevant for tourism growth.Tourism, Economic growth, Panel data

The Emergent Logic of Health Law

The American health care system is on a glide path toward ruin. Health spending has become the fiscal equivalent of global warming, and the number of uninsured Americans is approaching fifty million. Can law help to divert our country from this path? There are reasons for deep skepticism. Law governs the provision and financing of medical care in fragmented and incoherent fashion. Commentators from diverse perspectives bemoan this chaos, casting it as an obstacle to change. I contend in this Article that pessimism about health law’s prospects is unjustified, but that a new understanding of health law’s disarray is urgently needed to guide reform. My core proposition is that the law of health care provision is best understood as an emergent system. Its contradictions and dysfunctions cannot be repaired by some master design. No one actor has a grand overview—or the power to impose a unifying vision. Countless market players, public planners, and legal and regulatory decisionmakers interact in oft-chaotic ways, clashing with, reinforcing, and adjusting to each other. Out of these interactions, a larger scheme emerges—one that incorporates the health sphere’s competing interests and values. Change in this system, for worse and for better, arises from the interplay between its myriad actors. By quitting the quest for a single, master design, we can better focus our efforts on possibilities for legal and policy change. We can and should continuously survey the landscape of stakeholders and expectations with an eye toward potential launching points for evolutionary processes—processes that leverage current institutions and incentives. What we cannot do is plan or predict these evolutionary pathways in precise detail; the complexity of interactions among market and government actors precludes fine-grained foresight of this sort. But we can determine the general direction of needed change, identify seemingly intractable obstacles, and envision ways to diminish or finesse them over time. Dysfunctional legal doctrines, interest group expectations, consumers’ anxieties, and embedded institutional and cultural barriers can all be dealt with in this way, in iterative fashion. This Article sets out a strategy for doing so. To illustrate this strategy, I suggest emergent approaches to the most urgent challenges in health care policy and law—the crises of access, value, and cost

Constellations of public organic food procurement for youth. An interdisciplinary analytical tool

The research project “innovative Public Organic food Procurement for Youth” (iPOPY) combines a multitude of national and disciplinary perspectives: a necessary condition for a holistic understanding of public organic food procurement for youth (POPY). One challenge of such a research agenda lies in the integration of diverse results. This calls for an interdisciplinary research approach that facilitates discussion about results generated in different work packages (WP). This report sketches the methodological tool constellation analysis, one of the basic assumptions of which is that technical, natural and social elements and developments are closely intertwined and can only be analysed by taking into account their heterogeneity. Constellation analysis may serve as a bridging concept for the integration and synthesis of project results, which is a task of WP 1. This report presents preliminary results from an explorative constellation analysis of (organic) school meals. In the appendix, a list of definitions with regard to POPY is provided – the iPOPY glossary, which may later be further developed and published separately