Transaction costs in healthcare: empirical evidence from Portuguese hospitals

Transaction Cost Economics has been used in the healthcare context to discuss the make-or-buy dichotomy, focusing on minimizing production or governance costs, respectively. Nevertheless, it is important to recognize that there are other relevant costs, which influence these decisions in health care. Thus, the purpose of this research project was to study such additional variables which may significantly influence the dynamics of transaction costs in hospitals. Semi-structured interviewing was used to collect the data, complemented by some document analysis and observation in the visits made to the hospitals studied. The interviews were conducted during a period of three months, with directors and administrators of four Portuguese hospitals. A deeper study was developed in one of the hospitals where it was possible to get information from additional interviews and documents. Two important findings should be highlighted. Firstly, the internal transaction costs derived from the hospital’s own internal contracting process which generates retention costs of medical personnel and costs of control of the internal contract itself. Secondly, they were studied the intangible costs, particularly those related to the decision of carrying out a process that could deteriorate the patient’s health or her/his critical situation, making the total cost, including treatment and possible re-hospitalizations higher than the cost of having treated the patient internally since the initial cost was considered greater than treating the patient outside hospital facilities. These variables should be considered when studying or using TCE in hospitals, complementing and extending the traditional framework as it is discussed here.- (undefined

Terceirização de TI e Capacidade Absortiva: Um Estudo de Casos Múltiplos no Setor de Seguros:

Sources of external knowledge are critical to the implementation of strategies to achieve innovation, especially in the case of information technology. The concept of absorptive capacity reflects the ability of firms to obtain, assimilate, combine, and extract advantages from external knowledge to generate innovations. The objective of this multiple case study was to investigate how outsourcing of IT can influence the absorptive and innovative capacity of organizations, focused on the insurance sector. The results of comparing four insurers with different degrees of innovation and adoption of IT outsourcing indicate that the connections between the strategy of relationship with suppliers and the stance of the IT area of the cliente company, and its previous activity and level of knowledge, are essential to determine the absorptive and innovative capacity. Besides this, companies that neglect outsourcing of IT to leverage their absorptive and innovative capacity can suffer significant harm regarding the use of resources, agility, and competitiveness.As fontes de conhecimento externo são críticas na implementação de estratégias baseadas em inovação, especialmente as habilitadas pelas tecnologias da informação. O conceito de capacidade absortiva reflete a habilidade de uma firma de obter, assimilar, combinar e tirar proveito de conhecimentos externos para gerar inovações. O objetivo desta pesquisa foi investigar como a terceirização de TI pode influenciar a capacidade absortiva e inovativa de uma organização. Os resultados de um estudo de casos múltiplos, comparando quatro seguradoras com diferentes graus de inovação e de adoção da terceirização de TI, mostraram que as conexões entre a estratégia de relacionamento com fornecedores e a postura da área de TI do contratante, e a forma de atuação e nível de conhecimento prévio do contratado são essenciais para a capacidade absortiva e inovativa. Além disso, empresas que negligenciam a terceirização de TI para alavancar sua capacidade absortiva e inovativa podem ter ônus significativos para o uso de seus recursos, e sua agilidade e competitividade

Terceirização de tecnologia da informação e gestão de contratos no setor público: um estudo na SEFAZ/SE

Este artigo tem como objetivo analisar o processo de terceirização de Tecnologia da Informação (TI) e a gestão dos contratos na Secretaria de Estado da Fazenda de Sergipe (SEFAZ/SE). Metodologicamente, realizou-se uma pesquisa de abordagem qualitativa, adotando a estratégia de estudo de caso único. Para a produção dos dados, aplicou-se um roteiro de entrevista semiestruturado junto a servidores ligados à área de TI. Constatou-se que, diferentemente das organizações privadas, o órgão público não apresenta a redução de custos e aspectos econômicos como principais motivadores para a terceirização. Apesar das desvantagens, considera-se o processo vantajoso e eficiente. Revela-se ainda que a SEFAZ/SE utiliza um arranjo de terceirização total, divergindo das recomendações da literatura; e identificou-se como principal fator de risco a dependência do fornecedor. Este estudo pode auxiliar no fornecimento de informações para governo, sociedade e gestores públicos sobre o processo de terceirização de TI e seus impactos no setor público

El outsourcing y su influencia en la satisfacción de la demanda en una empresa de joyería artesanal, Lima, 2023

El presente estudio tiene como objetivo principal determinar de qué manerael outsourcing influye en la satisfacción de la demanda en una empresa dejoyeríaartesanal, Lima, 2023. El estudio consideró como población a 50 trabajadoresdelas áreas de fabricación de una joyería y en la muestra se consideróa45trabajadores de las áreas de fabricación de la joyería. El estudio presentaundiseñono experimental, con un enfoque cuantitativo que relaciona las variablesoutsourcing y satisfacción de la demanda. Para este estudio se planteócomodimensiones los procesos, beneficios y desventajas del outsourcing y surelacióncon la satisfacción de la demanda, demostrándose la hipótesis propuestaenlainvestigación, además el estudio tuvo como resultado que el 57.8 %delostrabajadores de las áreas de fabricación de la joyería, indica que si habríabeneficios hacer uso del outsourcing , asimismo, el outsourcing influye demaneradirecta en la satisfacción de la demanda, para ello se utilizó el análisisdecorrelación de Spearman y se validó el Alpha de Cronbach e instrumentomediantejuicio de expertos

Strategies for Managing Offshore Outsourcing for Business Sustainability

Ineffective offshore outsourcing strategies can contribute to unexpected and significant costs for businesses. Strategies to improve outsourcing outcomes are critical to business managers because often third parties contracted to implement offshore outsourcing fail to fulfil business managers’ expectations who can benefit from understanding how to manage outsourced operations and anticipate potential problems. Grounded in transaction cost theory, cultural and customs theory, and the resource-based view theory, the purpose of this qualitative single case study was to explore strategies and processes business managers use to maintain their organization after the implementation of offshore outsourcing. The participants consisted of 3 managers who successfully retained outsourcing contracts from one organization located in the northern region of the United Kingdom. Data were collected from semistructured interviews and company documents. Thematic analysis was used to analyze data. The 3 themes that emerged were preparation before outsourcing occurs, accountability for both the business and the outsource provider, and continuous involvement in developing a successful business/provider relationship. The implications for positive social change include the potential for the outsourcer’s country and the vendor’s country to benefit from economic stimulation associated with the successful implementation of offshore outsourcing, contributing to employing community members, investing in infrastructure projects, and enhancing collaboration among local businesses

Strategies Information Technology Outsourcing Managers Use to Improve Business Performance and Employee Retention

AbstractVoluntary employee turnover can result in adverse business outcomes. Information technology (IT) managers are concerned with voluntary turnover, which is the number one reason for actual turnover. Grounded in the transaction cost theory, the purpose of this qualitative multiple case study was to explore strategies IT managers use to improve business performance and employee retention. The participants comprised four IT managers from two firms in Arizona who effectively used strategies to improve business performance and employee retention. Data sources included semi-structured interviews, a review of archival company documents, and field notes. The data were thematically coded and analyzed, and four themes emerged: communication and relationships, labor costs, organizational learning and culture, and vendor management. A key recommendation is for IT managers to implement effective communication and relationships with vendors to achieve efficient labor costs in ITO contracts. The implications for positive social change include the potential for IT managers to create job opportunities, maintain socioeconomic stability for local citizens, provide social amenities and welfare, and promote regional communities’ economic development across the globe

Information Technology Outsourcing Strategies to Ensure Customer Satisfaction

Many information technology (IT) outsourcing initiatives fail, resulting in a high impact on business results and customer satisfaction. Without effective strategies, business leaders who outsource their IT services are at considerable risk of failure and stakeholder dissatisfaction. The purpose of this multiple case study was to explore outsourcing strategies that IT managers in Southern Ontario, Canada, used to ensure customer satisfaction. Participants included 9 executives with experience in complex IT outsourcing initiatives. Stakeholder theory and transaction cost economics theory were the conceptual frameworks for the study. Data were gathered using semistructured interviews to query 8 topical areas including IT outsourcing reasons, challenges, and successful solutions. Data analysis using thematic analysis revealed 4 themes: strategic intent for outsourcing, applicable frameworks, risk awareness, and partnership strategies. Key findings included the importance of clients’ and suppliers’ focus on deal principles, innovation, and work-collaboration strategies to enhance performance and customer satisfaction. Information technology managers’ application of the findings of this study may improve business success and contribute to positive social change by revitalizing the clients’ and suppliers’ economies to create job opportunities and improve the quality of lives of employees and their communities

Crisis Management Strategies for Sustaining Organizations During a Crisis

Public relations directors often lack crisis management strategies to maintain an organization\u27s reputation following a crisis to ensure continued profitability. Public relations directors who better understand crisis management strategies may benefit their organizations by improving crisis prevention and recovery while maintaining organizational reputation and profitability. Grounded in situational crisis communication theory, the purpose of this qualitative multiple case study was to explore crisis management strategies that some public relations directors use to maintain an organization\u27s reputation following a crisis to ensure continued profitability. Data were collected using semistructured interviews with three public relations directors from Upper Manhattan, New York, supporting documents from previous case studies listed on their website, and journal notes. Data analyzed using thematic analysis identified three themes: reactive crisis communications and decision making, sustainability crisis planning and organizational reputation, and precrisis prevention and preparedness. A key recommendation is for public relations directors responsible for handling crises to understand the potential threats, crisis, and organization encounters, thus innovating crisis management strategies to ensure continued profitability. Positive social change implications could include improved crisis preparedness and reduced crisis disruption while reducing damage economically to the organization and surrounding communities. The resulting positive social changes can help leaders and organizations increase profits, create jobs, and support economic development at the local community level

Cybersecurity Using Risk Management Strategies of U.S. Government Health Organizations

Seismic data loss attributed to cybersecurity attacks has been an epidemic-level threat currently plaguing the U.S. healthcare system. Addressing cyber attacks is important to information technology (IT) security managers to minimize organizational risks and effectively safeguard data from associated security breaches. Grounded in the protection motivation theory, the purpose of this qualitative multiple case study was to explore risk-based strategies used by IT security managers to safeguard data effectively. Data were derived from interviews of eight IT security managers of four U.S. government health institutions and a review of relevant organizational documentation. The research data were coded and organized to support thematic development and analysis. The findings yielded four primary themes: effective cyber-risk management strategies: structured, systematic, and timely cyber risk management; continuous and consistent assessment of the risk environment; system and controls development, implementation, and monitoring; and strategy coordination through centralized interagency and interdepartmental risk management. The key recommendation based on the study findings is for IT security managers to employ cybersecurity strategies that integrate robust cybersecurity controls and systematic processes based on comprehensive risk management. The implications for positive social change include the potential to positively stimulate patient trust and confidence in healthcare systems and strengthen healthcare professionals\u27 commitments to ensure patient privacy