Cost-effectiveness of Clinical Pathway in Coronary Artery Bypass Surgery

Few studies have been devoted to the exploration of the effect of clinical pathways on coronary artery diseases treated with coronary artery bypass (CAB) surgery. This study was aimed to investigate the cost and effectiveness of the clinical pathway on CAB surgery in a medical center. With a retrospective dataset in 2003-2007, 212 CAB surgery patients were included. Data of the costs and postoperative complication occurrence and length of stays were the focus and patient demographics, surgical risk indicator EuroSCORE, surgical conditions were collected. It revealed that there was differentiation across specified cost items in beating heart CAB surgery patients, but not for heart arrest CAB surgery patients with and without clinical pathways enrolled. In addition, there was no difference in postoperative complication occurrence in CAB surgery patients enrolled into clinical pathways. However, robotic beating heart CAB surgery patients enrolled clinical pathways were shown to have less postoperative ordinary ward stay than those not enrolled clinical pathways. CAB surgery patients' age and surgical risks were related to their postoperative lengths of stay to some extent

Internationalization, intangible assets and Taiwanese SMEs' performance: Evidence of an Asian newly-industrialized economy

This paper investigates the impact of internationalization and intangible assets on the performance of Small and Medium sized enterprises (SMEs) in newly industrialized economies (NIEs). Examining a sample of 3,194 Taiwanese SMEs, we find that: (1) the relationship between internationalization and performance is characterized by an inverted U-shaped curve; (2) SMEs investing more heavily in research and development achieve greater gains in profitability; and (3) though the hypothesized linear relationship between advertising and profitability is not confirmed, further analysis indicates a U-shaped curvilinearity between the two, suggesting that a minimum level of investment is required if advertising is to be effective

Are more exports better for a firm's performance? The moderating effect of FDI

This study extends the research on the relationship between exporting and firm performance into the context of Newly Industrialised Economies (NIEs). The study's examination of 577 Taiwanese manufacturers shows that the relationship between export-based internationalisation and performance may be characterised by an inverted U-shaped curve. Furthermore, firms' engagement in foreign direct investment-based internationalisation appears to have a negative moderating effect on the relationship between exporting and firm profitability

Subsidiary size, internationalization, product diversification, and performance in an emerging market

Purpose - This study aims to explore subsidiaries' diversification strategies, both internationally and with regard to their product offerings. The study seeks to examine, at the subsidiary level, the relationships between subsidiary size, internationalization, production diversification, and performance. Design/methodology/approach - Based on the archival data of an officially conducted survey, the study used ordered logit regression analysis to test its hypotheses using data from 920 Taiwanese subsidiaries in China. Findings - The study's results revealed: larger subsidiaries tend to engage in internationalization and product diversification activities to a greater degree, and, as a result, tend to exhibit superior performance; and subsidiaries that pursue outward internationalization and that reinvest in related businesses enjoy enhanced performance. Research limitations/implications - This study examines Taiwanese firms that have one foreign subsidiary in China. Future research should examine larger firms with numerous foreign subsidiaries in developed countries, and should employ more fine-grained measurements of subsidiary size to provide a clearer picture of subsidiary-specific advantages. Originality/value - Unlike the existing literature, which has tended to take the perspective of the multinational corporation, this study examines internationalization and product diversification at the subsidiary level. By extending the resource-based view to the subsidiary level, larger subsidiaries might be able to exploit their advantages so as to more successfully implement international and product diversification strategies and improve their performance in a host country

Understanding the antecedents to customer loyalty by applying structural equation modeling

The purpose of this study is to employ structural equation modeling to find linear structural relationships related to customer satisfaction. Analysis of 495 car owners patronizing five automobile service and repair centers operated by Taiwan's three major car companies (Nissan, Toyota, and Mitsubishi), produced the following empirical results: customers' perceptions of price fairness, the level of employee - customer interaction, and customers' perceptions of product quality all have the direct, positive impact on customer satisfaction. The authors identified and examined three dimensions of perceived service quality that positively affect customers' trust levels. These three are tangibility, employee - customer interaction, and employee empathy. Customers' perceptions of price fairness and product quality, as well as customer satisfaction and trust are all positively related to customer loyalty. Customer satisfaction can also affect customer loyalty by helping customers create trust. In light of these empirical findings, this study also includes a discussion of possible implications for managers

Partner nationality, market-focus and IJV performance: A contingent approach

This study examines how Taiwanese firms engaging in various types of international joint ventures (IJVs) have performed in China, and how different types of market-focus affect IJVs' performance. Based on the IJV classification scheme suggested by [Makino S., & Beamish P. W. (1998). Performance and survival of joint ventures with non-conventional ownership structures. Journal of International Business Studies, 29(4): 797-818], this study outlines and examines three categories of IJVs, according to partner nationality: Taiwan-Taiwan (T-T) JVs, Taiwan-Local (T-L) (China) JVs, and Taiwan-Foreign (T-F) (third-country) JVs. We propose two hypotheses, with associated sub-hypotheses, to examine the major effects of partner nationality on performance, as well as the moderating effects of local market-focus on the relationship between partner nationality and performance. Through the analysis of 236 Taiwanese JVs in China, we find that (1) T-LJVs perform better than T-T JVs and T-F JVs; (2) T-LJVs focusing on the local market do not perform better than those focusing on foreign markets; and (3) T-F JVs focusing on foreign markets perform better than those focusing on the local market. (C) 2008 Elsevier Inc. All rights reserved

The Relationship Between R&D Investment and Firm Profitability Under a Three-Stage Sigmoid Curve Model: Evidence From an Emerging Economy

The relationship between investment in research and development (R&D) and firm performance has been the subject of numerous academic investigations, but the findings of these investigations have varied greatly, with research revealing a number of different patterns in the R&D-performance relationship. This inconsistency may be partly attributable to the failure of the commonly used linear modeling method to capture the full dynamics of the R&D-performance relationship. Based on the sigmoid (S) curve paradigm, as well as on other economic foundations, this study proposes the use of a three-stage S-curve model to help reconcile the disparities in the literature. This S-curve model shows that the relationship between R&D intensity and firm profitability is nonlinear, with the slope negative at low levels (stage 1), positive at medium levels (stage 2), and negative again at high levels of R&D investment (stage 3). Empirical evidence from a sample of 377 publicly listed Taiwanese high-tech manufacturing firms and 179 nonhigh-tech firms, examined during the period between 2000 and 2007, confirmed our proposed model. This study not only establishes a relationship pattern that differs from that shown in past studies, but also has important managerial implications for R&D managers and important policy implications for governments

Choosing between wholly-owned subsidiaries and joint ventures of MNCs from an emerging market

Purpose - The purpose of this paper is to examine the impact that three sets of variables - derived from transaction cost theory (TCT), the resource-based view (RBV), and institutional environment - have on choice of entry strategies of multinational corporations (MNCs) from an emerging market. Design/methodology/approach - The sample consisted of 819 Taiwanese firms which were investigated using a national survey, and logistic regression analysis was used for testing the hypotheses. Findings - The empirical findings confirm that the following factors affect this decision: firm-specific assets, international experience, whether a firm is investing abroad in pursuit of a particular customer, whether a firm seeks complementary assets abroad, and the perceived institutional differences (PEDs) between a firm's home country and the host country. The findings also suggest that PEDs have a moderating effect on foreign market entry. Research limitations/implications - As MNCs from emerging markets make the decision of entry mode strategies, they must carefully consider not only the related variables in terms of TCT and the RBV, but also the influence of institutional factors in host countries. Originality/value - This paper explores the modes of entry chosen by Taiwanese firms investing in China on the basis of TCT, institutional environment, and the RBV

Multinational corporations (MNCs) and risk perception: Understanding causes and strategic consequences

This study examines the antecedents and strategic consequences of perceive risk when multinational corporations (MNCs) investing abroad. The study examine the complex relationships among risk's antecedent variables about host country factors and network perspective with a sample of 1,020 manufacturers, the study find that: MNCs perceive lower levels of risk when market potential is greater, infrastructure is better established, or lower level of corruption. Regardless of how MNCs engage in foreign direct investment-whether they actively following the customers or are requested by customers to follow-they perceive higher levels of risk in a host country. With regard to the strategic consequences of risk perceptions, when MNCs perceive higher host country risks, they enhance their level of subsidiary ownership, avoid granting access to local partners and associates, and reduce subsidiaries' autonomy. This study provide practitioners a guide for evaluating the risks associated with investing in foreign markets, furthermore the study also proposes MNCs some strategic alternatives in the face of higher investing risk

Does the length of a customer-provider relationship really matter?

This study examines both a moderator and a mediator of perceived service quality and payment equity as they relate to customer loyalty in the banking industry. Through the moderating factor, the length of the customer-bank relationship, this study builds a conceptual framework for distinguishing between transactional- and relationship-oriented customers and provides an empirical analysis by using structural equation modelling. The empirical findings of this study, the result of the examination of 610 banking customers, showed that different lengths of the customer-bank relationship form loyalty from different variables and from a different path. For transactional-oriented customers, loyalty was built through the achievement of overall customer satisfaction; whereas for relationship-oriented customers, loyalty was built through the establishment of trust. Suggestions and limitations based on the finding are also discussed