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We investigated the association of COVID-19 indicators and economic uncertainty indices on payment-based system cryptocurrency (i.e. Bitcoin, Ripple and Dogecoin) returns.

We used an autoregressive distributed lag (ARDL) model for panel data and performed robustness checks by utilizing a random effect model (REM) and generalized method of moments (GMM). There are 25 most adopted cryptocurrency’s countries and the data spans from 22 March 2021 to 6 May 2022.

This research discovered four findings: (1) the index of COVID-19 vaccine confidence (VCI) recovers the economic and Bitcoin has become more attractive, causing investors to shift their investment from Dogecoin to Bitcoin. However, the VCI was revealed to be insignificant to Ripple; (2) during uncertain times, Bitcoin could perform as a diversifier, while Ripple could behave as a diversifier, safe haven or hedge. Meanwhile, the movement of Dogecoin prices tended to be influenced by public figures’ actions; (3) public opinion on Twitter and government policy changes regarding COVID-19 and economy had a crucial role in investment decision making; and (4) the COVID-19 variants revealed insignificant results to payment-based system cryptocurrency returns.

This study contributed to verifying the vaccine confidence index effect on payment-based system cryptocurrency returns. Also, we further investigated the uncertainty indicators impacting on cryptocurrency returns during the COVID-19 pandemic. Lastly, we utilized the COVID-19 variants as a cryptocurrency returns’ new determinant.

Extant research documents the cost benefits of group purchasing organizations (GPOs) to member hospitals, but understudies concerns about the market dominance of a few large GPOs and the relatively weakened buyer power of hospitals in the US healthcare product supply chain. To fill the gap in the literature, this study investigates whether GPO size and a hospital’s relative power to its GPO affect the hospital’s supply expenses, and whether and how system membership moderates the power–performance link.

For this study, we collect the panel data from various secondary sources on GPO–hospital dyads, which include the seven largest GPOs and their 2,590 unique acute care hospital members in 51 states over the period of 2009–2017. To address the endogeneity issue associated with simultaneity, we establish a one-year time lag between dependent and independent variables and analyzed the 15,527 hospital-year observations using the time-series regression with fixed-effect.

We find that a hospital’s relative power to its GPO is the most critical factor to reduce its supply cost while GPO size has no effects. We also find that a nonsystem hospital achieves greater cost savings by leveraging its relative power to its GPO while a system hospital gains no benefits.

To the best of our knowledge, this study is the first to address the paradox of GPO size and a hospital’s relative power and the moderating role of system membership for the hospital’s purchasing efficiency using a large nation-wide dataset of US hospitals–GPO dyads.