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Modern lifestyle changes led to increased dental care needs in India. Consequently, there has been a sharp rise in dentist numbers. Karnataka state alone produces 2,500 dentists annually, who are engaged in the non‐government sector owing to inadequate public sector opportunities. This article aims to assess Karnataka private dental clinic quality and efficiency.

Dentists were interviewed using a close‐ended, structured interview schedule and their clinics were assessed using a checklist adopted from guidelines for providing machinery and equipment under the National Oral Health Care Programme (NOHCP). Dental “hotel” and clinical quality were scored based on this checklist.

Clinical quality was “excellent” in 12 per cent of clinics and poor in 49 per cent. Clinics with better infrastructure charged higher price (p<0.05). Multi‐chair clinics charging fixed rates were high (81 per cent). According to 59.5 per cent of dentists, competition did not improve quality while 27 per cent felt that competition increased price, not quality. About 30.9 per cent of the poor quality clinics, 41 per cent average quality clinics and 26 per cent good quality clinics were technically efficient.

The multi chair clinics offered better quality at higher prices and single chair clinics provided poorer quality at lower prices. In other words, they had a sub‐optimal price‐quality mix. Therefore, there is a need to regulate price and quality in all clinics to arrive at an optimal price‐quality mix so that clients are not overburdened financially even while receiving good quality dental care.

The article advocates that resources are used optimally as a way to achieve value for money and to achieve break‐even points thereby providing quality care in a competitive market. Factors that influence dental practitioner behaviour are evaluated.

Irrigation facility has been identified by many researchers as one of the essential institutional factors in agriculture sector of any country, including India. Furthermore, its importance has also been admitted in the agro-productions in any provinces, districts and blocks. The equitable distribution of such facilities may lead to equitable distributions in the productivity of land for different crop productions. Under this milieu, this chapter intends to examine the trends in the different types of paddy production and irrigational facilities in the Paschim Medinipur District of West Bengal State in India and tries to correlate whether disparities in paddy production are associated with disparities in the distribution of irrigational facilities. The results show positive association between the two and prescribe inclusive arrangements of irrigational facilities to all the blocks in the district to have long-term solutions.

The central lesson to be learned from studying the case is to understand the challenges and constraints posed by contextual conditions in designing contracts in public–private partnerships (PPP) for financing and delivering health care in emerging economies such as India.

Perverse incentives, along with contextual conditions, led to extensive opportunistic behaviors among involved agencies, limiting the effectiveness of otherwise highly regarded innovative design of the program.

India’s “Rashtriya Swasthya Bima Yojana” or National Health Insurance Program, launched in 2007 provided free health insurance coverage to protect millions of low-income families from getting pushed into poverty due to catastrophic health-care expenditure. The program was implemented through a PPP using standardized contracts between multiple stakeholders from the public and private sector – insurance companies, hospitals, intermediaries, the provincial and federal government.

Teaching Notes are available for educators only.

CSS: 10 Public Sector Management.

Indian healthcare is in the process of offering a plethora of services to customers hailing largely from India and from neighboring countries. The Indian hospital sector consists of private “nursing homes” and government and charitable missionary hospitals. Government and missionary hospitals determine their charges according to patients' income levels and treat poor patients freely. Nursing homes charged higher, market‐determined rates. They offer services in just a few medical specialties, owned and operated by physicians who worked with them. Nursing homes cannot afford the latest medical technology, but they provide more intimate settings than government hospitals. This case study aims to demonstrate the various strategic options available to a for‐profit hospital, in an emerging economy with a burgeoning middle‐class population and how it can choose which services that it can best offer to its target population.

Diagnosing and treating complex ailments in nursing homes could be a time‐consuming and expensive proposition as visits to several nursing homes with different specialties may be necessary. This paper demonstrates how an hospital can develop new customer‐oriented services and eliminate the hassle for patients needing to run around different healthcare outlets even for minor ailments.

The paper finds that large government hospitals generally have better facilities than nursing homes, but they were widely believed to provide poor‐quality care. They failed to keep up with advanced equipment, train their technicians adequately and did not publicize their capabilities to doctors who might refer patients. Many missionary and charitable hospitals were undercapitalized and did not offer all services. These conditions left an unsatisfied demand for high‐quality medical care. In 1983, LIFENET opened in Madras, becoming the first comprehensive, for‐profit hospital in India. LIFENET, invested in a cardiology laboratory and clinics with capacity to diagnose heart and lung ailments, which grew through referrals it received from other doctors.

Out of promoters' shared vision and the persistence to overcome financial and regulatory hurdles, LIFENET turned into a super specialty hospital. In early 2004, LIFENET promoters considered several options for expansion. In addition to building more hospitals, they considered licensing the brand name and establishing India's first health maintenance organization.

The purpose of this paper is to suggest the fuzzy quality function deployment (QFD) method to assess LIFENET customers' spoken and unspoken needs in order to achieve the various objectives like: how to decide optimum portfolio for health services strategically; how to assess competitors' market position in order to reckon the market position of LIFENET; and how to set the revised target in order to satisfy the customers' demand and to fetch profit in order to satisfy managers' mission and vision in a competitive market.

A fuzzy QFD method has been devised to take care of the various LIFENET objectives. Fuzzy logic's use has been recommended to remove the uncertainty, vagueness, and impreciseness from data obtained to assess customers' spoken and unspoken needs. Symmetric triangular fuzzy numbers (STFNs) may be used to assess various needs to enhance data accuracy. House of quality (HOQ), an in‐built QFD matrix, may be constructed to take care of LIFENET's various requirements in order to satisfy internal and external customers.

Fuzzy QFD plays a vital role in assessing customers' need in terms of WHATs. Various WHATs thus obtained can be accomplished by incorporating technical parameter HOWs'. The QFD HOQ offers various vital comparisons for instance, WHATs vs HOWs, HOWs vs HOWs, NOWs vs WHATs, etc. to obtain important inferences, which help to revise target to remain competitive in the market. Fuzzy QFD helps devise a management strategy to follow customers' needs in health industry successfully.

Accessing Indian customers' needs poses many challenges as the decision to opt for a given healthcare service is most uncertain because it varies from person to person. The set of parameters that influence individual decisions to opt for healthcare services are costs, treatment response time, disease/risk, and health service satisfaction. Fuzzy QFD may help LIFENET promoters to consider customers' favored health services thereby helping strategically in their attempt for major expansion, in order to get the most benefits of becoming first‐movers in the sector. Fuzzy QFD may also help LIFENET to avert major investment decisions that looked attractive in short‐term, but in fact were unfruitful, in long‐term.

This study seeks to provide a conceptual framework for the classification and selection of Healthcare 4.0 (H4.0) digital technologies affecting healthcare processes.

By examining the literature review, a set of processes of health services based on two axes of interaction and service customization and the axis of labor intensity of the service process matrix was divided into four categories: service factory, mass service, service shop and professional services. Then, using a combination of grey decision-making trial and evaluation laboratory (DEMATEL) and grey weighted aggregates sum product assessment (WASPAS) methods, a framework was presented to compute the impact of each of the H4.0 digital technologies on sub-criteria of the two main axes. Finally, based on the degree of the impact of each technology on the main axes, the technology affecting the four processes was segmented.

Findings show that the customer participation in the service process (C₁), ways to provide customer service (C₆) as well as the speed of service delivery (L₄) are the most important in the classification of digital technologies affecting healthcare processes.

Various other indicators from the behavioral, cultural, political, social and economic fields can be examined and used as a basis for evaluating H4.0 digital technologies.

The proposed framework can help managers select H4.0 digital technologies to prioritize, review and analyze appropriate technologies to improve and support different processes, prioritize appropriate technologies and review and analyze.

So far, no study has examined the link between digital technologies and various service processes. Therefore, this reinforces the originality and value of the present study.

Big Data (BD) is not only a quintessential part of many economic activities but also has evolved into a veritable business ecosystem. However, most Big Data ecosystem (BDE) models have a technical, bottom-up focus and mostly lack the capability for a broad socioeconomic analysis. This paper identifies the Millennium Ecosystem Assessment (MA) as a useful, operational framework and uses a metaphorical analogy to adapt it for the BDE. The top-down approach adopted here allows for seeing the big picture of the BD ecosystem. Meeting “end-user needs” is the main objective of the proposed BDE framework.

The methodology of this paper consists of two parts. First, the MA is adapted for the BDE through a metaphorical analogy. Then, to operationalize and validate the proposed framework, it is applied to an emerging BD ecosystem.

In total, four types of services are offered in the BD ecosystem: provisioning information and products; regulating; cultural and supporting services. Direct and indirect drivers of change impact ecosystem processes such as BD service provision. Based on the assessment results, interventions can be devised to remedy problems, sustain the ecosystem or accelerate growth. The proposed BDE assessment framework is applied to an emerging BDE as an example of operationalization and validation of the proposed BDE framework.

The strengths of the proposed BDE framework is that, in contrast to existing frameworks that are technical and bottom-up, it is constructed top-down by a metaphorical analogy from the proven MA framework. It is a generic framework with the ultimate objective of meeting the “end-user needs” and does not focus on a single sector or firm. Also, the proposed BDE framework is multi-faceted and considers broad socioeconomic issues such as regulating, cultural and supporting services and drivers of change.

Regardless of the diverse research on big data analytics (BDA) across different supply chains, little attention has been paid to exploit this information across service supply chains. The healthcare supply chains, where supply chain operations consume the second highest expenditures, have not completely attained the potential gains from data analytics. So, this paper explores the challenges of BDA at various levels of healthcare supply chains.

Drawing on the resource-based view (RBV), this research explores the various challenges of big data at organizational and operational level of different nodes in healthcare supply chains. To demonstrate the links among supply chain nodes, the authors have used a supplier-input-process-output-customer (SIPOC) chart to list healthcare suppliers, inputs (such as employees) supplied and used by the main healthcare processes, outputs (products and services) of these processes, and customers (patients and community).

Using thematic analysis, the authors were able to identify numerous challenges and commonalities among these challenges for the case of healthcare supply chains across United Arab Emirates (UAE). An applicable exploration on organizational (Socio-technical) and operational challenges to BDA can enable healthcare managers to acclimate efficient and effective strategies.

The identified common socio-technical and operational challenges could be verified, and their impacts on the sustainable performance of various supply chains should be explored using formal research methods.

This research advances the body of literature on BDA in healthcare supply chains in that (1) it presents a structured approach for exploring the challenges from various stakeholders of healthcare chain; (2) it presents the most common challenges of big data across the chain and finally (3) it uses the context of UAE where government is focusing on medical tourism in the coming years.

Originality of this work stems from the fact that most of the previous academic research in this area has focused on technology perspectives, a clear understanding of the managerial and strategic implications and challenges of big data is still missing in the literature.

This paper examines the relationship between participation and job performance. It also seeks to identify the impact of individual variables on the level of participation among managerial employees in the Public Service Department in Malaysia. Finally, it attempts to determine whether Porter and Lawler's (1968)‐expectancy model could represent an appropriate framework for studying employee participation. The results indicate that the level of perceived participation among managerial employees is high and that employee participation has acmoderate and positive relationship with job performance. The findings appear to match other studies conducted in the West, suggesting that these studies were not very much different across cultures. Managerial employees place equal importance on intrinsic and extrinsic outcomes. Employee participation could be better managed if employees possess certain critical factors. These include high job abilities, greater need for achievement, and a substantial amount of motivation. This study also suggests that Porter and Lawler's (1968) expectancy model is a suitable framework for studying employee participation.

Rapid urbanization and economic progress generate a significant quantity of waste from the built environment. Unawareness among the key stakeholders about the statutory requirements for waste management leads to ineffective practices and severe environmental concerns. The aim of this study is to develop an integrated statutory waste management framework (ISWMF) for the built environment to identify and implement the legal aspects of waste management practices in a national context.

About eight waste management rules were considered to identify the statutory requirements from the Ministry of Environment, Forest and Climate Change, Government of India. A total of 12 statutory requirements for the seven organizational contexts were identified. Through inferential statistics, stakeholder awareness about the legal requirements of waste management practices was assessed. An integrated statutory waste management framework was developed and evaluated by implementing it in a one-year case study project.

The results observed that 70% of stakeholders in the built environment are unaware of the statutory requirements for the waste management practices. The framework’s adoption correctly identified the statutory requirements for waste management practices in different organizational contexts. Implementing the statutory requirements in the case study project resulted in a reduction of 308 tons of CO₂ emissions. Furthermore, the circular economy promoted 35.67 tons of recyclable materials. Also, enabled the organization to maintain all the compliance requirements related to the aspects of waste management.

The researchers will use the findings to understand the statutory requirements for waste management practices in the built environment. A continuous improvement interface shall be further developed to synchronize the upcoming amendments or changes in the statutory requirements.

The research findings will enable industry practitioners or any organization to identify and understand their statutory requirements for waste management practices. Implementing the framework will mutually benefit the organization and the environment.

The research findings promote awareness about the statutory requirements of waste management practices among the stakeholders in the built environment. Furthermore, the actual implementation of the proposed framework significantly increases recycling promotion and reduces the environmental CO₂ footprint.

This study is the first to take into account the actual statutory requirements for various wastes generated from the built environment within a national context. The proposed framework can also be applied in other national contexts, taking into account the relevant waste management rules and acts. Additionally, the reported benefits encompass both environmental and economic aspects.