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Bundled payments for care are an efficient mechanism to align payer, provider, and patient incentives in the provision of health care services for an episode of care. In this chapter, we use agency theory to examine the evolution of bundled payment programs in private and public payer arrangements, and postulate future directions for bundled payment development as a key component in the provision and payment of health care services.

While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations.

We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, the Netherlands, Switzerland, and the United States).

Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition.

Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

Filiform corrosion was first detected on architectural aluminium in the early 1980s. Over the past decade the number of incidences has been small in relation to the number of projects which have been successfully enhanced and protected by organic coating systems. During this period use of painted aluminium has grown significantly to replace anodizing as the major finishing method in Europe. Reports of filiform have been largely limited to areas in Holland, Belgium and Germany, where a marine climate co‐exists with an industrial atmosphere.

Sex and age estimation is important, particularly when information about the deceased is unavailable. There are limited radiological studies investigating side, sex and age differences in normal ankle morphometric parameters. The authors’ goal was to evaluate different ankle joint morphometric measurements and document variations among Egyptians.

A prospective study was conducted throughout 23 months on 203 (100 males and 103 females) adult Egyptians, aged between 20-69 years old, who were referred for a plain x-ray of bilateral normal ankle joints.

Ankle parameters showed no statistical difference between both sides, except for tarsal width (TaW) which was significantly higher on right than left side (26.92 ± 2.66 vs 26.18 ± 2.65 mm). Males showed significantly higher morphometric values except for anteroposterior gap (APG) and talus height (TaH) which were significantly higher in females (2.29 ± 0.80 vs 1.80 ± 0.61 mm and 13.01 ± 1.68 vs 11.87 ± 1.91 mm, respectively). There was significant increase in tibial arc length, APG, distance of level of MTiTh from anterior limit of mortise, distance of level of MTiTh from vertex of mortise, sagittal distance between tibial and talar vertices and sagittal radius of trochlea tali arc in old age group compared to young one. A significant decrease in tibial width, malleolar width, TaW and TaH was noted in old age group compared to young one.

Ankle joints of both sides are mostly symmetrical; however, there are significant differences in most morphometric values due to sex and age factors. These findings may be essential during side, sex and age determination.

The purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.

An 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.

Triadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions’ contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.

These changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.

Structures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.

Contributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.

There is an increasing interest in the international management literature in cultural differences between in-country regions. Yet, the regions of any country may be merely political products and not necessarily cultural units. The goal of this article is to propose clear empirical criteria for deciding if a set of entities, such as a country's administrative regions, can be legitimate units of cross-cultural analysis and to test these criteria in an empirical study.

The authors review the literature on what constitutes a unit of cross-cultural analysis and propose empirical criteria. For instance, the regions of a given country are meaningful units of cross-cultural analysis if one can replicate (an) established dimension(s) of culture at the regional level, including some of the dimension(s)' antecedents and predictive properties. The authors apply this test in the context of the Russian Federation (RF), using an RF database (18,768 respondents from 60 administrative regions) with items borrowed from the World Values Survey.

The RF regions pass the authors’ test. At the regional level, the selected items yield an individualism-collectivism (IDV-COLL) dimension that is similar to its nation-level counterpart in the revised Minkov-Hofstede model in terms of concept and antecedents (wealth differences and geographic latitude) and outcomes that are relevant in business (innovation rates and quality of governance). The authors also find other patterns that confirm the properties of RF regions as meaningful units of cultural analysis.

The authors’ criteria and the test based on them are suitable for large countries, with significant geo-climatic variety and ethnic diversity, but may be inapplicable in small countries with less diversity. It is questionable if the latter countries contain enough cultural variation to justify a cross-cultural analysis of their sub-national regions.

The authors’ criteria can be used in future research in any large country to decide if its regions justify a cross-cultural analysis in the field of management and business or any other field.

Cultural differences within a country are important as they may inform political and management decisions. Yet, to demonstrate that those differences are real, and not imaginary, one needs a methodology like the authors’.

The study contributes to the discussion of the meaningfulness of in-country regions as cultural units for cross-cultural analysis in international business by focusing on the RF.

The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to identify the emergence of the term EBP in the professional literature to establish an empirical foundation for discussion. The understanding of and relevance to healthcare practitioners in a large South West London hospital are assessed and their views related to the perspective of library and information professionals to assess implications for practice.

An extensive literature search was carried out and the data generated used to produce a growth curve for the literature. A survey of health care professionals using e‐mail and follow‐up interviews was undertaken at the case hospital.

Between 1998 and 2004 the number of papers appearing to discuss the theme increased four‐fold. The first recorded reference was in 1991. The EBP model had strong official and political support in the field. On the user sample there is evidence of resistance to the orthodoxy.

The EBP model – variously adopted by several healthcare agencies – has placed information management at the centre of the care process. In spite of this, there are few definite implications for the role of library and information professionals, since the world of information and the UK NHS itself are continually in a state of flux, and the current EBP dominance may neither strengthen nor safeguard it.

The bibliometric study provides a baseline. The study of healthcare professionals is a case study to add to knowledge of practice.

The purpose of this study is to analyze the entrepreneurial intentions of higher education students in a private higher education institution (HEI), enrolled in the following courses: Business Management, Hospitality Management, Tourism and Business Relations.

A quantitative methodology was used through the application of a questionnaire in a private HEI located in the northern region of Portugal and 228 valid responses were collected.

We have found out that (1) the elder the students are, the higher is the probability that they will consider entrepreneurship as the first option to enter the job market; (2) the courses of Business Management and Hotel Management are those that influence the entrepreneurial intentions most positively; (3) the more prepared a student feels in order to start a business, the more likely he will become an entrepreneur; (4) to consider entrepreneurship as the first option to enter the job market is positively influenced by the dimensions of the Attitude Toward Enterprise (ATE), namely, leadership, creativity, achievement and personal control; (5) to have a business idea could be motivated by the course in which the students are enrolled in, if they feel they are prepared to start a business, and by the dimensions of ATE.

HEIs and/or regional governments may have an entrepreneurship support office, where students can get assistance in the process of creating their companies and develop innovative entrepreneurial models adapted to older students. The creation of “senior entrepreneurial ecosystems” can be an interesting path to be explored. HEIs can make extracurricular activities available to students. Policymakers must introduce entrepreneurship to primary and secondary education.

This study increases the understanding of the individual characteristics of the students in a private HEI, as well as the courses that positively influence entrepreneurial intentions.

Talk of “macrofoundations” helps foreground the constitutive and contextualizing powers of institutions – dynamics that are inadvertently obscured by the imagery of microfoundations. Highlighting these aspects of institutions in turn opens intriguing lines of inquiry into institutional reproduction and change, lived experience of institutions, and tectonic shifts in institutional configurations. However, there is a twist: taking these themes seriously ultimately challenges any naïve division of micro and macro, and undermines the claim of either to a genuinely foundational role in social analysis. The authors propose an alternative “optometric” imagery – positioning the micro and the macro as arrays of associated lenses, which bring certain things into focus at the cost of others. The authors argue that this imagery should not only encourage analytic reflexivity (“a more optometric institutionalism”) but also draw attention to the use of such lenses in everyday life, as an underexplored but critical phenomenon for institutional theory and research (“an institutionalist optometry”).

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.