Michele Thornton, Lindsey Howard and William Marty Martin
Medical tourism, characterized by patients leaving their home community to seek health-care services elsewhere, is on the rise globally. In New York state, approximately 5% of the…
Abstract
Purpose
Medical tourism, characterized by patients leaving their home community to seek health-care services elsewhere, is on the rise globally. In New York state, approximately 5% of the 35,661,559 hospital visits in 2018 were non-residents. Although some are visiting New York for other reasons, and unintentionally wind up hospitalized – a percentage of this population come to New York intentionally to seek care. Understanding the make-up, needs and patterns of this population allows hospitals to tailor investments in marketing, technological resources and culturally responsive initiatives to prepare for broadening their patient population and remain competitive globally.
Design/methodology/approach
Using a rich all-hospital discharge data set, the authors identify patterns in diagnoses, treatment and hospital choice of patients who intentionally travel across borders for health care. The authors model the characteristics associated with “elective” admit patients with a multivariate logistic regression approach.
Findings
The authors find that among non-resident patients in New York, domestic travelers, those using insurance plans for payment and women are positively associated with seeking elective inpatient care across border. There are clear patterns of type of treatment that is more likely to be sought, with care for musculoskeletal concerns accounting for more than one-third of all non-resident elective admissions. Proximity also matters, both in terms of patients being more likely to live in a travel zone adjacent to the state, as well as being more likely to seek care from hospitals in counties closest to the borders.
Originality/value
To the best of the authors’ knowledge, this is the first study, using a large set of claims data, that is able to empirically differentiate between patients who travel to NY for the primary purpose of obtaining health care versus those who emergently must access care while traveling for other reasons. This approach can inform future studies seeking to better understand patient migration patterns and strategic educational and marketing initiatives to motivate consumers to cross borders to seek care.
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Thomas Schneider and Michele Andreaus
In 1950, the Aluminum Company of Canada (Alcan) was given a perpetual water license for a large section of Northern British Columbia, Canada. The benefit to the original owner of…
Abstract
Purpose
In 1950, the Aluminum Company of Canada (Alcan) was given a perpetual water license for a large section of Northern British Columbia, Canada. The benefit to the original owner of the water rights, the Province of British Columbia, was economic and population growth. The purpose of this paper is to follow the contestation over these rights from 1948 to 2016.
Design/methodology/approach
An institutional logics perspective was taken to analyze the main actors and how their relative power (dominant versus fringe) changed in the institutional field. Archival data and selected interviews were mapped to institutional logics across three time periods.
Findings
In the inter-temporal setting, many of the actors that were fringe in 1950 became more dominant by 2016. For example, the local indigenous peoples, the Cheslatta Carrier First Nation, were flooded off their land to make way for Alcan’s dam. They ended up as very powerful players in the institutional field. The perpetual rights given to Alcan made it a dominant actor across all time periods, despite changes in the logics of the institutional field.
Research limitations/implications
A single case was studied; other comparative settings should be explored to contrast and compare. The data were primarily archival, supplemented by only three interviews of those related to the case study. This case study is also one where water rights were privatized in perpetuity, which may not be the case in other settings.
Practical implications
Current governments and non-governmental organizations (NGOs) should use this case to understand the long-term effects of resource policy decisions.
Social implications
The building of large dams has been, and continues to be, used worldwide to provide power to create economic growth. Our setting provides insight into the long-term societal outcomes of using water rights in this way.
Originality/value
This is an original use of institutional logics around a natural resource-based institutional field. Using institutional logics in a multi-period setting, focusing on the power relations of the key actors, and how they can be constrained by historical forces, provides a contribution to the literature.
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Research into entrepreneurial networking activities has ignored an aspect that is important to the entrepreneurs‐does it make sense to pay dues to an organization that promises…
Abstract
Research into entrepreneurial networking activities has ignored an aspect that is important to the entrepreneurs‐does it make sense to pay dues to an organization that promises networking opportunities to help build their business? This study looked at that aspect of networking by comparing revenue growth rates and average number of employees between those businesses whose owners belong to paid membership organizations and those who do not. No differences were found between the two groups of entrepreneurial firms. While there are still benefits to joining these organizations, entrepreneurs should not expect to grow their business because of membership.
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Giovanni Radaelli, Emanuele Lettieri, Abraham B. (Rami) Shani, Cristina Masella and Michele Tringali
Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of…
Abstract
Purpose
Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of these practices depends on policy-makers’ capacity to involve professionals dispersed in the ecosystem, and who are unaccustomed to cooperating. Our case study investigates the institutional work pursued by the Lombardy Region to stimulate a Health Technology Assessment (HTA) program.
Design/methodology/approach
This chapter is based on a longitudinal case study of institutional change linked with a HTA program in the Lombardy Region. The HTA program initiatives were implemented during the 2009–2012 period. The case study is based on triangulating data from archival data, contents of the assessment forms and interviews with regional staff and experts.
Findings
The Lombardy Region implemented two distinct strategies, with mixed results. A strategy that was based on the formalization of the HTA program in a legislative direct through educational efforts did not obtain the commitment of the key actors in the relevant ecosystem. Subsequently, the Region implemented an ‘institutional work’ design strategy that included a combination of political, cultural, technical and structural work. This strategy stimulated local HTA experiments that might be used in the future to legitimize the full diffusion of the new practice in the ecosystem.
Originality/value
This study highlights a viable strategy of change that policy-makers can use to manage processes of institutional change in a professional ecosystem. The ‘institutional work’ strategy can support the establishment of new practices that incorporate the logic of cost-opportunity, which might rationalize the use of resources and improve investment decisions.
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Jessica Strübel and Monica Sklar
In 1930s Britain, tennis champion Fred Perry was a household name. However, the name Fred Perry is more commonly associated with striped-collar polo shirts featuring a laurel…
Abstract
In 1930s Britain, tennis champion Fred Perry was a household name. However, the name Fred Perry is more commonly associated with striped-collar polo shirts featuring a laurel wreath logo. In the late 1960s, Fred Perry polo shirts were standard mod and Skinhead dress. When worn by working-class youth the shirt became subversive commentary on English elitism because it had originally been designed for the tennis courts. Many punks also aligned with the brand in dual demonstration of association with working-class ethics as well as an alternative to t-shirts. In the 1980s and onward, this sartorial style was appropriated by right-wing white nationalists, which stripped it of its subcultural spirit. Patriot groups, such as neo-Nazis and the alt-right have continued to co-opt the subcultural style, simultaneously turning the Fred Perry polo into a symbol of racism and bigotry. The multi-use of the Fred Perry brand creates a challenge in how to interpret visual cues when one garment has competing perceptions that at times can be completely opposing. This study examines the history of the Fred Perry brand through the lens of symbolic interactionism, specifically how the shirt evolved from a rather innocuous, yet subversive, form of merchandize repurposed from the tennis world to youth subcultures where the polo communicated group identity. As the brand has moved through fashion cycles, the association of the Fred Perry polo with deviant groups has reduced the brand to representations of hate and separation, which has impacted sales and brand image with its intended consumers.
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Do these reference requests sound familiar? “I need to know what has happened on this day in history. Can you help me?” Or, “I'm doing a paper on Thornton Wilder. He was born on…
Abstract
Do these reference requests sound familiar? “I need to know what has happened on this day in history. Can you help me?” Or, “I'm doing a paper on Thornton Wilder. He was born on 17 April. Can you tell me who else was born on that day?” Or, “Are any national or regional anniversaries coming up next Friday?” These questions call for a special type of reference work—a book of days. A book of days (or day book) lists important events that have occurred on each day of the year throughout history, and is arranged by month and day. These works often include not only historical, cultural, and literary events, but also the dates of the births and deaths of notable people, commemorative days of saints, and special anniversaries. A book of days, for example, can reveal that historians Will and Ariel Durant were married in New York City Hall on Halloween in 1913, or that Hart Crane and Ernest Hemingway were born on the same day in 1899 (21 July). This article will review some of the more useful books of days that are often found in reference collections—works that are uniquely suited to answer questions about each day of the year.
Nawel Lafioune, Erik Andrew Poirier and Michèle St-Jacques
The purpose of this study is to frame digital transformation (DT) within municipalities to improve the life cycles of urban infrastructure.
Abstract
Purpose
The purpose of this study is to frame digital transformation (DT) within municipalities to improve the life cycles of urban infrastructure.
Design/methodology/approach
The study provides the results from a systematic review of the literature on concepts of DT and its implications for municipalities, barriers and challenges to DT, as well existing DT frameworks for municipalities and their built assets. This literature review leads to the development of a DT framework to help cities conduct a planned and federated DT beforehand. Then, workshops are conducted with two major Canadian municipalities.
Findings
The results of these studies point to the need for a dedicated DT framework for municipalities because of their particular context and their role and proximity to citizens. The theoretical framework develops 22 elements, which are divided among 6 categories. Through its application, the framework helps to identify and target the predominant issues hindering the DT of municipalities, specifically “legacy practices” and “data management.”
Research limitations/implications
Limitations include limited experimental conditions and small sample size. Further work is needed to validate the framework. Other approaches are advocated to complement the data collection and analysis to generate more convincing results.
Practical implications
The theoretical framework was validated through two case studies on two large Canadian municipalities.
Social implications
Municipalities maximize the value they provide to citizens and to be at the forefront of resilience and sustainability concerns. The use of technology, digital processes and initiatives helps cities to improve planning, optimize works and provide better services to citizens.
Originality/value
The framework is original in that it specifically aligns assets management with DT in a municipal context.
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IN order to be able to discriminate with certainty between butter and such margarine as is sold in England, it is necessary to carry out two or three elaborate and delicate…
Abstract
IN order to be able to discriminate with certainty between butter and such margarine as is sold in England, it is necessary to carry out two or three elaborate and delicate chemical processes. But there has always been a craving by the public for some simple method of determining the genuineness of butter by means of which the necessary trouble could be dispensed with. It has been suggested that such easy detection would be possible if all margarine bought and sold in England were to be manufactured with some distinctive colouring added—light‐blue, for instance—or were to contain a small amount of phenolphthalein, so that the addition of a drop of a solution of caustic potash to a suspected sample would cause it to become pink if it were margarine, while nothing would occur if it were genuine butter. These methods, which have been put forward seriously, will be found on consideration to be unnecessary, and, indeed, absurd.
Larry E. Jones and Michèle Tertilt
In this paper, we use data from the US census to document the history of the relationship between fertility choice and key economic indicators at the individual level for women…
Abstract
In this paper, we use data from the US census to document the history of the relationship between fertility choice and key economic indicators at the individual level for women born between 1826 and 1960. We find that this data suggests several new facts that should be useful for researchers trying to model fertility. (1) The reduction in fertility known as the Demographic Transition (or the Fertility Transition) seems to be much sharper based on cohort fertility measures compared to usual measures like Total Fertility Rate; (2) The baby boom was not quite as large as is suggested by some previous work; (3) We find a strong negative relationship between income and fertility for all cohorts and estimate an overall income elasticity of about −0.38 for the period; (4) We also find systematic deviations from a time invariant, iso-elastic, relationship between income and fertility. The most interesting of these is an increase in the income elasticity of demand for children for the 1876–1880 to 1906–1910 birth cohorts. This implies an increased spread in fertility by income which was followed by a dramatic compression.
Vincent K. Chong, Ian R.C. Eggleton and Michele K.C. Leong
This chapter examines the effects of the value attainment and cognitive roles of budgetary participation on job performance. A structural model consisting of variables such as…
Abstract
This chapter examines the effects of the value attainment and cognitive roles of budgetary participation on job performance. A structural model consisting of variables such as budgetary participation, job-relevant information, job satisfaction, and job performance is proposed and tested using a survey questionnaire on 70 senior managers, drawn from a cross-section of the financial services sector. Their responses are analyzed using a structural equation modeling (SEM) technique. The results reveal that budgetary participation is positively associated with job-relevant information. These results lend support to the cognitive effect of budgetary participation, which suggests that subordinates participate in the budget setting process to share information. In addition, the results suggest that budgetary participation is positively associated with job satisfaction. These results support the value attainment role of budgetary participation, which increases subordinates’ levels of job satisfaction. Furthermore, the results reveal that there are positive relationships between job-relevant information and job satisfaction, job-relevant information and job performance, and job satisfaction and job performance.