Through a harmonization of IT-tools among intraorganizational units synergies can be attained through economies of scale and homogenous interfaces towards supply chain partners. In this thesis the possibilities for such synergies at Siemens Medical Solutions in Germany are investigated. By evaluating performance of IT-tools and the cost impact of different scenarios recommendations for harmonization at Siemens Medical Solutions are given.

Bamboo is an abundant resource in Ethiopia and has a great potential for commercialization, which can drive rural development. In view of these realities, this study analyzed the state and determinants of small-scale bamboo commercialization in Ethiopia. Data were collected from three major bamboo-growing districts (Awi, Sidama, and Sheka) and four urban centers (Masha, Hawassa, Bahir Dar, and Addis Ababa) via semi-structured interviews, group discussions, and questionnaire surveys with key actors along the value chain. Results revealed distinctive differences in proportion of cash income, value chain structure, and management engagement among the districts. Percentages of cash income were 60.15, 42.60, and 9.48 at Awi, Sidam, and Sheka, respectively. Differences were statistically significant between Sheka and both other districts (p = 0.05), but not between Awi and Sidama. The value chain structure showed that compared with Sheka, Awi and Sidama have a relatively large number of actors involved. The major factors explaining commercialization differences among regions were distance to market and presence of alternative forest products. Within Sheka, households with larger family size, higher education attainment, and access to training reportedly engaged more in commercial extraction. Therefore, we conclude that development of infrastructure for linking resource and consumer centers and expansion of extension education among producers may enhance the commercial engagement of producers and improve the accessibility of bamboo resources for commercial production.

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Made available in DSpace on 2010-04-20T20:51:22Z (GMT). No. of bitstreams: 3 57659.pdf.jpg: 19638 bytes, checksum: 9e5bd0c5201b6d99e3da4e91f332f1b9 (MD5) 57659.pdf: 509197 bytes, checksum: 7a7b5b23d42ea64ff6d345d627a0cf19 (MD5) 57659.pdf.txt: 218404 bytes, checksum: 81a61ea0397036f8654e17538664d034 (MD5) Previous issue date: 2006-07-04T00:00:00Z / Studies and researches on the reasons of the increase in healthcare costs tends to focus on a set of factors, such as the increase of materials and medicines prices, the new technologies, the aging of the population, among others. However, there are few studies that analyses the interactions between the healthcare system participants which may result in inefficiencies, or reveal the logic behind the exchange of values between healthcare market players and its rationality, in order to identify some issues which may contribute to the raising costs in the healthcare system, not followed by an increase of benefits to the end users. It is known that great part of healthcare expenses occurs within the hospital settings. Therefore this research analyzes some aspects of the hospital purchasing, in order to describe major aspects in the relationship between some parts involved in its dynamics, identify specificities of hospital purchasing, and verify some inefficiencies in the health care value chain. Four private hospitals of the city of São Paulo have been chosen and from each of these hospitals, an executive of the high administration, the purchasing/supply manager and a physician were interviewed. From the perception of the interviewees some inefficiencies were identified, as the dependence of some hospitals on the materials and medicine commercialization margins, which reveals the existence of a cost in the system not directly related to the real value added by the hospitals; the difficulty in standardizing the surgical materials that represent one the major purchase expenses in these institutions; the existence of supplier’s marketing practices that try to annul the rationality of the purchase; the difficulty to align the objectives between hospitals, health plans, physicians and suppliers, among others. / Os estudos e pesquisas sobre as razões do crescimento dos custos na Saúde apontam um conjunto de fatores, como o aumento dos preços dos materiais e medicamentos, os avanços tecnológicos, o envelhecimento da população, entre outros. Porém, poucos são os estudos que procuram analisar como a interação entre as partes que constituem o sistema de saúde pode resultar em ineficiências, ou que procuram desvendar a lógica de como se dão as trocas de valores entre os players desse mercado e sua racionalidade, a fim de identificar fatores que elevem os custos no sistema sem um aumento de benefícios aos usuários finais. Sabe-se que grande parte dos gastos na saúde ocorre dentro dos hospitais. Sendo assim, este trabalho buscou analisar a gestão de compras dos hospitais, para descrever aspectos relevantes no relacionamento entre algumas partes envolvidas na dinâmica da compra hospitalar, conhecer especificidades da gestão de compras destas organizações, e verificar algumas ineficiências na cadeia de valor da saúde. Foram escolhidos quatro hospitais privados do município de São Paulo, onde foram entrevistados um executivo da alta administração, um gestor de compras e um médico. A partir da percepção destes entrevistados foram identificadas algumas ineficiências, como a dependência de alguns hospitais nas margens de comercialização de materiais e medicamentos, que mostra a existência de um custo no sistema, desvinculado do real valor agregado pelos hospitais; a dificuldade em se padronizar os materiais cirúrgicos que representam um dos maiores gastos em compras nestas instituições; a existência práticas de marketing dos fornecedores que tentam anular a racionalidade da compra, a dificuldade de alinhamento de objetivos entre hospitais, operadoras de planos de saúde, médico e fornecedores, entre outros.

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