This dissertation uses the theory of the experimentallyorganised economy (EOE) and competence blocs to analyseeconomic development in the health care industry. The healthcare industry is both important and interesting to study fromseveral points of view. The industry is large, even larger thanthe manufacturing industry, and draws significantresources. The theory of the EOE and competence blocs is bothevolutionary and dynamic. It identifies the actors needed foran efficient selection and commercialisation of investmentprojects and the competences needed to support that process.For this, the institutional setting is important in thatinstitutions influence the incentives that guide actors in theeconomy and the nature of competitionthat forces change. Four empirical studies are carried out using severalempirical methods to study similar problems, ranging fromeconometric analyses of panel micro data to case studies. Weask if the withdrawal of a major employer (Pharmacia) from aregion (Uppsala) has had a negative effect on employmentgrowth. We then ask if the turnover of establishments has hadany effect on regional employment growth. We find no supportfor the first question. However, the regional turnover ofestablishments is found to have had a positive effect onregional employment growth, illustrating how important thisdynamic is for the economy. In addition, a case study of theintroduction of two almost identical innovations in twodifferent competence bloc environments, that of the US and thatof Sweden, captures the whole process from invention toinnovation and diffusion in the market. We find that without acomplete competence bloc the risk is high of“loosing awinner”. Finally, we study the role of the technologytransfer process from university to industry for thecommercialisation of new inventions. Among other things, thestudy illustrates how institutional changes, such as theBayh-Dole Act, have created positive effects for theeconomy. The Experimentally Organised Economy; Competence Blocs;Industrial Dynamics; Health Care Industry; IndustrialTransformation; Regional Turnover of Establishments; CaseStudies; Technology Transfer / <p>NR 20140805</p>

South African companies are said to be mining the so-called "Black Diamond", the emerging middle-class segment that is driving economic growth within the country (Mahajan, 2009:9). The focus on the emerging Middle Class in South Africa (SA) has left a knowledge gap on Low-Income consumers - even though they are still the largest consumer group in SA (Connecting with Survivors, 2014). The Unilever "Connecting with Survivors Report" (2014) highlights the fact that 70% of the SA Market earn less than R6000 per month, while together they have a spending power of R300 Billion per annum. According to Martin (2012:71), 5.8% of Low-Income Consumer Households (HH) spending is prioritised for the purchase of personal care products, while 64.2% of their HH income is prioritised for food and housing expenses. Given the trivial proportion allocated to personal care products, this research has been guided by the problem statement that Low-Income consumers are forced to make trade-offs, when purchasing personal care products, which fall outside their realm of affordability. The primary objective of this study was to investigate Low-Income consumers' buying behaviour in the Personal Care Industry in South Africa. The Theory of Buyer Behaviour was used as a theoretical framework to assist in the understanding of Low-Income consumer behaviour in the Personal Care industry. The phenomenological research paradigm was used in this study, utilising interviews to collect the data from respondents in the Western Cape Province. Inductive reasoning was practised to draw a conclusion on the investigation of Low-Income consumer buying behaviour in the personal care industry in South Africa. The findings from the study indicate that Low-Income consumers do indeed make trade-offs when personal care products fall outside their realm of affordability. The extent to which they do so varies, based on necessity. This research stands to contribute to the body of knowledge by narrowing the knowledge gap on the Low-Income Consumer market in South Africa with the focus on the Personal Care Industry, thereby allowing marketers to develop and implement effective marketing strategies.

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O objetivo deste trabalho é analisar situações em que a tecnologia da informação (TI) contribui para o desenvolvimento de estratégias de negócios, envolvendo interrelação e cooperação entre empresas no setor da saúde. O estudo baseia-se na análise das operações de serviços em uma rede de valor (grupo determinado de empresas) no setor da saúde. Esta análise é realizada por meio de técnicas estratégicas, buscando compreender como e por que a tecnologia da informação pode ser utilizada como um fator diferenciador e decisivo na escolha de estratégias de negócios. As estratégias de negócios obtêm vantagem competitiva na medida em que criam valor, aumentando a eficiência e/ou eficácia das empresas. Este valor pode ser mais bem percebido e até aferido ao se analisar as interações em uma rede de valor em que a empresa está inserida. O levantamento de dados deste trabalho tem respaldo no método exploratório cuja função, entre outras, é obter informações sobre possibilidades práticas de realização de pesquisas em situações de vida real. Utilizam-se, ainda, de levantamento bibliográfico, pesquisas de documentos e dados em geral, tendo como fonte principal um estudo de caso múltiplo, englobando empresas de uma rede de valor no setor da saúde. Os resultados da pesquisa demonstram que o uso da TI permite ampliar os pontos fortes da empresa, além de suas oportunidades no ambiente externo e propicia também formas alternativas de atuação das empresas no mercado, gerando possibilidades para o desenvolvimento de novas estratégias ou modelos de negócios. / The purpose of this study is the analysis of cases where information technology (IT) helps the development of business strategies. It involves the inter-relation and cooperation among companies in the health care sector. This study is based on the analysis of service operations in the health care sector (a particular group of companies) by means of strategic techniques. It addresses the reasons why information technology may be used as a decisive differentiating factor in the selection of business strategies. Business strategies result in competitive advantages as they create value and thus increase business efficiency and/or effectiveness. Such value may be perceived and measured when the chain of values, the value system, the supply chain, and most of all, the network of values where the company is encased, are analyzed. Data collection for this study is supported by the exploratory method whose function,among others, is getting information about the practical possibilities of carrying out researches in real life conditions. This study also makes use of bibliographic research, documents research and generic data. The main source of data is a multi-case study encompassing health care enterprises. Data obtained in this research show that IT application may amplify the company strong points as well as its business opportunities in the market. It also opens up alternative forms of market actuation and raises new possibilities for the development of new strategies and business models.

This research study examines the influence of two major forces, competition and regulation, on the strategic orientation of hospitals. This is a particularly relevant subject, as the effectiveness of competition versus the effectiveness of regulation in the health care market has been called one of the Bellwether issues in health care policy, and the most controversial and far reaching philosophical battle facing the health care industry. Even after three decades of research and debate, there is still no consensus on how the hospital industry responds to either a competitive environment or a regulated environment. There continues to be significant variation across the country on which model provides the environmental context for hospitals, and there is no resolution of the issue on the horizon. It is clear that the dichotomy of a competitive environment or a regulated environment and the wide variation from market to market will continue to be significant factors influencing the development of hospital strategies. Developing strategies that provide an appropriate fit with the particular environmental context is a critical aspect of the success of an organization.This study provides a unique perspective on the subject, with an examination of the relationship between the level of competition in the market and the level of regulation in the market, and whether these dimensions influence hospital strategic orientation. Porter's strategic orientation typology is used as the model for hospital strategy, and the theoretical framework combines the legitimacy seeking elements of institutional theory and the resource and cost control elements of resource dependency theory.The findings of this study indicate an association between a competitive environment and a differentiation orientation. As competition decreases, there is a greater likelihood of association with cost inefficiency. The results also indicate that in the absence of CON or as CON decreases, there is a greater likelihood of cost inefficiency. Although this study provides a timely analysis of a very controversial topic, it is clear that additional research efforts are needed on this critical issue that impacts every hospital in the country.

有關策略管理領域中，合作策略已漸成為競爭策略的另一選擇，同時在資源統治結構方面，介於市場結構與層級結構間的跨組織合作關係，為近年來組織理論中的重要研究議題。本研究主要探討跨組織合作關係類型及所採用的管理機制，並選定以醫療產業進行研究，限定以醫院評鑑合格之不涉及股權的跨組織合作關係，採實證方式來驗證理論觀點。 解釋跨組織合作關係之理論觀點，最常見者有資源依賴理論及交易成本理論，而此理論皆從經濟觀點出發，由於本研究所探討之醫療產業，其跨組織合作關係中多數係非以經濟觀點為考量，因此本研究補充社會交換理論加以闡述，期能從合作關係中投入與產出之明確性來區分經濟交換關係及社會交換關係。另因過去對於國內醫院間互動之相關研究指出，從醫院等級來看，發現醫院間的互動多為不同級之單向支援關係，同級醫院之合作很少，因此本研究捨棄醫院層級性角度，另外從每個合作關係之權力及互惠等實質面來觀察合作關係之對等性。 另外對於跨組織合作關係之管理，一般多沿用組織內的管理控制方式。而文獻指出組織間的管理機制包括市場機制、科層機制及關係機制，此三種機制係採結合方式加以應用。 本研究依文獻探討建立初步的研究架構，再經由個案實務分析加以修正，將跨組織合作關係依投入可明確衡量程度、產出可明確衡量程度及合作關係對等性三構面分成八類。另提出四種管理機制組合方式，包括：1.結合市場機制與科層機制。2.結合關係機制與科層機制。3.結合市場機制、關係機制與科層機制。4.單採用關係機制。 本研究採問卷調查方式，針對八十六年度評鑑合格醫院之不涉及股權合作關係進行研究，採分層抽樣，其中醫學中心（10家）及區域醫院（38）全部抽樣，地區醫院（166家）抽樣30家，問卷寄發單位以醫院之科別部門為單位，共計回收有效樣本155筆。 另外分別從理論推導及個案觀察提出六個研究假設，其中假設一至假設五為原理層次，主要從理論推導而得，採用多變量變異數分析法加以檢定，結果顯示假設一至假設五皆獲得支持；假設六為應用層次，又包括八個子假設，主要從個案實務觀察再配合理論推論而得。採用樣本比例分析法檢定，結果顯示八個子假設中，有三個得到支持，其他五個則未獲支持。依實證調查發現結果，對於跨組織合作關係類型及管理機制之關係，提出下列結論： 1.當跨組織合作關係的投入可衡量程度愈明確時，對於選擇市場機制的傾向大於選擇關係機制。 2.當跨組織合作關係的產出可衡量程度愈明確時，對於選擇市場機制的傾向大於選擇科層機制。而對於選擇市場機制的傾向亦大於選擇關係機制。 3.當跨組織合作為不對等關係時，對於選擇關係機制的傾向大於選擇市場機制。而對於選擇關係機制的傾向亦大於選擇科層機制。 4.當跨組織合作關係之投入與產出皆可明確衡量，且為不對等合作關係時，會傾向同時結合併用市場機制、科層機制與關係機制來管理。 5.當跨組織合作關係之投入不可明確衡量而產出可明確衡量，且為不對等合作關係時，會傾向同時結合併用市場機制、科層機制與關係機制來管理。 6.當跨組織合作關係之投入與產出皆不可明確衡量，且為不對等合作關係時，傾向單採用關係機制來管理。

The present day world has been experiencing rapid technological advancement on the one hand and increasing number of diseases afflicting the human beings on the other. To deal with the later, medical devices are innovated and introduced in to the market (making use of the technological advancements), on a continuous basis across the world. However, taking an innovated medical device to the market poses innumerable challenges and therefore, these have to be clinically trialled before its launch to ensure safety and efficacy. Of late, India has emerged as one of the preferred destinations to carry out clinical studies due to numerous advantages, primarily its diverse human gene pool and cost-competitiveness. However, there is very little understanding on the landscape of medical devices clinically trialled in India. It is to throw light on this critical issue with respect to the selection of participants in the clinical trial process, selection of locations and determination of trial duration that the present study has been carried out. In addition, the role of patents associated with the introduction of new medical devices in relation to the key challenges is examined. Furthermore, we studied the characteristics of clinical trials by industry and non-industry sponsors and between cardiovascular and other disease related trials. The present study has been carried out based on secondary data covering 108 medical device clinical trial registrations accessed from Clinical Trial Registry of India (CTRI) database pertaining to the period 2008-2014. At the outset, the pattern of trials related to the most prominent diseases such as cardiology and cardiovascular diseases and those which are invasive and non-invasive are examined. Our findings indicate that almost 50% of the trials are related to diseases of cardiology, cardiovascular diseases and those which are invasive in nature. For studying the patenting aspect, we proposed a conceptual grouping of sponsors as Incumbent, Potential Entrant and Supporter, based on their patent holdings in the domestic market and in PCT (Patent Cooperation Treaty) filings. Patents owned by Primary Sponsor (PS) showed significant variations in their clinical trial characteristics particularly the invasiveness of device, disease type, locations and participants. Three quantitative models are developed to identify the factors that influence the selection of number of participants, locations and time taken to execute medical device clinical trials using multivariate statistical techniques. The results of the three conceptual models on number of participants, locations and trial duration showed invasiveness of device and disease type playing significant roles in all the three models. The number of PCTs owned by PS was found to be influential in selecting the number of locations and participants but not the patents owned in IPO (Indian Patent Office). We also observed significant differences between industry and non-industry sponsors in terms of their clinical trial characteristics. The findings of the study formed the basis to understand the medical device clinical trial landscape and other pertinent issues in the Indian context, which enabled us to derive appropriate inferences and policy implications.

O objetivo deste trabalho é analisar situações em que a tecnologia da informação (TI) contribui para o desenvolvimento de estratégias de negócios, envolvendo interrelação e cooperação entre empresas no setor da saúde. O estudo baseia-se na análise das operações de serviços em uma rede de valor (grupo determinado de empresas) no setor da saúde. Esta análise é realizada por meio de técnicas estratégicas, buscando compreender como e por que a tecnologia da informação pode ser utilizada como um fator diferenciador e decisivo na escolha de estratégias de negócios. As estratégias de negócios obtêm vantagem competitiva na medida em que criam valor, aumentando a eficiência e/ou eficácia das empresas. Este valor pode ser mais bem percebido e até aferido ao se analisar as interações em uma rede de valor em que a empresa está inserida. O levantamento de dados deste trabalho tem respaldo no método exploratório cuja função, entre outras, é obter informações sobre possibilidades práticas de realização de pesquisas em situações de vida real. Utilizam-se, ainda, de levantamento bibliográfico, pesquisas de documentos e dados em geral, tendo como fonte principal um estudo de caso múltiplo, englobando empresas de uma rede de valor no setor da saúde. Os resultados da pesquisa demonstram que o uso da TI permite ampliar os pontos fortes da empresa, além de suas oportunidades no ambiente externo e propicia também formas alternativas de atuação das empresas no mercado, gerando possibilidades para o desenvolvimento de novas estratégias ou modelos de negócios. / The purpose of this study is the analysis of cases where information technology (IT) helps the development of business strategies. It involves the inter-relation and cooperation among companies in the health care sector. This study is based on the analysis of service operations in the health care sector (a particular group of companies) by means of strategic techniques. It addresses the reasons why information technology may be used as a decisive differentiating factor in the selection of business strategies. Business strategies result in competitive advantages as they create value and thus increase business efficiency and/or effectiveness. Such value may be perceived and measured when the chain of values, the value system, the supply chain, and most of all, the network of values where the company is encased, are analyzed. Data collection for this study is supported by the exploratory method whose function,among others, is getting information about the practical possibilities of carrying out researches in real life conditions. This study also makes use of bibliographic research, documents research and generic data. The main source of data is a multi-case study encompassing health care enterprises. Data obtained in this research show that IT application may amplify the company strong points as well as its business opportunities in the market. It also opens up alternative forms of market actuation and raises new possibilities for the development of new strategies and business models.