The high number of uninsured or underinsured Americans and the spiraling cost of healthcare in the United States has spurred growth in patients traveling abroad for affordable healthcare, which has become known as medical tourism. It is projected to become a $21 billion a year industry by 2011. Overseas prices for most procedures, including airfare, are often half the cost of those performed in the United States; some procedures are 80% less. International facilities in India, Thailand, and elsewhere are obtaining Joint Commission International (JCI) accreditation and aggressively marketing to Western customers and insurance agencies and advertising high quality standards and personalized service. The acceptance of medial tourism is growing, with a recent poll showing more than 40% of US healthcare consumers willing to travel abroad for care. Insurance companies have begun to integrate foreign care into their coverage, offering discounts to patients agreeing to overseas travel. Physician groups have been slow to respond, even though estimates are that medical tourism may represent $162 billion in lost spending in America by 2012. Some experts think the continued US healthcare cost crisis will drive an increase in medical tourism and international competition, significantly impacting domestic physicians and hospitals.

Information Systems (IS) offshoring is the transfer of IS services to a service provider outside the service consumer’s home country. The increasing amount of IS offshoring publications over the last years confirm the increasing interest in this topic. Furthermore, the transfer of knowledge from client to service provider poses major challenges in IS offshoring projects and directly affects IS offshoring success. Therefore, associated challenges must be overcome to achieve the resulting benefits. The dissertation aims to fill research gaps by investigating the following research questions: (1) What is the state of research in IS offshoring? (2) What are the characteristics of individuals conducting the knowledge transfer in an IS offshoring context? and (3) which determinants influence the knowledge transfer in IS offshoring? The answer to RQ1 aims to provide a conceptualization and the theoretical underpinning of the research field including a consolidated state of IS offshoring research. The results indicate that IS offshoring research is largely non-theory based, using almost entirely empirical data and interpretive research methods and - to a smaller extent - positivist research designs. The ISO research of the last 15 years focuses on the implementation stages 'how' and 'outcome' while the pre-implementation stages “why”, “what”, and “which” are comparatively sparsely researched. Future studies should apply a more theory-driven approach with a greater attention on pre- implementation aspects of information systems offshoring. RQ2 aims to understand the crucial role individuals must fulfill within the knowledge transfer process. The participants of the study agreed, with strong consensus, on a set of 16 tasks and 15 skills. The tasks focused primarily on relationship management and facilitating knowledge transfer on different levels. The set of skills consists of approximately 25 per cent “hard” skills, e.g. professional language skills and project management skills, and approximately 75 per cent “soft” skills, e.g. interpersonal and communication skills and the ability to deal with conflict. Two factors mainly influence implementing the offshore coordinator role: project size and the number of projects to be supported simultaneously. RQ3 aims to answer which determinants influence knowledge transfer in positive and negative ways. We identified 19 success and 20 failure determinants. These determinants are ranked in order of importance using best-worst scaling. Aspects of closer cooperation are critical for effective knowledge transfer. This includes regular collaboration, willingness to help and support, and mutual trust. In contrast, critical determinants of failure are concerned with fears and fluctuation of human resources. Hidden ambiguities or knowledge gaps, an unwillingness and disability to share knowledge, and high fluctuation of human resources negatively impact knowledge transfer. Overall, the dissertation consists of seven consecutive research articles. The results contribute to the understanding of IS offshoring in general and knowledge transfer in IS offshoring projects in detail. Furthermore, the results can facilitate organizations in ensuring their IS offshoring projects succeed.

With the increased demand for doing more with less, public sector managers embrace outsourcing back-office functions through a shared service model; however, maintaining service quality for public sector shared service centers (SSC) in financial management during peak cycles is a challenge. Framed with the transaction cost economy theory, the purpose of this single case study was to explore strategies used by SSC managers in a public sector company to maintain service quality. Seven participants with more than 4 years of SSC experience in public-sector companies participated in phone interviews including SSC department heads, managers, and a supervisor of a public-sector company in Mississippi who implemented strategies to successfully maintain service quality in the SSC relationship. Through method triangulation, a review of service level agreements and key performance indicators supplemented open-ended semistructured interviews. The research findings included emergent themes of training and documentation, employee engagement, control and communication, efficiency and automation, and standardization and metrics. The SSC strategies in training and documentation, control and communication, and employee engagement were fundamental for maintaining service quality in SSC relationship. Study findings may help public sector SSC managers understand how to incorporate and implement successful strategies in financial management divisions to maintain service quality. Positive social change includes identifying methods to increased efficiency and service quality in a financial management division. Society could benefit from improvements in employee work-life balance, reduced turnover, and increases in the economic well-being of community residents.

The purpose of this thesis is to study the impact of Industry 4.0 on the backshoring of international companies. As well, this thesis will provide an in-depth look of how backshoring is being carried out under the wave of Industry 4.0. In order to conduct this research, key characteristics concerning the rather new phenomenon of backshoring have been evaluated and later correlated to internationalization and Industry 4.0. In this thesis, an abductive research approach was adopted as the research area was considered rather unexplored. The literature review of this thesis discusses theories regarding internationalization, Industry 4.0 and backshoring. The literature review leads to a conceptual framework that displays interrelations between the different theories. The conceptual framework was next used to investigate the empirical data that was procured from case companies. The findings from this empirical research are then outlined in the following chapter. The analysis chapter presents a comparison between the theory and data, according to the conceptual framework. The final chapter brings together the results from the analysis and integrates insights, limitations, proposals and suggestions for future studies. The main theoretical implications that this thesis has led to involves filling the research gap as well as a definition of the phenomenon of backshoring in a context of international business.The main practical implication is that Industry 4.0 has the potential to enable backshoring for international companies, but there needs to be a balance between cost, quality and availability of skilled labour and infrastructure. While the full effects have yet to be seen, research shows that companies are already taking advantage of increased productivity and efficiency through Industry 4.0 technologies. This thesis presents a new, original perspective on the phenomenon of backshoring, providing fresh insight into the topic. Additionally, this research can be valuable to international companies who have already embraced or plan to invest in Industry 4.0 technologies within their manufacturing process.

No description available.

No / Under the public-private partnership (PPP) programme, private sector finance, management expertise and innovation are used in ‘partnership’ to modernize public services. However, advocates fail to account for the differing aims and responsibilities of the public and private sectors, in that private companies plan to make a profit out of non-profit public sector organizations. There is a paucity of critical empirical research into new ‘partnership’ forms of privatization and the implications that these have for employment and work. This article will examine the PPP of National Savings and Investments (NS&I) and some of the initiatives introduced and problems encountered, which resulted in the creation of a multi-tier workforce, together with the insourcing, outsourcing and the first ever offshoring of UK Government work to India.

Die vorliegende Dissertation besteht aus vier Aufsätzen, die sich mit Fragen des Außenhandels und der Arbeitsmarktökonomie auseinandersetzen. Der erste Aufsatz untersucht in einem internationalen Oligopol die Interaktion zwischen Handelsliberalisierung, Produkt- und Prozessinnovationen und der relativen Nachfrage nach niedrig qualifizierten Arbeitnehmern. Der Abbau von Handelsschranken führt zu einer Verschärfung des Wettbewerbs, auf die die konkurrierenden Firmen reagieren, indem sie ihre Investitionen in Produkt- und Prozessinnovationen ausweiten. Infolgedessen sinkt die Nachfrage nach niedrig qualifizierten Arbeitnehmern. Der zweite Aufsatz analysiert die Wirkung eines einseitigen Mindestlohnes in einem Zwei-Länder-Modell, in dem Firmen den ausländischen Markt entweder durch Exporte oder durch lokale Tochterfirmen bedienen. Eine Liberalisierung des Handels erhöht die negativen Beschäftigungseffekte von Mindestlöhnen. Dagegen begrenzt die Existenz von multinationalen Unternehmen den durch Mindestlöhne verursachten Arbeitsplatzabbau. Der dritte Aufsatz untersucht, wie sich kollektive Tarifverhandlungen bei freiem Marktzutritt auf die Produktivität und den wirtschaftlichen Erfolg von heterogenen Firmen auswirken. Zentrale Lohnverhandlungen verschärfen den Auswahlprozess und erhöhen die durchschnittliche Produktivität und den Gewinn überlebender Firmen. Stattdessen begünstigen dezentrale Tarifverhandlungen weniger produktive Firmen. Sind die Firmen internationalem Wettbewerb ausgesetzt, so können auch zentrale Tarifverhandlungen die Produktivität reduzieren. Der vierte Beitrag untersucht empirisch die Auswirkungen von Offshoring auf Arbeiterflüsse in Deutschland. Während Offshoring die Stabilität von Beschäftigungsverhältnissen in der verarbeitenden Industrie nicht beeinflusst, geht es einher mit einer Zunahme der Beschäftigungsstabilität im Dienstleistungssektor. Die Effekte von Offshoring hängen ferner stark vom Alter und der Bildung des einzelnen Arbeitnehmers ab. / This dissertation consists of four essays that contribute to the literature on international trade and labour markets. The first essay studies the interaction between economic integration, product and process innovation, and relative skill demand in a model of international oligopoly. As trade barriers are dismantled foreign competition intensifies. Competing enterprises respond by investing more aggressively in both product and process innovation. The relative demand for unskilled workers decreases as a result. The second essay studies labour market outcomes in a model of intra-industry trade between a rigid-wage Europe and a flexible-wage America. Firms can choose to serve the foreign market either through exports or through local subsidiaries. The essay demonstrates that the adverse employment effects of a unilateral wage floor increase significantly when trade barriers are removed. Multinational firms mitigate the adverse employment effects of one-sided wage rigidity. The third essay analyses how different unionisation structures affect firm productivity and firm performance in a monopolistic competition model with heterogeneous firms and free entry. While centralised bargaining induces tougher selection among heterogeneous producers and increases average productivity and profit levels, firm-level bargaining allows less productive entrants to remain in the market. The positive effect of centralised bargaining on average productivity can, however, be overturned when firms face international low-wage competition. Finally, the fourth chapter analyses empirically the effect of offshoring on workers'' labour market transitions in Germany. The results suggest that the effects of offshoring are strongly age- and skill-specific and also vary between sectors. While offshoring does not affect overall job stability in the manufacturing sector, it is associated with an increase in overall job stability in the service sector.

Communication technology allows companies to deliver services electronically. This leads to a lower dependence on geographical location. Historically, companies have moved IT related work to countries where wages are lower to decrees costs. When IT systems over time increases in complexity, competence and resource availability becomes more important. In order to achieve success, the customer and vendor need to work closely. In previous research the customers’ point of view are mainly presented when examining the offshoring relation, but participation effect the vendor as well. The need to examine the offshoring relationship from the vendor’s point of view has increased as the vendor becomes more significant. This thesis has examined the point of view of Indpro, an IT service provider located in Bangalore (India) primarily serving customers located in Sweden. The empirical materials are based on a field study of Indpro during the author´s ten-week stay in Bangalore, India, where daily work was conducted at Indpro’s office. Materials collected during the field study where analysed through the lens of the theoretical framework created by Balaji & Ahuja (2005), called the offshore project success model. In conclusion, there is no doubt that cross-cultural understanding and clear expectations form the foundation of a trusting relationship between the vendor and the customer, which builds project success.

Textil- och beklädnadsindustrin har expanderat kraftigt sedan 1990-talet och är idag en av de största industrierna i världen. Den globala försörjningskedjan inom industrin innefattar komplexa nätverk och förhållanden kring bland annat sourcingstrategier och var företag väljer att placera sin textilproduktion. För att skapa konkurrenskraftiga strategier krävs kontroll av företagens produktion- och leveranskedja, och allt fler företag har insett att offshoring inte är lönsamt. Sourcingstrategin nearshoring, vilket innebär att företag placerar produktionen närmare hemlandet och företagets huvudsakliga marknad, har istället blivit allt mer intressant. Tidigare forskning kring sourcingstrategierna offshoring och nearshoring fokuserar på hur implementering av strategierna kan ser ut, och vilka möjligheter och utmaningar det innebär. Det saknas däremot forskning kring hur textil- och modeföretag bemöter och hanterar dessa utmaningar. Denna uppsats syftar därmed till att studera drivkrafter bakom svenska textil- och modeföretags val av sourcingstrategi, samt hur företagen hanterar utmaningar för att upprätthålla en effektiv och lönsam försörjningskedja. Som hjälpmedel för att identifiera drivkrafter och strategiska hanteringsåtgärder, används Supply Chain Management och det teoretiska perspektivet Resource-based view. Studien är kvalitativ och materialinsamlingen utgörs av semistrukturerade intervjuer med kompletterande observationer av fem svenska textil- och modeföretag. Intervjuerna har transkriberats, och tillsammans med observationerna har en tematisk analys genomförts. Studiens resultat efter materialinsamlingen visar på att drivkrafter och utmaningar bakom företags val av sourcingstrategi har en koppling till hantering och effektivitet av försörjningskedjan. Studien visar även på att svenska textil- och modeföretag är intresserade av nearshoring, och vill implementera det i framtiden, men att vissa utmaningar är för stora för att hantera på ett lönsamt sätt. Svenska textil- och modeföretag har olika motiv för varför de väljer olika sourcingstrategier, och det innebär att företagen anpassar sina sourcingstrategier efter deras tillgångar och resurser. Studiens slutsats är att företag upplever drivkrafter och utmaningar med både offshoring och nearshoring, och att en kombination av dessa kan vara möjligt att tillämpa. Studien är applicerbar inom textilt management eftersom resultatet kan hjälpa svenska textil- och modeföretag att jämföra de olika sourcingstrategier för att därmed skapa strategiska beslut kring sourcing och val av leverantörer. / Since the dawn of the 1990s the textile and clothing industry has expanded rapidly, becoming one of the largest industries in the world. The global supply chain that enables the clothing industry requires complex networks and methods regarding, among other things, sourcing strategies and where companies choose to locate their textile production. In order to create more competitive strategies a company requires control of its production and supply chain so that they can change it to maximize profit, and recently actors within the industry have realized that offshoring is no longer as profitable. The sourcing strategy nearshoring, when companies choose to locate production closer to the home country and the company's main market, has instead become increasingly attractive. Previous research surrounding offshoring and nearshoring focus on what the implementation of these strategies can look like as well as what opportunities and challenges these strategies present. However, there is a lack of research on how textile and fashion companies respond to and manage these challenges. This essay therefore aims to study the driving forces behind Swedish textile and fashion companies´ choice of sourcing strategies, as well as how the companies deal with events that challenge the maintaining of an efficient and profitable supply chain. Supply Chain Management and the theoretical perspective Resource-based view are used as tools to identify the driving forces behind strategic management measures. This study is qualitative and the material collected comes from semi-structured interviews, with supplementary observations, of five Swedish textile and fashion companies. The interviews have been transcribed, and together with the observations, a thematic analysis has been carried out. The study's results show that the driving forces and reasoning deciding companies' choice of sourcing strategy has a connection to Supply Chain Management. The results also suggest that Swedish textile and fashion companies are interested in nearshoring, and want to implement it in the future, but the challenges are too great to handle in a profitable way. Swedish textile and fashion companies have different motives for why they choose different sourcing strategies, and this means that the companies adapt their sourcing strategies according to their assets and resources. The study's conclusion is that companies experience driving forces and challenges with both offshoring and nearshoring, and that a combination of the two strategies may be possible to apply. The study is relevant for textile management strategizing because the results can help Swedish clothing and textile companies to compare different sourcing strategies in order to make strategic decisions regarding sourcing and the choice of suppliers. This essay is written in Swedish.

We set up a general equilibrium model, in which offshoring to a low-wage country can lead to job polarisation in the high-wage country. Job polarisation is the result of a reallocation of labour across firms that differ in productivity and pay wages that are positively linked to their profits by a rent-sharing mechanism. Offshoring involves fixed and task-specific variable costs, and as a consequence it is chosen only by the most productive firms, and only for those tasks with the lowest variable offshoring costs. A reduction in those variable costs increases offshoring at the intensive and at the extensive margin, with domestic employment shifted from the newly offshoring firms in the middle of the productivity distribution to firms at the tails of this distribution, paying either very low or very high wages. We also study how the reallocation of labour across firms affects economy-wide unemployment. Offshoring reduces unemployment when it is confined to high-productivity firms, while this outcome is not guaranteed when offshoring is also chosen by low-productivity firms.