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The Impact of Bundled Payment on Hospital Operations 捆绑支付对医院运营的影响
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2023-01-17 DOI: 10.1287/serv.2022.0314
Yiming Fan, Jingqi Wang, Jingui Xie, Yugang Yu, Liqing Cao
This paper studies the impact of bundled payment policy on healthcare cost, efficiency, quality, and shift of care. Using insurance claim data, we empirically offer a more nuanced understanding of the impact of bundled payment policy on hospital operations and provide new evidence from China. Our evidence suggests that transitioning from fee-for-service to bundled payment reimbursement resulted in declines in treatment costs and length of stay. Along with that decline, there was an increase in planned revisits to outpatient clinics, which indicates a shift of care from the inpatient to the outpatient setting, as well as a rise in unplanned revisits, indicating a decline in service quality. The increase in readmission rate to inpatient wards is very small and not statistically significant. In addition, we discuss the design and implementation of bundled payment. Our results imply that careful bundle design is vital to encouraging providers to implement the new program without sacrificing quality. Funding: This research is supported by the National Natural Science Foundation of China [Grants 72091215/72091210, 71921001], the Research Grants Council of the Hong Kong Special Administrative Region, China [Grant HKU 17500217], and the Fundamental Research Funds for the Central Universities [Grant 2040000018].
本文研究了捆绑支付政策对医疗保健成本、效率、质量和护理转移的影响。利用保险索赔数据,我们从经验上对捆绑支付政策对医院运营的影响提供了更细致的理解,并提供了来自中国的新证据。我们的证据表明,从按服务收费到捆绑付款报销的转变导致了治疗费用和住院时间的下降。与此同时,计划到门诊诊所就诊的人数也有所增加,这表明护理从住院病人转向门诊病人,同时计划外的就诊人数也有所增加,表明服务质量有所下降。住院病房再入院率的增加非常小,没有统计学意义。此外,我们还讨论了捆绑支付的设计与实现。我们的结果表明,谨慎的捆绑包设计对于鼓励供应商在不牺牲质量的情况下实施新计划至关重要。基金资助:国家自然科学基金[资助项目:72091215/ 72091210,71921001]、香港特别行政区研究资助局[资助项目:HKU 17500217]、中央高校基本科研业务费[资助项目:2040000018]资助。
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引用次数: 0
Service Science: CCF 16th International Conference, ICSS 2023, Harbin, China, May 13–14, 2023, Revised Selected Papers 服务科学:CCF第16届国际会议,ICSS 2023,中国哈尔滨,2023年5月13-14日,修订论文选集
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2023-01-01 DOI: 10.1007/978-981-99-4402-6
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引用次数: 1
Station-Based or Free-Floating? An Integrated Carsharing System with Dual Service Types 站式还是自由浮动?一种具有双重服务类型的一体化拼车系统
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-11-30 DOI: 10.1287/serv.2022.0312
Hua Ke, Yutong Mo
A specific service type is applied by most one-way carsharing operators, either station-based or free-floating, which depends on whether users are required to pick up and return vehicles in fixed parking lots. However, both of them have inherent limitations. The station-based carsharing system encounters the weakness of low parking-space utilization, whereas the free-floating system needs to face high parking and relocation costs. To overcome the limitations of single-type carsharing systems, this paper proposes an integrated system to apply the two types in different parts of the service area. A mixed-integer linear-programming model is established to maximize the operator profit, considering both strategic decisions of service type and operational decisions of relocation and trip selection. Despite the fact that the model can be solved by the CPLEX solver, it is limited by excessive memory usage and too long solving time in large-scale cases. To enhance the solving feasibility of the proposed model, a heuristic algorithm is proposed to effectively iterate feasible strategic options and solve the operational subproblem. The numerical results of the case study show that the proposed algorithm can achieve comparable objectives with the CPLEX solver in a much shorter computational time. Through system comparison, the integrated system achieves a larger profit and higher demand-fulfillment rate, compared with the single station-based or free-floating system. History: This paper has been accepted for the Service Science Special Issue on Innovation in Transportation-Enabled Urban Services.
大多数单向汽车共享运营商都采用了一种特定的服务类型,要么是基于站点的,要么是自由浮动的,这取决于用户是否需要在固定的停车场上下车。然而,它们都有固有的局限性。基于站点的共享汽车系统存在车位利用率低的缺点,而自由浮动的共享汽车系统需要面对较高的停车和搬迁成本。为了克服单一类型的汽车共享系统的局限性,本文提出了一种集成系统,将两种类型的汽车共享系统应用于服务区域的不同部分。考虑服务类型的战略决策和搬迁、行程选择的运营决策,建立了以运营商利润最大化为目标的混合整数线性规划模型。尽管该模型可以用CPLEX求解器求解,但在大规模情况下,它受到内存占用过大和求解时间过长的限制。为了提高模型的求解可行性,提出了一种启发式算法来有效地迭代可行策略选项并求解操作子问题。算例结果表明,该算法可以在较短的计算时间内达到与CPLEX求解器相当的目标。通过系统对比,与单站式或自由浮动式系统相比,综合系统实现了更大的利润和更高的需求完成率。历史:本文已被《服务科学》特刊《交通驱动城市服务创新》接受。
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引用次数: 0
Personal Shopper Systems in Last-Mile Logistics 最后一英里物流中的个人购物系统
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-11-29 DOI: 10.1287/serv.2022.0310
Jelmer P. van der Gaast, Alp Muzaffer Arslan
This paper explores the logistics operations of instant grocery delivery services. Therefore, we introduce the instant delivery problem (IDP) to replicate and examine two widely adopted strategies in the rapid delivery market: the personal shopper system (PSS) and the inventory owned delivery (IOD) system. In the PSS, couriers visit affiliated brick-and-mortar stores in the delivery area to pick up and purchase ordered products and then deliver them to customers. In the IOD system, couriers collect products from a single distribution center, or so-called dark store, in which the platform manages the inventory. Even though a PSS strategy is asset light because of the utilization of existing retailers in the area, maintaining a good level of on-time instant deliveries with the PSS is more complex than with IOD. This is because the PSS requires deciding which store to purchase ordered goods from, and picking and shopping at stores needs to be considered in the real-time decision process. We propose a tailored rolling horizon framework that utilizes column generation to browse updated delivery plans for arriving customer orders. Computational studies both in real life–inspired settings and in case studies on selected urban areas show that the PSS is a highly competitive strategy compared with IOD, particularly when dealing with small-sized customer orders. We observe that the performance of the PSS is robust when varying the delivery service time frame. The case studies also suggest that the PSS becomes even more competitive in areas where the retail store density is high. History: Special Issue—Innovation in Transportation-Enabled Urban Services. Funding: This work was supported by National Natural Science Foundation of China [Grant 72150410444] to J.P. van der Gaast. Supplemental Material: The e-companion is available at https://doi.org/10.1287/serv.2022.0310 .
本文探讨了食品杂货即时配送服务的物流运作。因此,我们引入即时配送问题(IDP)来复制和检验快速配送市场中两种广泛采用的策略:个人购物者系统(PSS)和库存自有配送系统(IOD)。在PSS中,快递员访问配送区域的附属实体店,提取和购买订购的产品,然后将其交付给客户。在IOD系统中,快递员从一个配送中心或所谓的暗店收集产品,平台在暗店管理库存。尽管由于利用了该地区现有的零售商,PSS策略是轻资产策略,但使用PSS保持良好的准时即时交付水平比使用IOD要复杂得多。这是因为PSS需要决定从哪个商店购买订购的商品,并且在实时决策过程中需要考虑在商店中挑选和购物。我们提出了一个定制的滚动地平线框架,该框架利用列生成来浏览到达客户订单的更新交付计划。在现实生活环境和选定城市地区的案例研究中进行的计算研究表明,与IOD相比,PSS是一种极具竞争力的策略,特别是在处理小额客户订单时。我们观察到PSS在改变交付服务时间框架时的性能是鲁棒的。案例研究还表明,PSS在零售商店密度高的地区更具竞争力。历史:特刊——交通驱动型城市服务的创新。基金资助:国家自然科学基金项目[Grant 72150410444]资助对象:J.P. van der Gaast。补充材料:电子伴侣可在https://doi.org/10.1287/serv.2022.0310上获得。
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引用次数: 0
Peak-Hour Pricing Under Negative Externality: Impact of Customer Flexibility and Competitive Asymmetry 负外部性下的高峰时段定价:顾客灵活性与竞争不对称的影响
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-10-21 DOI: 10.1287/serv.2022.0309
Christopher S. Tang, Onesun Steve Yoo, Yufei Huang
Several industries that provide services to customers (e.g., public utility and transportation) charge higher prices during peak hours to smooth demand. With technologies (e.g., electronic shelf labels) enabling retailers to change prices easily within each day, should supermarkets use peak-hour pricing? To examine this question formally, we introduce a stylized duopoly model in the presence of “negative externality,” where firms compete for congestion-averse customers. We characterize how customers endogenously segment themselves regarding when and where to shop, and then use the equilibrium outcomes to examine whether the firms should implement peak-hour pricing for varying types of customer flexibility and competitive asymmetry. Our analysis shows that, if customers are not flexible in their store choice, then both firms would always use peak-hour pricing. However, if store choice flexibility is present, then firms’ decisions depend on the competitive asymmetry as follows. If one firm has a clear competitive advantage (in terms of value or price) over the other firm, then the dominant firm will use peak-hour pricing, whereas the other firm will not. Otherwise, both firms will use peak-hour pricing if they engage in symmetric competition (in terms of similar value and price), or neither firm will use it if they engage in differentiated competition (high value versus low cost). Through our analysis of different extensions, we find that a firm’s ability to set its regular price would dampen the effect of peak-period pricing. Also, we obtain consistent results when there is heterogeneity in customer valuation and customer congestion aversion level.
一些为客户提供服务的行业(例如,公共事业和交通)在高峰时段收取更高的价格以满足需求。随着技术(例如,电子货架标签)使零售商能够在每天内轻松更改价格,超市是否应该采用高峰时段定价?为了正式地检验这个问题,我们在“负外部性”存在的情况下引入了一个风格化的双寡头垄断模型,在这个模型中,企业争夺厌恶拥挤的客户。我们描述了消费者如何内生细分自己的购物时间和地点,然后使用均衡结果来检查公司是否应该针对不同类型的客户灵活性和竞争不对称实施高峰时段定价。我们的分析表明,如果顾客在商店选择上不灵活,那么两家公司都会使用高峰时段定价。然而,如果存在商店选择灵活性,那么企业的决策取决于竞争不对称,如下所示。如果一家公司比另一家公司有明显的竞争优势(在价值或价格方面),那么占主导地位的公司将使用高峰时间定价,而另一家公司则不会。否则,如果他们从事对称竞争(在相似的价值和价格方面),两家公司将使用高峰时段定价,或者如果他们从事差异化竞争(高价值与低成本),两家公司都不会使用高峰时段定价。通过对不同扩展的分析,我们发现企业设定常规价格的能力会抑制高峰时段定价的影响。在顾客评价和顾客拥塞厌恶程度存在异质性的情况下,我们得到了一致的结果。
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引用次数: 1
Cross-Channel Integration and Customer Experience in Omnichannel Retail Services 全渠道零售服务中的跨渠道整合与客户体验
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-08-31 DOI: 10.1287/serv.2022.0308
Kyunghwan Chung, Kyung Wha Oh, Minjeong Kim
Despite the increasing attention being given to cross-channel integration services, an understanding of the impact of cross-channel integration on customer experience is still lacking. This study fills this gap. With a focus on retail brand experience, this study demonstrates that cross-channel integration impacts customer experience and further results in changes in perception and behavioral intention. A conceptual model that illustrates the customers’ psychological mechanism responding to cross-channel integration was developed. To test the model, a scenario-based online experiment was conducted. The results show that perceived channel integration impacts retail brand experience, which in turn impacts perceived service convenience, satisfaction, and patronage intention. Creating a better experience is a key challenge for retailers to ensure customer satisfaction and brand loyalty. Our results show that cross-channel integration services can play a pivotal role in the shaping of retail brand experience in today’s competitive retail environment that continuously evolves, owing to digital technology. The findings of this study add valuable new knowledge to the growing omnichannel retailing literature and provide practical insights to develop omnichannel retail services.
尽管越来越多的人关注跨渠道整合服务,但对跨渠道整合对客户体验的影响的理解仍然缺乏。这项研究填补了这一空白。本研究以零售品牌体验为研究对象,论证了跨渠道整合对顾客体验的影响,进而导致顾客感知和行为意愿的改变。建立了顾客对跨渠道整合反应的心理机制的概念模型。为了验证该模型,进行了基于场景的在线实验。结果表明,感知渠道整合影响零售品牌体验,进而影响感知服务便利性、满意度和惠顾意愿。对于零售商来说,创造更好的体验是确保客户满意度和品牌忠诚度的关键挑战。我们的研究结果表明,由于数字技术的发展,在当今竞争激烈的零售环境中,跨渠道整合服务可以在塑造零售品牌体验方面发挥关键作用。本研究的发现为不断增长的全渠道零售文献增加了有价值的新知识,并为开发全渠道零售服务提供了实用的见解。
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引用次数: 1
Free Add-Ons in Services 免费附加服务
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-08-31 DOI: 10.1287/serv.2022.0307
P. Gao, XingYu Fu, Haoyu Liu, Ying‐ju Chen
The paper examines a seller’s offering of free add-ons in services. We build a stylized model where the seller decides the level of add-on provision to enhance its core service, and consumers make discrete choices between the seller and an outside option. When the seller supplies its service through a single channel, we show that the optimal add-on provision is unimodal in the difference between the seller’s service quality and the outside option, comparable with the existing literature. When the service is supplied through multiple channels, we show that the seller may make nonidentical add-on provisions among channels. If the cost of add-on provision is low, the seller should adopt a differentiation strategy. If the cost is high, the seller should adopt a homogenization strategy. Various extensions are considered to establish the robustness of our results.
这篇论文考察了卖家提供的免费附加服务。我们构建了一个程式化的模型,在这个模型中,卖方决定附加配置的级别以增强其核心服务,消费者在卖方和外部选项之间做出离散的选择。当卖方通过单一渠道提供服务时,我们证明了最优附加条款在卖方服务质量与外部选项之间的差异是单峰的,与现有文献相当。当服务通过多个渠道提供时,我们表明卖方可能在不同的渠道之间制定不相同的附加条款。如果附加条款的成本较低,卖方应采取差异化策略。如果成本较高,卖方应采取同质化策略。考虑了各种扩展来建立我们的结果的鲁棒性。
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引用次数: 0
Adoption Factors of Digital Services—A Systematic Literature Review 数字服务的采用因素——系统文献综述
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-08-22 DOI: 10.1287/serv.2022.0305
M. Paulus, Slawka Jordanow, J. Millemann
In recent years, the diffusion of digital technologies in the service sector offers great potential for growth and success. Today, many companies are trying to launch new digital services on the market to realize this potential. Prior research concludes that the success of such services depends crucially on whether a consumer adopts or rejects them. Hence, by using the methodology of a systematic literature review, this paper identifies key factors that drive a consumer to adopt digital services. As a result of a subsequent classification, the present work distinguishes among three main categories. First are consumer-specific factors relating to individual predispositions, demographics, and awareness factors that can be attributed to the consumer. Second are situation-specific factors, representing the smallest category found, concerning the service environment, the context of service delivery, and situations in which consumers may find themselves before or during the use of digital services. Third are service-specific factors that are mainly determined by individual characteristics and features of these services, such as ease of use, usability, compatibility, and enjoyment. Hence, this study provides a comprehensive overview of determinants affecting consumer’s adoption behavior and suggests several opportunities for future research. Whereas the rich set of identified factors serves as a foundation, it further proposes to what responsible service executives should pay particular attention in order to succeed with digital services.
近年来,数字技术在服务业的传播为增长和成功提供了巨大的潜力。如今,许多公司正试图在市场上推出新的数字服务,以实现这一潜力。先前的研究得出结论,此类服务的成功关键取决于消费者是否接受或拒绝它们。因此,通过使用系统文献综述的方法,本文确定了驱动消费者采用数字服务的关键因素。由于随后的分类,本工作区分了三个主要类别。首先是与个人倾向、人口统计和意识因素相关的消费者特定因素,这些因素可归因于消费者。第二种是特定于情境的因素,代表了所发现的最小类别,涉及服务环境、服务交付的背景以及消费者在使用数字服务之前或期间可能发现自己的情境。第三是服务特定因素,主要由这些服务的个人特征和特性决定,如易用性、可用性、兼容性和享受性。因此,本研究提供了影响消费者采用行为的决定因素的全面概述,并提出了未来研究的几个机会。虽然丰富的已识别因素集可以作为基础,但它进一步提出了负责任的服务主管应该特别注意的内容,以便在数字服务方面取得成功。
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引用次数: 1
Adaptive Design of Personalized Dose-Finding Clinical Trials 个性化剂量寻找临床试验的自适应设计
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-07-21 DOI: 10.1287/serv.2022.0306
Saeid Delshad, A. Khademi
A key and challenging step toward personalized/precision medicine is the ability to redesign dose-finding clinical trials. This work studies a problem of fully response-adaptive Bayesian design of phase II dose-finding clinical trials with patient information, where the decision maker seeks to identify the right dose for each patient type (often defined as an effective target dose for each group of patients) by minimizing the expected (over patient types) variance of the right dose. We formulate this problem by a stochastic dynamic program and exploit a few properties of this class of learning problems. Because the optimal solution is intractable, we propose an approximate policy by an adaptation of a one-step look-ahead framework. We show the optimality of the proposed policy for a setting with homogeneous patients and two doses and find its asymptotic rate of sampling. We adapt a number of commonly applied allocation policies in dose-finding clinical trials, such as posterior adaptive sampling, and test their performance against our proposed policy via extensive simulations with synthetic and real data. Our numerical analyses provide insights regarding the connection between the structure of the dose-response curve for each patient type and the performance of allocation policies. This paper provides a practical framework for the Food and Drug Administration and pharmaceutical companies to transition from the current phase II procedures to the era of personalized dose-finding clinical trials.
实现个性化/精准医疗的关键和具有挑战性的一步是重新设计剂量寻找临床试验的能力。这项工作研究了具有患者信息的II期剂量寻找临床试验的完全反应适应贝叶斯设计问题,其中决策者试图通过最小化正确剂量的预期(超过患者类型)方差来确定每种患者类型的正确剂量(通常定义为每组患者的有效目标剂量)。我们用一个随机动态规划来表述这个问题,并利用了这类学习问题的一些性质。由于最优解是难以处理的,我们提出了一个近似的策略,通过一步前瞻性框架的适应。我们展示了所提出的策略的最优性设置具有均匀的病人和两个剂量,并找到了它的渐近抽样率。我们在剂量发现临床试验中采用了许多常用的分配策略,例如后验自适应抽样,并通过合成和真实数据的广泛模拟测试了它们在我们提出的策略下的性能。我们的数值分析提供了关于每种患者类型的剂量-反应曲线结构与分配策略性能之间的联系的见解。本文为食品和药物管理局和制药公司从目前的II期程序过渡到个性化剂量寻找临床试验时代提供了一个实用框架。
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引用次数: 2
How Artificial Intelligence Enhances Human Learning Abilities: Opportunities in the Fight Against COVID-19 人工智能如何增强人类学习能力:抗击COVID-19的机遇
IF 2.3 4区 管理学 Q3 BUSINESS Pub Date : 2022-06-01 DOI: 10.1287/serv.2021.0289
C. Mele, Marialuisa Marzullo, Swapnil Morande, T. R. Spena
This paper widens the focus on how artificial intelligence (AI) can foster the learning abilities of human actors, adopting a wider view with respect to a strict focus on tasks and activities. The interaction between AI and human learning has not been investigated in service research. Placing its theoretical roots in work by Huang and Rust [Huang MH, Rust RT (2021) Engaged to a robot? The role of AI in service. J. Service Res. 24(1):30–41.] in service research and on Bloom’s revised taxonomy in education studies [Anderson LW, Krathwohl DR, Airasian PW, Cruikshank KA, Mayer RE, Pintrich PR, Raths J, Wittrock MC (2001) A Taxonomy for Learning, Teaching, and Assessing: A Revision of Bloom’s Taxonomy of Educational Objectives (Longman, London).], this study offers an integrative framework for the ways AI enhances human learning abilities. Some cases in the context of COVID-19 offer insightful illustrations of the framework.
本文扩大了对人工智能(AI)如何培养人类演员学习能力的关注,采用了更广泛的观点,严格关注任务和活动。人工智能与人类学习之间的相互作用尚未在服务研究中得到研究。将其理论基础置于Huang和Rust的工作中[Huang MH, Rust RT(2021)与机器人订婚?人工智能在服务中的作用。[j]参考文献,24(1):30-41。[Anderson LW, Krathwohl DR, Airasian PW, Cruikshank KA, Mayer RE, Pintrich PR, Raths J, Wittrock MC(2001)《学习、教学和评估的分类:布鲁姆教育目标分类的修订》(Longman, London)。],这项研究为人工智能增强人类学习能力的方式提供了一个综合框架。2019冠状病毒病背景下的一些案例为这一框架提供了深刻的例证。
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引用次数: 8
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Service Science
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