Kannan Sethuraman

Locus of supply and global manufacturing

Interest in supply chain management has been escalating during the last decade. Using a large sample of durable goods firms located in all major regions of the world, we extend two theoretical perspectives, namely the resource‐based view and the transaction cost economics view of the firm, to better understand the issues behind global sourcing. Both theory extensions were supported in separate by statistically significant regression results. Then, pooling predictors to represent both models together, these measures independently increase the odds of predicting global sourcing. For example, building of a firm’s technological capabilities that was captured through the levels of its RD length of frozen schedules, directly related) also emerged as a significant predictor of the level of global sourcing undertaken by a firm. This suggests that firms have two alternative ways to globalize operations supply, and raises the interesting question of whether or not these two strategies might operate simultaneously.

Case cancellations on the day of surgery: an investigation in an Australian paediatric hospital

Background:  This study investigates case cancellations on the intended day of surgery (DOS) at a paediatric hospital in Melbourne, Australia. The hospital in Melbourne treats over 32 000 inpatients annually and handles both elective and emergency cases.

On the Hospital Volume and Outcome Relationship: Does Specialization Matter More Than Volume?

OBJECTIVE To evaluate the relationship between hospital volume and outcome by focusing on alternative measures of volume that capture specialization and overall throughput of hospitals. DATA SOURCES/STUDY SETTING Hospital administrative data from the state of Victoria, Australia; data contain 1,798,474 admitted episodes reported by 135 public and private acute-care hospitals. STUDY DESIGN This study contrasts the volume-outcome relationship using regression models with different measures of volume; two-step and single-step risk-adjustment methods are used. DATA COLLECTION/EXTRACTION METHODS The sample is restricted to ischemic heart disease (IHD) patients (ICD-10 codes: I20-I25) admitted during 2001/02 to 2004/05. PRINCIPAL FINDINGS Overall hospital throughput and degree of specialization display more substantive implications for the volume-outcome relationship than conventional caseload volume measure. Two-step estimation when corrected for heteroscedasticity produces comparable results to single-step methods. CONCLUSIONS Different measures of volume could lead to vastly different conclusions about the volume-outcome relationship. Hospital specialization and throughput should both be included as measures of volume to capture the notion of size, focus, and possible congestion effects.

Reducing incremental costs associated with the delegation of incentive contracting decisions: An analysis of planning and control decisions in a manufacturing setting in the presence of moral hazard

Abstract We compare and contrast two specific regimes involving the centralization and delegation of the incentive contracting decision in manufacturing organizations. In the centralization regime, a single individual simultaneously makes the allocation of demand to production facilities and determines the incentive compensation scheme for the managers at the facilities. Under the delegation regime, the demand allocation is decided upon initially by a superior and the incentive contracting decision is subsequently made by a subordinate, who is neither of the two managers in charge of the production facilities. Using the principal–agent paradigm, which assumes that the managerial efforts are unobservable, we demonstrate that the centralization regime performs no worse than the delegation regime. For situations where strategic or other requirements necessitate firms to opt for the delegation of the incentive contracting decision, we propose a heuristic that significantly increases the likelihood of mimicking the allocation and contracting decisions made under the centralized regime.

Factors affecting outpatient non-attendance in an Australian children's hospital.

TO THE EDITOR: Outpatient nonattendance remains a major problem that significantly drains the ability of hospitals to provide efficient and effective outpatient services.1,2 Our earlier pilot study demonstrated the effectiveness of short message service (SMS) text message reminders in improving attendance at the outpatient department in Melbourne’s Royal Children’s Hospital (a 250-bed tertiary referral hospital).3,4 We present the results of a follow-up retrospective cohort study that examined the effect of the following eight factors on failure to attend (FTA): sex, native language, distance lived from hospital, day of appointment, time of appointment, wait time (days from scheduling to appointment), socioeconomic status (SES), and SMS reminders. Data included all outpatient appointments (65535) in the period July 2005 to January 2006. Incomplete data meant that 44 appointments were excluded, leaving 65 491 episodes for the analyses. The patients were classified into three SES groups: low (G1), middle (G2) and high (G3). This classification was based on the Jarman score (a proxy for SES) derived from the patient’s residential postcode.5 Similarly, patients were classified into three groups based on distance between the patient’s residence and the hospital: < 25km, 25–50km and > 50km. Univariate and multiple logistic regression analyses confirmed that all factors other than sex were significantly associated with FTA. We also found that the two populations with and without SMS reminders were significantly different. We conducted a stratified analysis for the two groups and the summary results are presented in the Box. Our analysis shows that FTA rates improve by 5.34% (from 14.85% to 9.51%), and confirms the effectiveness of SMS reminders in lowering FTA. It shows that native language, distance lived from hospital, SES and wait time are significantly associated with FTA across both groups. Although SMS reminders resulted in higher improvement in attendance for nonEnglish speaking patients compared with English speakers (8.33% versus 4.1%), those patients still had higher odds of missing an appointment. Lower SES was associated with an increased likelihood of defaulting. Longer waits until the appointment resulted in lower odds of attending, and odds of attending improved with increased distance from the clinic. Together these results suggest that in addition to SMS reminders, interventions targeted at specific groups may improve attendance rates and cost effectiveness.