Relevance
First, health systems differ in their capacity to provide care in an efficient and equitable way. To better understand and manage health care provision, variations in health care utilization and spending for specific patient populations need to be analyzed in much greater detail. With this goal in mind, I analyze how health care utilization and costs of patients with high and complex needs vary within and across health systems. In addition, by comparing how utilization and spending indicators vary throughout the care pathway—starting with the index hospitalization and studying care provision in the rehab and outpatient care settings—I can benchmark performance and identify better practices.
Next, the European Commission strengthened the regulation of the medical device industry by enacting the Medical Device Regulation (MDR) in May 2017. Switzerland eventually adopted the MDR to maintain the access to the EU market. Notoriously, a stricter regulation is often a double-edged sword: while the higher safety requirements shall improve patient well-being in the long run, the new law also causes a substantial bureaucratic burden, which may distort competition at the expense of small and medium-sized enterprises (SME). To provide implications for policy makers and practitioners, I examine the economic impact of the MDR on the medical device industry in the EU and Switzerland.
Lastly, employees can play an important role in improving the organization they work for. Kaizen, a managerial technique that is often employed in hospitals, empowers employees regardless of their hierarchy level to contribute to continuous improvement activities. The approach puts a special emphasis on frontline employees by enabling them to take more responsibility and participate in decision-making. To discover opportunities to enhance employee participation, I examine the application of kaizen and participation behavior of nurses in two acute care hospitals. I contrast examples of positive and a negative implementation—an approach missing in literature, though strongly advocated by scholars. Finally, I describe key influencing factors for the successful implementation of kaizen management.