Kshetri Nir
Bryan School of Business and Economics, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA.
Int J Health Care Qual Assur. 2011;24(6):453-70. doi: 10.1108/09526861111150716.
Industrialized world-based healthcare providers are increasingly off-shoring low-end healthcare services such as medical transcription, billing and insurance claims. High-skill medical jobs such as tele-imaging and tele-pathology are also being sub-contracted to developing countries. Despite its importance, little theory or research exists to explain what factors affect industry growth. The article's goals, therefore, are to examine economic processes associated with developing economies' shift from low- to high-value information technology enabled healthcare services, and to investigate how these differ in terms of legitimacy from regulative, normative and cognitive institutions in the sending country and how healthcare services differ from other services.
DESIGN/METHODOLOGY/APPROACH: This research is conceptual and theory-building. Broadly, its approach can be described as a positivistic epistemology.
Anti off-shoring regulative, normative and cognitive pressures in the sending country are likely to be stronger in healthcare than in most business process outsourcing. Moreover, such pressures are likely to be stronger in high-value rather than in low-value healthcare off-shoring. The findings also indicate that off-shoring low-value healthcare services and emergent healthcare industries in a developing economy help accumulate implicit and tacit knowledge required for off-shoring high-value healthcare services.
RESEARCH LIMITATIONS/IMPLICATIONS: The approach lacks primary data and empirical documentation.
The article helps in understanding industry drivers and its possible future direction. The findings help in understanding the lens through which various institutional actors in a sending country view healthcare service off-shoring.
ORIGINALITY/VALUE: The article's value stems from its analytical context, mechanisms and processes associated with developing economies' shift to high-value healthcare off-shoring services.
以工业化国家为基地的医疗保健服务提供商越来越多地将诸如医疗转录、计费和保险理赔等低端医疗服务外包到海外。远程成像和远程病理学等高技能医疗工作也被分包给发展中国家。尽管其很重要，但几乎没有理论或研究来解释哪些因素影响该行业的增长。因此，本文的目标是研究与发展中经济体从低价值信息技术支持的医疗服务向高价值信息技术支持的医疗服务转变相关的经济过程，并调查这些过程在合法性方面与输出国的监管、规范和认知机构有何不同，以及医疗服务与其他服务有何不同。
设计/方法/途径：本研究是概念性的且旨在构建理论。总体而言，其方法可描述为实证主义认识论。
输出国的反离岸外包监管、规范和认知压力在医疗保健领域可能比大多数业务流程外包领域更强。此外，此类压力在高价值医疗保健离岸外包中可能比在低价值医疗保健离岸外包中更强。研究结果还表明，在发展中经济体中离岸外包低价值医疗服务和新兴医疗行业有助于积累离岸外包高价值医疗服务所需的隐性和默会知识。
研究局限性/启示：该方法缺乏原始数据和实证记录。
本文有助于理解行业驱动因素及其可能的未来方向。研究结果有助于理解输出国各种机构行为者看待医疗服务离岸外包的视角。
原创性/价值：本文的价值源于其与发展中经济体向高价值医疗保健离岸外包服务转变相关的分析背景、机制和过程。
