Abstract
In many contexts, process standardisation and service customisation are considered rather opposed strategies in the search for competitive advantage: the former aimed at achieving economies of scale and experience to increase production efficiency and reduce costs, and the latter to achieve differentiation with respect to competitors based on “tailor-made” services to meet individual customer needs. In healthcare services, success depends on the ability to integrate these two strategies. No healthcare service is able to be effective unless it is targeted at the needs of individual patients. At the same time, the quality of services depends on the capabilities of professionals and organisations to provide healthcare pathways in line with international scientific evidence and to standardise processes according to clinical protocols defined by the scientific community. The service offer should hence be customised so that patients become the protagonists of their own healthcare pathway, but should also ensure that the best care (clinical appropriateness) is provided within the most appropriate setting for the best use of available resources (organisational appropriateness).
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Notes
- 1.
Three, when considering the focus, nevertheless resulting from cost leadership or differentiation, but applied to a segment rather than the entire market.
- 2.
Indeed, Anderson et al. (1997) revealed that customisation and standardisation are two often-conflicting aspects of quality.
- 3.
This is the main difference compared to other sectors and services, where the redefinition of the service process, in a standardised way, is considered an essential element but only to increase productivity (Lovelock and Wirtz 2007).
- 4.
In fact, in an array of economic studies it is believed that the relationship between increasing customersatisfaction and productivity is negative: increasing satisfaction involves increasing the characteristics of the exchanged product and thus the costs (Griliches 1971; Lancaster 1979). There are also those (e.g., Fornell and Wernerfelt 1988) who observe that by increasing quality, and therefore customer satisfaction, operating costs associated with returns are reduced, or those who (Reichheld and Sasser 1990) emphasise greater loyalty and thus cost reductions resulting from future transactions and positive word of mouth.
- 5.
It is worth noting, in particular, that health services are similar to experience goods (Nelson 1970), i.e., goods whose quality can be known through actual consumption or, often, credence goods (Darby and Karni 1973), impossible to judge even after prolonged use.
- 6.
Other positive externalities are the dissemination of scientific knowledge in the medical field, the discovery of a new diagnostic technique and the identification of risk factors. While the party carrying out the research or training activity sustains the costs related to project implementation, society takes advantage of the external benefits.
- 7.
It should be noted that health services are public goods (i.e., non-rival and non-excludable), but goods worthy of special protection because they are socially meritorious (Dirindin and Vineis 1999; Brenna 1999).
- 8.
More specifically, the relation in turn is negative in underdeveloped countries, thus as income increases mortality decreases significantly, while in developed countries, life expectancy increases with the decline in inequality in the community rather than with the increase of wealth.
- 9.
The ISTAT survey shows that those who have at most an elementary school leaving certificate and declare they are sick, or affected by chronicity, are in fact up to three times more numerous than graduates.
- 10.
A woman in labour with a low educational level is in fact more prone to social problems and difficulties in accessing services, entailing the greater probability for a child to incur health risks and food shortages.
- 11.
We recall in this respect, the health management text of Gerteis et al. (1993), widely diffused in the United States.
- 12.
The Tuscany Cancer Network was established by the Regional Council Decree No 532 of May 27, 2002.
- 13.
The clinical protocols were made available to all local health professionals and through publication of the “Clinical Recommendations for Main Solid Tumours” (Tuscan Cancer Institute 2005), elaborated by over 400 oncological healthcare workers.
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Nuti, S., Panero, C. (2013). The challenge of healthcare services: between process standardisation and service customisation. In: Cinquini, L., Minin, A.D., Varaldo, R. (eds) New Business Models and Value Creation: A Service Science Perspective. Sxi — Springer per l’Innovazione / Sxi — Springer for Innovation, vol 8. Springer, Milano. https://doi.org/10.1007/978-88-470-2838-8_9
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