A neo-Schumpeterian model of health services innovation

The paper presents and empirically applies a neo-Schumpeterian model of innovation capable of studying interactions between service providers, patients and policy makers, and how these complex interactions determine the timing, direction, and success of innovations in the public sector. The model is tested using a case study that traces the introduction and development of ambulatory surgery in a Spanish hospital. The multi-agent model applies the ideas of Schumpeter to services, encompassing Schumpeter's five types of innovation, and re-introducing the policy-maker as a key agent in the innovation process. The model has a number of advantages over previous, reduced form models. First, it can analyse the interactions between the economic, social and political spheres that make up the complex selection environment of innovations. Second, it captures the recursive impact of radical innovations on agents' competences and preferences, and their relative power. This brings politics, power, and rhetorical persuasion to the fore. Third, it provides an improved set of definitions for radical and incremental innovation. These are not only important for understanding the sources and drivers of innovation, but also for the accurate measurement of innovation.

[1]  V. Fuchs,et al.  Economics, values, and health care reform. , 1996, The American economic review.

[2]  G. Dosi.  Technological Paradigms and Technological Trajectories , 1993 .

[3]  M. Callon,et al.  The involvement of patients' associations in research , 2002 .

[4]  Ian Miles,et al.  Innovation systems in the service economy : measurement and case study analysis , 2000 .

[5]  Ina Drejer.  Identifying innovation in surveys of services: A Schumpeterian perspective , 2004 .

[6]  Arnold C. Harberger.  A Vision of the Growth Process , 1998 .

[7]  B. Latour.  The pasteurization of France , 1988 .

[8]  Paul Israel,et al.  The Sources of Innovation , 1990 .

[9]  Manuel García-Goñi.  Diferencias y similitudes entre los procesos de adopción de innovaciones tecnológicas y organizacionales en los hospitales , 2006 .

[10]  Paul Windrum,et al.  Structural change in the presence of network externalities: a co-evolutionary model of technological successions , 2004 .

[11]  Qian-Li Xue,et al.  Impaired Vision and the Ability to Take Medications , 2005, Journal of the American Geriatrics Society.

[12]  S Leader,et al.  Medicare trends in ambulatory surgery. , 1989, Health affairs.

[13]  Faïz Gallouj,et al.  Mapping innovation dynamics in hospitals , 2005 .

[14]  John Metcalfe,et al.  A theoretical approach to the construction of technological output indicators , 1984 .

[15]  M. Mitchell.  Patients’ perceptions of day surgery: A literature review , 1999 .

[16]  I. Miles,et al.  Innovation, Measurement and Services: the new problematique , 2000 .

[17]  Kim B. Clark,et al.  The Interaction of Design Hierarchies and market Concepts in Technological Evolution : Research Policy , 1985 .

[18]  M. Mcclellan,et al.  Is technological change in medicine worth it? , 2001, Health affairs.

[19]  A. Hughes,et al.  Rethinking Innovation Comparisons Between Manufacturing and Services: The Experience of the CBR SME Surveys in the UK , 2000 .

[20]  S. Winter,et al.  The Co-evolution of Capabilities and Transaction Costs: Explaining the Institutional Structure of Production , 2005 .

[21]  Victor R. Fuchs,et al.  The Growing Importance of the Service Industries , 1965 .

[22]  H. Varian.  Intermediate Microeconomics: A Modern Approach , 1987 .

[23]  N. Rosenberg,et al.  The dynamics of technological change in medicine. , 1994, Health affairs.

[24]  J. Schumpeter.  Capitalism, Socialism and Democracy , 1943 .

[25]  H. Grabowski,et al.  Substitution laws and innovation in the pharmaceutical industry. , 1979 .

[26]  Stephen Martin,et al.  Rationing by waiting lists: an empirical investigation , 1999 .

[27]  H. Hotelling.  Stability in Competition , 1929 .

[28]  R. Barras.  Interactive innovation in financial and business services: The vanguard of the service revolution , 1993 .

[29]  K. Lancaster.  A New Approach to Consumer Theory , 1966, Journal of Political Economy.

[30]  P. Saviotti.  Technological Evolution, Variety and the Economy , 1996 .

[31]  P. Hertog.  KNOWLEDGE-INTENSIVE BUSINESS SERVICES AS CO-PRODUCERS OF INNOVATION , 2000 .

[32]  Alfred D. Chandler,et al.  The Visible Hand , 1977 .

[33]  Ian Miles,et al.  Services and the Knowledge-Based Economy , 2000 .

[34]  Daniel A. Levinthal,et al.  ABSORPTIVE CAPACITY: A NEW PERSPECTIVE ON LEARNING AND INNOVATION , 1990 .

[35]  Peter C. Smith,et al.  Performance signals in the public sector: the case of health care , 2003 .

[36]  G. Dosi.  Technological Paradigms and Technological Trajectories: A Suggested Interpretation of the Determinants and Directions of Technical Change , 1982 .

[37]  William J. Abernathy,et al.  Patterns of Industrial Innovation , 1978 .

[38]  Burton A. Weisbrod,et al.  The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment , 1991 .

[39]  Gary S. Becker,et al.  Accounting for Tastes , 1997 .

[40]  J. Docherty,et al.  REPORT OF THREE AUTOPSIES FOLLOWING CARBON TETRACHLORIDE TREATMENT , 1923, British medical journal.

[41]  Frank Windmeijer,et al.  Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level , 2004 .

[42]  M. Callon.  The Sociology of an Actor-Network: The Case of the Electric Vehicle , 1986 .

[43]  J. Newhouse,et al.  Medical care costs: how much welfare loss? , 1992, The journal of economic perspectives : a journal of the American Economic Association.

[44]  R. Barras.  Towards a theory of innovation in services , 1986 .

[45]  L. Vogel,et al.  Strategy and Structure , 1986 .

[46]  F. Gallouj.  Innovation in the Service Economy , 2002 .

[47]  C. Birchenhall,et al.  Is product life cycle theory a special case? Dominant designs and the emergence of market niches through coevolutionary-learning , 1998 .

[48]  Yannis Caloghirou,et al.  Knowledge Flows in European Industry , 2009 .

[49]  J. Metcalfe.  Evolutionary Economics and Creative Destruction , 2002 .

[50]  M. Callon,et al.  Mapping the Dynamics of Science and Technology , 1986 .

[51]  C. Sicotte,et al.  Cost-minimization analysis of a wide-area teleradiology network in a French region. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[52]  G. Dosi,et al.  Technical Change and Economic Theory , 1989 .

[53]  Alfred D. Chandler,et al.  Managerial Hierarchies, Comparative Perspectives on the Rise of the Modern Industrial Enterprise , 1981 .

[54]  J. Schumpeter.  The Theory of Economic Development: An Inquiry into Profits, Capital, Credit, Interest, and the Business Cycle , 1934 .

[55]  Pier Paolo Saviotti,et al.  An approach to the measurement of technology based on the hedonic price method and related methods , 1985 .

[56]  Jonathan E Alltimes.  The Organisation of Innovation in Services , 1999 .

[57]  M. Tushman,et al.  Technological Discontinuities and Dominant Designs: A Cyclical Model of Technological Change , 1990 .

[58]  R. Westrum.  The Social Construction of Technological Systems , 1989 .

[59]  R. Tibshirani,et al.  An introduction to the bootstrap , 1993 .

[60]  Faïz Gallouj,et al.  Innovation in services , 1997 .