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A neo-Schumpeterian model of health services innovation

  • Windrum, Paul
  • Garci­a-Goñi, Manuel

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.

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Article provided by Elsevier in its journal Research Policy.

Volume (Year): 37 (2008)
Issue (Month): 4 (May)
Pages: 649-672

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Handle: RePEc:eee:respol:v:37:y:2008:i:4:p:649-672
Contact details of provider: Web page: http://www.elsevier.com/locate/respol

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  1. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
  2. Victor R. Fuchs, 1965. "The Growing Importance of the Service Industries," NBER Books, National Bureau of Economic Research, Inc, number fuch65-1, December.
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  4. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
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  9. Dosi, Giovanni, 1993. "Technological paradigms and technological trajectories : A suggested interpretation of the determinants and directions of technical change," Research Policy, Elsevier, vol. 22(2), pages 102-103, April.
  10. K. K. Lancaster, 2010. "A New Approach to Consumer Theory," Levine's Working Paper Archive 1385, David K. Levine.
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  13. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  14. Paul Windrum & Chris Birchenhall, 2005. "Structural change in the presence of network externalities: a co-evolutionary model of technological successions," Journal of Evolutionary Economics, Springer, vol. 15(2), pages 123-148, January.
  15. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74, pages 132.
  16. Frank Windmeijer & Hugh Gravell & Pierre Hoonhout, 2004. "Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level," IFS Working Papers W04/35, Institute for Fiscal Studies.
  17. Weisbrod, Burton A, 1991. "The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment," Journal of Economic Literature, American Economic Association, vol. 29(2), pages 523-52, June.
  18. Fuchs, Victor R, 1996. "Economics, Values, and Health Care Reform," American Economic Review, American Economic Association, vol. 86(1), pages 1-24, March.
  19. Drejer, Ina, 2004. "Identifying innovation in surveys of services: a Schumpeterian perspective," Research Policy, Elsevier, vol. 33(3), pages 551-562, April.
  20. Barras, Richard, 1986. "Towards a theory of innovation in services," Research Policy, Elsevier, vol. 15(4), pages 161-173, August.
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