Search Results (73)

The analysis of household health financing vulnerability and its impact on health service utilization during the COVID-19 pandemic remains inadequately explored in Kenya. This study was designed to examine the impact of health financing vulnerability on health services utilization during the COVID-19 period. A health financing vulnerability index (HFVI) was constructed to assess the financial risk that individuals faced in accessing essential health services. A pooled panel probit model was estimated to measure the effect of HFVI on service uptake. The study found a significant negative association between HFVI and health service utilization, indicating that a high level of health financing vulnerability is linked to poor health in periods of emergencies. To address this issue, the study recommends implementation of multiple policy measures during crisis periods, including enhancing social health insurance, providing financial support to vulnerable households, and increasing public expenditure on primary healthcare systems across counties, especially on drugs, referral logistics, personnel, medical equipment, and diagnostic technologies. Full article

This study evaluates the competitiveness and sustainable development prospects of French-speaking African countries by constructing a comprehensive framework integrating the TOPSIS method and adaptive LASSO algorithm. Using multivariate data from sources such as the World Bank, 30 indicators covering core, basic, and auxiliary competitiveness were selected to quantitatively analyze the competitiveness of 26 French-speaking African countries. Results show that their comprehensive competitiveness exhibits spatial patterns of “high in the north and south, low in the east and west” and “high in coastal areas, low in inland areas”. Algeria, Morocco, and six other countries demonstrate high competitiveness, while Central African countries generally show low competitiveness. The adaptive LASSO algorithm identifies three key influencing factors, including the proportion of R&D expenditure to GDP, high-tech exports, and total reserves, as well as five secondary key factors, including the number of patent applications and total number of domestic listed companies, revealing that scientific and technological investment, financial strength, and innovation transformation capabilities are core constraints. Based on these findings, sustainable development strategies are proposed, such as strengthening scientific and technological research and development and innovation transformation, optimizing financial reserves and capital markets, and promoting China–Africa collaborative cooperation, providing decision-making references for competitiveness improvement and regional cooperation of French-speaking African countries under the background of the “Belt and Road Initiative”. Full article

This study conducts a comprehensive systematic review of the economic impact of Digital Twin (DT) technology within the Architecture, Engineering, and Construction (AEC) industry, following the PRISMA methodology. While DT adoption has been accelerated by advancements in Building Information Modelling (BIM), the Internet of Things (IoT), and data analytics, significant challenges persist—most notably, high initial investment costs and integration complexities. Synthesising the literature from 2016 onwards, this review identifies sector-specific barriers, regulatory burdens, and a lack of standardisation as key factors constituting DT implementation costs. Despite these hurdles, DTs demonstrate strong potential for enhancing construction productivity, optimising lifecycle asset management, and enabling predictive maintenance, ultimately reducing operational expenditures and improving long-term financial performance. Case studies reveal cost efficiencies achieved through DTs in modular construction, energy optimisation, and infrastructure management. However, limited financial resources and digital skills continue to constrain the uptake across the sector, with various extents of impact. This paper calls for the development of unified standards, innovative public–private funding mechanisms, and strategic collaborations to unlock and utilise DTs’ full economic value. It also recommends that future research explore theoretical frameworks addressing governance, data infrastructure, and digital equity—particularly through conceptualising DT-related data as public assets or collective goods in the context of smart cities and networked infrastructure systems. Full article

The integration of financial technology expenditures and green total factor productivity (GTFP) constitutes a critical impetus for sustainable economic advancement. This study employs provincial panel data from China (2012–2020) and uses the SBM model with undesirable outputs, the PVAR model, moderation effect analysis, and threshold regression to investigate the underlying mechanisms and threshold effects of financial technology expenditure on GTFP. The results show that (1) financial technology expenditure has a significant promoting effect on the growth of GTFP, with a coefficient of 0.614 (p < 0.05), indicating the need for further increases in fiscal investment in science and technology; (2) the effect of financial technology expenditure on GTFP varies across the eastern, central, and western regions of China, with stronger effects observed in the eastern region, suggesting that the government should formulate differentiated financial technology expenditure policies on the basis of local conditions; and (3) that educational investment and industrial upgrading play strong moderating roles in the impact of financial technology expenditure on GTFP, with interaction term coefficients of 0.059 (p < 0.05) and 0.206 (p < 0.1), respectively. Threshold analysis further reveals that the positive effect strengthens significantly once educational investment surpasses a log value of 9.3674 and industrial upgrading exceeds a ratio of 0.0814. However, currently, China’s education investment and industrial structure upgrading are still insufficient, necessitating further increases in education investment and promoting the transformation and upgrading of the industrial structure. Full article

Background/Objectives: European healthcare systems are increasingly adopting automation technologies to improve efficiency. This study evaluates the economic viability of hospital automation and medication management digitalization. Methods: An economic evaluation was based on a standardized hospital model comprising 561 beds, representative of an average acute care hospital across EU27 + UK. For each technology, several cost items were estimated using country-specific parameters such as labor costs, medication error rates, healthcare expenditure, and money discount rate. The financial metrics (Return On Investment—ROI, Net Present Value—NPV, Payback Time—PBT) were first calculated at the hospital level. These results were then extrapolated to the national level by scaling the per-hospital estimates according to the total number of hospital beds reported in each country. Finally, national results were aggregated to derive the overall European impact. Results: The analysis estimated a total European investment of EUR 3.55 billion, with an average PBT of 4.46 years and annual savings of 1,96 billion. ROI averaged 167%, and the total NPV was 8.21 billion. A major saving driver was the reduction in Medication Administration Errors that has an impact of 37.2% on the total savings. Payback times ranged from 3 years in high-GDP countries, to 7 years in lower-GDP nations. Conclusions: These findings demonstrate how providing structured data on hospital automation benefits could support decision-making processes, highlighting the organizational and economic feasibility of the investment across different European national contexts. Full article

The private healthcare sector in Romania, led by prominent players such as Medlife, Regina Maria, Medicover and Sanador, has become a cornerstone of the country’s healthcare system. However, achieving sustainability in this sector remains a challenge. This study evaluates sustainability practices in Romania’s private medical sector using the Triple Bottom Line (TBL) framework, comparing them to those of the EU, USA and Japan. Using statistical methods and benchmarking, we identify correlations between healthcare expenditures, financing schemes and sustainability metrics. A bibliographic review highlights global trends in sustainable healthcare management, including environmental, social and economic strategies and provides insights into the cost-effectiveness of green initiatives. Special focus is given to the role of technology in driving sustainability through innovations in telemedicine, digital health records and operational optimization. Using statistical methods (Pearson and Spearman correlation coefficients), we have performed an analysis of health expenditure data for EU countries, the USA and Japan. The dataset was extracted from the Organisation for Economic Co-operation and Development (OECD) data portal and included various health expenditure indicators, financing schemes and administrative data for all EU countries, the USA and Japan for the period 2018–2023. We have performed a structured analysis that explores correlations between these indicators, with a focus on financial schemes, expenditures and management sustainability. The analysis shows strong correlations between healthcare expenditures, financing schemes and administrative costs. Countries with efficient governance, balanced financing and proactive population health strategies (e.g., Japan and Nordic countries) demonstrate better management sustainability. However, countries like the USA and Eastern EU nations face challenges due to high administrative costs and inefficient financing models, respectively. Addressing these issues is critical to sustaining healthcare systems in the long term. The findings reveal that while Romanian providers excel in patient satisfaction and technological innovation, they lag behind their European counterparts in environmental sustainability and equitable access. Recommendations are proposed to address these gaps, drawing on successful strategies implemented in other European healthcare systems. This study fills a gap in the literature by providing a structured analysis of sustainability practices in Romania’s private healthcare sector, contextualized within a global comparative framework. Full article

Financial support for agriculture has mainly focused on grain production, while insufficient efforts have been made to ensure water security, potentially intensifying water pressure in grain production (WPGP). This study applies the entropy weight Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method to measure WPGP from the perspective of sustainable agricultural water use, investigating the impact of agricultural fiscal expenditure on WPGP. Our findings reveal several key points. First, there is a clear linkage between the spatial and temporal patterns of fiscal support and WPGP. Projections indicate that water pressure for grain production in China will continue to rise from 2019 to 2030, with the fastest increases in the Northeast and Huang-Huai-Hai regions, at 20.53% and 13.39%, respectively. Second, agricultural fiscal expenditure distorts the allocation of grain production factors, causing cultivation areas to expand beyond local water resource capacity and, thus, exacerbating WPGP. This effect exhibits a time lag due to the gradual nature of factor allocation. Further analysis shows that in non-major grain-producing regions, lower production efficiency and higher opportunity costs of factor use weaken the impact of fiscal expenditure on WPGP compared to major grain-producing regions. Third, in regions with advanced technical conditions for grain production, the negative impact of agricultural fiscal expenditure on WPGP is mitigated by higher irrigation technology levels, improved water allocation efficiency, and lower water demand per unit of grain. Fourth, the public good characteristics of water resources and water conservancy facilities—namely, strong externalities and non-exclusivity—along with the agronomic demonstration effect, lead to a spatial spillover effect of agricultural fiscal expenditure on WPGP. Full article

The transformation from traditional financial methods to the adoption of new financial technologies is a key challenge for micro and small business enterprises in ensuring sustainability. Therefore, the purpose of this study is to identify the key factors of financial literacy and examining their significance in adoption of FinTech by MSEs in Odisha that leads to sustainability of the firm. The study has been conducted using the MCDM technique integrating grey Delphi for relevant factor identification and Fuzzy AHP for prioritizing the factors of financial literacy. In total, 33 financial literacy factors were initially identified through extensive literature review, which were reduced to 18 factors using grey Delphi. Further, these factors were prioritized on the level of their significance towards FinTech adoption, using fuzzy AHP. The results of the study highlighted that financial knowledge holds greater significance among all four criteria of financial literacy, i.e., financial knowledge, financial behaviour, financial attitude, and financial training, towards adoption of FinTech ensuring sustainability in MSEs. The prioritization of the factors further revealed that knowledge of current products and services, evaluation of FinTech products, expenditure behaviour, assurance for the future security, and financial education have the most significant impact on the adoption of FinTech services by entrepreneurs. The study is innovative as it shows the importance of financial literacy factors in influencing the adoption of FinTech by micro and small businesses, which helps in ensuring firms’ sustainability. The results of the study have come up with some key factors, which need to be considered at priority basis if an MSE is willing to adopt FinTech services for its operations to ensure sustainable practices. Full article

Air pollution imposes a substantial economic burden globally, with estimated annual losses exceeding $8.1 trillion due to healthcare costs, lost productivity, infrastructure degradation, and agricultural damage. This review assesses the economic effectiveness of advanced air pollution control technologies within the broader context of sustainable energy transitions. Through comparative life-cycle cost-benefit analyses, we evaluate the financial viability, energy efficiency, and policy relevance of innovations such as carbon capture and storage (CCS), AI-driven emissions monitoring, and nanotechnology-enhanced filtration. Among the technologies assessed, CCS presents the most significant capital expenditure (up to $500 million per facility) but offers long-term returns through carbon credits and enhanced oil recovery, yielding up to $30–40 in economic benefits for every $1 invested. AI-based monitoring systems demonstrate strong economic efficiency by reducing energy consumption in industrial operations by up to 15% and improving regulatory compliance at a larger scale. Nanotechnology-enabled filters provide high pollutant capture efficiency and reduce operational resistance, yet face scalability and end-of-life challenges. Additionally, emerging technologies such as bioengineered filters offer promise for low-resource settings but require further economic validation. The integration of these technologies with renewable energy systems, such as hydrogen-powered pollution control units and solar-driven filtration, further amplifies their environmental and economic benefits. By aligning air pollution mitigation with climate and energy goals, this review highlights a pathway for policymakers and industries to achieve both economic resilience and environmental sustainability. The findings underscore that, while upfront costs may be high, strategic investments in advanced pollution control deliver substantial long-term returns across sectors. Full article

As an essential component of China’s comprehensive transportation network, freeways play an irreplaceable role in promoting regional economic integration, improving logistics efficiency, and serving public travel. However, the development of freeways faces challenges such as the underutilization of road resources, significant financial pressure for construction and maintenance, and imbalanced revenue and expenditure leading to heavy debt burdens, which severely impact the sustainable development of freeways. Optimizing freeway toll rates is an effective measure to alleviate these issues, playing a crucial role in enhancing the operational efficiency of the road network and increasing the revenue of freeway operating enterprises. Existing studies have focused on finding the optimal toll rates for freeways based on bi-level programming models, neglecting the dynamic relationships among individual travel behavior preferences, toll rates, travel demand, and toll revenue. Grounded in bounded rationality theory, the research employs microscopic traffic simulation technology to analyze the dynamic relationships among freeway toll rates, travel demand, and toll revenue. The results confirm that travel demand decreases as toll rates increase, while toll revenue exhibits asymmetric “synchronization” and “asynchronization” phases, peaking at CYN 58.9 thousand (USD 8246) when the toll rate reaches CYN 0.45/km (USD 0.06/km). Additionally, users’ rationality levels significantly affect the stabilization time of toll revenue, and the speed difference between freeways and parallel roads demonstrates a threshold effect on travel demand and revenue. These findings provide theoretical and technical support for optimizing freeway toll strategies, enhancing operational efficiency, and promoting sustainable transportation development. Full article

Objectives: The transformation of healthcare systems during crises, particularly demonstrated during the COVID-19 pandemic, emphasizes the urgent need for effective research methodologies to evaluate digital healthcare innovations. These methodologies are essential in addressing the rapid shift in healthcare service delivery modalities, responding to unprecedented challenges that have revealed both opportunities and barriers within the digital ecosystem. Methods: For this review, research was carried out on the Medline/PubMed, Scopus, and Google Scholar databases to locate articles published from 2015 to 2024, using the search terms digital health, digital technologies, management implications, and digital platforms. The inclusion criteria referred to studies that were directly related to the topic, available in the English language, and published in peer-reviewed scientific journals. The exclusion parameters were as follows: (a) articles not relevant to the topic as defined in the purpose of the review, (b) systematic reviews and meta-analyses, and (c) articles published in a language other than English. Results: Key findings indicate that, while digital health technologies have the potential to mitigate healthcare disparities, they often exacerbate existing inequities, especially among vulnerable populations lacking consistent access to technology. Furthermore, the shift towards digital platforms has revealed significant gaps in workforce training and support, which are essential for effective implementation. Conclusions: This review underscores the financial implications, with expenditures rising significantly due to the increased use of digital services, reflecting a broader trend noted in studies of related health conditions. Moreover, discussions on public health governance suggest a critical need for democratic frameworks to support such digital transformations effectively. Full article

Entrepreneurship is crucial in promoting innovation, job creation, and poverty alleviation, particularly in developing economies. This study adopts a mixed-methods approach, using quantitative and qualitative analysis to examine macroeconomic factors’ impact on entrepreneurial activity. The quantitative analysis utilises fully modified least squares and dynamic ordinary least squares to estimate long-run relationships, while the qualitative component applies thematic analysis to assess the role of school-based gardening initiatives in promoting students’ economic participation. Our findings indicate that government expenditure on education significantly enhances entrepreneurship, whereas access to credit remains ineffective, suggesting persistent barriers in financial intermediation. Labour force participation shows a positive relationship with entrepreneurship, supporting the idea that a more engaged labour force promotes business creation. The findings also show a negative impact of regulatory quality on entrepreneurship, stressing the need for regulatory reforms to reduce entry barriers. While technology adoption has a delayed effect, long-term investments in digital infrastructure are recommended. At the micro-level, school-based entrepreneurship programs, such as vegetable gardening, cultivate entrepreneurial skills, though sustainability depends on consistent support and resources. Based on these findings, this study suggests the need to enhance education, improve access to finance, and streamline regulatory frameworks to promote entrepreneurship. Full article

India is committed to becoming a net-zero emitter by 2070 to fight climate change; however, road transportation causes a major challenge for decarbonising transport in India. This paper investigates the low-carbon strategy and implementation of fiscal and financial policies in India. The research delves into the innovative strategies to address unique regional hurdles and transportation demands. These strategies include customised policies to incentivise EVs, creating charging infrastructure networks, the integration of renewable energy sources in public transport systems, and the formulation of specific regulations to curb emissions from high-traffic areas. Findings from the review of low-carbon strategies and financial policies in road transportation advocate for penalising high-emitters, subsidising clean technology, and reorienting government expenditure towards sustainable infrastructure for combating climate change and adhering to India’s commitment announced at COP26. This paper suggests the efficacy and replicability of these new strategies, thus, providing valuable insights to policymakers and stakeholders for creating a more sustainable and efficient road transportation network in India. Full article

Based on panel data from 30 provinces in China from 2000 to 2023, this study examines the relationship between knowledge complexity and carbon lock-in. The results indicate that an increase in knowledge complexity alleviates carbon lock-in. Heterogeneity results show that the mitigating effect of knowledge complexity on carbon lock-in is more pronounced in eastern China, areas south of the Qinling–Huaihe River, regions with higher levels of infrastructure construction, lower proportion of state-owned enterprises, areas with higher government financial science and technology expenditures. In terms of the mechanisms, knowledge complexity primarily suppresses carbon lock-in through optimization of factor allocation, enhancement of efficiency levels, and upgrading of industrial structures. Further investigations reveal that knowledge complexity exhibits a significant spatial spillover effect on carbon lock-in. Full article

Lack of digitization in data sharing between enterprises and inspection solutions suppliers negatively affects cash flows between parties, which results in late payments that negatively affect the adoption of automatic inspection equipment. This paper contributes to improving the implementation of a new Inspection as a Service Business Model for deploying automatic inspection solutions using non-destructive inspection solutions, and to enhance workflows by integrating Blockchain and Smart Contracts. The Inspection as a Service offers flexible, cloud-based, or on-premise inspection solutions through the Marketplace, reducing upfront costs with a recurring service fee and automated payments. The marketplace platform supports automatic payment processes and facilitates industry adoption of IaaS solutions. The digital ecosystem offers improved capital expenditure and payback periods. It enhances communication, collaboration, data sharing, and payment processes through a subscription model. The case study demonstrates that the IaaS Business Model (on-premise or cloud) improves the economic feasibility of automatic non-destructive inspection solutions by lowering initial investments and enhancing return on investment and payback periods, even with higher operating costs. The analysis confirms the profitability and sustainability of IaaS Business Model over traditional one-fee selling by emphasizing its potential to improve operational performance and sustainability in manufacturing. The current proposal of automatic non-destructive solutions implements a new revenue model based on pay-per-use or volume, which makes it more financially viable to adopt this technology in industry. Full article