Search Results (78)

Introduction and Objectives: Risk-sharing agreements (RSAs) have emerged as a key strategy for financing high-cost medical technologies while ensuring financial sustainability. These payment mechanisms mitigate clinical and financial uncertainties, optimizing pricing and reimbursement decisions. Despite their widespread adoption globally, Latin America has reported limited implementation, particularly for high-cost medical devices. This study aims to share insights from designing RSAs in the form of Outcome Protection Programs (OPPs) for medical devices in Latin America from the perspective of a medical devices company. Methods: The report follows a structured approach, defining key OPP dimensions: payment base, access criteria, pricing schemes, risk assessment, and performance incentives. Risks were categorized as financial, clinical, and operational. The framework applied principles from prior models, emphasizing negotiation, program design, implementation, and evaluation. A multidisciplinary task force analyzed patient needs, provider motivations, and payer constraints to ensure alignment with health system priorities. Results: Over two semesters, a panel of seven experts from the manufacturer designed n = 105 innovative payment programs implemented in Argentina (n = 7), Brazil (n = 7), Colombia (n = 75), Mexico (n = 9), Panama (n = 4), and Puerto Rico (n = 3). The programs targeted eight high-burden conditions, including Coronary Artery Disease, atrial fibrillation, Heart Failure, and post-implantation arrhythmias, among others. Private providers accounted for 80% of experiences. Challenges include clinical inertia and operational complexities, necessitating structured training and monitoring mechanisms. Conclusions: Outcome Protection Programs offer a viable and practical risk-sharing approach to financing high-cost medical devices in Latin America. Their implementation requires careful stakeholder alignment, clear eligibility criteria and endpoints, and robust monitoring frameworks. These findings contribute to the ongoing dialogue on sustainable healthcare financing, emphasizing the need for tailored approaches in resource-constrained settings. Full article

Supplier selection is one of the critical processes that entail multiple complex deliberations. The selection of an appropriate alternative supplier is a highly intricate process, primarily due to there being multiple criteria which are exceptionally subjective. This paper aims to develop a practical framework for choosing a suitable precast supplier by integrating the Value Engineering (VE) concept, Stepwise Weight Assessment Ratio Analysis (SWARA), and the Weighted Aggregated Sum Product Assessment (WASPAS) technique. This paper introduces a novel method to estimate the quality weights of alternative suppliers’ criteria (CQW) by linking factory capacity with the coefficients of the nine significant criteria, computed using principal component analysis (PCA). None of the formal studies make this link directly. The framework’s findings were validated by comparing its results with an expert assessment of five Saudi supplier alternatives. The results revealed that the framework’s results agree with the expert’s judgment. The method of payment criterion received the highest weight, indicating that it was considered the most important of the nine criteria identified. Combining PCA and VE with the WASPAS technique resulted in an unprecedentedly effective selection tool for precast suppliers. Full article

In the digital era, face recognition technology has emerged as a promising solution for enhancing payment system security and convenience. This systematic literature review examines face recognition advancements in payment security following the PRISMA framework. From 219 initially identified articles, we selected 10 studies meeting our technical criteria. The findings reveal significant progress in deep learning approaches, multimodal feature integration, and transformer-based architectures. Current trends emphasize multimodal systems combining RGB with IR and depth data for sophisticated attack detection. Critical challenges remain in cross-dataset generalization, evaluation standardization, computational efficiency, and combating advanced threats including deepfakes. This review identifies technical limitations and provides direction for developing robust facial recognition technologies for widespread payment adoption. Full article

Payment of people participating in research is a common practice in research. Research ethics guidelines often require additional scrutiny of payment practices and research practices more generally for groups identified as vulnerable, including people with disability. However, the existing guidelines are vague, and often conflict, meaning that it is difficult for researchers to determine what is appropriate in relation to the payment of participants in research. This situation is addressed in this paper, which provides a review of the existing research on the topic of payment of participants considered ‘vulnerable’ in research. We followed a systematic approach to our scoping review, thematically analysed the data identified and reported our results according to the PRISMA-ScR guide for scoping reviews. Fifteen papers met the inclusion criteria and were included in this review. Where studies included empirical findings, most studies were based in the US and Canada, with a small number from European, African, and Asian countries. The key ethical concepts identified in the papers were consent, justice, and reciprocity, which were positioned in relation to coercion and concerns about undue influence from payment. The papers consistently identified economic precarity as being a shared factor across the groups identified as vulnerable which placed them at risk of coercion in relation to payment. The papers also strongly identified context as being an important consideration in both mitigating and enhancing risks around the payment of participants. A framework for considering the payment of participants is offered which responds to the areas identified in the papers. It focuses on the research environment, research situation, participant group, risks and benefits of the research, individual context, relational context, and research practices. This framework is provided as a resource for researchers considering the payment of people with disability in research, and those identified as vulnerable in research more broadly. Full article

This study explores how system-based and cognitive-based factors affect platform trust and its role in the actual use of PayLater services (buy now, pay later or BNPL) in Indonesia and Malaysia. PayLater, a fintech innovation, provides fast and convenient payment options through online platforms. By incorporating platform trust into the technology acceptance model (TAM), the research investigates whether borrowing intention acts as a mediator between platform trust and actual usage. Utilizing a quantitative approach with purposive sampling, data were gathered from 106 respondents in Indonesia and 169 in Malaysia, with 62 and 85 respondents meeting the criteria, respectively. Partial least squares (PLS) analysis indicates notable differences in how Indonesian and Malaysian users perceive platform trust, while the effect of platform trust on borrowing intention remains consistent across both nations. Borrowing intention emerges as a crucial factor influencing the actual use of PayLater services. The results offer important insights into the adoption of fintech services in emerging markets, highlighting the significance of platform trust in shaping user behavior. This research provides practical suggestions for fintech providers to improve platform trust and user engagement in cross-country scenarios. Full article

This paper aims to define a model for measuring the localness of a company in an innovative and reliable way, motivated by the growing consumer interest in purchasing local products and supporting local economies. The proposed Expenses Localness Indicators (ELI) model uses existing data from information systems to define Localness Indicators, and incorporates Localness Levels based on geographic and economic criteria. It can be applied to any type of financial entity and overcomes the difficulty of defining localness in e-commerce companies or digital businesses in general. Previous studies have examined the impact of localness and investigated its effectiveness as a branding strategy for managers, mainly through product traceability. The ELI model uses as data the expenses of a company paid to other financial entities. The Expenses Localness Indicators are determined based on the distribution of these payments combined with the localness of the paid financial entities. These Indicators represent the degree of localness as a percentage, ranging from 0% (non-local) to 100% (fully local), and may vary over time. The results of the presented examples indicate that a company’s localness increases as it spends more of its expenses on local financial entities and vice versa. Specific strategies have been tested using synthetic data that demonstrate the correct functioning of the model’s indicators. The ELI model could be used to provide reliable and certifiable information to consumers who want to know where their money goes when they buy products. Implementing the proposed model on a large scale would require acceptance by as many companies and states as possible. However, by making the necessary adjustments, the model could be applied on a smaller scale, supported by consumers and local governments interested in uncovering knowledge about localness. It could also be established as a valid indicator of localness to provide information that researchers, government agencies and professionals can use to promote local entrepreneurship. Full article

Mobility-as-a-service (MaaS) apps provide a single platform for journey planning, booking, payment and ticketing, and are proposed as a medium for encouraging sustainable travel behaviour. Generating sustainable-vehicle-based journey alternatives can be formulated as a multi-modal multi-objective journey-planning problem, one that is known to have a prohibitively large solution space. Building on prior insights, we develop a scalable decomposition-based solution strategy. A Pareto set of journey profiles is generated based on inter-transfer-zone objective criteria contributions. Then, guided by neural-network predictions, extended versions of existing shortest-path algorithms for open and public transport networks are used to optimise the paths and transfers of journey profiles. A novel hybrid k-means and Dijkstra’s algorithm is introduced for generating transfer-zone samples while accounting for transport network connectivity. The resulting modularised algorithm knits together and extends the most effective existing shortest-path algorithms using neural networks as a look-ahead mechanism. In experiments based on a large-scale transport network, query response times are shown to be suitable for real-time applications and are found to be independent of transfer-zone sample size, despite smaller transfer-zone samples, leading to higher quality and more diverse Pareto sets of journeys: a win-win scenario. Full article

One of the main challenges faced by many rural areas is the presence of natural constraints, such as climatic conditions, steep slopes, and poor soil quality, which make agricultural production and activities more difficult and costly. In these areas, there is a significant risk of agricultural land abandonment, leading to potential losses in biodiversity, degradation of rural landscapes, desertification, and increased forest fire risk. The Common Agricultural Policy (CAP) aims to mitigate these risks through specific payment schemes provided to areas facing natural and other specific constraints. In this context, mapping and measuring territorial differentiation is essential for informing policy responses. At the end of the previous CAP programming period, the EU updated its classification of Less Favored Areas (LFAs), experimenting with a flexible approach based on common biophysical criteria (definitions and thresholds) and methodological guidelines to delineate territorial differentiations that are both locally relevant and comparable across member states. This contribution presents a review of the current state of data and spatial inference systems used in Italy to delineate biophysical limitations and assess the presence of factors that may help offset the impact of natural constraints. This process has supported the analysis of territorial differentiation and highlighted the related implications for agricultural entrepreneurs operating in diverse contexts. Full article

Adopting advanced e-commerce practices is essential for enhancing user engagement and business performance, particularly in tourism. This study evaluates the e-commerce adoption of Kazakhstan’s tourism websites using an innovative Integrated Multi-Criteria Decision Analysis (IMCDA) methodology. Traditional evaluation methods overlook the interplay between website functionality, user experience, and strategic objectives. To address this gap, the IMCDA framework integrates qualitative and quantitative approaches by combining advanced Multi-Criteria Decision-Making (MCDM) techniques, including SPOTIS, ESP-COMET, RANCOM, and SITW, with content analysis and logistic regression. The study assessed 77 tourism websites, categorized into Online Travel Agencies (OTAs), Official Tourism Websites (OTWs), and Attraction Websites (AWs), based on 34 e-commerce features grouped into dimensions such as product information, functionality, reservations, payment systems, and customer relationship management (CRM). The findings reveal that OTAs significantly outperform OTWs and AWs in most dimensions, especially in online booking and CRM functionalities. At the same time, AWs lag in key e-commerce features like reservations and payment systems. This research highlights critical gaps in Kazakhstan’s tourism e-commerce ecosystem. It provides actionable recommendations, including enhancing CRM tools, integrating advanced booking systems, and leveraging collaborations with local financial technology providers like Kaspi Pay. The IMCDA framework offers a robust, adaptable evaluation model with practical implications for digital transformation and competitiveness in the tourism industry. This study contributes to advancing digital maturity in Kazakhstan’s tourism sector by addressing these gaps. It sets the foundation for future research to explore innovative strategies in e-commerce adoption across various regions and industries. Full article

The advent of advanced molecular diagnostic techniques has revealed plenty of information about signaling pathways and gene regulation in cancer, as well as new inputs for the classification of cancer subtypes, diagnosis, prognosis, and prediction of response to therapy. However, in most cases we do not have single biomarkers yet and, therefore, the final diagnosis is often rendered by the combination of multiple results by means of complex algorithms, eventually leading to an increase in their costs. The problem of the costs of such tests is particularly relevant in the case of thyroid cancer (TC), because of the observed increase in the number of patients affected by thyroid nodules (TN)s, in what is considered a global pandemic. High-income countries can afford the cost of the advanced molecular tests for such a multitude of TNs, since they are covered by private insurances. People living in upper-middle, lower-middle, and especially in low-income countries, where the costs for these advanced molecular tests are supported by general taxation and out-of-pocket payments, are exposed as a personal financial burden. Immunohistochemistry in cancer management represents an extremely cost-effective method in different clinical scenarios. In the preoperative recognition of TC, the use of such method, based on Galectin-3 and others protein markers, such as HMBE1, proved to be effective in diagnosing TC in TNs indeterminate at conventional cytology (Bethesda classification III or IV), with an extremely low cost. Moreover, Galectin-3 fulfills one of the major criteria of an ideal marker, being involved in the thyroid cell transformation. Despite this evidence, Galectin-3 ThyroTest is not considered and not even mentioned in many reviews, focused on the appropriate identification of TC, as well as in studies where the cost-effectiveness of the different approaches is comparatively evaluated. The aim of this review is to emphasize the value of the Galectin-3 based immunohistochemistry as a cheap and “good enough” method in the preoperative diagnosis of TC especially in, but not limited to, low-middle income countries. Full article

High-income countries like Aotearoa New Zealand are grappling with inequitable access to healthcare services. Out-of-pocket payments can lead to the reduced use of appropriate healthcare services, poorer health outcomes, and catastrophic health expenses. To advance our knowledge, this systematic review asks, “What interventions aim to reduce cost barriers for health users when accessing primary healthcare in high-income countries?” The search strategy comprised three bibliographic databases (Dimensions, Embase, and Medline Web of Science). Two authors selected studies for inclusion; discrepancies were resolved by a third reviewer. All articles published in English from 2000 to May 2022 and that reported on outcomes of interventions that aimed to reduce cost barriers for health users to access primary healthcare in high-income countries were eligible for inclusion. Two blinded authors independently assessed article quality using the Critical Appraisal Skills Program. Relevant data were extracted and analyzed in a narrative synthesis. Forty-three publications involving 18,861,890 participants and 6831 practices (or physicians) met the inclusion criteria. Interventions reported in the literature included removing out-of-pocket costs, implementing nonprofit organizations and community programs, additional workforce, and alternative payment methods. Interventions that involved eliminating or reducing out-of-pocket costs substantially increased healthcare utilization. Where reported, initiatives generally found financial savings at the system level. Health system initiatives generally, but not consistently, were associated with improved access to healthcare services. Full article

The South African preferential procurement policy emerged from the demand for transparency, fair competition, value-for-money, standardised and benchmark pricing, and regulation of public procurement arrangements in the construction industry. The policy aims to address historical inequalities, support economic growth, and foster sustainable development. The effectiveness of the preferential procurement policy in South Africa is affected by the inhibiting factors of its implementation system. Given this, this study assesses the factors inhibiting preferential procurement policy implementation in the South African construction industry. This study reviewed the extant literature from online databases as a secondary data source to identify and understand the factors inhibiting procurement policy implementation. A quantitative research design using a closed-ended survey questionnaire surveyed 31 identified inhibiting factors affecting procurement policy implementation from the literature review. One hundred sixty-seven (167) questionnaires were retrieved from two hundred (200) distributed, representing an 83.5 per cent response rate, distributed through Google Forms to the respondents in Northwest Province, South Africa. The reliability of the data collection instrument was determined using Bartlett’s sphericity, Cronbach’s alpha, and Kaiser–Meyer–Olkin tests. The exploratory factor analysis findings established eight components from the 31 identified inhibiting factors affecting procurement policy implementation, which are the absence of due diligence in procurement screening, corruption and political interference in procurement systems, an ineffective regulatory framework supporting public procurement policy, discrepancies in award of contracts and the absence of dispute resolution, ambiguity in procurement selection criteria, poor enforcement mechanisms, cost discrepancies in advance payment, and excessive bureaucracy in procurement documentation. This study’s practical implications provide an understanding of establishing and prioritising procurement selection criteria, such as project requalification requirements, cost performance requirements, technology integration in the prequalification process, and contract change order requirements, which would improve procurement systems in the South African construction industry. Full article

The paper investigates and assesses the contract selection procedure used in Kuwait’s construction sector. The ideas and insights of engineers involved in significant Kuwaiti construction projects will be extensively considered. In the Kuwaiti building sector, various ways of choosing the contract form will be discussed. In order to gather pertinent data about the country’s primary construction projects, questionnaires will be used. This methodology ensures a first-hand account of the challenges and preferences within the industry. This data will be analyzed to determine the best ways to enhance the current system utilized for Kuwaiti building contracts for the choice of contract forms and payment terms that could benefit from the inclusion of measures to guarantee those types of task delivery systems and payment terms in the country’s future construction projects. This paper explores the typical contract types and payment mechanisms used in Kuwait, drawing on a thorough analysis of current literature, governmental regulations, and business practices. The Standard Forms of Contract, which offer fixed-priced payments, have become the most popular option. However, when used for extensive and technically challenging projects, this contract form’s simplicity presents difficulties. Additionally, the existing system encourages contract awards based on the lowest tender, which raises questions regarding appropriateness and proportionality. The study suggests an arsenal of criteria for improving the deal selection process, with an emphasis on diverse terms of payment inside the task delivery system, in order to allay these worries. It highlights the need for a more comprehensive approach for deal selection that takes project complexity, financial constraints, and long-term project interest into account. The proposed criteria additionally include adaptability to project complexity, ensuring flexibility for challenges in large projects. Financial considerations, aligning with budgetary requirements, are crucial. The emphasis is on long-term project success, and finding a balance between simplicity and adaptability in contracts is key. These comprehensive criteria aim to improve decision-making in selecting standard contract forms for construction projects, addressing challenges in large, technically demanding endeavors in Kuwait. This research contributes to the field by introducing a novel set of criteria for contract selection, tailored to the Kuwaiti construction context. The study’s originality lies in its approach to addressing the challenges posed by current practices and its focus on refining the system for future projects. Additionally, the study employs a rigorous questionnaire survey to extract firsthand insights from industry professionals, ensuring a robust and contextually relevant exploration of the contract selection landscape in Kuwait’s construction sector. Full article

Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration. Full article

Blockchain technology has become significant for financial sectors, especially digital payment systems, offering enhanced security, transparency, and efficiency. However, there is limited research on the factors influencing user trust in and acceptance of blockchain adoption in digital payment systems. This systematic review provides insight into the key factors impacting consumers’ perceptions and behaviours towards embracing blockchain technology. A total of 1859 studies were collected, with 48 meeting the criteria for comprehensive analysis. The results showed that security, privacy, transparency, and regulation are the most significant factors influencing trust for blockchain adoption. The most influential factors identified in the Unified Theory of Acceptance and Use of Technology (UTAUT) model include performance expectancy, effort expectancy, social influence, and facilitating conditions. Incorporating a trust and acceptance model could be a viable approach to tackling obstacles and ensuring the successful integration of blockchain technology into digital payment systems. Understanding these factors is crucial for creating a favourable atmosphere for adopting blockchain technology in digital payments. User-perspective research on blockchain adoption in digital payment systems is still insufficient, and this aspect still requires further investigation. Blockchain adoption in digital payment systems has not been sufficiently conducted from the user’s perspective, and there is a scope for it to be carried out. This review aims to shed light on the factors of trust in and acceptance of blockchain adoption in digital payment systems so that the full potential of blockchain technology can be realised. Understanding these factors and their intricate connections is imperative in fostering a conducive environment for the widespread acceptance of blockchain technology in digital payments. Full article