Most developed countries generate more CO2 emissions for their imports than they generate to produce exports, while most developing countries generate more CO2 emissions to produce exports than they generate foreign emissions to produce their imports. Most developed countries ‘import’ CO2 emissions in net terms, while most developing countries ‘export’ CO2 emissions in net terms. There has been a negative cross-country correlation between net CO2 emission transfers and per-capita income.

Two interpretations exist. On one side, the emission transfers between the developed and developing economies may stem from the shift of CO2-intensive production from the developed to the developing economies. On the other side, the size and direction of international emission transfers may also be determined by international technology differences: in the presence of technology differences, the exchange of identical products of similar monetary value would imply emission transfers. This dissertation uses Environmentally-Extended Multi-Regional Input-Output (EE MRIO) analysis to study the international emission transfers and regression analysis to assess whether the economy-emission decoupling observed in developed countries is indeed valid.

Additionally, there arises a need to explore specific mechanisms to address the increase in CO2 emissions. Carbon tax represents one such mechanism. A carbon tax generates revenue and creates incentives for behavioral changes among both producers and consumers. However, in the short run, a carbon tax leads to price increases and disproportionately affects poor households. This dissertation combines EE MRIO and microsimulation analysis to analyze the distributional impacts of carbon tax reform.@en

Palladium is a critical raw material that is considered economically and strategically important by various national governments. The palladium supply chain is subject to several supply chain risks, including the geopolitical risk of potential Russian palladium export restrictions. Considering these disruption risks, it is essential to gain insight into the resilience of the palladium supply chain. Accordingly, this study investigates the temporal dynamics of resilience in the palladium supply chain using literature review, data analysis, and regression modelling. To that end, the diversity of supply, stockpiling, price, and substitution mechanisms from the qualitative resilience framework by Sprecher et al. (2015) are operationalised in terms of quantitative proxy variables. A PCA-weighted compound resilience index is constructed and quantitatively validated using the palladium market balance as a resilience performance indicator. It is found that the palladium supply chain exhibited an overall improvement of resilience, but still a structural lack of resilience during the years 2012-2021. This thesis contributes to the scientific study of how material criticality and resilience change over time. Moreover, this study informs policy-makers about potential risks for the palladium supply chain and makes policy recommendations to improve the resilience of the palladium supply chain.

In the current environmental conditions, with the rise of sustainable finance concepts like Environmental, Societal and Governance (ESG), firms in the financial sector have found new ways to drive sustainable change. Banks in particular play a key role in promoting sustainable practices both within their organization and also have a significant effect on the global economy. However, banks have had difficulties integrating ESG practices in their sustainable credit distribution products to corporate clients.
Due to the qualitative nature of ESG data, even with the involvement of regulatory bodies, there are no established standardized processes for ESG integration. Literature exhibits a clear knowledge gap on the utilization of ESG data in the credit risk assessment process. Furthermore, the primary barriers faced during this process have been attributed to comparability, materiality, accuracy, and reliability of ESG data quality with the lack of comparability having the most significant impact. Hence, based on the knowledge gap identified, the following main research questions were formed:
“How can banks in the EU effectively utilize corporate ESG data during the sustainable corporate financing process?”
By fusing a thorough literature review and 11 interviews of professionals from the banking industry, consultancies, and asset management companies, a process flow diagram was mapped highlighting the different phases of the sustainable corporate financing process. The main phases were comprised of: Opportunity, Due diligence, Determining need for ESG data, Sourcing ESG data, Corporate Sustainability Assessment, Setting KPI’s and Decision. Furthermore, during this process the primary barriers were classified as Data Quality Barriers (Lack of Materiality, Lack of Accuracy, Lack of Comparability and Lack of Reliability) and Integration Challenges (Lack of Data, Sourcing Data, Quantification of Data). Given the relevance of the comparability barrier, its effects were studied in more detail and was followed by proposing a conceptual framework bolstered by stakeholder theory, legitimacy theory and institutional theory to solve the barrier of Lack of Comparability. The relevant dependent variables in this framework were identified as: Data Harmonization Initiatives, Standardization Efforts, Industry Collaboration, Regulatory Interventions/Compliance and Client Engagements. As directed by the conceptual framework, banks were recommended to adopt the dependent variables Data Harmonization Initiatives, Standardization Efforts and Industry Collaboration and were further advised to help clients adhere to compliance. Furthermore, stakeholders' motivation and regulatory incentives were highlighted as key determiners in addressing the barrier. A processual validity approach was adopted to ensure validity throughout the research process which additionally consisted of validating the generated process flow and conceptual framework by relevant experts.
The outcomes of the explorative research showcased the intricacies in the sustainability credit risk assessment and the stakeholders involved while highlighting the interrelation between the barriers identified. Though the lack of a comparability conceptual framework was proposed to be a barrier with significant effects, during the interview analysis it was revealed that the advent of the Corporate Sustainability Reporting Directive (CSRD) would have a significant effect on this barrier and that challenges like sourcing ESG data and lack of ESG data would be more relevant in a few years. Although the conceptual framework accounted for this, some of the limitations in this research study were the inability to recruit more interviewees and also the inability to gather interview data from an external data provider to retrieve a true holistic approach. For future research, studies are recommended to research the effects of the implementation of CSRD and to study the state of other pressing barriers.

As the world's third-largest emitter of greenhouse gases, India stands at a crucial juncture in the global fight against climate change. Recognising the delicate balance India must strike between rapid economic growth and sustainable development, this research employs a Computable General Equilibrium (CGE) model tailored specifically for the nation. By incorporating Greenhouse Gas (GHG) emissions, the model delivers an in-depth analysis of the potential economic impacts of climate mitigation strategies, especially carbon taxation, within the intricate fabric of India's diverse economy. This endeavour fills a significant knowledge gap, offering a tool that policy analysts can use to harmonise India's developmental aspirations with its global climate commitments.
Tapping into the power of quantitative methodologies, the study leverages CGE models known for their proficiency in capturing a country's economic interconnections. For India, this model weaves in GHG emissions to holistically assess the economic ramifications of carbon taxation. Core to this research is data sourced from India's Social Accounting Matrix (SAM) (Pal et al., 2020), complemented by inputs from national databases capturing carbon intensities, labour productivity, and capital stock depreciation.
The application of the CGE model to India's context yielded pivotal insights. A deep dive into sectors revealed that five of them, led prominently by the coal-intensive energy sector, are responsible for over 95% of India's emissions. Notwithstanding the nation's push towards renewables, emissions are dauntingly high. While a modest carbon tax has limited impact, a more aggressive tax rate, although effective, disrupts income distribution, disproportionately affecting India's marginalised populations. The research thus underscores a synergistic approach, merging targeted reinvestments with a robust carbon tax as the linchpin for sustainable decarbonisation in India. While potent in emission reduction, such strategies necessitate protective measures, like subsidies, to prevent deepening India's socio-economic divides.
The study recognises intrinsic limitations that need addressing. The current model's architecture possesses constraints, particularly in its representation of export levels and wage growth. An endogenous presentation in these areas would provide a richer systemic view. While the research touched upon two primary tax rates, a broader exploration of tax rates is warranted to align more accurately with Key Performance Indicators (KPIs). The present pricing mechanism, which leans heavily on consumers bearing the entirety of the carbon tax, hints at a potential imbalance in economic impact and needs reevaluation. Additionally, using placeholder coefficients for decarbonisation offers a limited perspective, potentially glossing over the nuances of carbon reduction dynamics. Notably, the model's exclusion of simulations for extreme weather events is a critical oversight, which could affect its forecasting abilities, especially in climate change.
This research presents actionable policy recommendations, chiefly underscoring the role of targeted reinvestment coupled with a high carbon tax rate. With India's energy sector at the forefront, targeted reinvestments promise to bolster GDP and reduce emissions, providing a roadmap that aligns economic growth with climate mitigation. However, given India's socio-economic fabric, implementing such strategies mandates careful consideration of potential impacts, especially on vulnerable sectors like agriculture and the vast populace of lower-income households.

This thesis evaluates the effects of including automated event data for interstate conflict prediction. Automated event data are web-scraped news stories converted into data and they may allow conflict models to increase their performance. Accurate models can then be used for early-warning purposes.

To predict three separate problems, tree ensemble classifiers were used. The three outcomes to be predicted were the occurrence of interstate conflict, its onset, and its escalation. They were predicted globally at the dyad month level, meaning monthly for every country pair, using data from 1995 to 2014. The feature set consisted of eleven structural, slow-changing variables, and 268 event features, which were event counts on a dyad month according to event type.

The analysis showed that event data did not increase performance. This held across all three prediction problems. Additionally, it was found that the models for occurrence and escalation and performed well and decently well, respectively, but that the models for conflict onset performed poorly.

In conclusion, event data needs further testing in different constellations to be effective in interstate conflict prediction. It seems likely, however, that effective prediction for policy guidance is possible, given the model performance of the occurrence and escalation models.

In India the COVID-19 pandemic resulted in a nationwide lockdown from March 25, 2020 till the end of May 2020. During this time public and private transportation activities were limited, economic activities came to a standstill and healthcare resources were redistributed. India’s healthcare system faced problems prior to the COVID-19 pandemic such as insufficient availability, suboptimal healthcare services and high out-of-pocket expenditures. The exponential rise in patient care during the COVID-19 pandemic exacerbated existing problems in the Indian healthcare system while introducing new ones. Realizing optimal care during the health crisis became more challenging as the focus was on mitigating the spread of the virus. The absent of public transportation and the pressure on healthcare resources impacted the healthcare accessibility of different demographic groups. During this study we assessed how access to healthcare was influenced due to the policy interventions that were meant to mitigate the spread of COVID-19. The hypothesis is that healthcare access for different demographic groups was negatively impacted by the policies meant to curb the spread. In order to analyse the impact, we performed a case study in the state of Goa using the Network-based Health Accessibility Index Method (NHAIM). This gravitational model allows us to study the spatial distribution of healthcare resources in the state of Goa. Based on our findings we can conclude that healthcare access is unevenly distributed in the state of Goa. Furthermore, we concluded that there is no significant correlation between healthcare availability and the urban and rural mortality rate for the state of Goa. However, there is a significantly strong positive correlation between geographical healthcare access and the urban and rural mortality for the state of Goa.

This thesis applies design science to the monetary and financial system as a whole. The application of this novel methodology offers new possibilities to examine this complex system. The contribution of this thesis is threefold. First, different theories on money, banking and systemic financial crises have been researched through an extensive literature review and balance sheets. Second, those theories have been used to develop design requirements and guidelines. Finally, the consensus and pivotal dissensions about the systemic problem(s) of the current monetary and financial system, requirements and guidelines among experts have been identified through semi-structured interviews. This research process results in widely supported requirements that demarcate the design space and widely supported guidelines that aim to give direction within the design space, that is, to the future development of the monetary and financial system.

The main artifact of this research are these three guidelines:
GDG 1: Develop and gradually introduce public digital money.
GDG 2: Move the financial system towards funding based on securities offering market liquidity.
GDG 3: Move financial regulation towards transparency.@en

This master thesis seeks to better understand the investment valuation procedure followed by software venture capitalists (VC) in the European context. I explain how VCs perform fair value estimations of software start-ups with the emerging comparable analysis technique. Furthermore, this study examines the relative importance of start-up characteristics in determining the multiple and how these factors influence the VC’s valuation behaviour. Additionally, I explore whether this behaviour and the multiples paid can be explained by differences in VC firm experience at a time of historically low interest rates and record-breaking fund inflows. Based on 36 interviews with European VCs, primarily from the Benelux region, I find that all start-up characteristics matter in the determination of the multiple, but the management team a little more. As a result, software VCs are willing to pay higher multiples for stellar management teams than for exceptional business characteristics. In contrast with the other characteristics, poor traction does not necessarily kill the deal, but VCs might rather use it to enforce a lower valuation. Overall, VC firm experience is not a strong predictor of the valuation behaviour and ARR multiples paid for deals. However, I do find that more experienced VCs are willing to pay higher premiums for benchmark-exceeding traction than their less experienced counterparts.

In 2020, the world was hit by a global pandemic through COVID-19, causing millions of deaths worldwide. The last two years proved that a health-related crisis like COVID-19 strains us as a society and the capacities of health systems worldwide. Severe infections of COVID-19 require higher capacities of hospital beds, ICUs with ventilators and Personal Protective Equipment. For health systems, the question arises of how to secure enough PPE and ventilators before and during a health-related crisis like COVID-19.
This research explores how health systems can create responsive and prepared supply strategies to meet the rising demand for critical medical supplies during health-related crises. Concerning the availability of critical medical supplies, preparedness entails stockpiling as a supply strategy. Furthermore, preparedness entails actions decision-makers in health systems can take to increase the effectiveness of responsive supply strategies. Responsiveness refers to supply strategies used at the beginning of a health-related crisis in the short term. Responsive supply strategies include ramping up domestic production, supporting innovations, loaning medical supplies, and purchasing medical supplies from the world market or through direct tender.
In this research, a System Dynamics model was developed to explore how health systems can create resilient and responsive supply strategies, a System Dynamics model was developed, focusing on the English health system as an example for the Global North. Given the deep uncertainties surrounding the supply chain of critical medical supplies, Exploratory Modelling and Analysis was conducted to identify candidate policies and explore their performance given the uncertainties. Specifically, uncertainties affecting the success of purchasing supplies through direct tender and from the world market had the most impact on the availability of PPE and ventilators.
The results of the analysis and the findings in the literature provide the following recommendations to decision-makers in health systems to create prepared and responsive supply strategies that ensure the availability of critical medical supplies during health-related crises. Decision-makers can implement (i) stockpiles exhibiting higher inventory levels than recommended, and no delays concerning the operation within the warehouse or the delivery of the medical supplies. Furthermore, it is suggested to (ii) implement diverse supplier frameworks and crisis frameworks, (iii) diversify supplier, (iv) implement stocks of raw material for domestic production. It is useful for decision-makers to apply several responsive supply strategies simultaneously. Furthermore, health systems can further investigate additional supply strategies.
In this research, it is assumed that collaboration is not relevant nor of interest for the English health system. Hence, it would be interesting to explore the effect that sharing critical medical supplies between national health systems could have on the shortage of PPE and ventilators in the future.

This thesis focuses on frugal innovations and over-engineering in the mobile phone industry and medical industry. These industries often over-engineer their products and services. For the mobile phone industry, businesses strive to give ever-improving products and services to their most profitable and demanding customers while paying less attention to others who are less demanding. In reality, firms’ over-engineered products/services often beat less-demanding customers’ performance standards. On the other hand, over-engineering medical equipment is due to owing to standards and regulations. This makes it more difficult for people to access medical equipment. Not everyone can afford it and not everyone is capable of operating such sophisticated equipment. Frugal innovations aim to strive to lower the cost of products, services and systems for the Bottom of the Pyramid. To (partially) solve the problem described, the research objective for this thesis is to investigate the factors of frugal innovations to affect over-engineering in the mobile phone industry and for medical equipment in the medical industry by means of two case studies.

This thesis focuses on frugal innovations and over-engineering in the mobile phone industry and medical industry. These industries often over-engineer their products and services. For the mobile phone industry, businesses strive to give ever-improving products and services to their most profitable and demanding customers while paying less attention to others who are less demanding. In reality, firms’ over-engineered products/services often beat less-demanding customers’ performance standards. On the other hand, over-engineering medical equipment is due to owing to standards and regulations. This makes it more difficult for people to access medical equipment. Not everyone can afford it and not everyone is capable of operating such sophisticated equipment. Frugal innovations aim to strive to lower the cost of products, services and systems for the Bottom of the Pyramid. To (partially) solve the problem described, the research objective for this thesis is to investigate the factors of frugal innovations to affect over-engineering in the mobile phone industry and for medical equipment in the medical industry by means of two case studies.

Thirteen percent of the world’s population currently does not have access to electricity. This lack of access to electricity limits the overall development. Having access to clean energy can provide education access, productivity and possibilities for economic growth. Frugal innovations are new or improved products, with a lower cost and fewer used resources in their production chain, while maintaining quality, achieving predefined criteria, fulfilling a specific purpose and are user-friendly. Frugal solar-photovoltaic systems, are one of the possible technologies that could be able to contribute to reducing the number of people without access to electricity. Despite the potential of frugal solar-PV systems for reducing energy poverty, market diffusion of these innovations is not a given. Political risks can pose a barrier to the market diffusion of these innovations, due to endangering a stable environment for development and investments.
However, the span of this relationship, specifically in the combination with frugal solar-PV systems, is unknown. To analyse this, the following main research question has been posed in this research: ‘To what extent is there a relationship between political risks and the market diffusion of frugal solar-PV systems?’. The answer to this research question has been researched with a mixed-methods research approach. First, a quantitative analysis is performed with a correlation analysis. The second phase includes qualitative research. Based on the results of the quantitative results, the factors which could influence the diffusion of frugal solar-PV systems in Uganda and Namibia are analysed with means of case studies and interviews.
The correlation analysis showed that there is no relationship between political risks and the diffusion of frugal solar-PV systems. There are too little significant results to convince that there is a relationship between the political risks and the diffusion of frugal solar-PV systems worldwide and per continent. Given the fact that this is a research area where little operationalising has been done so far, it is also important to find possible explanations for this result. Based on the case studies and interviews, it can be stated that that there are more factors playing a role in the diffusion of frugal solar-PV systems than the included political risks. For example, the need for frugal innovations, (renewable) energy technologies which are already invested in, the varying degree of involvement of foreign investors and non-governmental organisations, the history of relationships with other countries and current trading agreements.
To conclude, this research has contributed to the knowledge gaps and scientific debates in the frugal innovation field by looking at the market diffusion of these systems and the possible role political risks can play in this process. Valuable knowledge has been gathered, which has contributed in filling in gaps in academic research: political risks have been operationalised, a contribution has been made in the field of diffusion theories, specifically for frugal innovations, and the scope of the extent of a relationship between political risks and the diffusion of frugal solar-PV systems has been determined. The results of this research can hopefully on the long term contribute to increasing the percentage of people having access to affordable and renewable generated electricity and reducing the energy poverty worldwide.

The research was conducted looking into the possibilities of local manufacturing and assembly of medical devices in low and middle-income countries. Desktop research and expert interviews were conducted to learn the operations of medical devices (and other product) manufacturers. The interview process validated the literature study and also brought to light some new information on how medical device manufacturing (both local and international) operates. The research resulted in key drivers and inhibitors that companies need to consider when shifting their operations (or not) to low and middle-income countries.

SMEs are in the midst of a digital economy driven by the rapid growth of technologies, pushing them to change or be excluded from the system. Compounded by the COVID-19 outbreak, SMEs are required to catch up with the transition quickly. Governments and policymakers have previously conceived numerous policies to support SMEs' digital transformation in most countries. Nevertheless, in Indonesia, these efforts are dominated by digital literacy development programs while paying little attention to the holistic entrepreneurial capacity. Whereas only as a part of a comprehensive approach digital literacy can be developed. As SMEs are part of a system, the holistic entrepreneurial capacity should encompass internal and external capacity, from SMEs' capacity as an entity, the availability of enabling environment, and the synergy. This research attempted to solve the research question: "How to raise the SMEs' capacity in Indonesia to perform digital transformation?". The proposition was studied by carrying a multiple embedded case study of Indonesian SMEs to determine the existing capacity, barriers and ultimately answer the research question. The case study includes 18 SMEs with different business scales assorted into three categories according to the entrepreneurial capacity and digital literacy level. Data collection in this case study combined semi-structured interviews and observations. Additionally, three inclusive case descriptions are presented to illustrate the profile of targeted companies in the Government's digital transformation agenda. Furthermore, cases were cross-analyzed to reveal their capacities based on the value and institutional context of each company, and also the relation to its digital transformation phase. Meanwhile, data about the current landscape and the interaction with SMEs are collected from a literature review and interviews with four experts from Kemenkop, Bank Indonesia, and eCommerce. The empirical results reveal that Indonesia's current landscape is shifting within traditional and more modern practices. Numerous policies, regulations, development programs, and financial supports exist to boost SMEs' digital transformation. However, there are manifold barriers at this level. There is a solid patrimonial system and bureaucracy in a decentralized Government system, compounded by a sectoral ego that creates disintegration and hampers coordination. In addition, the lack of arrangement and regulations enforcement due to the Government's limited capacity generates suboptimal outputs. Next, lack of capacity is the central barrier to digital transformation at the SME level. However, the empirical evidence showed that this issue is beyond the lack of knowledge and skills in technology utilization. Hence, capacity building should not only concentrate on improving digital literacy but also the overall SMEs’ capacity. Another noteworthy finding is that some SMEs with high capacity prefer to stay out of the systems and refuse to take digital transformation due to weak regulations enforcement from authorities and lack of incentives. On the other hand, SMEs utilizing digital technology both in transition business model and digital business model obtain several benefits from their participation. First, they enjoy the broader market and network up to national also international markets. Such a network will also lead to cost savings and access to funding. Next, they can have better engagement with customers that contribute to their innovation capacity. Then, combining the broader market, network, and customer interaction enables SMEs to create demand-based innovation, leading to the better product value. Participating in the digital platform and the motivation for business escalation also affect the SMEs' compliance level. As they try to develop the business and increase the product value, they will register their business and strive to obtain relevant certifications. Ultimately, with intensive assistance and consecutive improvements, the company's overall performance would be enhanced, and in turn, this will promote business sustainability. This study confirms that SMEs' digital transformation requires comprehensive knowledge and skills, a supporting mindset, and enabling environment. Therefore, we propose a comprehensive SMEs development program for the Indonesian Government, namely SCALE-UP: SMEs Capacity Development and Upgrading Program. This program is a top-down approach for the Government and relevant authorities that focus on providing appropriate capacity building for SMEs according to their needs reflected on capacity assessment output. So, the capacity development between SMEs might vary. The traditional enterprises with a lack of capacity in most aspects will get different development plans than the SMEs with higher entrepreneurial capacity but lack digital literacy, as they need a more entrepreneurial mindset and attitude. This capacity development should be followed by intensive assistance and collaboration with civil society. Eventually, regular evaluation and more vigorous enforcement are essential to monitor progress and anticipate obstacles. Nevertheless, this development program requires more transparency, cooperation, and compliance within Government institutions. To deal with the sectoral ego, a dedicated working group for SMEs development consisting of the Government and relevant authorities is required. In addition, the Ministry of SMEs and Cooperative, as the SMEs authority, can build a showcase of progressive SMEs that is accessible for investors, financial institutions, NGOs, and relevant stakeholders. This showcase can be an incentive to encourage SMEs to take digital transformation and participate in the formal economy voluntarily.

Baumol's unbalanced growth model predicts the tendency of aggregate productivity growth to slow down in the process of tertiarisation. This thesis studies the relationship between employment structural changes and aggregate productivity growth in the case of China. William Nordhaus’s (2008) testing methodology will be applied to the China Industrial Productivity (CIP) Database that follows the KLEMS principles. The results suggest that there is a significant sign of Baumol’s cost disease in China during 1987-2010. Moreover, with more and more workers tolerating lower pay in the stagnant sectors, aggregate demand growth in the market will slow down. Eventually, the unbalanced growth may lead to economic stagnation. Hence, it is necessary to intervene in income distribution through fiscal and monetary policies to make the workers in the stagnant industries benefit from the technological progress.

This research provides a performance measurement framework for Reverse Innovation (RI) within the healthcare sector. In order to design this performance measurement framework, literature analysis was combined with data from current practices that was obtained by interviewing product managers from multination companies (MNCs) in the healthcare sector that have produced RIs. Within the performance measurement framework four categories are used: financial performance, product innovation performance, sustainability performance and customer satisfaction performance. This performance measurement framework can be used to assess the performance of RIs and MNCs pursuing RIs which can help managers in their decision making and daily business management.

From a practical perspective, the UK, like so many other countries, is struggling to have a complete HTM implementation. The sources suggest that British health care managers face financial and personnel availability pressures, and this makes it difficult to follow the instructions provided by the various organizations for the implementation of HTM activities including procurement. It is worth mentioning that the guidelines and decision-making frameworks provided by national organizations and various authors, mainly follow a project-based approach, characterized by linear HTM implementation/decision-making, and usually focusing on purely technical and legislative aspects of HTM. However, the health care sector, as well as procurement of medical devices, is characterised by complexity, constitutes an interconnected network of actors, parties and policies, and it is mainly context-dependent. Therefore, in addition to technical and legislative advice, it would be sensible to train health care managers in recognising the presence of internal networking relationships, and how to negotiate with all the actors involved in the different procurement, or more in general HTM, activities.

From an academic perspective, almost all the articles analysing procurement aim to identify potential challenges, mainly related to financial and technical concerns, and subsequently provide decision-making frameworks to indicate the right path to follow when deciding which device to purchase. Very few articles perform a satisfactory analysis of the main actors involved during the procurement process and their responsibilities. Moreover, no attempts have been made to look at hospital-based procurement from a networking perspective and apply ‘Management in Networks’ theories and strategy to understand and improve it.

Considering the aforementioned practical and academic issues, this study wants to investigate how hospital-based procurement could be analysed under the network point of view. Therefore, this dissertation wants to propose a new way of looking at hospital-based procurement, taking into account the presence of potential internal networks and interactions proper of an interconnected world. More specifically, this thesis project aims to provide a satisfactory description of the main procurement activities performed within the hospital, inform about who are the actors involved, how they interact, how/if they follow specif guidelines, and the main challenges encountered. Once the author will arrive at a satisfactory description of hospital-based procurement, she will analyse this last one under the paradigms of an interconnected world, explaining how the various networking strategies and paradigms can be used to understand and analyse hospital-based procurement. Finally, this research will identify factors that could be addressed by health care decision-makers to manage technology successfully. In particular, this study intends to identify valuable strategies for technology management decision-making and activities, to detect which one should be addressed by hospitals, and to establish technology management system priorities for health care managers and clinical engineers.

The jobs of the world population are increasingly threatened in a world filled with constant technological improvements, and automation of tasks by machinery and artificial intelligence. Substitution of labour by machines is not only occurring in blue-collar jobs (usually uniformed workers working in eg. manufacturing) but increasingly also in white-collar jobs (usually ‘suit-and-tie’ workers working in offices). The more labour-saving technology is created and deployed, the more jobs are made obsolete, possibly leading to technological unemployment. This problem is likely to be aggravated by research and policies that are concerned with the so-called 'productivity paradox' or 'Solow-paradox', as well as the 'cost disease', and that seek to avoid or remedy both by increasing labour productivity across-the-board, that is, in 'personal services' such as education, health care, research, and the arts as well as in the goods-producing economy. If this were feasible, how could technological unemployment be avoided? Another option, explored in this thesis, is to take a fresh look at these phenomena, by asking whether they really are a 'disease' or 'paradox', or simply a consequence of a (harmless) natural structural change that is taking place in society, namely, the growth of 'personal services' relative to the physical (goods-producing) economy. Inspired by the writings of William Baumol (1993, 2012), this thesis explains that it will be possible to avoid dramatic increases in unemployment, if the productivity gains that are achieved in the technologically progressive sector (that implements labour-saving technologies) are used to fund the creation of new work in the technologically stagnant sector, the sector that tends to have a lower labour productivity growth compared to the technologically progressive sector. According to Baumol (1993, 2012), it is not possible or not desirable to increase labour productivity in the stagnant sector in the same way as this happens in the progressive sector by for example replacing human beings with software, machines, and AI. It may not be possible because of the nature of work in the stagnant sector compared to the progressive sector and it may not be desirable because the quality of services may decrease (Baumol & Wolff 1998). A case study involving the Netherlands and Germany, both of which are shown to suffer from the 'cost disease', was carried out to investigate whether the transfers of funds from the progressive to the stagnant sector is a realistic possibility. If resources are to be transferred from the progressive to the stagnant sector, the question arises how this could be realised. One possibility is investigated, namely, that governments implement profit taxation in the technologically progressive sector to collect the productivity gains in this sector and then use it to fund new work 7 in the technologically stagnant sector, including a public educational system. The conditions under which this solution is feasible was then investigated for the Netherlands and Germany, and concludes that Baumol’s (1993, 2012) solution to the cost disease could be realised if 50-70% of productivity gains in the progressive sector are used to fund work in the stagnant sector, and as long as the average wage rate in the stagnant sector is not consistently higher than the average wage rate in the progressive sector.