Fisioterapia e reabilitação em Portugal : o financiamento como factor crítico do desempenho

RESUMO - Num contexto em que a prestação de cuidados de Fisioterapia e Reabilitação é identificada como apresentando uma desigualdade e desajustamento da oferta regional superior à dos restantes cuidados de saúde, assim como uma falta de adequação dos preços praticados, perante as condições de oferta e procura actualmente existentes, o presente trabalho tem por objectivo investigar, no domínio do Desempenho, a influência do Financiamento na definição da prestação destes cuidados, tendo como pressuposto genérico que as decisões estratégicas e a reestruturação produtiva das organizações de saúde são condicionadas pelo sistema de preços. Considera-se que o actual sistema de Financiamento/Pagamento provoca um constrangimento na qualidade da resposta destes cuidados a dois níveis: um primeiro nível, ao colocar o pagamento no âmbito dos Meios Complementares de Diagnóstico e Terapêutica (MCDTs) a contratar pelo Serviço Nacional de Saúde, com isso determinando a configuração organizativa do sistema; um segundo nível de constrangimento que incide sobre as estruturas das organizações prestadoras, pela modelação que induz, nomeadamente a nível da sua produção. Na impossibilidade de tratar as duas dimensões do problema, pela falta de indicadores de desempenho deste sector, analisou-se, relativamente ao segundo nível de constrangimento, a produção de fisioterapia de três organizações que, potencialmente, teriam o mesmo o mesmo perfil de oferta por se enquadrarem num mesmo perfil de procura. Os resultados reflectem o pressuposto genérico do trabalho e abrem espaço para colocar como futura hipótese de investigação a razão da(s) causa(s) que poderão estar subjacentes à discrepância encontrada na média de tratamentos por sessão (duas vezes e meia) na produção das duas organizações que foi possível comparar.------------------- ABSTRACT - In a context where the provision of Physical Therapy and Rehabilitation care is identified as having a regional mismatch of supply and inequality above all the others health cares, and a lack of adequacy of prices in the current conditions of supply and demand, the present work has, as main purpose, to investigate, in the field of Performance, the Payment’s influence in shaping the provision of such health care. The general assumption tracking this analysis is that the strategic decisions on productive structure of health care organizations are influenced by the price systems. It is considered that the current Finance / Payment system causes two levels of constraints on the quality of such health care: a first constraint, as it putts its payment under the Supplementary Means of Diagnosis and Therapy (MCDTs), witch ends up establishing the organizational setup of the system; a second level of constraint by modelling the internal structure of these organizations. The lack of indicators characterizing the performance of this sector, addressed the present study to the second dimension, in witch was analysed the physical therapy production in three organizations that, potentially, would have the same profile of supply responding to similar characteristics of demand. The results reflect the above mentioned general assumption that supported the work, and leave an open space for future research, about the reason (s) that lay behind the discrepancy found between the average of treatments per session (two and a half times) in

Econet wireless Zimbawe Limited: Building the future

In February 2015, when Econet Wireless Zimbabwe Limited, EWZL, the market leader of the telecommunications sector in Zimbabwe, published the financial results, the management team was worried about the shareholders’ reaction. With over 60% market share in its core business (the voice and SMS market), it has achieved remarkable results due to the great diversification strategy. However, the share price was continuously falling due to exogenous factors that were pressuring margins and threatening future sustainability of the company. EWZL was highly exposed to Zimbabwe’s specific risks and regulatory policies. This case explores both the business environment surrounding the company and the strategic decisions necessary to fight against the economic and political challenges. Students will step into Econet’s obstacles by analyzing the strategies and diagnosing the multiple risk factors affecting the profitability of the firm. Furthermore, they will have to compute the valuation of the firm, facing several challenges of a developing country.

Essays on bounded rationality: Individual decision and strategic interaction

Economics is a social science which, therefore, focuses on people and on the decisions they make, be it in an individual context, or in group situations. It studies human choices, in face of needs to be fulfilled, and a limited amount of resources to fulfill them. For a long time, there was a convergence between the normative and positive views of human behavior, in that the ideal and predicted decisions of agents in economic models were entangled in one single concept. That is, it was assumed that the best that could be done in each situation was exactly the choice that would prevail. Or, at least, that the facts that economics needed to explain could be understood in the light of models in which individual agents act as if they are able to make ideal decisions. However, in the last decades, the complexity of the environment in which economic decisions are made and the limits on the ability of agents to deal with it have been recognized, and incorporated into models of decision making in what came to be known as the bounded rationality paradigm. This was triggered by the incapacity of the unboundedly rationality paradigm to explain observed phenomena and behavior. This thesis contributes to the literature in three different ways. Chapter 1 is a survey on bounded rationality, which gathers and organizes the contributions to the field since Simon (1955) first recognized the necessity to account for the limits on human rationality. The focus of the survey is on theoretical work rather than the experimental literature which presents evidence of actual behavior that differs from what classic rationality predicts. The general framework is as follows. Given a set of exogenous variables, the economic agent needs to choose an element from the choice set that is avail- able to him, in order to optimize the expected value of an objective function (assuming his preferences are representable by such a function). If this problem is too complex for the agent to deal with, one or more of its elements is simplified. Each bounded rationality theory is categorized according to the most relevant element it simplifes. Chapter 2 proposes a novel theory of bounded rationality. Much in the same fashion as Conlisk (1980) and Gabaix (2014), we assume that thinking is costly in the sense that agents have to pay a cost for performing mental operations. In our model, if they choose not to think, such cost is avoided, but they are left with a single alternative, labeled the default choice. We exemplify the idea with a very simple model of consumer choice and identify the concept of isofin curves, i.e., sets of default choices which generate the same utility net of thinking cost. Then, we apply the idea to a linear symmetric Cournot duopoly, in which the default choice can be interpreted as the most natural quantity to be produced in the market. We find that, as the thinking cost increases, the number of firms thinking in equilibrium decreases. More interestingly, for intermediate levels of thinking cost, an equilibrium in which one of the firms chooses the default quantity and the other best responds to it exists, generating asymmetric choices in a symmetric model. Our model is able to explain well-known regularities identified in the Cournot experimental literature, such as the adoption of different strategies by players (Huck et al. , 1999), the inter temporal rigidity of choices (Bosch-Dom enech & Vriend, 2003) and the dispersion of quantities in the context of di cult decision making (Bosch-Dom enech & Vriend, 2003). Chapter 3 applies a model of bounded rationality in a game-theoretic set- ting to the well-known turnout paradox in large elections, pivotal probabilities vanish very quickly and no one should vote, in sharp contrast with the ob- served high levels of turnout. Inspired by the concept of rhizomatic thinking, introduced by Bravo-Furtado & Côrte-Real (2009a), we assume that each per- son is self-delusional in the sense that, when making a decision, she believes that a fraction of the people who support the same party decides alike, even if no communication is established between them. This kind of belief simplifies the decision of the agent, as it reduces the number of players he believes to be playing against { it is thus a bounded rationality approach. Studying a two-party first-past-the-post election with a continuum of self-delusional agents, we show that the turnout rate is positive in all the possible equilibria, and that it can be as high as 100%. The game displays multiple equilibria, at least one of which entails a victory of the bigger party. The smaller one may also win, provided its relative size is not too small; more self-delusional voters in the minority party decreases this threshold size. Our model is able to explain some empirical facts, such as the possibility that a close election leads to low turnout (Geys, 2006), a lower margin of victory when turnout is higher (Geys, 2006) and high turnout rates favoring the minority (Bernhagen & Marsh, 1997).

Does the existing Corporate Governance structure and strict Legal Framework, affect the strategic decisionmaking of CEOs?

This thesis is a case study on Corporate Governance and Business Ethics, using the Portuguese Corporate Law as a general setting. The thesis was conducted in Portugal with illustrations on past cases under the Business Judgment Rule of the State of Delaware, U.SA along with illustrations on current cases in Portugal under the Portuguese Judicial setting, along with a comparative analysis between both. A debate is being considered among scholars and executives; a debate on best practices within corporate governance and corporate law, associated with recent discoveries of unlawful investments that lead to the bankruptcy of leading institutions and an aggravation of the crisis in Portugal. The study aimed at learning possible reasons and causes for the current situation of the country’s corporations along with attempts to discover the best way to move forward. From the interviews and analysis conducted, this paper concluded that the corporate governance structure and legal frameworks in Portugal were not the sole influencers behind the actions and decisions of Corporate Executives, nor were they the main triggers for the recent corporate mishaps. But it is rather a combination of different factors that played a significant role, such as cultural and ethical aspects, individual personalities, and others all of which created gray areas beyond the legal structure, which in turn accelerated and aggravated the corporate governance crisis in the country.

Strategic marketing plan for Sant'Anna

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Oi merger with Portugal Telecom: A strategic partnership

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics

(Non) - Demand driven servitization: strategic implications for suppliers from incorporating their customers up front

Double Degree. A Work Project, presented as part of the requirements for the Award of a Master’s Degree in Management from NOVA – School of Business and Economics and a Masters Degree in International Business, Strategy and Innovation from Maastricht University

Application of different heuristic classes in memory-based and stimulus-based decisions

This paper studies the drivers of heuristic application in different decision types. The study compares differences in frequencies of heuristic classes' such as recognition, one-reason choice and trade-off applied in, respectively, memory-based and stimulus-based choices as well as in high and low involvement decisions. The study has been conducted online among 205 participants from 28 countries.

Strategic account management: the path to gain customer loyalty

The account management field works closely with the sales team, serving as the customer’s primary point of contact. This project’s purpose was to understand if shifting the account management from brand centric to customer centric, would be the best fit for a Portuguese Pharmaceutical company. This customer centric approach - Strategic Account Management (SAM) - was studied, understanding the implicated trade-offs to the company. The workforce was probed about the project and their comments were analyzed. The conclusion points to an implementation of SAM and proposes the adaptations to follow in order to smooth the change.

Starburst accelerator and incubator construction & energy: How to monitor the activities of an incubator and give strategic advice to startups

This work project takes the format of a problem-solving approach suggested by “Impulse Partners”, a French consulting firm. It recommends a way to measure the success of ten startups in the incubators “Starburst” and “Incubator Construction & Energy” and give them strategic guidance. A Balanced Scorecard is elaborated to help incubated startups building up and implementing their strategy. The Scorecard suggests possible initiatives for the startups that are ideally realized with the help of the consulting firm that is steering the incubator. Special attention is drawn to what the startups need to succeed, which typically concerns financing, networking and managing skills.

The influence of price changes on consumers' purchase decisions

The development of an effective pricing strategy requires the acquaintance of consumers’ price perception as well as the range of elements that influence the price sensitivity. This paper analyses the relationships between product features, individual characteristics and the level of price increase/decrease that induces the consumers to change their purchase decisions. The results of a dedicated survey show, that price sensitivity, individual preferences, type of product and direction of price change and individual characteristics of consumers (gender, age, professional situation) have a significant impact on a threshold at which people are willing to choose the less attractive, but cheaper alternative to their favorite product or give up the variety in consumption. From a consumer behavior perspective, these findings play a fundamental role in pricing.

Construction sector: Need for strategic reorientation

The construction sector in Portugal declined sharply over the past 10 years. The current crisis can wiped out the entire industry. Can the industry survive? What lessons can we learn? What can be done to revive the sector? These are questions this study intends to answer. By analyzing the best practices of the industry and of the largest construction companies in Portugal, as well as the difficulties and constrains that they all faced, I found that retrenchment (operational costs and selling assets) are the main measures companies resort to, and that strategic reorientation is essential to turnaround. I found that internationalization is a key driver on strategic reorientation and diversification and concentration are complementary strategies that can enforce and strengthen the main one.

Strategic design of There App’s business model: From product to multi-sided platform

The following work project illustrates the strategic issues There App, a mobile application, faces regarding the opportunity to expand from its current state as a product to a multisided platform. Initially, a market analysis is performed to identify the ideal customer groups to be integrated in the platform. Strategic design issues are then discussed on how to best match its value proposition with the identified market opportunity. Suggestions on how the company should organize its resources and operational processes to best deliver on its value proposition complete the work.

Primera Reservoir Ltd. strategic position analysis

The purpose of this work is to understand the internal and external structure in which the company operates to provide an idea of the strategic actions needed to accomplish their organizational objectives. A strategic software was employed to build up phase one and phase two, phase one involved analysing internal and external factors that influence the company, comprehending their core competences, factors that influence the market and identification of strengths and weaknesses. Phase two consisted on providing an idea of their real competitive position and the suggestion of a development strategy, given the possible limitations in the external factors, the company should carefully analyse some of the opportunities present in the industry overseas to continue to develop their business and increase its profitability. Furthermore, a source of competitive advantage was found in their outbound logistics which could serve a differentiator between their competitors.

Impact of mobile app user acquisition on managerial decisions: Evidence from empirical experiment

In this research we conducted a mixed research, using qualitative and quantitative analysis to study the relationship and impact between mobile advertisement and mobile app user acquisition and the conclusions companies can derive from it. Data was gathered from management of mobile advertisement campaigns of a portfolio of three different mobile apps. We found that a number of implications can be extracted from this intersection, namely to product development, internationalisation and management of marketing budget. We propose further research on alternative app users sources, impact of revenue on apps and exploitation of product segments: wearable technology and Internet of Things.