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This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

This paper aims to examine the performance efficiency of 56 real estate assets within the rental sector in the UAE to evaluate the relative operation efficiency in relation to revenue generation.

The data envelopment analysis (DEA) approach was used to measure the relative operational efficiency of the studied assets in relation to the revenue performance. This method could produce a more informed and balanced approach to performance measurement.

The outcomes show that scores of efficiencies ranging from 7% to 99% in some of the models. The results showed that on average buildings are 75% relatively less efficient in maintenance, in term of revenue generation, than the benchmark set. Likewise, on average, the inefficient buildings are 60% relatively less efficient in insurance. Result also shows that 95% of the building assets in the sample are by and large operating at decreasing returns to scale. This implies that managers need to considerably reduce the operational resources (input) to improve the levels of revenue.

This study recommends that the FM operational variables that were found to inefficiently contribute to the revenue should be re-examined to test the validity of the findings. This is necessary before generalising or interpolating the results that are presented in this study.

The information obtained about operational performance can help FM managers to understand which improvements in the productivity of inefficient FM resources are required, providing insight into how to reduce operating costs and increase revenue.

This paper adds value in using new FM operational parameters to evaluate the efficiency of the performance of built assets.

This paper aims to examine the extent to which these reforms address the limitations of Saudi Arabia’s previous investment framework. Long viewed as a hostile environment in which to do business, the Saudi Government has enacted a broad sweep of measures aimed at restoring investor confidence in central aspects of the country’s evolving private law framework.

This paper offers a timely assessment of the raft of foreign investment reforms, both legislative and regulatory, that have been introduced in Saudi Arabia over the last decade.

The paper will proceed by outlining the perceived failings of the old investment regime before going on to reforms.

It will consider the remaining obstacles to the flow of foreign investment in Saudi Arabia in the context of the dual forces that have historically defined the Kingdom’s ambivalent investment law regime.

Managers must make numerous strategic decisions in order to initiate and implement a business model innovation (BMI). This paper examines how managers perceive the management team interacts when making BMI decisions. The paper also investigates how group biases and board members’ risk willingness affect this process.

Empirical data were collected through 26 in-depth interviews with German managing directors from 13 companies in four industries (mobility, manufacturing, healthcare and energy) to explore three research questions: (1) What group effects are prevalent in BMI group decision-making? (2) What are the key characteristics of BMI group decisions? And (3) what are the potential relationships between BMI group decision-making and managers' risk willingness? A thematic analysis based on Gioia's guidelines was conducted to identify themes in the comprehensive dataset.

First, the results show four typical group biases in BMI group decisions: Groupthink, social influence, hidden profile and group polarization. Findings show that the hidden profile paradigm and groupthink theory are essential in the context of BMI decisions. Second, we developed a BMI decision matrix, including the following key characteristics of BMI group decision-making managerial cohesion, conflict readiness and information- and emotion-based decision behavior. Third, in contrast to previous literature, we found that individual risk aversion can improve the quality of BMI decisions.

This paper provides managers with an opportunity to become aware of group biases that may impede their strategic BMI decisions. Specifically, it points out that managers should consider the key cognitive constraints due to their interactions when making BMI decisions. This work also highlights the importance of risk-averse decision-makers on boards.

This qualitative study contributes to the literature on decision-making by revealing key cognitive group biases in strategic decision-making. This study also enriches the behavioral science research stream of the BMI literature by attributing a critical influence on the quality of BMI decisions to managers' group interactions. In addition, this article provides new perspectives on managers' risk aversion in strategic decision-making.

From the buying club’s perspective, the transfer of a player can be interpreted as an investment from which the club expects uncertain future benefits. This paper aims to develop a decision-oriented approach for the valuation of football players that could theoretically help clubs determine the subjective value of investing in a player to assess its potential economic advantage.

We build on a semi-investment-theoretical risk-value model and elaborate an approach that can be applied in imperfect markets under uncertainty. Furthermore, we illustrate the valuation process with a numerical example based on fictitious data. Due to this explicitly intended decision support, our approach differs fundamentally from a large part of the literature, which is empirically based and attempts to explain observable figures through various influencing factors.

We propose a semi-investment-theoretical valuation approach that is based on a two-step model, namely, a first valuation at the club level and a final calculation to determine the decision value for an individual player. In contrast to the previous literature, we do not rely on an econometric framework that attempts to explain observable past variables but rather present a general, forward-looking decision model that can support managers in their investment decisions.

This approach is the first to show managers how to make an economically rational investment decision by determining the maximum payable price. Nevertheless, there is no normative requirement for the decision-maker. The club will obviously have to supplement the calculus with nonfinancial objectives. Overall, our paper can constitute a first step toward decision-oriented player valuation and for theoretical comparison with practical investment decisions in football clubs, which obviously take into account other specific sports team decisions.

This paper aims to investigate empirically the impact of economic policy uncertainty (EPU) on small-to-medium enterprises’ (SMEs) investment efficiency and whether product market competition influences this association.

The study was conducted on French SMEs listed on the “CAC Mid & Small” Index over 2008–2021. This paper proposes a quantitative approach to test the relationship between the EPU and SME investment efficiency.

These findings show that EPU significantly alleviates SMEs’ investment inefficiency, reflected in the reduction of overinvestment and underinvestment. As EPU increases, firms with more exposure to such uncertainty invest more efficiently, and their overinvestment tendency becomes lower, while reducing the risk of underinvestment. These results are still significant after a series of robustness checks. Further analysis shows that EPU mitigates investment inefficiency to a greater extent for firms operating in highly competitive industries, and better information environments.

This study was limited to the French EPU index and could be extended to a European or even international scale. Moreover, using alternative uncertainty indexes across various European countries can be more advantageous in further studies. Although results suggest that EPU affects investment efficiency, future studies could further explore the mechanisms through which EPU affects SMEs’ investment efficiency and, in particular, across different industries. Understanding these variations due to the specific industry-EPU sensitivity can provide valuable insights. Finally, it would be interesting to examine the risk management strategies adopted by SMEs in the face of EPU, combined with other growing risks, such as climate risk.

In the face of high EPU, SME managers must improve risk management, adopt appropriate investment strategies, consider using predictive analytics or economic forecasting tools and embrace technology and innovation that enhance agility and responsiveness to policy uncertainty. Besides, political decision-makers should adapt their regulatory policies (tax, labor, housing, etc.) to preserve the efficiency of SME investment.

Although the debates on how policy uncertainty affects the investment and financing of large businesses have received a great concern of academia, to the best of the authors’ knowledge, this is the first study that focuses on the effect of EPU on investment distortions for SMEs.

The purpose of this paper is to investigate the relationship between CEOs' inside debt holdings (pension benefits and deferred compensation) and the operating leverage of the firms they manage, with the aim to examine whether CEO incentives play a role in corporate risk-taking.

The authors investigate the relation between CEO inside debt holdings (CIDH) (pension benefits and deferred compensation) and the operating leverage (DOL) of the firms they manage. Using a sample of 11,145 US firm-year observations over the period 2006–2017, the authors find a strong negative association between CIDH and DOL. Additional analyses reveal that the relationship between CIDH and DOL is more pronounced in firms with heightened agency issues, powerful CEOs and for CEOs with stronger professional networks. The results are robust to various sensitivity and endogeneity tests.

The authors find strong evidence confirming the expected negative association between CEO inside debt and DOL suggesting that firms with higher inside debt tend to maintain lower levels of operating leverage. These findings continue to hold with the alternative measure for the inside debt and operating leverage, and across a range of tests designed to rule out the possibility that the primary findings are in any way driven by potential endogeneity. In addition, the findings demonstrate that the presence of manager-shareholder agency conflicts can strengthen the inside debt–DOL relationship suggesting the strong role of inside debt in reducing firm risk.

Findings in this paper have implications for design of compensation structures so that corporate boards can establish incentives as a tool for risk management. A limitation of this study is that it is focused on one market, i.e. US listed companies, so the findings may not be applicable on a global scale.

To the best of the authors’ knowledge, this is the first study that links firm-level management of operating leverage through design of CEO inside debt incentives (two obvious choices for risk-reduction at the CEOs’ disposal include reducing financial risk through reduction of firm leverage and reducing operating risk through reduction of operating leverage). While use of firm leverage as an instrument of choice has been explored in the past, use of operating leverage to achieve risk reduction when CEO possess high inside holding, has received very little attention.

The purpose of this study is to evaluate the potential variances in strategic entrepreneurial small and medium-sized enterprises (SMEs) across different countries while also exploring the cultural implications that may arise.

In this study, a qualitative research approach was used, involving semi-structured interviews conducted with seven technology start-ups from two countries – Portugal and France.

The results of this study demonstrate significant differences in opportunity-seeking, performance and long-term orientation behaviors between the technology start-ups in Portugal and France.

This knowledge can help entrepreneurs and investors make informed decisions when developing strategies, entering new markets or seeking partnerships with start-ups from different countries. Furthermore, policymakers can use these findings to support entrepreneurship initiatives and foster an environment that encourages strategic entrepreneurship practices.

This study offers a unique perspective by focusing on the firm level of entrepreneurial SMEs and the strategic practices adopted by technology start-ups in Portugal and France. In contrast, prior studies have predominantly centred on analysing individual motivations for entrepreneurship, such as personal traits or attitudes, rather than exploring the actual strategic behaviors and practices of start-ups in various countries. By shifting the emphasis to the firm level, this study provides a more comprehensive understanding of how strategic entrepreneurship practices differ across different cultural contexts. As such, it represents a significant contribution to the existing literature on strategic entrepreneurship.

The elderly service industry is emerging in China. The Chinese government introduced a series of policies to guide elderly service enterprises to improve their service quality. This study explores novel differentiated subsidy strategies that not only promote the improvement of service quality in elderly service enterprises but also alleviate the financial burden on the government.

Evolutionary game and Hotelling models are employed to investigate this issue. First, a Hotelling model that considers consumer word-of-mouth preferences is established. Subsequently, an evolutionary game model between local governments and enterprises is constructed, and the evolutionary stable strategies of both parties are analyzed. Finally, simulation experiments are conducted.

The findings indicate that local government decisions have a significant influence on the behavior of elderly service enterprises. Increasing the proportion of local governments opting for subsidy strategies helps incentivize elderly service enterprises to improve their service quality. Furthermore, providing differentiated subsidies based on the preferences of the customer base of elderly service enterprises can encourage service quality improvement while reducing government expenditure. The findings offer valuable insights into the design of government subsidy policies.

Compared with previous research, this study examines the role of consumer preferences in a differentiated subsidy policy. This enriches the authors’ understanding of the field by incorporating neglected aspects of consumer preferences in the context of the emerging elderly service industry.

Over the last two decades, most organizations have considered technologies to drive digital transformation, and the recent pandemic has brought significant changes in the healthcare sector. Therefore, this study explores the technological nexus in supporting digital transformation as a process to govern the healthcare sector more effectively.

This study uses quantitative and qualitative methods to analyse the impact of ArogyaSetu (a health and wellness app) on India’s digital transformation process. The study involves 212 responses to understand how the app enables digital transformation and its impact on governance, healthcare systems and stakeholders. Additionally, 31 semi-structured interviews were conducted to validate the quantitative study’s findings.

Referring quantitative part of research design, ArogyaSetu has had a positive impact on the digital transformation of India’s healthcare industry, which has in turn affected stakeholders and improved governance. Moreover, qualitative findings suggest that a governance system like ArogyaSetu can aid in the development of dynamic capabilities within the healthcare system and governance.

This study adds to our understanding of the digital transformation of healthcare by examining it through the lens of dynamic capability. In this framework, “sense” refers to the stakeholders, “seize” the healthcare system and “transform” governance. The study also provides practical implications for managers, academics and government administrators responsible for digital healthcare transformation.