The DOI matches its Crossref record; 64 of the 64 references it cites were found in a registry or an index.
Value cocreation in service ecosystems: Investigating health care at the micro, meso, and macro levels
Abstract
Purpose: The purpose of this paper is to understand value cocreation in service ecosystems from a multilevel perspective, uncovering value cocreation factors and outcomes at the micro, meso, and macro levels. Design/methodology/approach: A Grounded Theory approach based on semi-structured interviews is adopted. The sample design was defined to enable the ecosystem analysis at its different levels. At the macro level was the Portuguese Health Information ecosystem. Embedded meso level units of analysis comprised eight health care organizations. A total of 48 interviews with citizens and health care practitioners were conducted at the micro level. Findings: Study results enable a detailed understanding of the nature and dynamics of value cocreation in service ecosystems from a multilevel perspective. First, value cocreation factors are identified (resource access, resource sharing, resource recombination, resource monitoring, and governance/institutions generation). These factors enable actors to integrate resources in multiple dynamic interactions to cocreate value outcomes, which involve both population well-being and ecosystem viability. Study results show that these value cocreation factors and outcomes differ across levels, but they are also embedded and interdependent. Practical implications: The findings have important implications for organizations that are ecosystem actors (like the Portuguese Ministry of Health) for understanding synergies among value cocreation factors and outcomes at the different levels. This provides orientations to better integrate different actor roles, technology, and information while facilitating ecosystem coordination and co-evolution. Originality/value: This study responds to the need for a multilevel understanding of value cocreation in service ecosystems. It also illuminates how keystone players in the ecosystem should manage their value propositions to promote resource integration for each actor, fostering resource density and ecosystem viability. It also bridges the high-level conceptual perspective of Service-Dominant logic with specific empirical findings in the very important context of health care.
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“This feature enables both health care organizations and patients to interact directly, allowing them to be actively involved with the value cocreation process [76].”
From Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review (2020) · cites this paper as [76]
Citations
Cites
(1984) · Cited by 81,983
(1998) · Sage eBooks · Cited by 38,631
(2006) · Cited by 18,730
Basics of Qualitative Research
Ozanne, J. L., Strauss, A., & Corbin, J. (1992) · Journal of Marketing Research · doi:10.1177/002224379202900312 · Cited by 17,864
Basics of Qualitative Research
Ozanne, J. L., Strauss, A., & Corbin, J. M. (1992) · Journal of Marketing Research · doi:10.2307/3172751 · Cited by 17,852
Building Theories from Case Study Research
Eisenhardt, K. M. (1989) · The Academy of Management Review · doi:10.2307/258557 · Cited by 17,455
Service-dominant logic: continuing the evolution
Vargo, S. L., & Lusch, R. F. (2008) · Journal of the Academy of Marketing Science · doi:10.1007/s11747-007-0069-6 · Cited by 7,824
Systematic combining: an abductive approach to case research
Dubois, A., & Gadde, L.-E. (2002) · Journal of Business Research · doi:10.1016/s0148-2963(00)00195-8 · Cited by 4,941
Brodie, R. J., Hollebeek, L. D., Jurić, B., & Ilić, A. (2011) · Journal of Service Research · doi:10.1177/1094670511411703 · Cited by 4,505
Institutions and axioms: an extension and update of service-dominant logic
Vargo, S. L., & Lusch, R. F. (2015) · Journal of the Academy of Marketing Science · doi:10.1007/s11747-015-0456-3 · Cited by 4,208
Research works printed but not linked: 3
- 2004, Evaluating the Healthcare System: Effectiveness, Efficiency, and Equity
- Camacho, N., Landsman, V. and Stremersch, S. (2010), “The connected patient”, in Wuyts, S., Dekimpe, M., Gijsbrechts, E. and Pieters, F.G.M. (Rik) (Eds), The Connected Customer: The Changing Nature of Consumer and Business Markets, Routledge, New York, NY, pp. 107-139.
- 2014, Service-Dominant Logic: Premises, Perspectives, Possibilities
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Metadata
- Authors
- Beirão, G., Patrício, L., & Fisk, R. P.
- Affiliations
- Universidade do Porto (PT)
- Texas State University (US)
- Venue
- Journal of Service Management
- Publisher
- Emerald
- Published
- 2017-04-18
- Volume
- 28
- Issue
- 2
- Pages
- 227-249
- ISSN
- 1757-5818 (ISSN-L)
- OpenAlex
- W2607384897
- Semantic Scholar
- f70da56e7fefedad2e2dccb368a277b638a9b3b7
- Cited by
- 271
- References
- 64
- Citations by year
- 2026: 25 · 2025: 31 · 2024: 26 · 2023: 37 · 2022: 35 · 2021: 38 · 2020: 32 · 2019: 23 · 2018: 16 · 2017: 8
- FWCI
- 39.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of service management (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Funders
- Fundação para a Ciência e a Tecnologia
- European Regional Development Fund
- Topics
- Social Sciences › Business, Management and Accounting › Marketing › Service and Product Innovation
- Social Sciences › Business, Management and Accounting › Management of Technology and Innovation › Innovative Approaches in Technology and Social Development
- Social Sciences › Public Administration › Public Policy and Administration Research
- Keywords
- value co-creation, service ecosystems, multilevel analysis, health care organization, resource integration, resource sharing, resource recombination, governance and institutions, ecosystem viability, population well-being, service-dominant logic
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