Md8091 HM Iiibme Ia (Qa)

Agni College of Technology
Thalambur, Chennai 600 130

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MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1
1. Define Marketing.
Marketing is the study and management of exchange relatonships.
Marketing is the social process by which individuals and organizations obtain

what they need and want through creating and exchanging value with others.
Kotler and Armstrong (2010).
The process by which companies create value for customers and build strong
customer relationships in order to capture value from customers in return.
Kotler and Armstrong (2010).
Marketing is the management process for identifying, anticipating and satisfying

customer requirements profitably. The Chartered Institute of Marketing
(CIM). Accessed 2012.
Marketing is the activity, set of institutions, and processes for creating,

communicating, delivering, and exchanging offerings that have value for
customers, clients, partners, and society at large. (Approved October 2007)
American Marketing Association Board of Directors. Accessed 2012.
The enigma of marketing is that it is one of man’s oldest activities and yet it is
regarded as the most recent of business disciplines.
Baker (1976).
2. Define Market Research. List what are the types of Market Research.
What are the factors that can be investigated through market research?
Market Research / Industrial Research is any organized efort to gather
informaton about target markets or customers. It is a way of getting an
overview of consumers' wants, needs and beliefs. It can also involve
discovering how they act. The research can be used to determine how a
product could be marketed. Peter Drucker believed, market research to be
the quintessence of marketing.
Types of Market Research:
There are two major types of market research. Primary Research sub-
divided into Quanttatve and Qualitatve research and Secondary research.
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Factors that can be investgated through market research:

Market informaton
Through Market information one can know the prices of diferent
commodities in the market, as well as the supply and demand situaton.
Market researchers have a wider role than previously recognized by helping
their clients to understand social, technical, and even legal aspects of
markets.
Market segmentation
Market segmentation is the division of the market or populaton into
subgroups with similar motivations. It is widely used for segmentng on
geographic diferences, personality differences, demographic differences,
techno graphic diferences, use of product differences, psychographic
differences and gender differences.
Market trends
Market trends are the upward or downward movement of a market, during
a period of tme. Determining the market size may be more difficult if one is
startng with a new innovation. In this case, you will have to derive the
fgures from the number of potential customers, or customer segments.
SWOT analysis
SWOT is a written analysis of the Strengths, Weaknesses, Opportunites and
Threats to a business entty. Not only should a SWOT be used in the creation
stage of the company but could also be used throughout the life of the
company. A SWOT may also be written up for the competiton to
understand how to develop the marketing and product mixes.
Another factor that can be measured is marketing effectveness. This

includes
 Customer analysis
 Choice modeling
 Competitor analysis
 Risk analysis
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 Product research
 Advertsing the research
 Marketng mix modeling
 Simulated Test Marketng
3. What are the benefits of Marketing Research? Write briefly about the
market research process.
Market Research is an essental tool which assists in making strategic
decisions. It reduces the risks involved in making decisions as well as
strategies. Companies either do this research in house or outsource this
process to business experts or organizatons that have dedicated and
trained resources to perform this.
Some major benefits are -
i. Marketng research assists in providing accurate and latest trends
related to demand, consumer behavior, sales, growth opportunities
etc.
ii. It helps in better understanding of the market, thus helps in product
design, features and demand forecasts
iii. It assists in studying and understanding the competitors, thus
identfying unique selling propositons for a business.
iv. Market research reaps many such benefits which are Industry and
business specific and have high ROI's.
T he Marketing Research Process
Marketng research spans a number of stages, including:
i. Defne the problem
ii. Develop a research plan
iii. Collect the data
iv. Interpret data into informaton
v. Disseminate informaton formally in the form of a report
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4. Why health care sector needs Marketing Research?

As the healthcare industry becomes more specialized, streamlined, and
consolidated, companies are increasingly looking for ways to improve
service and add tailored-products. Market research – qualitative market
research – relies on person-to-person interview and observation techniques,
making it the most efectve way to understand how people use and
consume products and services.
Healthcare market primarily consist of

 Pharmaceutcal companies
 Medical device, supplies and equipment businesses
 Primary and Secondary Care Facilites (e.g. hospitals, nursing homes)
 Healthcare providers (e.g. doctors, nurses, pharmacists)
 Patents who need products and services provided by any of the above
Can use marketing research to:
 Identfy your organization’s key decisions and information needs
 Defne healthcare marketing research objectives based on those needs
 Design a research methodology–or combination of methodologies–that
makes sense given your organizaton’s goals, resources, size, patent
characteristcs, provider characteristcs, geographic markets served, and
any prior marketng research you may have conducted
 Collect the data needed to answer your questions
 Present results that can be put to use immediately in terms of
marketing, staff training, media placement, public relatons, and
communicatons efforts
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5. Define Marketing Information system and mention its components.

A system that analyzes and assesses marketing information,
gathered continuously from sources inside and outside an
organization. Timely marketing information provides basis for
decisions such as product development or improvement, pricing,
packaging, distribution, media selection, and promotion.
6. What do you mean by consumer market?

Markets dominated by products and services designed for the general
consumer. Consumer markets are typically split into four primary
categories: consumer products, food and beverage products, retail
products, and transportation products. Industries in the consumer markets
ofen have to deal with shiftng brand loyaltes and uncertainty about the
future popularity of products and services.
7. What is meant by consumer buyer behavior? Name some Model of

Consumer behavior?
Consumer buyer behavior refers to the buying behavior of fnal consumers –
individuals and households who buy goods and services for personal
consumpton. All of these final consumers combine to make up the
consumer market.
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Models of consumer behavior
 The economic model

 Learning model
 Psychological model
 The sociological model
 The howard sheth model of buying behavior
 The Nicosia model
8. Give examples of consumer behavior.

Consumer attitudes are a composite of a consumer’s (1) beliefs about, (2)
feelings about, (3) and behavioral intentons toward some object--within the
context of marketng, usually a brand or retail store. These components are
viewed together since they are highly interdependent and together represent
forces that infuence how the consumer will react to the object.
9. Draw the model of business buyer behavior
10. Write a note on WTO
The World Trade Organization is a Multi-lateral organizaton which

facilitates the free fow of goods and services across the world and
encourages fair trade among natons. The result is that the global
income increases due to increased trade and there is supposed to be
overall enhancement in the prosperity levels of the member nations. To
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put it in brief WTO encourages a multi-lateral trading system within its

member countries.
11. Explain Global Marketing.

The process of conceptualizing and then conveying a final product or service
worldwide with the hopes of reaching the international marketng
community. Proper global marketing has the ability to catapult a company
to the next level, if they do it correctly. Different strategies are
implemented based on the region the company is marketng to. For
example, the menu at McDonald's varies based on the locaton of the
restaurant. The company focuses on marketng popular items within the
country. Global marketng is especially important to companies that provide
products or services that have a universal demand such as automobiles and
food.
12. Explain the benefits of Clinical Information System (CIS).

A Clinical Information System (CIS) is a computer based system that is
designed for collecting, storing, manipulatng and making
available clinical information important to the healthcare delivery
process.
13. Define Hospital Information System (HIS). Mention its components and
benefits.
HIS is a comprehensive, integrated information system designed to manage all

the aspects of a hospital's operation, such as medical, administratve, fnancial,
and legal issues and the corresponding processing of services.
The purpose of a hospital informaton system (HIS) is to manage the information

that health professionals need to perform their jobs efectively and eficiently.
Informaton Requirements:
 Operational Requirements
o up-to-date factual information
o necessary for day to day tasks
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 Planning requirements
o short- and long-term decisions about patent care
o decisions about hospital management
 Documentation Requirements
o the maintenance of records
o accreditation
o legal record
It costs a lot of money to deal with the information in a hospital.
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14. How are computers useful for medical records in a hospital?

The additon of computers to the health care system was done with one
goal in mind: eficiency. Computers have helped nurses and doctors keep
track of various items ranging from work schedules to patent's scheduled
appointments. They not only handle the logistcs of hospitals, but also
medical implicatons, such as X-rays and surgery equipment. The specifc
advancements that computers have brought to everyday hospital life can be
seen in four diferent categories: clinical implicaton, administration,
research, & community settngs. In all reality, when you read the
informaton listed below of all the various uses of computers in hospitals,
you will come to wonder, as I did, how did hospitals survived without
technology? It certainly has brought much less paper cuts.
15. How to decide the location of hospital pharmacy?
The pharmacy should be easily located & identfed by the public. Exterior of the
pharmacy should be maintained neat and clean. The façade should be clearly
marked with the word “PHARMACY” written in English as well as in the local
language(s) of the area. As far as possible, the pharmacy should be conveniently
assessable to people using prams or wheel chairs etc. pharmaceutical services
and products should be served from an area which is separate from the other
actvities/services and products. This facilitates the integrity &quality of
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products, and minimizes the risk of dispensing errors. The Pharmacist should be
directly & easily accessible to public for informaton, counseling, etc.
16. Write short notes on support services in a hospital.

Support service departments ensure: the hospital is clean, limitng the risk
for infectons; patient rooms are ready and available, improving throughput;
food is nourishing and delicious, improving healing and wellbeing; linens are
fresh, instlling trust and comfort; equipment works, improving clinical
diagnostcs and outcomes; and the lights are on, welcoming those in need.
17. Write short notes on the medical transcription process.

Medical Transcription Services include the act of transcribing medical
reports that are dictated by physicians, nurses and other healthcare
practtoners. Dictatons are voice fles typically called in over the telephone
or uploaded digitally via the Internet and now through smart phone apps.
18. List out the responsibilities for a dietician in hospital food services.
Under general direction, the Chief Diettan is assigned full professional and
administrative responsibility for a large nutrition service program including
clinical dietetcs and food service operations that provide comprehensive
nutriton services through a large staf of clinical and management
diettans, food service managers, technicians, skilled and skilled employees.
The Chief Diettan plans, administers, and evaluates dietetic and food
service policies and procedures; plans major service programs; oversees
staf supervision and development; coordinates nutrition service with other
major hospital and clinic units; determines future program needs; develops,
monitors, and forecasts budgets; represents the nutriton service on related
hospital and medical staf commitees; monitors adherence to laws,
regulatons, and codes within the nutrition service areas.
19. What are the advantages and disadvantages of Medical Records keeping?
Advantages of electronic medical records
1. The data tends to be more accurate. Electronic records eliminate the
possibility of mistakes as a result of misreading a doctor's handwritng.
2. They are easily accessible to all care providers and to more than one care
provider at a time
3. They are easily portable from one doctor's ofice to another.
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4. Their use can lead to cost savings, since keeping electronic records is more
efficient than retaining paper records.
Disadvantages of electronic medical records
1. The possible incompatbility of computer systems among various health
providers can lead to diffculty in sharing the data.
2. Privacy and security can be an issue. If someone hacks into a computer
system, patent's records can be compromised.
3. Computer crashes make records inaccessible.
4. Cost of implementng EMR can be expensive.
20. What are the required skills and abilities for a medical transcriptionist?
 Knowledge of medical terminology

 Above-average typing skills, writing skills, grammar skills, memory skills,
and communication skills
 Basic to above-average knowledge of computers
 Can accurately transcribe information, particularly patient
identifying information
 Ability to follow directions and instructions
 Real-world experience in medical transcription
 Will consult reference materials and resources to ensure use of
correct terminology
 Has ability to record and maintain records and number figures
PART – B
MARKETING INFORMATION SYSTEMS
INTRODUCTION:
To understand the proper role of information systems one must examine what
managers do and what information they need for decision making. One must
also understand how decisions are made and what kinds of decision problems
can be supported by formal information systems. One can then determine
whether information systems will be valuable tools and how they should be
designed.
OBJECTIVES:
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1. Explain the importance of information to managers

2. Define Marketing Information System and understand its parts
3. List out the steps in the Marketing Research Process
4. Outline how organisations analyze and distribute the Marketing
Information
5. Issues that Marketing Researchers face
An understanding of the different roles managers play and how marketing

information systems can support them in these roles.
 What managers do:
1. Analysis
2. Planning
3. Organizing
4. Coordinating
5. Deciding
6. Controlling
 How do they do it?
1. Managerial roles: managerial activities fall into 3 categories:
interpersonal, information processing and decision making.
2. Managers work on issues that are current, specific and adhoc.
3. Managers converse with customers, competitors, colleagues,
peers, secretaries, government officials and so that they
together act as an information system.
4. Communication of a manager: managers prefer verbal forms of
communication to written forms. Verbal media are perceived to
ofer greater flexibility, require less efort and bring a faster
response.
5. Maintaining day’s work: Successful managers are those who can
control the activities that they choose to get involved in on a
day-to-day basis.
6. Interpersonnel management: Managers act as a liaison between
various levels of the organization and, within each level, among
levels of the management team.
7. Information processing: Managers act as the nerve centre for
the organization, receiving the latest, most concrete, most up-
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to-date information and redistributing it to those who need to

know.
8. Decision making: Managers initiate new kinds of activities,
handle disturbances arising in the organization, allocate
resources where they are needed in the organization, mediate
between groups.
A marketing information system (MkIS) is a management information system

(MIS) designed to support marketing decision making. Jobber (2007) defines it
as a "system in which marketing data is formally gathered, stored, analysed
and distributed to managers in accordance with their informational needs on a
regular basis."
 ASSESSING THE MARKETING INFORMATION NEEDS

o A marketing information system (MIS) consists of people,
equipment, and procedures to gather, sort, analyze,
evaluate, and distribute needed, timely, and accurate
information to marketing decision makers.
o Assess the information needs
o Develop needed information
o Analyze information
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o Distribute information
MIS provides information to the company’s marketing and other

managers and external partners such as suppliers, resellers, and
marketing service agencies.
A good MIS balances the information users would like to have
against what they need and what is feasible to ofer.
Issues to consider:
• Amount of information
• Availability of information
• Costs
 DEVELOPING MARKETING INFORMATION

Marketers can obtain information from:
o Internal data
 Internal databases are electronic collections of
consumer and market information obtained from
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data sources within the company network, including

accounting, marketing, customer service, and sales
departments.
 Advantages and Disadvantage of Internal Databases

Advantages:
1. Can be accessed more quickly
2. Less expensive
Disadvantages:
1. Incomplete information
2. Wrong form for decision making
3. Timeliness of information
4. Amount of information
5. Need for sophisticated equipment and
techniques
o Marketing intelligence
 Marketing intelligence is the systematic collection
and analysis of publicly available information about
competitors and developments in the marketplace.
 The goal of marketing intelligence is to:
1. Improve strategic decision making
2. Assess and track competitors’ actions
3. Provide early warning of opportunities
and threats.
 MARKETING RESEARCH
Marketing research is the systematic design, collection, analysis,
and reporting of data relevant to a specific marketing situation
facing an organization.
o Steps in the marketing research process:

1. Defining the problem and research objectives
2. Developing the research plan
3. Implementing the plan
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4. Interpreting and reporting the findings
o Defining the Problem and Research Objectives:

Types of objectives:
 Exploratory research is the gathering of
preliminary information that will help to
define the problem and suggest hypotheses.
 Descriptive research is to describe things
such as market potential for a product or the
demographics and attitudes of consumers
who buy the product.
 Causal research is to test hypotheses about
cause-and-effect relationships.
o Developing the Research Plan

 The research plan outlines sources of existng data
and spells out the specific research approaches,
contact methods, sampling plans, and instruments
that researchers will use to gather data
 The research plan is a writen proposal that includes:
1. Management problem
2. Research objectives
3. Information needed
4. How the results will help management
decisions
5. Budget
 Secondary data consists of information that already

exists somewhere, having been collected for another
purpose
 Advantages: Speed, Cost, Provides data that a
company cannot collect on its own
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 Disadvantages: Availability, Relevance,

Accuracy, Impartial
 Primary data consists of information gathered for

the special research plan. Primary data is collected
with the following methods,
Research approaches:
1. Observational research involves gathering
primary data by observing relevant people,
actions, and situations.
2. Ethnographic research involves sending
trained observers to watch and interact with
consumers in their natural environment.
3. Survey research is the most widely used
method and is best for descriptive
information—knowledge, attitudes,
preferences, and buying behavior.
 Flexible
 People can be unable or unwilling to
answer
 Gives misleading or pleasing answers
 Privacy concerns
4. Experimental research is best for gathering

causal information and tries to explain cause-
and-efect relationships.
Contact methods:
 Mail questionnaires
o Collect large amounts of information
o Low cost
o Less bias with no interviewer present
o Lack of flexibility
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o Low response rate

o Lack of control of sample
o Sampling plan
o Research instruments
 Telephone interviewing
o Collects information quickly
o More flexible than mail
questionnaires
o Interviewers can explain difficult
questions
o Higher response rates than mail
questionnaires
o Interviewers communicate directly
with respondents
o Higher cost than mail
questionnaires
o Potential interviewer bias
 Personal interviewing
o Involves talking with people at home
or the office, onthe street, or in
shopping malls
o Flexible
o More expensive than telephone
interviews
 Group interviewing or focus group

interviewing
o Involves inviting 6 to 10 people to talk
with a trained moderator
 Online marketing research

o Internet surveys
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o Online panels
o Online experiments
o Online focus groups
Features of Online research:

o Low cost
o Speed to administer
o Fast results
o Good for hard-to-reach groups
o Hard to control who’s in the sample
o Lack of interaction
o Privacy concerns
 Sampling Plan
o A sample is a segment of the
population selected for marketing
research to represent the population
as a whole.
o Who is to be surveyed?
o How many people should be
surveyed?
o How should the people be chosen?
o Probability samples: Each population
member has a known chance of being
included in the sample.
o Non-probability samples: Used when
probability sampling costs too much
or takes too much time.
 Research Instruments
o Questionnaires
 Most common
 Administered in person, by
phone, or online
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 Flexible
 Open-end questions allows
respondents to answer in their
own words and this is useful in
exploratory research
 Closed-end questions, include
all the possible answers and
subjects are to make choices
among them. Provides answers
that are easier to interpret and
tabulate.
Implementng the research plan

Collecting data, processing the information, analyzing
the information
Issues to consider:
 What if respondents refuse to cooperate?
 What if respondents give biased answers?
 What if interviewer makes mistakes or takes
shortcuts?
 ANALYZING MARKETING INFORMATION
Customer Relationship Management (CRM)
 Consists of sophisticated software and analytical tools

 Integrates customer information from all sources
 Analyzes it in depth
 Applies the results to build stronger customer relationships
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Data warehouses are comprehensive company wide electronic databases

of finely-tuned, detailed customer information.
Uses:
 To understand customers better

 To provided higher levels of customer service
 To develop deeper customer relationships
 To identify high-value customers
Touch points: Every contact between the customer and company
 Customer purchases
 Sales force contacts
 Service and support calls
 Web site visits
 Satisfaction surveys
 Credit and payment interactions
 Research studies
 DISTRIBUTING AND USING MARKETING INFORMATION

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 Information distribution involves entering information into

databases and making it available in a time-useable manner.
 Intranet provides information to employees and other stake
holders.
 Extranet provides information to key customers and suppliers
 OTHER MARKETING INFORMATION CONSIDERATIONS
 Marketing Research in Small Businesses and Nonprofit

Organizations:
 Need information about their industry, competitors,
potential customers, and reactions to new ofers
 Must track changes in customer needs and wants,
reactions to new products, and changes in the
competitive environment
 Sources of marketing information:
o Observing their environment
o Monitoring competitor advertising
o Evaluating customer mix
o Visiting competitors
o Conducting informal surveys
o Conducting simple experiments
o Secondary data:
 Trade associations
 Chambers of commerce
 Government agencies
 Media
 International Marketing Research
Additional and different challenges:

 Level of economic development
 Culture
 Customs
 Buying paterns
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 Difficulty in collecting secondary data: Hard-to-reach

respondents
 Public Policy and Ethics in Marketing Research
 Intrusions on consumer privacy

 Consumer resentment
 Misuse of research findings
MARKETING RESEARCH (MR)
1) DEFINITION
MR is the systematic design, collection, analysis & reporting of data &

findings relevant to a specific marketing situation facing the company
(OR)
MR is the systematic gathering, recording and analyzing of data about

problems related to the marketing of goods & services
2) PURPOSE OF MR
• To improve quality of decision making process by providing

information
• To help reduce the risk associated with managerial decision
making
– Risk due to two types of uncertainties:
• About the expected outcome
• About the future environment
• To discover opportunity & exploit profitably
3) SCOPE OF MR
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• Consumers of products & services : Buyer behaviour, Influencers,

Buying habits, Incentives
• Product & product design : Pricing, Sourcing, Physical atributes
• Distribution Channels : Performance, Dealer Satisfaction, Own vs

Mult-brand
• Advertising Impact : Image, Positioning, Media Planning, Message

Content & Prioritizing
• Macro Level Phenomenon: Govt spending. Mood of the Industry,

State of Economy
4) MANAGEMENT RESEARCH QUESTION HIERARCHY
 Management dilemma – Why are sales declining in south

while sales are booming in all other regions
 Research questions – How can we improve sales in south?
 Management questions – Introduce individual incentive?
Quota based incentive? Advertise more?
 Investigate questions – If compensation scheme is
changed, will good sales persons leave?
 Measurement questions – Conduct an employee survey
for outcomes of change in compensation structure
 Management decision
5) WORKING WITH THE DILEMMA
Management Dilemma
a. The symptom of an actual problem

b. Not dificult to identify a dilemma, however choosing one
to focus on may be dificult
c. Needs proper prioritizing
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Management Question Categories
d. Choice of purposes or objective

e. Generation and evaluation of solutions
f. Troubleshooting or control situation
Fine tune the research question
g. Examine concepts and constructs

h. Break research questions into specific second-and-third-
level questions
i. Verify hypotheses with quality tests
j. Determine what evidence answers the various questions
and hypothesis
k. Set the scope of your study
Investigative Questions
l. Questions the researcher must answer to satisfactorily

arrive at a conclusion about the research question
Measurement Questions
m. The questions we actually ask to extract information from

respondents
6) MARKET RESEARCH PROCESS

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7) WHY CONDUCT MARKET RESEARCH IN NEW PRODUCT

DEVELOPMENT?
The product must appeal to the customer (however widely

defined)
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Timely market research can help you mould the product to the
consumer’s need/wants
Market research tend to point out successes and failures before

products are launched “for real”
As a result, it can save you money and time
8) TYPES OF MARKET RESEARCH
BY SOURCE
Primary Collection of data specifically for the problem or

project in hand
Secondary Based on data previously collected for purposes

other than the research in hand (e.g.
published articles, government stats, etc)
BY OBJECTIVE
• Exploratory Preliminary data needed to develop an idea

further. Eg outline concepts, gather insights, formulate
hypotheses
• Descriptive Describe an element of ideas precisely. Eg
who is the target market, how large is it, how will it develop
• Causal Test a cause and efect relationship, e.g.
price elasticity. Done through experiment
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CONSUMER MARKET AND CONSUMER BUYER BEHAVIOUR
Consumer market refers to all of the personal consumption of final

consumers
Consumer buyer behavior refers to the buying behavior of final

consumers—individuals and households who buy goods and services for
personal consumption
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1) CHARACTERISTICS AFFECTING CONSUMER BEHAVIOUR
Cultural Factors
1) Buyer’s culture - Culture is the learned values,

perceptions, wants, and behavior from family and other
important institutions
2) Buyer’s subculture - Subculture are groups of people
within a culture with shared value systems based on
common life experiences and situations. Hispanic, African
American, Asian, Mature consumers.
3) Buyer’s social class - Social classes are society’s relatively
permanent and ordered divisions whose members share
similar values, interests, and behaviors. Social class is
measured by a combination of occupation, income,
education, wealth, and other variables. The major
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American social classes : Upper class, Middle class,

Working class, Lower class.
Social Factors
Membership groups have a direct influence and to which a person

belongs;Aspirational groups are groups to which an individual wishes to
belong;Reference groups are groups that form a comparison or reference
in forming attitudes or behavior.Opinion leaders are people within a
reference group with special skills, knowledge, personality, or other
characteristics that can exert social influence on others;Buzz marketing
enlists opinion leaders to spread the word;Social networking isa new
form of buzz marketing : MySpace.com, Facebook.com.
a. Reference groups
b. Family - Family is the most important consumer-buying
organization in society
c. Roles and status - Social roles and status are the groups, family,
clubs, and organizations to which a person belongs that can
define role and social status
b) Personal Factors
a. Age and life-cycle stage : Youth—younger than 18; Geting started
—18-35; Builders—35-50; Accumulators—50-60; Preservers—over
60
b. Occupation
c. Economic situation : Personal income, Savings, Interest rates
d. Lifestyle - is a person’s patern of living as expressed in his or her
psychographics Measures a consumer’s AIOs (activites, interests,
and opinions) to capture information about a person’s pattern of
acting and interacting in the environment
e. Personality and self-concept : Brand personality refers to the
specifc mix of human traits that may be atributed to a particular
brand : Sincerity, Excitement, CompetenceSophistication,
Ruggedness.Self-concept refers to people’s possessions that
contribute to and reflect their identities
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c) Psychological Factors
a. Motivation: A motive is a need that is sufficiently pressing to
direct the person to seek satisfaction. Motivation research refers
to qualitative research designed to probe consumers’ hidden,
subconscious motivations
b. Perception : Perception is the process by which people select,
organize, and interpret information to form a meaningful picture
of the world from three perceptual processes : Selective
atention(is the tendency for people to screen out most of the
information to which they are exposed), Selective distortion(is the
tendency for people to interpret information in a way that will
support what they already believe), Selective retention(is the
tendency to remember good points made about a brand they
favor and to forget good points about competing brands)
c. Learning (Learning is the changes in an individual’s behavior
arising from experience and occurs through interplay of: Drives,
Stimuli, Cues, Responses, reinforcement)
d. Beliefs and atitudes : Belief is a descriptive thought that a person
has about something based on: Knowledge,Opinion,Faith.
Attitude describe a person’s relatively consistent evaluations,
feelings, and tendencies toward an object or idea.
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2) TYPES OF BUYING DECISION BEHAVIOUR
• Complex buying behavior : When consumers are highly motivated

in a purchase and perceive significant differences among brands
• Purchasers are highly motivated when:
• Product is expensive
• Product is risky
• Product is purchased infrequently
• Product is highly self-expressive
• Dissonance-reducing buying behavior: occurs when consumers
are highly involved with an expensive, infrequent, or risky
purchase, but see little difference among brands. Post purchase
dissonance occurs when the consumer notices certain
disadvantages of the product purchased or hears favorable things
about a product not purchased
• Habitual buying behavior :occurs when consumers have low
involvement and there is little significant brand diference
• Variety-seeking buying behavior : occurs when consumers have
low involvement and there are significant brand diferences
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3) CONSUMER BUYING DECISION PROCESS
Five stages in the buyer decision process
1. Need recognition
2. Information search
3. Evaluation of alternatives
4. Purchase decision
5. Post-purchase behavior
Need recognition occurs when the buyer recognizes a

problem or need triggered by:
• Internal stimuli
• External stimuli
Information search is the amount of information needed in

the buying process and depends on the strength of the drive, the
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amount of information you start with, the ease of obtaining the

information, the value placed on the additional information, and
the satisfaction from searching
• Sources of information:
• Personal sources—family and friends
• Commercial sources—advertising, Internet
• Public sources—mass media, consumer organizations
• Experiential sources—handling, examining, using the product
Evaluation of alternatives is how the consumer processes

information to arrive at brand choices
The purchase decision is the act by the consumer to buy the most
preferred brand.The purchase decision can be affected by:
• Atitudes of others
• Unexpected situational factors
The post-purchase decision is the satisfaction or dissatisfaction

the consumer feels about the purchase.The larger the gap
between expectation and performance, the greater the
consumer’s dissatisfacton.Cognitive dissonance is the discomfort
caused by a post-purchase conflict
• Relationship between:
• Consumer’s expectations
• Product’s perceived performance
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4) CONSUMER BUYING PROCESS FOR NEW PRODUCTS
• New product is a good, service, or idea that is perceived by

some potential customers as new
• Adoption process is the mental process an individual goes
through from first learning about an innovation to final
regular use
• Stages in the Adoption Process: Awareness ,Interest,
Evaluation, Trial, Adoption
• Awareness is when the consumer becomes aware of the
new product but lacks information
• Interest is when the consumer seeks information about
the new product
• Evaluation is when the consumer considers whether trying
the new product makes sense
• Trial is when the consumer tries the new product to
improve his or her estimate of value
• Adoption is when the consumer decides to make full and
regular use of the product.
5) TYPES OF BUYING DECISION

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It is not only products differ. Even the buying situation differs. each time the
buyer is to take a purchase decision ,it may or may not be the same as the
previous one. The differentiaton between the two buying situations may be
caused by the absence of any or all of the following factors.
1.Awareness about competing brands in a product group.
2.Customer has a decision criteria and
3.Customer is able to evaluate and decide on
his choice.
Viewed against these parameters ,one may observe that it is not the product
that differentates one buying situaton from another; rather it is the time that
the buyer spends in learning and evaluatng the alternatves or fnally selectng
one of them .Howard and Sheth have described these buying situatons as
being:
1.Routnisedresponsebehavior
2.Limited problem solving and
3.Extensive problem solving.
Routinized Response Behavior or Straight Re buy
This is a buying situation characterized by the presence of all the above three
criteria for differentation .In other words, here the customers is aware of his or
her choices, knows what he is looking for, as his or her decision is based on
personal experience of either self or others. Generally, the customers spends
little or no time choosing an alternative .Brand loyalty is relatively higher here.
Moreover, this is a buying situatons where a customer perceives a low risk in
buying the product and/or the brand. Consider the typical shopping behavior of
a housewife .She goes to the grocer or a supermarket and spends much less
tme in selecting her toiletries ,beverages like tea or cofee and other food
products. For each time she goes to buy her family requirements ,she generally
ends up buying the same brand.
Limited Problem Solving or Modified Re buy

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This is a buying situation with a difference .This could be for example,

introduction of a new brand or product ofen requiring a change in the
customers decision criteria. Contnuing the example of the housewife ,assume
that in her next shopping cycle ,she sees a new liquid toilet soap which promises
to keep her skin soft and moisturized .the brand also promises to give vitamin E,
which the manufacturer claims is required in temperate conditons.
The liquid toilet soap brand is available in four fragrances .The pack can be
reflled every time the soap gets fully consumed .Now this introduction is likely
to change her decision and may be the choice criteria. If she spends some time
in evaluatng the liquid toilet soap against the normal bar soap and then decides
to try it, we conclude that for her it was a limited problem solving situation. As
can be seen, this buying situaton will often lead to a trial purchase. the
customer may even decide to contnue with her current product selecton.
generally it has been observed that brand extension strategy help the customer
to reduce the element of newness in the purchase decision. Like ,for example
Unilever deciding to introduce liquid toilet soap under its most popular brand
name lux. It may be remembered that customer perceives moderate risk in this
situaton.
Extended Problem Solving (EPS)
- High degree if complexity

- Ofen occurs with expensive items or can be fuelled by doubts and fears
- All 7 consumer decision making stages are ofen used (need recogniton,
search for informaton, pre-purchase evaluaton of alternatves, purchase,
consumpton, post-consumpton evaluation and divestment)
- Dissatisfaction ofen leads to negative word of mouth
- A longer tme is taken to decide
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6) BUYER DECISION PROCESS
A buying decision process is the process a customer goes through when

buying a product. It can be seen as a particular form of a cost–benefit
analysis. The buying decision model has gone through lots of
interpretation by scholars. Although the models vary, there is a common
theme of five stages in the decision process.
The stages are:
1. Problem/Need recogniton
2. Informaton search
3. Evaluation of alternatves
4. Purchase decision
5. Post-purchase behavior
These five stages are a framework to evaluate customers' buying decision

process. However, it is not necessary that customers get through every stage,
nor is it necessary that they proceed in any partcular order. For example, if a
customer feels the urge to buy chocolate, he or she might go straight to the
purchase decision stage, skipping information search and evaluation.
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Problem/need-recognition
Problem/Need-recogniton is the frst and most important step in the buying

decision. Without the recogniton of the need, a purchase cannot take place.
The need can be triggered by internal stmuli (e.g. hunger, thirst) or external
stmuli (e.g. advertsing).Maslow held that needs are arranged in a hierarchy.
According to Maslow's hierarchy, only when a person has fulfilled the needs at a
certain stage, can he or she move to the next stage. The problem must be
addressed through the products or services available. It's how the problem must
be recognized.
Information search
The information search stage is the next step that the customers may take after
they have recognized the problem or need in order to fnd out what they feel is
the best soluton. This is the buyers' effort at searching the internal and external
business environments to identfy and observe sources of information related to
the focal buying decision. Consumers can rely on print, visual, and/or voice
media for gettng information.
Evaluation of alternatives
At this stage, consumers evaluate different products/brands on the basis of

varying product atributes, and whether these can deliver the benefts that the
customers are seeking. This stage is heavily infuenced by one's atitude, as
"attitude puts one in a frame of mind: liking or disliking an object, moving
towards or away from it". Another factor that infuences the evaluation process
is the degree of involvement. For example, if the customer involvement is high,
then he/she will evaluate a number of brands; whereas if it is low, only one
brand will be evaluated.
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Customer involvement High Medium Low
Characteristcs High Medium Low
Number of brands examined Many Several One
Number of sellers considered Many Several Few
Number of product attributes evaluated Many Moderate One
Number of external informaton sources used Many Few None
Time spent searching Considerable Litle Minimal
Purchase decision
This is the fourth stage, where the purchase takes place. According to Kotler,
Keller, Koshy and Jha (2009), the fnal purchase decision can be disrupted by
two factors: negative feedback from other customers and the level of
motvaton to comply or accept the feedback. For example, after going through
the above three stages, a customer chooses to buy a Nikon D80DSLR camera.
However, because his good friend, who is also a photographer, gives him
negatve feedback, he will then be bound to change his preference. Secondly,
the decision may be disrupted due to unantcipated situatons such as a sudden
job loss or the closing of a retail store.
Post-purchase behavior
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These stages are critcal to retain customers. In short, customers compare

products with their expectatons and are either satisfied or dissatsfied. This can
then greatly afect the decision process for a similar purchase from the same
company in the future, mainly at the information search stage and evaluation of
alternatives stage. If customers are satisfed, this result in brand loyalty, and the
informaton search and evaluaton of alternative stages are often fast-tracked or
skipped completely. As a result, brand loyalty is the ultmate aim of many
companies.
On the basis of either being satsfed or dissatsfed, a customer will spread

either positive or negatve feedback about the product. At this stage, companies
should carefully create positve post-purchase communication to engage the
customers.
Also, cognitve dissonance (consumer confusion in marketing terms) is common

at this stage; customers often go through the feelings of post-purchase
psychological tension or anxiety. Questions include: "Have I made the right
decision?", "Is it a good choice?” etc.
7) MODEL OF BUSINESS BUYER BEHAVIOUR

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8) WTO AND ITS IMPLICATIONS
Introduction:
The World Trade Organization is a Multi-lateral organization which

facilitates the free flow of goods and services across the world and
encourages fair trade among nations. The result is that the global
income increases due to increased trade and there is supposed to be
overall enhancement in the prosperity levels of the member nations.
To put it in brief WTO encourages a multi-lateral trading system within
its member countries.
Origin and Evolution of WTO: - GATT to Uruguay
WTO is of a very recent origin, it came into formal existence on

st
January 1 1995. As an organization it has vast powers and functions
than what its predecessor GATT (General Agreement on Tariffs and
Trade) had, the objectives and goals of both being broadly the same.
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GATT came into existence in the year 1948, after long negotiations to
form an organization called ITO immediately after the Second World
War did not materialize. The ITO was supposed to be the third
international organization in the "Golden Triangle" that was supposed
to come into existence, the first two being IMF and World Bank.
To begin with 23 countries became founding GATT members (officially,

"contracting parties"). GATT remained the only multilateral instrument
governing international trade from 1948 until the WTO was established
in 1995. There were several controversies on whether the GATT had
actually contributed to enhancement of world trade and did it serve its
purpose of a multi-lateral trading organization. The liberalization of
international trade during GATT era in its true sense was always
debatable. However, it is very clear that over the period of 47 years of
its existence, GATT was successful in initiating a process of tariff
cutting in several groups of manufactured goods. Moreover the
signatories in the GATT increased from 23 to more than 100 in a short
span, ratifying the fact that being in the system was proved and
considered more beneficial than not being in it.
On the other front, the internal and domestic economic problems and
fluctuations made some economies to go back to increase the levels of
protection and increase trade barriers to enable faster domestic
growth and recovery. The problem was not just a deteriorating trade
policy environment, but some other serious issues. GATT negotiations
did not include services and agricultural trade in its gamut. As the
world trade grew in size, the share of services trade along with that of
merchandise started to increase leading to the insufficiency of the
GATT principles to cover the expanding aspects of ever evolving global
trade. As a result, these loopholes were taken as advantage by many
trading countries, resulting in a lopsided development of world trade.
These and other factors convinced GATT members that a new effort to
reinforce and extend the multilateral system should be attempted.
That effort resulted in the Uruguay Round, the Marrakesh Declaration,
and the creation of the WTO.
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WTO - Some Basic Facts:
Location: Geneva, Switzerland

Established: 1 January 1995
Created by : Uruguay Round negotiations (1986-94)
Membership: 148 countries (as of April 2005)
Budget: 155 million Swiss francs for 2003
Secretariat staff: 560
Head : Director-General, Supachai Panitchpakdi
What are its Objectives and Functions?
The overriding objective of the World Trade Organization is to help

trade flow smoothly, freely, fairly and predictably; to meet its
objective WTO performs the following functions
 Administering W.T.O Trade Agreements.

 Acting as a Forum for trade negotiations.
 Settling and Handling Trade disputes
 Monitoring and reviewing national trade policies,
 Assisting the member in trade policies through technical
assistance and training programmes
 Technical assistance and training for developing countries.
 Co-operation with other International Organization
What are its Principles?
The agreements of WTO cover everything from trade in goods,

services and agricultural products, these agreements are quite
complex to understand, however all these agreements are based on
some simple principles;
 Non-Discrimination
This is a very simple principle which advocates that every

member country must treat all its trading partners equally
without any discrimination, meaning that if it offers any special
concession to one trading partner, such concessions need to be
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extended to its other trading partners as well in entirety. This

principle effectively gets translated into "MFN" or the Most
Favored Nation. However, this principle is relaxed in certain
exceptional cases, such as if country X has entered into a
regional trade agreement with another country Y, then the
concessions extended to Y country need not be extended to
other non-members of the agreement. Besides these
developing countries facing Balance of Payment problems also
get concessions, and if a country can prove unfair trade it can
retain its power to discriminate.
The Non-discrimination principle is also translated as a principle

that would ensure "National Treatment" to all the goods,
services or the intellectual property that enters any other
countries national borders.
 Reciprocity
This Principle reflects that any concession extended by one

country to another need to be reciprocated with an equal
concession such that there is not a big difference in the
countries Payments situation. This was further relaxed for
developing countries facing severe Balance of Payments crisis.
This principle along with the first principle would actually result
in more and more liberalization of the world trade as any
country relaxing its trade barriers need to extend it to all other
members and this would be reciprocated. Thus progressive
liberalization of the world trade was aimed at by WTO.
 Transparency
The multilateral trading system is an attempt by governments

to make the business environment stable and predictable. Thus
this principle ensured that there is lots of transparency in the
domestic trade policies of member countries. Moreover, the
member countries are required to sequentially phase out the
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non-tariff barriers and progressively reduce the tariff barriers

through negotiations.
Thus, these principles were primarily to serve the purpose of freer and
fair trade and also to encourage competitive environment in the global
market. This was further supposed to enhance development and
Economic reforms in the developing countries over a period of time in
a phased manner.
What are the Major Agreements in WTO?
There are several agreements which are agreed upon by member

countries in the last round of negotiations under GATT, The Uruguay
round (1986-94), which resulted in the formation of WTO The
complete set runs to some 30,000 pages consisting of about 60
agreements and separate commitments (called schedules) made by
individual members in specific areas such as lower customs duty rates
and services market-opening.
The main agreements cover vast areas from tariff reduction on specific
manufactured goods and services; other agreements deal with trade in
Textiles, Agriculture, Services; some other agreements talk about
trade in Intellectual Property, cross-border Investments, anti-dumping
duties, CVD's, Safeguards, and finally there are few agreements that
aim to reduce the Non-Tariff Barriers that hinder trade between
countries. Let us now discuss the decision making process followed to
reach consensus for these agreements at WTO, the organizational
structure and then in detail look at the impact of these agreements on
the member countries with specific reference to India.
The Decision Making Process and Organizational Structure of

WTO
Decisions are made by all the members together what we can term as
by consensus. A majority vote is also possible but it has never been
used in the WTO, and was extremely rare under the WTO's
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predecessor, GATT. After the decision by individual countries, the

WTO's agreements have been ratified in all members' parliaments. The
structure of WTO is shown in Figure 1. The WTO's top level decision-
making body is the Ministerial Conference which meets at least once
every two years. The Fifth WTO Ministerial Conference was held in
Cancún, Mexico from 10 to 14 September 2003. Below this is the
General Council (normally ambassadors and heads of delegation in
Geneva, but sometimes officials sent from members' capitals) which
meets several times a year in the Geneva headquarters. The General
Council also meets as the Trade Policy Review Body and the Dispute
Settlement Body. At the next level, the Goods Council, Services
Council and Intellectual Property (TRIPS) Council report to the
General Council. Numerous specialized committees, working
groups and working parties deal with the individual agreements and
other areas such as the environment, development, membership
applications and regional trade agreements.
The WTO has nearly 148 members, accounting for over 97% of world
trade; there are many other countries who are planning to become the
members.
How Does the Agreements affect the Member Countries?
The World Trade organization was established with an objective of

enhancing the free and fair trade, improve growth rate of world trade
by encouraging members to reduce trade barriers and to increase the
overall prosperity in the global economies. As given in the official
document of WTO following are the ten ways in which the
organization affects the world Trade and its member countries.
1. The system helps promote peace

2. Disputes are handled constructively
3. Rules make life easier for all
4. Freer trade cuts the costs of living
5. It provides more choice of products and qualities
6. Trade raises incomes
7. Trade stimulates economic growth
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8. The basic principles make life more efficient

9. Governments are shielded from lobbying
10. The system encourages good government
However, there are several groups that are against this multi-lateral
organization, and they continuously propagate against the
agreements considering them as being dis-advantageous to the
developing countries and several other sectors in the economy.
Following are
some of the general aspects of disagreements on the principles and
existence of WTO.
1. The WTO dictates policy

2. The WTO is for free trade at any cost
3. Commercial interests take priority over development …
4. It takes over the environment aspects to give concessions to some
countries for raising barriers.
5. Some issues which are continuously raised in the ministerial for
discussions but never discussed are over health and safety
6. The WTO destroys jobs, worsens poverty
7. Small countries are powerless in the WTO
8. The WTO is the tool of powerful lobbies
9. Weaker countries are forced to join the WTO
10. The WTO is undemocratic
How Does it Affect India?
India is a founder member of World Trade Organization, and also

treated as the part of developing countries group for accessing the
concessions granted by the organization. As a result, there are several
implications for India for the various agreements that are signed under
WTO. Let us understand each agreement in general, what it means
and its implications for India in specific.
1. India was a signatory of the General Agreement on Tariffs &

Trade (GATT), and as a part of the commitment had to change
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several laws and policies; the major changes that were incorporated
were as a follows
 Reduction of peak and average tariffs on manufactured

products
 Commitments to phase out the quantitative restrictions over a
period as these were considered non-transparent measure in
any countries policy structure.
The result of this agreement as mentioned earlier was limited as, GATT
was only an agreement and there was no enforcing agency to strictly
implement the clauses and punish the country which breaks the
clauses. Thus the impact was partial. However, with WTO coming into
effect, the competition from imports for the domestic firms has
increased. WTO had the deadline till 2005, for the domestic policy was
supposed to phase out the QR's; for those countries which face severe
balance of payments problems special concession period was given.
Thus it is very clear that only those firms that have competitive
advantage would be able to survive in the long run, and those firms
which are weak would fade into history in the process.
2. Trade Related Investment Measures (TRIMS)
The agreement relates to investments originating from one country to

another. The agreement prohibits the host country to discriminate the
investment from abroad with domestic investment, which implies that
it favours national treatment of foreign investment. Besides this, there
are several other clauses of the agreement totaling to 5 in this
segment, one agreement requires investment to be freely allowed
within domestic borders without any maximum cap on it. Another
restricts to impose any kind of export obligation or import cap on the
investment. Another requires that there should not be any domestic
content requirement on foreign firms operating and manufacturing in
other countries.
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These agreements have a direct impact on our Trade, Investment and

foreign exchange policy, domestic annual budgetary proposals and
also on the industrial policy.
Implementation process for the above requires proper preparation by

the industries and policy makers, as sudden change may result in loss
of revenue and decline of foreign exchange for the government and
economy, and it may result in decline of market share and profitability
of businesses, decline in employment opportunities and over all decline
in growth.
3. Trade Related Intellectual Property Rights

(TRIPS)
An intellectual property right refers to any creation of human mind

which gets legal recognition and protection such that the creator of the
intangible is protected from illegal use of his creation. This agreement
includes several categories of property such as Patents, Copyrights,
Trademarks, Geographical indications, Designs, Industrial circuits and
Trade secrets.
Since the law for these intangibles vastly varied between countries,
goods and services traded between countries which incorporated these
intangibles faced severe risk of infringement. Therefore the agreement
stipulated some basic uniformity of law among all trading partners.
This required suitable amendment in the domestic IPR laws of each
country. Since this process is not a simple one, a time period of 10
years was given to the developing countries.
As a result, in India there was a requirement to change the patents

act, Trade and merchandise mark act and the copyright right act.
Besides these main laws, other related laws also required changes.
The main impact of this is on industries such as pharma and bio-

technology, because now with the law in place, it is not possible to
reverse engineer the existing drugs and formulas, change the process
and produce the same product. Now new investment in fresh research
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is required. This is quite a burden for small industries and there is a

possibility that they are thrown out of business due to competition.
Besides these, the technology transfer from abroad is expected to

become costly and difficult.
Strict implementation of law is very important in India, otherwise there

could be disastrous affect on the revenue of industries which invest
millions of rupees in Research and development if their products get
infringed.
4. Agreement on Agriculture (AOA): The Agriculture happens to be

one of the most protected sectors in all the countries without any
exceptions, and therefore an agreement on the agricultural issues
have always been evading and debated strongly by all the countries
involved in trade in agriculture.
The agreement on agreement deals with market access, Export

subsidies and government subsidies. Broadly, as of now the
requirement is to open up the markets in specific products in market
access and incase of subsidies, it is to go for tarrification and phase it
out eventually or reduce it to bound limits. The immediate impact of
the agreement would be on the policy makers to scrutinize all the
items under subsidy, QRs and tariffs. However, the calculation of AMS
reveals that the subsidy given to Indian farmers are much below the
acceptable levels and therefore need not be changed. Looking from
other perspective, the reduction of tariffs and subsidy in export and
import items would open up competition and give a better access to
Indian products abroad. However, the concern is on the
competitiveness and sustainability that the Indian farmer would be
able to prove in the long run once the markets open up. Thus there is
a requirement to change policy support to meet the changing needs of
Indian agriculture to gear it up for future.
5. Agreement on Sanitary and psyto-sanitary measures (SPM):

this agreement refers to restricting exports of a country if they do not
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comply with the international standards of germs/bacteria etc… if the

country suspects that allowing of such products inside the country
would result in spread of disease and pest, then there is every right
given to the authorities to block the imports.
Indian standards in this area are already mentioned and therefore

there is no need to change the law, but the problem is that of strictly
implementing the laws. There is an urgent need to educate the
exporters regarding the changing scenario and standards at the
international arena, and look at the possible consequence and losses
to be incurred if the stipulations are not followed. Therefore, to meet
the standards certain operational changes are required in the
industries such as food processing, marine food and other packed food
that is being currently exported from India.
6. Multi-Fiber Agreement (MFA): This agreement is dismantled with

effect from 1 January 2005. The result was removal of QR on the
textile imports in several European countries. As a consequence a
huge textile market is opened up for developing countries textile
industry as well as for other countries that have competitive
advantage in this area. The immediate impact is on the garment and
textile manufacturers and exporters. However, it still needs to be seen
whether the industry is able and ready to take advantage of the large
markets. This requires quite an amount of modernization,
standardization, cost efficiency, and customization and frequent up
gradation of designs to meet the changing need of global customers.
The dismantling of QR also mean more competition to Indian textile
exporters and therefore, it becomes imperative to enhance the
competitiveness in niche areas.
Besides these major agreements there are several other agreements

such as agreement on Market Access , which propagates free market
access to products and reduction of tariff and non-tariff barriers;
agreement to have Safeguard Measures if there is an import surge
and it is liable to affect the domestic industries in the transition
economies. These measures can include imposing QR for a certain
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period and also imposing tariffs on the concerned products. There are
other agreements that call for direct reduction of S ubsidies on
Exports, which are not permissible, and phasing it out over a period
of time. Besides these there are other Counter-Veiling Duties (CVD)
that are permitted to be used in certain conditions. These are
supposed to have an impact positive if they help the industries and
negative if they reduce the cost competitiveness.
The trading countries are allowed to impose an Anti-Dumping Duty

(ADD) against imported products if the charge of Dumping is claimed
against them. The requirement is to prove that the product is being
sold at a price, which results in material injury to the domestic
industries. There are several cases in which the duty is imposed but it
still remains to be proven by the Dispute settlement tribunal in case
the other trading party opposes the duty imposed as "unfair".
However, the proposal always should come from the representatives of
the industries affected; this may result in a problem, as small
industries voice may remain unheard in the process.
Certain Other Unresolved Issues:
There are several clauses in each of the above agreements; where

there has been no consensus arrived. Besides that there are several
other cases where there is no consensus on the entire agreement
itself, which means that these are still in their conceptual and drafting
stages.
Some of such agreements are on Labour Standards and core social

clauses, which intend to impose a labour standard and certain norm
against exploitation of labour by the organization where they work.
Such standards are likely to result in banning of certain items exports
to developed world causing severe damage to industries such as
Carpet manufacturing, crackers, leather, handicrafts and sports goods.
There is another agreement, which is still under discussion by member

countries; this is on Trade and Environment. Some countries wish to
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impose restrictions on trade on environmental grounds. The

agreement revolves around protecting global environment by enforcing
standards on production and consumption. The ranges of clauses are
from production, packaging to transportation of the goods as specified
by norms. The main impact of this clause would be on industries such
as seafood, food processing and drugs and chemical manufacturing.
There would also be a overall impact on the export business as the
rules related to packaging would be very stringent.
Another agreement where the consensus is yet to be reached is on

Trade and Investment. The main objective of this agreement is to
enable a free operating environment for foreign investment in host
countries such that there is minimum interference and equal rights.
There would be a direct impact on the foreign investment policy and
trade policy of the government with a long-term impact on balance of
payment and foreign exchange position of the country. This agreement
would affect almost all industries and services without an exception.
However the specific impact is expected on auto components and
small retailers.
Trade and Competition is another agreement on which the

discussions are going on to reach a consensus. The main aim of this is
to stop the business practices that distort competition in any way and
to curb monopolistic growth in trade. The agreement would have an
impact on the MRTP act, which needs to be replaced by the new
competition law, the process for which has already started. These
changes would result in a more competitive environment and it would
also be a deterrent for big business houses if they wish to expand
further in the same area. Thus, the formation of cartels and mergers
and acquisitions would be restricted to a great extent.
Transparency in Procurements made by the Government is one

such clause where it is being debated to a large extent. This is
particularly of concern to developing countries as the role played by
the government in a countries development is much higher than what
it is in other developed countries. This would have a serious impact on
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the way the government and other public sector units approach the
domestic procurement. This would imply that no special preference
would be given to the domestic suppliers and they also need to
compete on a price basis for getting orders from domestic
government. This clearly can mean that many government suppliers
may lose out in competition with efficient and low cost foreign
suppliers.
Major Conclusions
The Indian economy has experienced a major transformation during

the decade of the 1990s. Apart from the impact of various unilateral
economic reforms undertaken since 1991, the economy also had to
reorient itself to the changing multilateral trade discipline within the
newly written GATT/WTO framework. The unilateral trade policy
measures have encompassed exchange-rate policy, foreign
investment, external borrowing, import licensing, custom tariffs, and
export subsidies. The multilateral aspect of India's WTO commitments
is regarding trade in goods and services, trade-related investment
measures, and intellectual property rights.
After analyzes of the economic effects on India and other major

trading countries/regions of the Uruguay Round (UR) trade
liberalization and the liberalization that might be undertaken in a new
WTO negotiating round. India's welfare gain is expected to be 1.1%
($4.7 billion over its 2005 GDP) when the UR scenarios get fully
implemented. The additional welfare gain is an estimated 2.7% ($11.4
billion) when the assumed future WTO round of multilateral trade
liberalization is achieved.
It is expected that Resources would be allocated in India to the labor-

intensive sectors such as textiles, clothing, leather and leather
products, and food, beverages, and tobacco. These sectors would also
experience growth in output and exports. Real returns to both labor
and capital would increase in the economy. However as mentioned
above in the analysis of each agreement there is a serious and urgent
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need to re-look the strategies followed by individual firms in the

changing context of increasing competition and opened markets. As
said time and again there is no reversal of agreements, so what is
required is to make internal policy changes at macro, meso and micro
level to suit the changed external environment.
9) GLOBAL MARKETING IN THE MEDICAL SECTOR
Across the globe, governments, health care delivery systems, insurers, and
consumers are engaged in a persistent tug-of-war between competing
priorites: meeting the increasing demand for health care services and reducing
the rising cost of those services.
This report examines the current issues impactng the global health care sector,
provides a snapshot of activity in a number of geographic markets, and suggests
considerations for stakeholders as they look ahead to 2015.
Top sectors issue in 2015
The global health care sector outlook for 2015 is mixed. Treatment
advancements and government initatives to increase access to care should
drive sector expansion but pressure to reduce costs is escalatng. Growing
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populatons and consumer wealth are increasing demand for health care
services but aging societes and chronic diseases are forcing health payers to
make difficult decisions on beneft levels. In the midst of this tug-of-war, many
historic business models and operatng processes will no longer suffice. Read on
to learn more about trends impactng the global health care sector in 2015 and
suggested considerations for stakeholders. Four major trends are antcipated to
impact stakeholders along the global health care value chain in 2015: cost,
adaptng to market forces, transformaton and digital innovaton, and
regulatons and compliance.
Cost
Cost is the biggest health care issue facing most countries in 2015.
Pressure to contain costs and demonstrate value is coming from
all sides. Political uncertainty, persistent economic stress, and
austerity measures in numerous countries are calling into question
the sustainability of public health care funding. In addition,
questions and concerns exist about the amount of funding needed
to better align supply to demand and, in particular, how to fund
integration and primary care while meeting increasing demands
for acute activity. Also, the high cost of targeted therapies,
personalized medicine, genetic-based medicine, medical devices,
and other advances continues to add to the health care cost burden
along with the impact of waste, fraud, and abuse.
Adapting to market forces
Change is requiring providers and health plans to rethink traditional

business models to better address shifting or emerging health care
challenges and opportunities.
Increasing role of government – Governments’ pivotal – and growing –

role as payer, regulator, and market-shaper in the global health care sector
cannot be understated.
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Scale to prosper – Converging market forces are setting the stage for
what may be a period of rapid consolidation among health care providers,
particularly in the U.S. Both vertical and horizontal consolidation has been
increasing, despite heightened regulatory scrutiny. In addition, cross-
sector convergence is expected to rise with the shift towards an ―eco-
system‖ of product and service providers.
Competition for talent – As their populations and health care needs grow
both developed and developing countries are struggling to supply adequate
numbers of trained, qualified health care professionals, especially
physicians and nurses.
Improving access to care – Workforce shortages, patint location, lack of

health care infrastructure in certain countries, and outdated facilities in
both developed and developing markets are major contributors to health
care access problems around the world.
Consumerism – Patients facing large deductibles and cost-sharing for

medical treatments and services – including specialty pharmaceuticals and
medical devices – are becoming more cost-conscious and more involved
in their health care decisions.
Transformation & digital innovation
Adoption of new digital HIT advances such as electronic health records,

mHealth, telemedicine and predictive analytics is transforming the way
physicians, payers, patients, and other health care stakeholders interact.
Digital innovations like additive manufacturing, artificial intelligence,
diagnostic devices and wearables are helping to facilitate new diagnostic
and treatment options, increase process efficiency, and reduce costs.
Technology advancements are also connecting developed and emerging
markets — and participants along the health care value chain. These
changes may be rapid and, in some parts of the world, disruptive to
established health care models. However, their potential to improve the
care process is already being seen.
Regulations & compliance

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The global health care regulatory landscape is complex and

evolving. The primary driver is patient health and safety; however
authorities’ approaches to protecting patients can vary widely
from country to country. Adding to this complexity are factors
including rapid clinical and technology changes; increased
scrutiny by governments, the media, and consumers; more
sophisticated risk-monitoring techniques; and coordination across
agencies and regions. Payment transparency is also taking center
stage. Protected health information impacted by security breaches
and cyber attacks will also continue to be of importance to
stakeholder.
 DEFINITION OF MODEL
 A model may be described as a representative of an actual system. It

represents the similar characteristcs of a system. However various
models have been proposed based on various factors such as scope,
social, environmental, psychological, etc.
 USES OF CONSUMER BEHAVIOUR MODEL
 The chief purpose of proposing models is to identify the purchasing

behavior of consumers. However, these models can be utlized in
determining.
• Buying attitudes of consumers.
• Useful variables while purchasing.
• The characteristics of various variables and
• Interrelatonships among them.

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 Models of consumer behavior
 Traditonal models:
 Economic Model
 Learning Model
 Psychoanalytic Model
 Sociological Model
 Economic model
 According to economic model, buying power of a consumer depends on

the concept of utlity which states that if an individual has certain sum
of money and defned sets of requirements and a set of products then
he or she will spend his or her money only on those products which
yields him or her maximum benefts.
 LEARNING MODEL
 The learning model is entrely based in the capability of an individual to

learn, forget and discriminate. It states that in order to bring changes in
buyer's behavior one must change the drives, stmuli and responses as
per buyer's attitude or perceptons.
 Learns to associate connecton between stimulus and response which

becomes habit
 Understanding the response of consumer at the market place
 PSYCHOANALYTICAL MODEL
 it mainly deals with the analysis of psychology of consumers. According

to this model, every purchasing decision has a complex motive by a
purchaser which can be infuenced by his or her sense of desires and
longings.
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 Personality of consumers and their responses
 Consumer behavior is directed by a complete set of deep seated

motves
 SOCIOLOGICAL MODEL
 According to the sociological model individual's decisions not only

depends on utlity factors but mainly they are dependent on societal
factors like levels of society, groups of society and attitudes of
individuals of society. However it should also be noted that purchasing
decisions are governed by societal restrictions also.
 As his role, status, interaction, influence,
group relation, lifestyle, income, occup-
ation, place of residence, social class etc.
 CONTEMPORARY MODELS
 Howard Sheth model
 Nicosia
 Webster and wind
 Engel, blackwell and minard model
 Howard sheth model
 The Howard sheth model has been put forward by John Howard and
Jagadish Sheth in 1969. This model states that there exists certain
variable which affects the perception and learning of consumer, apart
from inputs and outputs. These variables are imaginary as it is difficult
to measure them directly.
 Customer lacks well defned evaluative criteria to judge the product

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 Searches for information
 After passing his own personality, his intake is modified
 Evaluates the brands available
 Seeks greatest potential of satsfying his motives
 example
 Online shopping
 Nicosia model
 The Nicosia model is one of the examples of systems model where

human being is treated as a system, with inputs as stimuli and behavior
being its output. It is mainly constructed by considering the marketing
viewpoint of a consumer. It was proposed by Francisco Nicosia, an
expert in consumer motivaton and behavior in 1990. It establishes the
relatonship between the frms and its consumer. It focuses how the
actvities of frm target the consumer to purchase firm's products and
fnally its usage and evaluaton on certain criteria.
 A number of assumptions have been made that question the validity of

this model, for instance:
 What type of consumer are we talking about?
 The company and the consumer have an existng relatonship?

What type?
 Is this for a new product? Is this the frst exchange the

consumer has had with the producer?
 example
 Four-wheelers
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
Engel, Blackwell and minard model
 Informaton input
 Informaton processing
 Decision process stage
 Variables influencing decision making process
 example
 Garment sector
 Social class
 Family
 Lifestyle
 Personality
 Beliefs
 attitudes
 Webster and wind
 parttones the buying process into several processes
 processes of decision-making are determined by environmental and

organizatonal factors.
 Final buying process rendered as the mixture of individual and group

decision
 example
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 Automobile manufacturing
 CLINICAL INFORMATION SYSTEM
 DEFINITION
 A Clinical Information System (CIS) is a computer based system that is

designed for collecting, storing, manipulatng and making available
clinical information important to the healthcare delivery process.
 TYPES
 limited in extent to a single area (e.g. laboratory systems, ECG

management systems).
 widespread and include virtually all aspects of clinical informaton

(e.g. electronic medical records).
 BENEFITS
 Easy Access to Patient Data: Clinical Information Systems can provide

convenient access to medical records at all points of care.
 Structured Information: The clinical informaton captured in Clinical

Informaton Systems is well organized, thus making I easier to maintain
and quicker to search through for relevant information. The informaton
is also legible, making it less likely that mistakes would be made due to
illegible writng.
 Improved Drug Prescription and Patient Safety: Clinical Information

Systems improve drug dosing and this leads to the reducton of adverse
drug interactions while promotng more appropriate pharmaceutcal
utlisaton.
 HOW CIS HELPS US PROVIDE YOU WITH BETTER CARE

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 In an emergency, your doctor has immediate access to your complete

medical history.
 During your ofice visit, doctors can schedule and order the tests you
need directly through the system.
 Doctors can access test results immediately.
 Doctors can send your prescriptions directly to the pharmacy, where

you can pick them up as you leave the clinic.
 FUNCTIONS OF CLINICAL INFORMATION SYSTEM
 part of the Hospital Informaton System (HIS)
 to plan tasks and to gather data that is generated when the tasks are
performed
 to help create the Medical record
 enable descriptons of unplanned clinical events to be recorded. These

data are accumulated in the pool of data regarding the patent, termed
as the Patient Informaton Database, from where it can be retrieved
when needed.
 Patent Management (Administraton) System and the Informaton

Systems for Clinical Support Services (Laboratory (LIS), Radiology
services (RIS), Pharmacy services(PhIS) .
 CLINICAL CARE PROCESSES AS DATA MANAGEMENT ACTIVITIES
 Data collection (gathering, capture, input, entry)
 Data storage (accumulate and make available) data sharing, data

aggregaton and data analysis.
 Data extraction (retrieval, output)

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 Data transmission (submission, retrieval)
 Data presentaton (display, view)
 Data analysis and interpretaton (use)
 EXAMPLE OF CIS (LIS) – LABORATORY INFORMATION SYSTEM
 INTEGRATE AND INTERFACE
 To receive orders, the Laboratory Information System (LIS) is integrated

with the Clinical Informaton System (CIS). Hence the two systems are
designed either to be integrated from the very beginning or integrated
only after procurement i.e. during implementation..
 An integral feature of LIS is the capability of sending messages and

gettng results from machines that perform tests automatcally
(analyzers) via interface brokers to create works lists, communicate
instructons and conversely convey results to the Patent Information
Database.
 STEPS IN LIS
 PROPER IDENTIFICATION
 STATUS REPORTS
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MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

Marketing is the study and management of exchange relatonships.

Marketing is the social process by which individuals and organizations obtain

Marketing is the management process for identifying, anticipating and satisfying

Marketing is the activity, set of institutions, and processes for creating,

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

Factors that can be investgated through market research:

Another factor that can be measured is marketing effectveness. This

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

4. Why health care sector needs Marketing Research?

Healthcare market primarily consist of

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

5. Define Marketing Information system and mention its components.

6. What do you mean by consumer market?

7. What is meant by consumer buyer behavior? Name some Model of

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

Models of consumer behavior

 The economic model

8. Give examples of consumer behavior.

9. Draw the model of business buyer behavior

10. Write a note on WTO

The World Trade Organization is a Multi-lateral organizaton which

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

put it in brief WTO encourages a multi-lateral trading system within its

11. Explain Global Marketing.

12. Explain the benefits of Clinical Information System (CIS).

HIS is a comprehensive, integrated information system designed to manage all

The purpose of a hospital informaton system (HIS) is to manage the information

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

14. How are computers useful for medical records in a hospital?

15. How to decide the location of hospital pharmacy?

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

16. Write short notes on support services in a hospital.

17. Write short notes on the medical transcription process.

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

 Knowledge of medical terminology

MARKETING INFORMATION SYSTEMS

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

1. Explain the importance of information to managers

An understanding of the different roles managers play and how marketing

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

to-date information and redistributing it to those who need to

A marketing information system (MkIS) is a management information system

 ASSESSING THE MARKETING INFORMATION NEEDS

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

MIS provides information to the company’s marketing and other

 DEVELOPING MARKETING INFORMATION

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

data sources within the company network, including

 Advantages and Disadvantage of Internal Databases

o Steps in the marketing research process:

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

4. Interpreting and reporting the findings

o Defining the Problem and Research Objectives:

o Developing the Research Plan

 Secondary data consists of information that already

MD8091-HOSPITAL MANAGEMENT INTERNAL TEST-1

 Disadvantages: Availability, Relevance,

 Primary data consists of information gathered for