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Economic theory suggests that consolidation of hospital ownership through the formation of multiple hospital ‘‘systems’’ should lead to improved hospital performance. The general view of system superiority follows from considerations of economies of scale, improved financial and other administrative management, and better access to financial capital. Still, there is little evidence demonstrating greater efficiency in system-affiliated hospitals. The majority of studies have found hospitals belonging to multiple hospital systems to be more cost than independent hospitals, raising questions regarding the social value of much of the recent growth of new inter- organizational relationships. (Carey, 2003)

Decision-making process about the development of new products is fundamental for the growth and prosperity of any company, particularly in the fast changing medical device market (Ivlev et al., 2015). Companies must innovate to be successful but this invariably carries some risk and uncertainty. In recent years, the issue of evaluation of investment effectiveness into medical devices has been intensively solved, both at national and international level (Heintz et al., 2016) due to the growing market with medical devices (Craig et al., 2014).

In the past, companies attempted to address customers using marketing communication tools such as television ads and public relations. A major disadvantage of these tools is the passive way in which customers receive information on products and brands (Hennig- Thurau et al., 2010; Libai et al., 2010). In recent years there has been steady growth in the share of two-way communication, which has resulted in a revolutionary change in the role of the customer from passive to active. This change was brought about in particular by the internet boom and the emergence of social media (Ungerman, 2016).

Conducting business involves a constant flow of money and capital, whose renewal and expansion on the one hand and distribution and investment on the other need to be managed. Business entities are required to be able to sustainably appreciate capital invested, therefore, it is necessary to conduct analyses of the rate of return on capital invested as part of business management.

Every economy aspires to enlarge the share of high-tech industries in its industrial structure, considering this share as one of the main determinants of country’s economic development. Hence, the induction of high and medium-high technology industries through R&D support, stimulation of innovation activities and higher quality may help economies to avoid getting trapped in the low-tech specialization during the long term.