Decision Sciences Volume 40 Number 2 May 2009 C 2009, The Author Journal compilation C 2009, Decision Sciences Institute Health Care Supply Chain Design: Toward Linking the Development and Delivery of Care Globally ∗ Kingshuk K. Sinha † and Emily J. Kohnke Joseph M. Juran Center for Leadership in Quality & Operations and Management Scienc Department, 3-150 Carlson School of Management, University of Minnesota, 321-19th A South, Minneapolis, MN 55455, e-mail: ksinha@umn.edu, mcilv004@umn.edu ABSTRACT This article is motivated by the gap between the growing demand and available s high-quality, cost-effective, and timely health care, a problem faced not only by d oping and underdeveloped countries but also by developed countries. The signific of this problem is heightened when the economy is in recession. In an attempt to the problem, in this article, first, we conceptualize care as a bundle of goods, ser and experiences—including diet and exercise, drugs, devices, invasive procedure biologics, travel and lodging, and payment and reimbursement. We then adopt a end-to-end, supply chain–centric view of the health care sector to link the develop of care with the delivery of care. This macro, supply chain–centric view sheds light on the interdependencies between key industries from the upstream to the down of the health care supply chain. We propose a framework, the 3A-framework, that is founded on three constructs—affordability, access, and awareness—to inform the sign of supply chain for the health care sector. We present an illustrative example of the framework toward designing the supply chain for implantable device–based c cardiovascular diseases in developing countries. Specifically, the framework provides a lens for identifying an integrated system of continuous improvement and innova initiatives relevant to bridging the gap between the demand and supply for high- cost-effective, and timely care. Finally, we delineate directions of future research are anchored in and follow from the developments documented in the article. Subject Areas: Globalization, Health Care Systems, New Product Intro tion, Quality, Supply Chain Management, and Technology Manage ∗ The contents of this article were shaped during the course of the corresponding author’s invited presentations at the Cincinnati Innovations in Health Care Delivery Conference, University of Cincin the Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata (India); and keynote talks atthe Research Symposium on Operations Strategy and Supply Chain Management at the Sun Yat-Sen University in Guangzhou (China), the Asia-Pacific Operations Management Symposium, and the Aus New Zealand Academy of Management Operations Management Symposium in Melbourne (Australia). The article has benefited from the comments of the participants at these events and Sriram Thiruma earlier version of the article. Research for this article was supported by the Carlson Family Foundat the Deans’ Small Research Grant from the Carlson School of Management. † Corresponding author. 197