Analysis of cost and coverage of government financed primary health care services in Tanzania.

A method for cost analysis is presented and applied to Primary Health Care Services in Tanzania. Primary care utilization figures are combined with budget and cost data to arrive at estimates of per capita and per visit cost. Data for analysis of geographical coverage, health care needs, and utilization are most readily available for the MCH sector of Primary Health Care Services, the most important health care sector in LDCs, which is used in this paper as a proxy for estimating health care needs and utilization. The importance of separating appropriately identified investment costs from recurrent costs is illustrated. Speedy implementation of health care for all requires assistance for investment costs, the recurrent costs of appropriately designed Primary Health Care Services being within the reach of developing nations themselves.     

The Demand for Health Care Services in Rural Tanzania

This paper examines the pattern of health care demand in rural Tanzania. We distinguish between hospital and clinic‐based care, in both the public and private sector using a two‐level nested multinomial logit model. Own price elasticities of demand for all health care options are high, although less so for public clinics and dispensaries than other choices. However, there is a high degree of substitution between public and private care. Consequently, price increases or user fees will result in small percentage of people opting for self‐treatment. Another important contribution of this paper is that the quality of medical care has large effects on health demand. This applies to the quality and availability of doctors/nurses, drugs and the clinic environment.     

A low quality–high cost–low satisfaction trap in public health care: a model and an efficiency-quality-welfare improving stochastic resolution

This paper develops an applied stochastic model of public health care and shows that the public health care sector in Turkey is plagued by a low quality–high cost–low satisfaction trap which has been persistent over time. The values in question are shown to be stochastically stable. We formulate an efficiency-quality-welfare improving stochastic policy rule, which helps the sector to reach a selected target and which stabilizes quality, cost and welfare around that target.     

WHICH INDUSTRIES TO BAIL OUT FIRST IN ECONOMIC RECESSION? RANKING US INDUSTRIAL SECTORS BY THE POWER-OF-PULL

There have been intense debates regarding which industrial sectors should be prioritized for receiving bailout in economic recessions. This paper takes a network perspective to rank sectors according to the Power-of-Pull (PoP), i.e. a sector's power to pull the overall economy. An eigenvector method is employed to assess the PoP of sectors in the USA, using input–output data from 1998 to 2010. The results support bailout to the motor vehicle sector, but argue against bailout to public infrastructure, health care and information technologies design and service sectors, and also reveal the continual decline of PoP ranking of computer and electronics manufacturing sector over time. These results confirm some but also show little support to some other economic revival policies of the Obama Administration in the USA.     

Entrepreneurial branding: measuring consumer preferences through choice-based conjoint analysis

Start-ups face branding challenges. Not only are they confronted with the task of building brands from scratch, their newness also leads to a particularly high amount of customer uncertainty. This paper contributes to the emerging field of entrepreneurial branding by investigating start-up characteristics that signal trustworthy information to potential customers. An extended choice-based conjoint approach for modeling brand equity is used to explore the impact of different signals as initiated by established and new firms in the field of tablet computers. An empirical study reveals brand signals that have significant effects on purchase probabilities and are appropriate to overcome information asymmetries between start-ups and prospective customers.     

Determinants of consumer demand for circular economy products. A case for reuse and remanufacturing for sustainable development

We investigate determinants of consumer demand for circular (reused and remanufactured) products. Based on exploratory choice-based conjoint experiments with a sample of 800 adults in the United Kingdom, we examine two types of premium segment electronic appliances: a mobile phone and a robot vacuum cleaner. We find that consumers prefer partly circulated products over fully or not at all circulated products and that circular products can likely successfully enter the existing market at the retail price of a new product. Interestingly, circular products compete for market share primarily with new products, leaving the market share of second-hand options less affected. The results show a promising path for firms considering a transition to circular business models.     

物流中心选址的模糊方法研究

提出了一种模糊情况下的物流中心选址综合因素模糊评价方法。在此方法中，用三角模糊数给出各项决策指标的评语以及各备选地点的排序。给出了确定各备选地点排序的步骤、方法。     

An integrated approach to measuring potential spatial access to health care services

In recent years there have been several attempts to develop quantitative measures of potential spatial access to health care services which, despite their limitations, offer many positive ideas that can perhaps be integrated into a logically consistent and generally acceptable index. It is in this vein that the current paper presents an integrated approach, drawing partially from past contributions, to measuring potential spatial access to health care services. The final access index is derived as the culmination of a series of individual measures, starting with an initial gravity formulation and progressing through successive stages as new elements, consistent with the definition and conceptualization of potential spatial access, are introduced. Application of the proposed index to the ambulatory medical care system of the Akron, Ohio SMSA, demonstrates the validity of the measure, and its suitability as a potential health care planning tool.     

Coordination Mechanisms for Implementing Complex Innovations in the Health Care Sector

Abstract

Coordination is a central element in the public sector, especially for introducing complex innovations. In health care, this issue takes on great importance since many stakeholders are involved, pursuing multiple interests, and influencing the outputs and outcomes of the health care system. This paper discusses the introduction of a specific health care innovation (i.e. electronic patient records) in two Italian regions, and it aims to contribute to the debate on coordination in health care, depicting the coordination mechanisms that took place in two different contexts in order to introduce the same kind of innovation, and highlighting any potential enabling conditions.     

Managing under pressure: HRM in hospitals

Health reforms in the last 25 years focused largely on structural change, cost containment and the introduction of market mechanisms, and the importance of the management of HR has often been overlooked. Pressures for efficiency and effectiveness are particularly pronounced in the hospital sector, which is the most resource-intensive component of the health care system. One important aspect of improving and maintaining service delivery in hospitals is to better manage the HR function. This paper highlights the importance and complexities of HRM in hospitals throughout the world.     

Institutional perspective of financial sector development: A multidimensional assessment

Financial sector development is a multidimensional process that plays a vital role in the economic growth and development of a country. This study investigates the effect of institutional quality on multidimensional financial sector development, and its dimensions, such as, depth, access, and efficiency. We used a panel dataset of 85 emerging and developing economies from 1996 to 2018 for analysis. Our findings based on 2SLS estimation demonstrate that institutional quality has a significant positive effect on the progress of the financial sector, especially its depth, access, and efficiency. The breakdown analysis shows that most of the key components (control of corruption, government effectiveness, regulatory quality, rule of law, and voice and accountability) of institutional quality enhance the financial sector development. Our empirical results are robust across alternative measures of institutional quality, split-sample analysis, alternative instrument, and estimator. This paper also offers useful policy implications to the stakeholders in emerging and developing economies.     

Analysis of U.S. theme park selection and international implications

ABSTRACT

Theme parks face stiff competition in local and international markets. Theme parks tend to create competitive advantages in the market by investing in different factors which influence visitors’ selection of a theme park. Theme parks attract visitors from all nationalities. The purpose of this study was to explore six influencing factors on U.S. theme park visitors’ choice that can be applicable in different geographic positioning parks. A choice-based conjoint (CBC) model was designed with respective levels for six considered influencing factors: type of park, price, distance from accommodation, children friendly, and online reviews. The findings revealed that online reviews were the most important relative factor followed closely by price and type of theme park. The other factors shared a lower relative importance. CBC analysis results generated the best and the worst profile for theme parks, which can serve as a guide theme park managers as they invest and plan strategically for success. Results of this study of U.S. parks but as theme parks are targeted toward similar populations the results could have implications internationally.     

Ranking participants in tournaments by means of rating functions

In this paper we bring a novel approach to the theory of tournament rankings. We combine two different theories that are widely used to establish rankings of populations after a given tournament. First, we use the statistical approach of paired comparison analysis to define the performance of a player in a natural way. Then, we determine a ranking (and rating) of the players in the given tournament. Finally, we show, among other properties, that the new ranking method is the unique one satisfying a natural consistency requirement.     

Maximizing value in healthcare partnerships: A case examining an inter-organizational relationship in the public and non-profit sectors

Healthcare organizations around the world are striving to find the right balance between using their resources effectively and providing personalized care to patients. Health care is shifting from a reactive, towards a more person-centric approach to improve health outcomes. To achieve quality improvements and efficiencies, health care organizations are forming inter-organizational relationships. Despite the benefits, little is known about how organizations capture value from strategic partnership. In this context, this paper aims to examine the processes that occur as part of a public and non-profit sector relationship within health care that directly relate to how the partnering organization acts to capture value. Using a qualitative case study of an Australian public-sector health service partnership, the study employs a value mapping framework to distinguish between different types of value (captured, missed, destroyed, and opportunity), and presents an integrated model consisting of three process phases: (1) inter-organizational cooperation effort, (2) organizational effect, and (3) social value. The study highlights the potential for negative and unintended consequences and discusses implications for management.     

A job to believe in: recruitment in the Scottish voluntary sector

The voluntary sector is an important source of employment in the UK and is increasingly providing services previously provided by the public sector. However, the ability of the sector to provide such services is dependent on the quantity and quality of suitable labour. This article examines recruitment issues in seven case‐study voluntary organisations offering social care in Scotland. Interviews were conducted with 137 managers and employees in these organisations. In addition, to assess potential labour supply, interviews and focus groups were conducted with careers advisers and potential employees. The findings suggest that, with a tightening labour market, uncompetitive pay and misconceptions about the sector, recruitment is a problem. However, job satisfaction is high for current employees, and potential employees whose values are commensurate with the sector might be attracted. The findings thus have relevance not just for the case‐study organisations, but for HRM in the voluntary sector generally.     

The curse of bureaucratisation or the blessings of professionalisation? Nurses’ engaged adoption of quality management in hybrid managerial positions

The paper concerns how new quality management in the Danish hospital sector has created new career and professionalisation opportunities for nurses. While the well-known dualism between the logics of professionalism and managerialism is challenged in the literature, not much is known about how engagement in the tighter steering of practice may converge with professional identities and meaningfulness in work. The paper applies a Bourdieusian and ethnographic approach to the examination of nurses’ enthusiastic involvement in quality management as they take up hybrid managerial positions in an acute care department. The findings demonstrate the importance of the material and symbolic value of scientific-bureaucratic knowledge in legitimizing quality management, achieving meaningfulness in practice and bolstering the professional role of nurses.     

Quality in health care: possibilities and limitations of quantitative research instruments among health care users

Quality in health care has traditionally been dominated by medical profession, where patients’ opinions were labelled as lay evaluation. Patients’ views and opinions are important because they give us an insight into dimensions of quality that are not evaluated by medical profession and often seem to be more important. In health care quantitative methodology is often used to address these quality dimensions and introduce patients’ views and opinions. There are various benefits using quantitative research instruments, such as a detailed analysis of the importance of various quality dimensions for patients and an analysis of factors influencing patients’ satisfaction. On the other hand serious deficiencies can be tackled too, that are usually dealt with qualitative research instruments, because they go deeper into people’s motives and feelings. However, health care service is specific—it is very important to patients (health is one of the most important values), but their participation in health care service is rather low. They also don’t always say and do what they mean. In such a context combination of quantitative and qualitative research instrument does not give satisfactory answers. The importance of complaints is stressed and rewards for taking them seriously and acting upon them is discussed.     

Strategic giving and the nursing shortage

• Health care organizations in the United States face a significant nursing shortage, which seriously impacts the quality and availability of health care. Confronting this challenge requires involvement from organizations beyond the public sector. This paper explores an initiative by Blue Cross and Blue Shield of Florida, exemplifying the concept of ‘strategic philanthropy,’ to contribute their financial resources and strong institutional ties to respond to the current and future shortage of nurses in Florida. Through this intervention, the company and partnering organizations hope to benefit the health care sector, the public, and themselves from the outcomes associated with the generation of a greater supply of nurses.

Copyright © 2006 John Wiley & Sons, Ltd.     

Social partners' levers: job quality and industrial relations in the waste sector in three small European countries

This article examines how social partners in the waste sector in Austria, Bulgaria and Denmark strive to protect job quality from negative impacts of two European trends: privatisation and greening. The article uses qualitative, comparative research to examine social partners' levers for protecting and improving job quality. Three levers are identified: negotiation power, collective agreements and general regulation that facilitate negotiation and social partnership. In general, privatisation has had a negative influence on job quality and the levers of collective actors, whereas the impact of greening is ambiguous, that is, not necessarily positive. The article concludes that stakeholders' ability to improve job quality is contingent upon their activity on both a national and European level.