The diffusion of medical practice patterns in a community hospital.

There has been some evidence which suggests that HMOs alter the hospitalization rate of the fee for service medical sector. If true, this spillover effect would have important implications for reducing hospital utilization, because HMO affiliated physicians use substantially less resource intensive in-patient services. This research investigates one possible mechanism, whether there is a diffusion of medical practice patterns from HMO affiliated physicians to non-HMO physicians when both groups share admitting privileges in the same hospital. Intervention analysis was used to test this hypothesis by comparing the time series of in-patient utilization, in a community hospital, before and after the hospital became affiliated with a HMO. The results of this analysis did not substantiate the theorized HMO spillover effect.     

Social compliance audits and multinational corporation supply chain: evidence from a study of the rituals of social audits

This study investigates the use of social compliance audits in the supply chain of multinational corporations (MNCs). Particularly, we explore the use of such audits in assessing and managing the working conditions of factory workers in the garment industry in a developing nation. Through a range of interviews with MNCs’ internal auditors, with commissioned external auditors and with representatives of the suppliers in Bangladesh, this study finds that social compliance audits become ritual strategies and are not a primary means of advancing workers’ rights. Drawing on the concept of surrogate accountability, the study suggests that to create real change in workers’ conditions and in order to hold MNCs and their suppliers accountable, some form of surrogate (government, non-governmental organisations or media) intervention is necessary. This is, we argue, preferable to leaving it in the hands of ‘markets’ and simply waiting for another major incident such as Rana Plaza to stir public concern. This study contributes to the literature by investigating how social compliance audits are undertaken by MNCs sourcing products from a developing nation, what motivations drive the adoption of such audits, and what, if anything, are the likely outcomes from the process.     

The costs of freer trade

Free trade cannot exist as a pure benefit in a democracy because there will always exist political pressures that seek to protect some group from foreign competition or uncertainty. These groups must be taken care of politically and administrative costs are incurred in so doing. Similarly, there must be a dispute settlement apparatus at the supernational as well as the national level. Administrative costs are incurred in maintaining as well as in achieving the existing degree of liberalization. There may exist a state in which the gains from additional liberalization are outweighed by the marginal administrative costs incurred.     

Book reviews

Working with Developers in Urban Renewal

Francis Terry (Ed.). Public Finance Foundation London (1989). Discussion Paper 26, 78 pp. £10.00. ISBN 0 85299 445 1.

Councils in Conflict

S. Lansley, S. Goss and C. Wolmar. Macmillan, London (1989). x + 216 pp. £8.99. ISBN 0 333 454 138.

The Future of Housing Allowances

J. Hills, R. Berthoud and P. Kemp. Policy Studies Institute (1989). 71 pp. £5.95. ISBN 0 85374 461 0.