Efficiency and productivity change in Ukrainian health care

The study analyses technical efficiency and efficiency change of 193 community hospitals and polyclinics across Ukraine, for the years 1997–2001. These facilities are a subset of the medical institutions in rural Ukraine; they are identical w.r.t. their function in the health system and share the same departmental structure. The data comprise the number of beds in the hospitals, the number of staff employed in the hospitals as well as the polyclinics connected to the hospitals, the number of inpatient and outpatient admissions as well as the number of surgical procedures, lab tests, X-rays performed and the number of deaths and deaths after surgery. Because of the known sensitivity of traditional nonparametric frontier estimators to outlier observations, we employ an order-m estimator, a robust technique, to assess the efficiency of these health care providers as well as changes of their productivity time. The efficiency scores are calculated with an output-oriented model; they are close to unity for hospitals whereas polyclinics seem somewhat less efficient. The Malmquist-indices averaged over all observations are close to unity indicating that productivity does not change over during our observation period. But, depending on the period and the region, substantial deviations from unity can be observed.

A model to evaluate the effectiveness of enterprise training programmes

This paper describes a model developed to measure customer satisfaction with enterprise training programmes. Based on developments in customer satisfaction and quality measurement, it is proposed as an alternative to the training evaluation model developed by Kirkpatrick (1959). A single indicator, a Customer Satisfaction Index (CSI), quantifies the level of satisfaction with each training programme. The model also measures the individual parameters that contribute to the CSI, as well as their relative importance. It facilitates a benchmarking process regarding these parameters and between training programmes. The development process of the model is described, as is its use in practice.     

Cost effectiveness of tiotropium for chronic obstructive pulmonary disease: a systematic review of the evidence

Abstract

Background:

Tiotropium has been shown to reduce exacerbations and improve quality of life for patients with chronic obstructive pulmonary disease (COPD), a lung disease characterized by a persistent and progressive airflow limitation.

Objectives:

To present a systematic literature review of the cost effectiveness of treatment with tiotropium compared with other currently used treatments for COPD.

Methods:

A systematic search was performed via PubMed, the Cochrane database, and EMBASE from 2002 to 2009. Methods and results by study design and by country were compared.

Results:

Seventeen studies were included in the review. Study designs were characterized as follows: modeling based on clinical trial data, and empirical analysis based on either clinical trial or observational data. Comparing monotherapy regimens (12 studies), all study designs found that treatment with tiotropium was associated with lower costs for hospitalisation and other non-drug services. Total costs, including the costs of maintenance drugs, were lower with tiotropium in some, but not all, of the studies. Tiotropium was shown to be cost effective based on commonly accepted benchmark values. Limitations of the review included the wide variety of outcome measures used in different studies, the limited number of observational database studies for monotherapy, and limited data for combination therapy regimens.

Conclusions:

The main conclusions of the economic evaluations derived from clinical trial data at the time of product approval and from later observational data reflecting clinical use are similar: use of tiotropium monotherapy is associated with lower hospital and other non-drug costs and better health outcomes and is either cost saving or cost effective compared with other maintenance monotherapies.     

A resilience-based framework for evaluating adaptive co-management: Linking ecology, economics and society in a complex world

Adaptive co-management brings together collaborative and adaptive approaches in pursuit of sustainable resource use and social-ecological resilience. Enthusiasm for this management approach, however, is countered by recent critiques regarding outcomes. A lack of evidence from consistent evaluation of adaptive co-management further exacerbates this situation. This paper revisits the issue of evaluation in natural resource management and recasts it in light of complex adaptive systems thinking. An evaluative framework for adaptive co-management is developed which directs attention toward three broad components: ecosystem conditions, livelihood outcomes and process and institutional conditions. Scale-specific parameters are offered for each component to facilitate systematic learning from experience and encourage cross-site comparisons. Conclusions highlight the importance of systematically incorporating evaluation into the adaptive co-management process and recognize the challenge for resource agencies and researchers to shift from a conventional to a complex adaptive system perspective.     

论项目投资评价中的时间风险值效应及其选择

基于现行现金流折现的项目投资评价的有效性取决于对项目现金流量预测的正确性,而项目现金流量具有预测发生的时间越遥远,现金流量不确定性的程度越大但又趋于相对稳定的特征.从这一特征出发,本文引入时间风险值进行折现调整这种系统可循的方法来解决在投资评价时难以预计的项目现金流量未来的不确定性问题,从而使不确定性条件下的项目投资评价更具有客观性.     

从竞争战略角度评估城市商业银行价值

由于商业银行是一个经营货币的服务型企业,其盈利模式、资产负债结构与生产型企业及非银行金融企业有很大不同,而且银行的行业性质非常特殊。因此,从战略角度评估银行价值是非常必要的。     

非财务指标的业绩评价分析及实施对策

本文介绍了几种新的业绩评价模式，并且就其优劣与传统的企业业绩评价系统做出比较。引入了非财务指标的业绩评价的分析，之后，对我国的业绩评价系统作出了对策性建议。     

无形资产审计的构想与评价

随着知识经济的发展,无形资产的比重呈现出越来越大的趋势。因此,审计部门应重视无形资产的审计。对企业来说,无形资产是可持续发展的重要基础,是企业潜在的巨大财富。面对无形资产管理不规范,国有企业无形资产流失的现状,需要重视无形资产审计。无形资产审计内容包括无形资产战略审计、无形资产重点审计、无形资产效益审计、无形资产管理审计。     

流动人口“社会融合度”指标体系构建

我国流动人口的社会融合已成大势所趋,现有对流动人口社会融合的研究存在缺陷,有必要借鉴欧盟社会融合指标和欧盟移民整合指数,并根据中国人口流动的特殊国情,建构我国流动人口社会融合指标体系,以推动我国流动人口的社会融合进程。