Productivity efficiencies in Ukrainian polyclinics: lessons for health system transitions from differential responses to market changes

Ukraine’s recent elections revealed deep divisions between eastern regions, which favored central economic planning, and western regions, which preferred more free market reforms. This study compares polyclinics in Ukraine to see if the inflexibility of Soviet-style planned economies results in lower economic efficiency in eastern regions. Using data from two geopolitical regions, Data Envelopment Analysis (DEA) scores for polyclinic efficiencies are modeled as a function of demographic and economic determinants. Surprisingly, results indicate that polyclinics in western Ukraine are less efficient. Possible explanations, including case mix intensity, responsiveness to local preferences, physician entrepreneurial behavior and a legacy of inequitable funding, are discussed.

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.

The Crisis of Economic Reform in the USSR and Possibilities for Change

What are the prospects for economic reform in the Soviet Union? Anatoly Chubais, of the Institute of Economics and Technology in Leningrad, explores the roads by which the Soviet economy can move from central planning to a market economy.     

What Influences Stock Market Behavior in Russia and Other Emerging Countries?

We empirically test the dependence of the Russian stock market on the world stock market and world oil prices in the period 1997:10–2012:02. We also analyze countries that can be considered to be relatively similar to Russia, e.g., Poland, the Czech Republic, and South Africa. First, we apply a rolling regression to identify periods when oil prices or stock indices in the United States and Japan were important. Surprisingly, oil prices are not significant for the Russian stock market after 2006. Second, we employ a TGARCH-BEKK model to assess the degree of correlation between the markets in question, taking into account the global market stochastic trend. Correlation between markets increased between 2000 and 2012.     

Interaction of the Russian Financial Markets

The different segments of he Russian financial markets are studied in the paper. The market crashed on 17 August 1998. We consider the stable period of the market between May 1996 and October 1997. We study the structure of interactions between the GKO market, stock market, currency market, currency futures market, GKO futures market, interbank credit market. We study the relations between the world financial market and the Russian financial market. It was shown that, in the period under consideration, different segments of the Russian financial market became more integrated and the market as whole became more stable and more integrated in the international capital flows.     

An extremal property of the generalized arcsine distribution

The main result of the paper is the following characterization of the generalized arcsine density p _γ (t) = t ^γ?1(1 ? t) ^γ?1/B(γ, γ)   with ${t \in (0, 1)}$ and ${\gamma \in(0,\frac12) \cup (\frac12,1)}$ : a r.v. ξ supported on [0, 1] has the generalized arcsine density p _γ (t) if and only if ${ {\mathbb E} |\xi- x|^{1-2 \gamma}}$ has the same value for almost all ${x \in (0,1)}$ . Moreover, the measure with density p _γ (t) is a unique minimizer (in the space of all probability measures μ supported on (0, 1)) of the double expectation ${ (\gamma-\frac12 ) {\mathbb E} |\xi-\xi^{\prime}|^{1-2 \gamma}}$ , where ξ and ξ′ are independent random variables distributed according to the measure μ. These results extend recent results characterizing the standard arcsine density (the case ${\gamma=\frac12}$ ).     

Collective management of residential housing in Russia: The importance of being social

Homeowners associations (HOAs) implement collective management in residential housing. We assess the performance of such associations in Russia by using the stochastic frontier technique. Cultural traits enabling tenants to make proper use of the HOA decision-making procedures are essential for resolving the collective action problem and ensure accountability of governing bodies and outside contractors. Such “technical civic competence” has a stronger impact on HOA performance than more conventional forms of social capital which rise in their significance when HOA governance breaks down and informal grassroots alternatives are mobilized instead. Massive and indiscriminate “supply-led” introduction of collective management in residential housing without matching cultural and institutional prerequisites could be counterproductive. Flexibility, freedom of choice, and market development are required to avert the failures of HOAs commonly observed in Russia.     

Law and the Determinants of Property-Casualty Insurance

This article examines the importance of legal rights and enforcement in influencing property‐casualty insurance (PCI) consumption. We extend the existing literature by examining the role of legal factors in determining insurance density across countries. Also, measures of risk aversion, loss probability, and price, which overcome limitations of proxies used in the existing literature on insurance demand, are analyzed. Using a panel data set, we apply a generalized methods of moments dynamic system estimator, which relaxes the assumption of strict exogeneity of the regressors and produces unbiased and efficient estimates. The results show a strong positive relationship between the protection of property rights and insurance consumption, which is robust to various model specifications and estimation techniques. Moreover, the results show the purchase of PCI is significantly and positively related to loss probability and income, as well as providing weaker evidence of a negative relationship with price.     

Doing business in Russia: Lessons from early entrants

The business climate in Russia during the first half of the 1990s has been uncertain and difficult. Many companies would hesitate to invest in such a risky environment. Yet some have, and many others will do so, in light of President Boris Yeltsin's continued commitment to a market economy, and other positive developments. A survey of 49 American firms compares 24 American early entrant companies which began doing business in Russia before 1990, with 25 later arrivals. Companies in both groups shared many views about doing business there. However, differences between the two groups concerning motives, attitudes, and strategies suggest characteristics which might contribute to longer term staying power in this uncertain environment. Analyses are supplemented with examples of recent company activities, particularly those of early entrants. The article concludes with lessons based on early entrants' experiences. These lessons may benefit other firms like the newer entrants if they too choose a similar long-term horizon. © 1998 John Wiley & Sons, Inc.