Non-elective C-sections in public hospitals: capacity constraints and doctor incentives

Using administrative records of births from the Perinatal Surveillance System of the Peruvian Social Security System (ESSALUD), we test whether high admissions of pregnant women affected non-elective caesarean section (C-section) rates in the ESSALUD public hospitals during 2005–2006. We present a basic theoretical model that considers physician preferences for leisure and hospital capacity constraints, and test the model predictions. We find that physician demand for leisure increases the probability of C-sections in small and medium-size hospitals, while hospital capacity constraints set a limit on them. We discuss the policy implications as well as the policies implemented to avoid unnecessary C-sections.     

地方财政支农投入与农业技术效率的省际差异:1995～2011年

运用参数法中的随机前沿分析法,结合我国1995—2011年的省级面板数据,选取地方财政"一般预算支出"中的"农林水事务"支出作为代理变量,分析地方财政支农投入对农业技术效率的影响,发现地方财政支农投入对于农业技术效率以及农业产出具有显著的积极作用,财政支农投入差异是我国各省市农业技术效率差异的重要根源之一。但鉴于目前我国在中央与地方的财政分配上严重倾向于中央财政,不少省市的地方财政收入很有限,财政支农投入的数量、结构、区域分布等方面都亟待调整和完善。     

Public sector efficiency in transition and beyond: evidence from Czech local governments

This article provides the first comparison of public sector efficiency in and beyond transition. We compare the comprehensive efficiency scores of 202 local governments in the Czech Republic in the transition period of 1995–1998 and the post-transition period of 2005–2008 and identify the period-specific determinants of local government efficiency. We observe convergence to the best practice frontier but also a growing efficiency gap between small and large governments. In both periods, municipal size and the main fiscal variables qualitatively affect efficiency in the same direction and in line with the fiscal stress hypothesis. Left-wing ideology is only robustly associated with cost inefficiency in the transition period. The geographic distances begin to matter for efficiency only in the post-transition period.     

Efficiency,heterogeneity and cost function analysis: empirical evidence from pathology services in the National Health Service in England

Pathology services are increasingly recognized as key to effective healthcare delivery – underpinning diagnosis, long-term disease management and research. To the extent that pathology services affect a patient’s treatment pathway, significant healthcare costs are influenced directly by the performance of these services. Given pressures on the UK Department of Health to make efficiency savings and that little is known about the efficiency of pathology laboratories, this area offers unlocked potential for efficiency gains. We adopt a time varying inefficiency model, with laboratory-specific time paths for inefficiency, to identify potential savings in pathology services based on a panel of 57 English laboratories over a 5 year period. We apply a range of approaches to account for observable and unobservable heterogeneity between laboratories. We find potential efficiency savings of 13% in pathology services in this sample, which implies the potential for an annual saving of £390m in pathology across the NHS. Our study also provides valuable insights into the impact of a range of factors influencing laboratory costs.     

Openness and the Efficiency of FDI: A Panel Stochastic Production Frontier Study

This paper uses a stochastic translog production frontier to estimate technical inefficiency indices whose conditional mean is specified as a function of FDI and its interaction with openness of the economy. The model is estimated using an annual panel of 46 countries for the years, 1981–2001. The results suggest that increased FDI increases potential output in both developed and developing countries with the effect being more profound in the former. It is also found that increased FDI reduces technical inefficiencies the more open is the economy but that this effect holds only for developed economies. Thus qualified support is found for the “Bhagwati hypothesis” as the results reveal that the efficiency–enhancing effect of FDI depends not only on openness but also on the degree of development of the host country.

The public sector and convergence with spatial interdependence: empirical evidence from Spain

We propose a framework to analyse convergence between regions, incorporating the public sector and technological knowledge spillovers in the context of a Neoclassical Growth Model. Second, we apply novel estimation methods pertaining to the spatial econometrics literature introducing a spatial Durbin panel data model based on instrumental variables and maximum-likelihood estimation. Our model makes it possible to analyse, in terms of convergence, the results obtained in Spanish regions with the policies implemented during the period 1980–2011. The results support the idea that education and fiscal policies have a positive effect on regional development and cohesion. Therefore, we can conclude that it is possible to obtain better results for regional convergence with higher rates of public investment in education and tax revenues. We also obtain interesting results that confirm the existence of spillover effects in economic growth and public policies, identifying their magnitude and significance.     

新医改形势下公立医院绩效考核与奖金激励机制探讨

深入开展公立医院人事和收入分配制度改革,坚持公立医院公益性,把维护人民群众健康权益放在第一位,建立以医德医风、技术能力和工作业绩为主要评价标准的综合绩效考核制度,加大工作量和医疗质量的考核权重,重实绩、重贡献,向优秀人才和关键岗位倾斜,从根本上切断科室收入与奖金分配的关系,更加关注综合目标,关注医疗质量、技术难度、成本控制、群众满意度,避免单纯的经济取向,提高临床一线医护人员的奖金待遇水平。     

Health spending and public pension: evidence from panel data

This article empirically investigates the determinants of aggregate health expenditure in a panel of OECD countries from 1980 to 2005. We differ from most existing studies by testing some new determinants motivated by recent theoretical advances in the literature. We find that a one percentage increase in public pension payments per elderly person leads to approximately a one third percentage increase in aggregate health spending, and this effect is significant and robust across a variety of model specifications. A back of the envelope calculation based on this estimate suggests that the expansion of the public pension programme on average accounts for approximately over one fifth of the rise in aggregate health expenditure as a share of GDP in the set of OECD countries during 1980–2005. In addition, we find that the estimated effect of GDP per capita in our model ranges from 0.66 to 0.80, which is consistent with the results from some recent studies, and thus further reinforces the finding in the literature that health care is not a luxury good.     

Institutional quality and public spending in Europe: A quantile regression approach

We appraise the effects of institutional quality on public spending for a set of 27 European countries and 18 Euro-area economies over the 1996–2017 period. While institutions play a weak role in affecting spending once the fixed-effects model is employed, the application of the quantile regression indicates that improved institutional quality mitigates public spending, although the effects crucially depend on the distribution of public expenditure and the sample examined. For both the Euro-area sample and the full sample, we show that better quality of institutions reduces public spending, although the effects become less significant the higher the levels of public spending. Further, for the Euro-area sample, institutions appear to have a stronger role in mitigating public spending. Several robustness tests confirm our findings.     

Elasticity of substitution and technical efficiency: evidence from the US electricity generation

ABSTRACT

The implications of national or regional energy policies for technical efficiency and environmental outcomes in electricity generation depend on fossil fuel input substitution. This study uses state level data to examine fossil fuel (coal and natural gas) substitution in electricity generation under increased availability of natural gas in the United States. We observe that changes in elasticities of substitution from pre-2009 to post-2009 differ across states suggesting that the effects of increased availability of inexpensive natural gas on electricity generation have been spatially heterogeneous. We rely on the observed heterogeneity to assess the effects of fossil fuel input substitution on technical efficiency and CO₂ emissions. The results reveal that state level elasticity of substitution between natural gas and coal has a positive effect on technical efficiency and a negative effect on CO₂ emissions. Therefore, future policy design and analyses should reflect the implications for regional elasticities of fossil fuel substitution and associated environmental outcomes.     

浅议高校档案管理人员应具备的素质

高校档案人员是高校档案事业的主体,档案人员素质的高低,关系到高校档案部门的职能发挥,全面提高档案人员的整体素质,是高校档案工作质量提高的重要保证。本文系统地阐述了高校档案管理人员应具备无私奉献精神、优质的服务意识、过硬的业务技能、良好的工作作风和心理素质。     

Determinants of privatization of public corporations: evidence from the Japanese experience

The main purpose of this study is to find factors affecting privatization decisions. This study investigates the determinants of privatization by applying the probit model for a data set of special public corporations in Japan. In December 2001, the Japanese government made a resolution to consider the privatization of special public corporations, evaluating 74 special public corporations for possible privatization. In the empirical analysis on the determinants of privatization, we find that among several factors affecting privatization decisions, two are important—the market condition factor and the policy/regulation factor. As for market conditions, a public corporation which exists in a commercialized industry is about 20% more likely to be privatized than others. As for the policy and regulation factor, the public corporation’s privatization under a single regulator is about 25% more likely, compared with the public corporation’s privatization under multiple regulators.     

当前公共突发事件中的政府危机处理主要存在问题探析

突发事件是一种显性社会不稳定现象,主要包括自然灾害、事故灾难、公共卫生事件、社会安全事件,具有突发性、公共性、针对性、复杂性和危害性等特点。当前,公共突发事件中的政府危机处理主要存在问题包括缺乏可行的预警机制、信息发布面临挑战、缺乏对公众进行必要和有效的教育与引导、应对公共突发事件的法律法规还不太健全。     

The adoption and diffusion of high-performance management: lessons from Japanese multinationals in the West

This paper draws on surveys and case studies of management practicesin Japanese transplants in the US, the UK and France to studypossible impediments to introducing high-performance work practices.It shows significant national differences in the adoption ofspecific practices and in their clustering. While the exerciseof power by labour and management and public policy result innationally specific hybrid arrangements, the results demonstratea common pattern in types of traditional practices that surviveand of Japanese practices transferred. The most commonly adoptedpractices (such as teamwork and quality circles) relate directlyto management interests in productive efficiency, while theretained traditional practices most often relate to worker compensationand internal labour market structures. National industrial relationssystems appear to be important in the balancing of efficiencygains for managers and economic benefits for workers.     

实施流程管理 提升运营质量

流程管理是以规范化地构造端到端的卓越业务流程为中心,以持续地提高组织业务绩效为目的的系统化方法,其核心是加强协作、提高效率,实施步骤和关键因素是流程管理企业流程管理的难点。某置业集团实施流程管理,经历建立标准、分类建模、评估上线、持续改进4个步骤,实现提高运营质量的目的,而目标驱动、完整适用、共同参与、持续优化和信息化支撑成为其关键因素。     

Metafrontier frameworks for the study of firm-level efficiencies and technology ratios

This paper uses the concept of a metafrontier to compare the technical efficiencies of firms that may be classified into different groups. The paper presents the basic analytical framework necessary for the definition of a metafrontier, shows how a metafrontier can be estimated using non-parametric and parametric methods, and presents an empirical application using cross-country agricultural sector data. The paper also explores the issues of technological change, time-varying technical inefficiency, multiple outputs, different efficiency orientations, and firm heterogeneity.     

Childcare quality and pricing: evidence from Wisconsin

Childcare prices vary dramatically both between and within states. We identify the effects of demographic and provider characteristics on childcare pricing, but focus primarily on whether unique government-provided information on childcare quality has an effect on pricing. Using provider-level observations across three adjacent counties in southern Wisconsin, we find that this government-provided information on childcare quality does not significantly affect pricing. Recognizing that information asymmetry may be the root cause of the insignificant relationship, we test the relationship further within multiple subsamples and with alternative models. Only the lowest quality childcare providers are significantly associated with lower prices in areas that we hypothesize suffer from greater information asymmetry.     

An analysis of the impact of unionization on efficiency: evidence from a meta-frontier analysis

This article examines the impact of unions on the efficiency of establishments in the manufacturing industry by comparing the results from two different empirical strategies: stochastic frontier analysis (SFA) and meta-frontier analysis (MFA). While SFA concludes that union establishments show higher technological efficiency, the results are the opposite when estimating production functions with MFA. In SFA, unionized establishments appear to be more efficient because they remain closer to their own production frontier; however, in MFA – where groups with heterogeneous technology can be compared – we find that nonunionized establishments are more efficient because they are closer to the meta-frontier than their unionized counterparts.     

Product quality and competition: evidence from the broadband industry

Access to high-quality broadband internet is important in many different respects such as in communication, education, commerce and information acquisition. We investigate the relationship between the number of broadband providers in an area and the quality of broadband service provided where download speed is used as a proxy for quality. We find that increased competition in an area positively affects the access to fast download speeds. This finding is robust to three different top download speeds tested. Additionally, a theoretical model is provided which shows that competition can decrease the profits associated with offering slow speeds; this gives an incentive for providers to offer higher speeds as a way to increase profits.     

Effects on the medical revenue of comprehensive pricing reform in Chinese urban public hospitals after removing drug markups: case of Nanjing

Aims: The State Council of China requires that all urban public hospitals must eliminate drug markups by September 2017, and that hospital drugs must be sold at the purchase price. Nanjing-one of the first provincial capital cities to implement the reform—is studied to evaluate the effects of the comprehensive reform on drug prices in public hospitals, and to explore differential compensation plans.

Methods: Sixteen hospitals were selected, and financial data were collected over the 48-month period before the reform and for 12 months after the reform. An analysis was carried out using a simple linear interrupted time series model.

Results: The average difference ratio of drug surplus fell 13.39% after the reform, and the drug markups were basically eliminated. Revenue from medical services showed a net growth of 28.25%. The overall compensation received from government financial budget and medical service revenue growth was 103.69% for the loss from policy-permitted 15% markup sales, and 116.48% for the net loss. However, there were large differences in compensation levels at different hospitals, ranging from –21.92% to 413.74% by medical services revenue growth, causing the combined rate of both financial and service compensation to vary from 28.87–413.74%, There was a significant positive correlation between the services compensation rate and the proportion of medical service revenue (p?<?.001), and the compensation rate increased by 8% for every 1% increase in the proportion of services revenue.

Discussion: Nanjing’s pricing and compensation reform has basically achieved the policy targets of eliminating the drug markups, promoting the growth of medical services revenue, and adjusting the structure of medical revenue. However, the growth rate of service revenue of hospitals varied significantly from one another.

Conclusions: Nanjing’s reform represents successful pricing and compensation reform in Chinese urban public hospitals. It is recommended that a differentiated and dynamic compensation plan should be established in accordance with the revenue structure of different hospitals.