Statistical rehabilitation of improper correlation matrices

The simplest way to describe the dependence for a set of financial assets is their correlation matrix. This correlation matrix can be improper when it is specified element-wise. We describe a new method for obtaining a positive definite correlation matrix starting from an improper one. The expert's opinion and trust in each pairwise correlation is described by a beta distribution. Then, by combining these individual distributions, a joint distribution over the space of positive definite correlation matrices is obtained using Cholesky factorization, and its mode constitutes the new proper correlation matrix. The optimization is complemented by a visual representation of the entries that were most affected by the legalization procedure. We also sketch a Bayesian approach to the same problem.     

Managed care,technology adoption,and health care: the adoption of neonatal intensive care

Managed care may influence technology diffusion in health care. This article empirically examines the relationship between HMO market share and the diffusion of neonatal intensive care units. Higher HMO market share is associated with slower adoption of mid-level units, but not with adoption of the most advanced high-level units. Opposite the common supposition that slowing technology growth will harm patients, results suggest that health outcomes for seriously ill newborns are better in higher-level units and that reduced availability of mid-level units may increase their chance of receiving care in a high-level center, so that slower mid-level growth could have benefitted patients.     

The interdependencies of intra- and inter-organisational controls and work practices—The case of domestic care of the elderly

The paper gives a grounded account of inter-organisational controls and work practices in the public sector to complement previous literature's strong focus on inter-organisational customer–supplier relationships in the private sector. We draw theoretically on Hopwood's (1974) administrative, social and self controls, which enable us to analyse the influence of non-managerial controls on behaviour. Empirically, a case study of inter-organisational cooperation between home help units and health centres is used as the basis of analysis. Most inter-organisational controls were developed locally and involved a mix of administrative, social and self controls. Intra- and inter-organisational social and self controls were important forms of control which impacted on intra- and inter-organisational work practices and we see the need for a broad conceptualisation of control (Van der Meer-Kooistra and Scapens, 2008). Inter-organisational social controls created an informal hierarchy that by-passed the formal hierarchies of the two organisations. Self controls reinforced the importance of being flexible to accommodate pensioner's wishes and needs in specific care situations. We also show the importance of the internal financial situation of home help units for the analysis of the interdependencies of intra- and inter-organisational controls and work practices.     

Improving the delivery of clinic care

There has been an increasingly widespread movement toward the delivery of health care in outpatient settings. Hospitals must start to prepare for the shift from inpatient to outpatient services. Reductions in reimbursement and increasing costs will force hospitals to collect and obtain more data on outpatient services. Projecting future demands and assessing current utilization rates are two of the key factors in maintaining stability. This article is a case study of a major urban medical center's outpatient clinic. It includes a summary of observations on the clinic's daily operations and several recommendations for improvement. While the original analysis was highly specific to the actual facility observed, this article has been structured so that it may be applied to other institutions.     

Medicaid and long‐term care: The effects of penalizing strategic asset transfers

Medicaid provides a critical source of insurance for long‐term care, and individuals may strategically offload assets (typically to children) to meet the means‐tested eligibility requirement. In this article, we quantify the extent of such behavior using variation in the penalty for improper parent‐to‐child transfers induced by the Deficit Reduction Act of 2005. We estimate difference‐in‐differences models based on the hypothesis that only individuals with high levels of nursing home risk (high risk) will alter transfers because of the Act. We find that over a 2‐year horizon, high‐risk individuals reduced transfers to children on the extensive margin by 11 percent and that the average total amount of transfers decreased by $4,860. The results hold only for coupled respondents. We also conduct a triple‐differences analysis to examine heterogeneity with financial literacy and find that even those with a low level of financial literacy responded to the penalty.     

Mental health: Shifting the balance of care

For the first time, Departments have been forced to go public on their medium‐term spending forecasts. As one might expect, a good deal of smoke has been made. PUBLIC MONEY invites its readers to penetrate the smokescreen and pick the high and low spenders of the next ten years.     

保持职业谨慎应贯穿审计全过程

一、案情介绍A水保站是B市水利局下属事业单位,因性质特殊而拥有一部分政府无偿划拨的土地。2004年6月,B市水利局与某集团公司签订土地合作开发意向:     

Pattern-of-treatment differences among primary care physicians in alternative systems of care

In a recent study, the average treatment pattern of HMO-based primary care physicians is found to be significantly less expensive than that of indemnity-based primary care physicians. This difference is because the HMO-based physicians' style of medical practice is less hospital-intensive.     

Benefits sought by the employed care giver

More than 600 full-time employed care givers of older family members reported the impact of care giving on their work performance. While a large proportion reported a minimal negative impact on work performance, this impact was positively correlated with the extent of their care giving burden. When asked what employers could do to help, employees most often requested flexibility.     

On the DuPont analysis in the health care industry

Prior research documents that the DuPont components of return on net operating assets (profit margin and asset turnover) represent an incremental source of information about the operating characteristics of a firm and are useful tools for market participants (Soliman, 2008). We find that the informativeness of DuPont components about future profitability is reduced in the healthcare setting, relative to an all-industry sample. Moreover, to the extent that DuPont components are useful for market participants, we show that profit margin is more persistent than asset turnover for US for-profit health care providers, which contradicts the results documented in prior literature that considered all industries. We argue that the special features of the health care industry (i.e. heavy regulation, unique operational characteristics) affect the information content of accounting signals obtained based on financial statements.