Is low-priced primary care bad for quality? Evidence from Australian general practice

We examine whether patients’ perceptions of general practitioner (GP) care varies by the price paid for consultations. Australian consumer survey data from 2275 individuals were used to analyse the relationship between price and patient experience of GP care. Using both standard models for count data and a latent class model that distinguishes between patients with high- and low-quality experiences, we find no evidence that lower prices have a negative impact on patients’ perceptions of GP quality. Nevertheless, some patient characteristics such as age, gender and health status play a significant role in quality-of-care perceptions. The results show that Australian patients have not had to compromise GP quality, as expressed in terms of patient experience, when seeking low-priced care. This supports the view that there are sufficient checks and balances on the GP sector in Australia to ensure positive patient experiences even for low-cost GP consultations.     

Production and Employment Impacts of Biotechnology —Input-output Analysis for Germany

Biotechnology is often regarded as a key technology with high potential for far-reaching social, environmental and economic impacts. Among others, the development and diffusion of biotechnology may have considerable economic effects on production and employment. This paper analyses the economic impacts of different prospective diffusion paths of biotechnology in some major application fields for Germany. Bottom-up technology information from the literature, expert judgements and explicit scenario assumptions for various impact factors are combined and integrated in an input-output framework to calculate direct and indirect production and employment effects. The impact on net production and employment differs greatly between the different application sectors and depends on the respective importance of the various impact mechanisms. The indirect economic effects are rather high and exceed the direct economic effects. These findings show the importance of a bottom-up approach as well as the consideration of the indirect economic effects for appropriate analyses of the impact of biotechnology.     

Competitive diffusion of new prescription drugs: The role of pharmaceutical marketing investment

We investigate the impact of marketing interventions on the diffusion of new products in a competitive setting. We develop a family of trial–repeat diffusion models to identify the longitudinal effects of marketing efforts, and complement this with a cross-sectional analysis to identify the between-drug effects. We believe that we are the first to consider both longitudinal and cross-sectional marketing effects in a trial–repeat diffusion context. The models are calibrated on 34 drugs in three therapeutic categories using monthly data. Our longitudinal analyses demonstrate that the trial rate responds positively to increases in own marketing expenditures but is affected negatively by competitors' expenditures. We show how these within-drug analyses provide opportunities for accelerating the diffusion process by reallocating marketing expenditures over time. The cross-sectional analyses demonstrate that pharmaceutical marketing has both an informative and a persuasive influence on the diffusion of new drugs. We find that direct-to-consumer advertising does not affect the trial nor repeat rates during the first months after introduction. We illustrate the managerial relevance of our results and find that a reallocation of marketing budgets does not alter the saturation level, but can help in attaining this level faster. We show that this has a great effect on sales, market share and ROI.     

What Drives the International Transfer of Climate Change Mitigation Technologies? Empirical Evidence from Patent Data

Technology transfer plays a key role in global efforts to reduce greenhouse gas emissions. In this paper, we characterize the factors that promote or hinder the international diffusion of climate-friendly technologies using detailed patent data from 96 countries for the period 1995–2007. The data provide strong evidence that lax Intellectual Property regimes have a strong and negative impact on the international diffusion of patented knowledge. Restrictions on international trade and foreign direct investment also hinder the diffusion of climate-friendly technologies. Surprisingly, local technological capabilities tend to discourage transfers. While broad indicators of technology capabilities are expected to facilitate transfers, this latter result stems from our technology-specific definition of local capabilities, which makes it possible to capture a substitution effect between local and foreign inventions.     

Modularity and productivity: Assessing the impact of digital technology in the U.S. telecommunication industry

This article investigates the impact of digital technology diffusion on the productivity of firms making up the local operating sector of the U.S. telecommunications industry for the years 1991 to 1993. Diffusion of digital technology is measured as the extent of line digitalization that has taken place, with digitalization expected to enable firms to reap significant operating efficiencies. While the diffusion of this particular technology in the local operating company sector has been relatively low, it is found that, after controlling for the effects of a number of other covariates also likely to affect firm-level performance, the spread of digital technology within the U.S. local telephone network plays a significant and positive role in impacting productive efficiency of the firms making up the network. The investments that have been made in energizing the U.S. information superhighway, via the digitalization of telephone lines, are justified in productive efficiency terms. The article contributes to empirical literature in the technical change area which assesses the firm-level productive efficiency consequences of technology diffusion.     

自愿参与型环境规制与企业技术创新——公众关注度和市场进程的调节作用

“波特假说”有效性一直是学术界颇具争议的话题，然而现有文献对于自愿参与型环境规制与企业技术创新的关系讨论较少，也缺乏对其作用情景因素的关注。基于2011—2019年730家沪深A股上市企业面板数据，采用负二项回归模型和倾向得分匹配法，分析我国上市企业在市场化进程影响下，自愿参与型环境规制、公众关注度对企业技术创新的影响。结果发现，自愿参与型环境规制对企业技术创新具有正向影响；公众关注度在自愿参与型环境规制对企业技术创新的影响过程中起正向调节作用；自愿参与型环境规制、公众关注度和市场化进程交互项结果表明，企业位于市场化程度较高地区时，公众关注度对自愿参与型环境规制与企业技术创新的调节作用更显著。结论不仅丰富了“波特假说”相关研究，还为我国企业提高信息共享意识以及政府优化市场环境提供了微观证据。     

Financial Deregulation and the Role of Statecraft: Lessons from Britain’s 1971 Competition and Credit Control Measures

Within the financialisation literature, a number of approaches identify the coexistence of financial expansion and productive stagnation. Yet there is no consensus on which direction causality operates between these two phenomena. This impasse has been widened by the lack of attention paid to the role of statecraft strategies in mediating possible causal mechanisms. This article contributes to rectifying this shortcoming by focusing on the governance advantages granted to states through financial deregulation. By presenting archival evidence on Britain’s 1971 Competition and Credit Control deregulation, this article lends support to financialisation accounts that argue that weaknesses in the productive economy spurred financial expansion, yet it also indicates that the state’s desire for depoliticised forms of governance played a crucial role in mediating this relationship. This further suggests that International Political Economy should focus on the strategic manner in which states relate to markets.     

Do R&D expenditures matter more than those of marketing to company performance? The moderating role of industry characteristics and investment density

Confronting competitive environment, enterprises differentiate their product by promoting their R&D or marketing capacities. Scholars have verified that there is a direct relationship and a deferred effect between R&D expenditures and firm performance, but that there exists an inconsistency between marketing expenditures and firm performance. However, previous studies have neglected to analyse and compare the impact of corporate R&D and marketing investment on performance, and also ignored the moderating effects of different industry characteristics and investment densities. The study attempts to fill the gap by constructing a model to accommodate all these factors. The empirical results indicate that R&D and marketing expenditures have a positive impact on enterprise operating performance, and that there is a longer deferred effect in R&D expenditures than in marketing expenditures. By investing in R&D expenditures, manufacturing enterprises can increase their performance more than in service enterprises, and electronic enterprises can improve their performance compared with other types of firms. Finally, investments with higher R&D density can result in a higher performance.     

组织信息化环境下知识流动对组织创造力的影响

通过解析知识流动和组织信息化环境的内部构成,探究知识溢出/知识扩散、高管支持/ICT应用对组织创造力的差异性影响,以及不同组织信息化环境对知识流动与组织创造力关系的调节作用。利用信息化程度较高的企业数据,使用层级回归分析进行实证检验。结果表明：组织创造力受知识流动的正向影响,知识扩散对其的正向影响更强;组织信息化正向影响组织创造力,相比ICT应用,高管支持对组织创造力的正向影响更强;高管支持在知识溢出/知识扩散与组织创造力之间的正向调节作用显著;ICT应用对知识扩散与组织创造力的强化作用显著强于对知识溢出与组织创造力之间的调节作用。     

Some aspects of an analytical framework for studying the diffusion of organizational innovations

The objective of this paper is to explore the extent to which the more recent literature on innovation and decision, with a prime focus on technical innovations, can contribute to a useful analytical framework for studying the diffusion of organizational innovations. We review that literature, compare the intrinsic features of technical and organizational innovations, and explore what these differences may mean for an eventual analytical framework specifically developed for studying organizational innovations. We conclude that the received 'innovation' literature has a great deal to offer but that some modifications are required. In particular, we suggest that the role of factors 'inside' the non and of non-market mechanisms for transfer of organizational innovations needs special emphasis.     

Does quality influence choice of general practitioner? An analysis of matched doctor–patient panel data

The impact of quality on the demand facing health care providers has important implications for the industrial organization of health care markets. In this paper we study the consumers' choice of general practitioner (GP), assuming they are unable to observe the true quality of GP services. A panel data set for 484 Norwegian GPs, with summary information on their patient stocks, renders the opportunity to identify and measure the impact of GP quality on the demand, accounting for patient health heterogeneity. We apply a multi-equation model in the LISREL format, with GP quality and patient health as latent determinants of demand for GP services. Patient excess mortality rate at the GP level is one indicator of quality. Our results indicate that GP quality has a clear positive effect on demand, even when patient heterogeneity is accounted for.     

Does asymmetric information matter in the early insurance market? Evidence from the auto insurance market

In the late 1960s, the performance of automobile insurance declined dramatically in Japan in spite of rapid growth in the diffusion rate, and the premiums were sharply raised several times in order to improve the situation. This observation indicates the possible presence of adverse selection (death spiral), and provides an ideal situation for assessing informational asymmetry. Using bodily injury liability (BIL) insurance data from 46 Japanese prefectures over the period 1966 to 1975, this article tests two hypotheses of adverse selection: (i) high-risk drivers were more likely to join the BIL insurance market and (ii) sharp premium increases drove low-risk policyholders away. Various empirical analyses show that there is little evidence for either type of adverse selection. We also test whether a risk-misperception hypothesis can explain our results, and find some evidence that the population density have a significantly positive impact on the demand for BIL insurance.     

A methodological framework to address gaps in the evidence on infrastructure impacts: the case of an Indian railway project evaluation

ABSTRACT

Infrastructure is a key area of public investment and development cooperation, and can be seen as a critical enabler of trade and integration. Stakeholders increasingly demand evidence on the effectiveness of investments in infrastructure such as railways, in part because these investments typically lock in development patterns for decades. In this article we take stock of the main findings, methodological approaches, gaps and caveats of the current literature with a focus on railways. Based on this analysis, we present a methodology for an impact evaluation framework which builds on existing knowledge and addresses some of these shortcomings. Beyond the dearth of empirical evidence on the socio-economic and environmental impacts of infrastructure, we discuss critiques of the currently prevalent methodological toolbox. Using a real-world railway project in India, the Konkan Railway, we exemplify how a rigorous quantitative impact assessment can integrate inter-disciplinary and mixed-methods features to address these issues. Specifically, we apply different quasi-experimental techniques on the level of intermediate and ultimate outcome and impact indicators, using census, survey and satellite data and information from document analyses, interviews and focus group discussions. We draw on insights from economics, sociology, engineering and geography in making sense of large infrastructure projects and their impacts.     

基于特征分析的城市创意经济发展支点研究

通过对创意经济经典文献的分类综述,文章对创意经济的主要特征进行了分析。在此基础上提出创意经济的发展受到教育水平、经营环境以及媒体平台三大支点的影响和制约。通过采集跨国横截面数据进行结构方程建模,进一步检验了三者对消费性创意经济和生产性创意经济的支撑原理。实证说明,三大支点对于创意经济的发展具有不同程度的正向影响。最终依据实证结论,给出了我国城市发展创意经济的政策建议。     

Innovation and its diffusion: process,actors and actions

Seeking to understand factors affecting innovation diffusion, research has increasingly focused on process, actors and activities. After two decades of research, however, a systematisation of these three sets of studies is still lacking. Thus, this paper contributes to the existing literature providing a comprehensive framework of factors affecting innovation diffusion between organisations. Specifically it evidences phases of innovation diffusion process, clarifies the role of innovator, adopters and intermediaries and evidences actions that policy-makers can implement to support it.     

Regulations and Technology Diffusion: Cross Subsidies and Digital Infrastructure Creation

Using contemporary historical data, the analysis has examined the impact of cross‐subsidization on technology diffusion within telecommunications networks for local exchange sector telecommunications firms in the United States for the years 1995 to 2000. Firms obtaining greater cross‐subsidies engage in greater technology diffusion via network modernization using digital technologies. Contingent on the institutional setting, cross subsidies have risen. These amounts have been put to relevant use in the diffusion of technology via deployment of digital infrastructure. The principles of subsidization are considered negatively as they have presumed anti‐competitive consequences. In technology diffusion they have played a positive role, as the evidence shows. From a radical subjectivist perspective, cross subsidies generate financial capital for firms, which permits them to deploy high quality technology investments such as broadband and these investments can be used for entrepreneurial experiments in providing several customer services.     

Exploring the causes of the slowdown in remittances to Mexico

This article explores the slowdown of remittances to Mexico and the role that may have been played by some key variables from the United States economy. The findings show that several measures of United States economic activity and different proxies for the unemployment of Mexican nationals living in the United States do not appear to have a strong impact on remittance transfers. On the other hand, this study finds that United States housing variables do seem to affect remittance transfers. In particular, there is a special prominence of the impact shown by the number of housing starts in the United States. Overall, the results seem to suggest that there is not a single United States economic factor that is responsible for the decrease of remittances to Mexico but rather a combination of factors. Among these factors, the decrease in United States housing activity seems to play a major role.     

农产品区域品牌资产影响因素及其作用机制的实证研究

笔者基于文献回顾和访谈,构建了农产品区域品牌资产影响因素及其作用机制模型。研究发现,资源基础、产业优势、组织管理、创新氛围和营销刺激作为关键因素,对农产品区域品牌资产构成维度有差异化影响,并且,在农产品区域品牌资产维度间也存在着一定程度的因果作用关系。     

Health economics of market access for biopharmaceuticals and biosimilars

Abstract

Background and scope: This article discusses health economic challenges of research and development, registration, pricing and reimbursement of biopharmaceuticals and biosimilars. A literature search was carried out of PubMed, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews and EconLit up to March 2009.

Findings: The development process of biopharmaceuticals is risky, lengthy, complex and expensive. Registration is complicated by the inherent variation between biopharmaceuticals. Also, as biopharmaceuticals are likely to be efficacious in a subgroup of the patient population, there is a need to select the most responsive target population and to identify biomarkers. To inform pricing and reimbursement decisions, the development process needs to collect comparative data to calculate the incremental cost effectiveness and budget impact of biopharmaceuticals. There is a role for innovative mechanisms such as risk-sharing arrangements to reimburse biopharmaceuticals.

Conclusions: Given that biosimilars are similar, but not identical to the reference biopharmaceutical, the development process needs to generate clinical trial data in order to gain marketing authorisation. From a health economic perspective, the question arises whether inherent differences between biopharmaceuticals and biosimilars produce differences in safety, effectiveness and costs: to date, this question is unresolved. The early inclusion of health economics in the process of developing biopharmaceuticals and biosimilars is imperative with a view to demonstrating their relative (cost) effectiveness and informing registration, pricing and reimbursement decisions.     

Complementarities between firm-sponsored training and information technology use

In this article, we investigate the presence of possible complementarities between investments in information technology (IT) and firm-sponsored training using economy-wide longitudinal representative workplace-level data. Since information on the firm’s capital stock is often missing in such representative data, we match our workplace records to tax data to construct measures of the firm’s capital stock. We find some evidence of positive complementarities between investments in human capital and IT, suggesting that on-the-job training can also have a positive impact on productivity when complemented with investments in CAD or other technologies.