Perceptions of Stakeholding: The Case of an NHS Trust

This article considers the significance of stakeholding for an NHS trust. The trust concerned was confronted with significant changes in its environment which posed a threat to its services and, therefore, its contract income. The trust appeared to be in a vulnerable position because it had not given adequate consideration to its relationship with its stakeholders. To establish where the trust needed to improve relations with stakeholders, the article adopts a model drawn from Johnson and Scholes (1993) and presents an analysis of the view of key individuals through the use of structured interviews.     

Autopsy of Change: Contextualising Entrepreneurial and Accounting Potential in the NHS

Set in the context of New Public Management (NPM), this paper uses two NHS Pathology departments to provide a clearer picture of what reforms have really achieved. Contrasting illustrations of management processes, entrepreneurialism and accounting practices are provided in the case studies. The paper seeks to explain these differences and concludes that the impact of NPM, in terms of entrepreneurial management and accounting practices, is not just contingent upon the type of activity undertaken but also upon the 'antecedent conditions of possibility' embedded therein and the personality and competence of individuals managing front line change.     

Developing Primary Care Groups in the New NHS: Towards Diversity or Uniformity?

This article examines how the Government's 'third way' is being implemented in relation to the involvement of primary care professionals in the commissioning of health services. Prior to 1997, the single preferred model of GP fundholding evolved into a diversity of approaches to commissioning and these approaches became increasingly collaborative rather than competitive. From this starting point, the authors examine the key assumptions underlying the present single model of the primary care group (PCG) as the commissioning body for the 'New NHS'. They suggest that PCGs will also evolve into a diversity of models, but there will be tensions arising over the greater emphasis on central direction and performance management.     

Coping with Technological Change: The Case of Retail

Functional obsolescence in real estate occurs because of technological change. A theoretical model suggests that the early years of building life are characterized by functional obsolescence that is undiminished by reinvestment (cures in appraisal terminology). Later, observable functional obsolescence is eliminated by cures. A national, proprietary data set consisting of department store sales is utilized to test these propositions. The test is structured within a hedonic model in which the effect of age represents functional obsolescence and technological change, while other variables control for physical condition and location quality. The empirical results do not permit the rejection of the hypotheses developed from the theory. The measured rate of techological change in retail real estate is 1.7 percent per annum.     

Issuance Decisions and Strategic Focus: The Case of Long-Term Care Insurance

Increasing costs of long-term care are placing ever greater burdens on state and federal budgets, yet private long-term care insurance remains a relatively minor financing vehicle. Although many researchers provide rationales for the limited private market, some life–health insurers have forged ahead into this relatively new and risky line of business. We investigate what makes these insurers different and whether managers are following a diversification or strategic focus strategy. We find that strategic focus is a consistently important factor and that managers' participation and volume decisions are made independently.     

Competition and Efficiency in Health Care: An Analysis of the Italian Case

In this paper we look at the Italian NationalHealth System as a case study, in order to investigate whethercompetition exerts positive effects on the efficiency of hospitals.Using the DEA technique we measure the efficiency of Italianhospital production; secondly, we take a regression analysisapproach to analyse its determinants. A general conclusion stemmingout of the analysis is that competition is not a value per seand that its effects on hospitals' performance are affected bythe rules governing the health system.     

Patient Power: The Free-Enterprise Approach to the U.S. Health Care Problem

Giving people choices in health care and instilling cost-consciousness is plain old common sense. In Medical Savings Accounts, authors Goodman and Musgrave have hit upon a bold concept that may revolutionize the way health care is delivered throughout America.     

在案例教学法中要重视案例库建设

案例教学在西方管理研究和教学中较为流行,在美国哈佛大学商学院、法学院等一些高级专业课程中已经普遍运用.国内虽然也有很多高校已在尝试案例教学,但仅有少数开展得比较成功.要推广案例教学除了需要教育理念的更新以外,更要重视案例库的建设.     

决策模型在职业生涯与发展决策过程中的应用

大学生是重要的人力资源,其就业是关系到个人前途和全社会发展稳定的大事。我们应从高校入手关注大学生的职业生涯发展,指导学生如何利用决策模型来规划自己的职业,这对大学生而言具有重要的现实意义。     

Asymmetric Information, Long-Term Care Insurance, and Annuities: The Case for Bundled Contracts

This article examines the markets for long-term care insurance and annuities when there is asymmetric information and there are costs of administering contracts. Individuals differ in terms of their risk aversion. Risk-averse individuals take more care of their health and are relatively high risk in the annuities market and relatively low risk in the long-term care insurance market. In the long-term care insurance market, both separating and partial-pooling equilibria are possible. However, in the stand-alone annuity market, only separating equilibria are possible. We show, consistent with the extant empirical research, that in the presence of administration costs the more risk-averse individuals may buy relatively more long-term care insurance and more annuity coverage. Under the same assumptions, we show that equilibria exist with bundled contracts that Pareto dominate the outcomes with stand-alone contracts and are robust to competition from stand-alone contracts. The remaining empirical puzzle is to explain why bundled contracts are such a small share of the voluntary annuity market.     

Applying Portfolio Change and Conditional Performance Measures: The Case of Industry Rotation via the Dynamic Investment Model

This paper applies portfolio change and conditional performance measures to assess the performance of the dynamic investment model in various industry-rotation settings spanning the 1934–1995 period. The dynamic investment model employs the empirical probability assessment approach in raw form. In addition, it incorporates three adjustments for estimation error: James–Stein, Bayes–Stein, and CAPM-based corrections. The tests are unanimous in their conclusion that the excess returns attained by the (unadjusted) historic, the Bayes–Stein, and the James–Stein estimators are (sometimes highly) statistically significant over the 1966–1995 and 1966–1981 sub-periods. This lends support to the idea that the joint empirical probability assessment approach based on the recent past, with and without Stein-based corrections for estimation error, contains information that can be profitably exploited. The relationship of these findings to the extant literature on momentum and contrarian strategies is addressed.     

The NHS Financial Manager in 2010

In the White Paper, 'The New NHS' (Cm 3807), the competitive nature of the internal market was removed and annual contracts were replaced with long-term service agreements to facilitate best value. Using the findings from earlier research studies, the implications for NHS financial managers are discussed in this article. Financial managers have a major task in maintaining financial stability in the move from one financial regime to another. Improving budget devolution to Primary Care Groups and encouraging good financial planning and control are essential. Financial managers must develop and integrate reliable cost information into the wider performance framework.     

A Bayesian Approach to Real Options: The Case of Distinguishing between Temporary and Permanent Shocks

Traditional real options models demonstrate the importance of the “option to wait” due to uncertainty over future shocks to project cash flows. However, there is often another important source of uncertainty: uncertainty over the permanence of past shocks. Adding Bayesian uncertainty over the permanence of past shocks augments the traditional option to wait with an additional “option to learn.” The implied investment behavior differs significantly from that in standard models. For example, investment may occur at a time of stable or decreasing cash flows, respond sluggishly to cash flow shocks, and depend on the timing of project cash flows.     

The price of fear: Estimating the financial cost of bullying and harassment to the NHS in England

Using a spectrum of measures, this paper estimates some of the financial costs of bullying and harassment to the NHS in England. By means of specific impacts resulting from bullying and harassment to staff health, sickness absence costs to the employer, employee turnover, diminished productivity, sickness presenteeism, compensation, litigation and industrial relations costs, we conservatively estimate bullying and harassment to cost the taxpayer £2.281 billion per annum.     

Extended Viewpoint: Achieving Democratic Potential in the NHS

'Zones' are closely defined localities which have special status in terms of recent Government initiatives. This article begins by examining the early stages of the Education Action Zone (EAZ) initiative which was launched in 1998, and the policy context into which it fits. It offers a critique of the selection processes used in the first round of applications for EAZ status, and an account of LEA responses to the changes introduced for the second round of zones. The article concludes by identifying a series of tensions, problems and paradoxes which lie at the heart of the initiative-problems which may not have been solved by the revised application procedures.     

Agent Change and Seller Bargaining Power: A Case of Principal Agent Problem in the Housing Market

When a seller hires an agent to sell his/her property, a successful outcome depends on the list price, marketing time, unobserved relative bargaining power of the buyers and sellers, and the effort levels of the seller and the seller’s agent. A divergence with respect to the list/transaction prices and the expected effort levels between seller and agent will create a principal-agent interest conflict. This conflict in some cases results in an agent change before the house is sold. The change will reduce the relative bargaining power of the seller, affecting the observed marketing time and transaction price. This study estimates the effects of an agent change on marketing time and transaction price after controlling for degree of overpricing, list-price revisions, marketing time, and endogenous selection bias. Our results show that: (1) on average, an agent change increases the marketing time by about 3 months and adversely affects the transaction price by about 2.7 %. Furthermore, we found that an agent change before the expiration of the listing contract, compared to that of after the expiration, has a smaller effect on the marketing time (2.3 vs. 3.8 months) and has a smaller transaction price discount (2.1 % vs. 4.2 %).