基于平衡计分卡的SAP实施绩效评价模型研究

根据国内企业实施SAP及其绩效评价研究现状,借鉴平衡计分卡在绩效评价中的思路,提出SAP平衡计分卡,并运用层次分析法为指标赋予权重,构建一套SAP实施绩效评价模型。     

商业银行绩效评价研究——基于EVA的平衡计分卡模型

针对银行绩效指标的多层次性,从财务、战略目标、环境和客户等多维角度,提出以EVA为核心的平衡计分卡模型。运用层次分析法,根据度用数值评价指标间的重要程度,通过案例,给出应用分析。     

高校产业集团绩效管理的战略性工具——平衡计分卡

随着平衡计分卡理念逐步引入我国大型企业,它对于企业提高战略目标,加快企业实现绩效管理的进程有着非常重要的作用。结合高校产业的实践,运用平衡计分卡工具,对高校产业的战略目标如何得以实施进行了设计,为高校产业改善绩效管理,提升经营绩效提供了可行的路径。     

How to improve government performance?

The article reviews Timothy Besley's book Principled Agents? The Political Economy of Good Government and considers application of the concepts and conclusions of the book to China.     

Analysis of chronic emergency department use

This retrospective emergency department (ED) chart review study examined the relationship between acuity level and the type of insurance in a patient population who used the ED on a chronic basis (seven or more times in the calendar year 1996). Of 1,185 patients seen in the ED in 1996, 122 had between 7 and 29 visits. In the study population: 62.5% of their visits were classified as nonurgent; 42.6% of the nonurgent visits were made by those with insurance; the highest frequency of visits took place between 8:00 am and 4:00 pm when most alternative nonemergency facilities are open. Some of the factors seen as influencing overuse of the ED include: the fact that some chronic use appeared to be associated with psychiatric conditions including substance abuse and patients with recurrent chest pain; and patient's perceptions that access to lab and X-ray facilities are readily available within the ED.     

平衡计分卡在内部审计部门中的应用研究

本文探讨如何将平衡计分卡方法引入内部审计部门以利于其正确选择业绩度量指标,在将平衡计分卡的四个维度和内部审计部门的业绩指标相结合的基础上,详细阐述了具体应用时所应遵循的步骤,并指出相关的注意事项.     

平衡计分卡在内部审计部门中的应用研究

本文探讨如何将平衡计分卡方法引入内部审计部门以利于其正确选择业绩度量指标，在将平衡计分卡的四个维度和内部审计部门的业绩指标相结合的基础上，详细阐述了具体应用时所应遵循的步骤，并指出相关的注意事项。     

Placing emergency department crowding on the decision agenda

The causes of emergency department crowding (EDC), and the outcomes and strategies for resolution are reviewed. This is a call to the nursing profession to elevate EDC on hospital, community, and national agendas to garner resources to restore timely emergency care.     

A bed management strategy for overcrowding in the emergency department

In 2006, the Institute of Medicine cited growing visit volumes, hospital closures, financial pressures, and operational inefficiencies as the principal reasons for emergency department (ED) overcrowding and called for regulatory measures to resolve the problem. A Midwest medical center with 59,000 annual ED visits instituted a bed management strategy to decrease the need to board, or hold, admitted hospital patients in the ED awaiting transfer to an inpatient care unit. This strategy was successful in improving the hold time from an average of 216 minutes to 103 minutes, or by 52%. This allowed the staff at the hospital to care for an additional 2,936 patients. During this same time, the overall hospital mortality decreased by 0.07% and patient satisfaction scores improved 1%. The greatest outcome from this intervention was realized in the potential revenue increase of over $2 million.     

Costs of inpatient and emergency department care for chronic obstructive pulmonary disease in an elderly Medicare population

Objective:

Treatment in the hospital setting accounts for the largest portion of healthcare costs for COPD, but there is little information about components of hospital care that contribute most to these costs. The authors determined the costs and characteristics of COPD-related hospital-based healthcare in a Medicare population.

Methods

Using administrative data from 602 hospitals, 2008 costs of COPD-related care among Medicare beneficiaries age ≥65 years were calculated for emergency department (ED) visits, simple inpatient admissions and complex admissions (categorized as intubation/no intensive care, intensive care/no intubation, and intensive care/intubation) in a cross-sectional study. Rates of death at discharge and trends in costs, length of stay and readmission rates from 2005 to 2008 also were examined.

Main results:

There were 45,421 eligible healthcare encounters in 2008. Mean costs were $679 (SD, $399) for ED visits (n = 10,322), $7,544 ($8,049) for simple inpatient admissions (n = 25,560), and $21,098 ($46,160) for complex admissions (n = 2,441). Intensive care/intubation admissions (n = 460) had the highest costs ($45,607, SD $94,794) and greatest length of stay (16.3 days, SD 13.7); intubation/no ICU admissions had the highest inpatient mortality (42.1%). In 2008, 15.4% of patients with a COPD-related ED visit had a repeat ED visit and 15.5–16.5% of those with a COPD-related admission had a readmission within 60 days. From 2005 to 2008, costs of admissions involving intubation increased 10.4–23.5%. Study limitations include the absence of objective clinical data, including spirometry and smoking history, to validate administrative data and permit identification of disease severity.

Conclusions:

In this Medicare population, COPD exacerbations and related inpatient and emergency department care represented a substantial cost burden. Admissions involving intubation were associated with the highest costs, lengths of stay and inpatient mortality. This population needs to be managed and treated adequately in order to prevent these severe events.     

外经企业:发展呼唤改革的深化

虽然处在国企改革进程不断深化的大环境中，但我国外经企业至今仍未见彻底而显著的变化，除了少数原中央部委所属的外经企业归入中央大企业工委管理，少数地方国际公司进行了公司制改造成为有限责任公司及上市的股份有限公司或由地方政府进行资产重组后成为企业集团外，大多数地方国际公司和部分中央公司的改革仍处于停滞不前的状态。由于符合现代企业制度要求的公司制在多数外经企业中尚未确立，企业的健康发展未能解决体制上的根本问题，机制上的一些改革也就流于治标不治本的状态。从全行业角度看，外经行业并未解决诸如其他行业的国企三…     

Using the Hawthorne effect to examine the gap between a doctor's best possible practice and actual performance

Many doctors in developing countries provide considerably lower quality care to their patients than they have been trained to provide. The gap between best possible practice and actual performance (often referred to as the know-do gap) is difficult to measure among doctors who differ in levels of training and experience and who face very different types of patients. We exploit the Hawthorne effect-in which doctors change their behavior when a researcher comes to observe their practices-to measure the gap between best and actual performance. We analyze this gap for a sample of doctors and also examine the impact of the organization for which doctors work on their performance. We find that some organizations succeed in motivating doctors to work at levels of performance that are close to their best possible practice. This paper adds to recent evidence that motivation can be as important to health care quality as training and knowledge.     

Using data envelopment analysis to assess macroeconomic policy performance

It is common practice to summarize the macroeconomic performance of countries in terms of the four well-known dimensions captured by the magic diamond of the OECD. This study provides a comparison of several synthetic indicators that merge the four separate indicators into one single statistic. These indicators are inspired by Data Envelopment Analysis (DEA)-based models, which allow for unequal weighting of the different economic objectives. The calculated weights then act as proxies for the true policy priorities. Comparison of the models focuses on the underlying assumptions as well as on the empirical results they generate.     

Using demographic identification to estimate the effects of board size on corporate performance

Motivated by agency theory, we investigate the effect of board size on corporate outcomes. To address endogeneity, we exploit the variations in the director-age populations across the states in the US. We argue that firms with access to a larger pool of potential directors tend to have larger boards. Consistent with this notion, our empirical results show that firms located where the size of the director-age population is larger have significantly larger board size. Because the director-age population represents broad demographic trends outside of any firm’s control, it is unlikely related to firm outcomes or policies and should be exogenous. Using the director-age population as our instrument, we estimate the effects of board size on firm value and profitability. Our approach is less vulnerable to endogeneity and is more likely to show a causal effect.     

打造第三代港口,提高综合竞争能力

随着世界经济的全球化、市场的国际化水平进一步加深,港口作为全球综合运输网络上的重要节点和国际物流链上的重要一环,其竞争也越来越激烈,厦门港应如何在这一竞争中巩固并提升自己的地位?本文认为应找出差距、重点打造第三代港口,实现跨越式发展,全面提升自己的综合竞争能力.     

打造第三代港口，提高综合竞争能力

随着世界经济的全球化、市场的国际化水平进一步加深，港口作为全球综合运输网络上的重要节点和国际物流链上的重要一环，其竞争也越来越激烈，厦门港应如何在这一竞争中巩固并提升自己的地位？本文认为应找出差距、重点打造第三代港口，实现跨越式发展，全面提升自己的综合竞争能力。     

Evaluating the length of stay and value of time in a pediatric emergency department with two models by comparing two different albuterol delivery systems

Abstract

Objective:

Asthma is one of the most common childhood illnesses and accounts for a substantial amount of pediatric emergency department visits. Historically, acute exacerbations are treated with a beta agonist via nebulizer therapy (NEB). However, with the advent of the spacer, the medication can be delivered via a metered dose inhaler (MDI?+?S) with the same efficacy for mild-to-moderate asthma exacerbations. To date, no study has been done to evaluate emergency department (ED) length of stay (LOS) and opportunity cost between nebulized vs MDI?+?S. The objective of this study was to compare ED LOS and associated opportunity cost among children who present with a mild asthma exacerbation according to the delivery mode of albuterol: MDI?+?S vs NEB.

Methods:

A structured, retrospective cross-sectional study was conducted. Medical records were reviewed from children aged 1–18 years treated at an urban pediatric ED from July 2007 to June 2008 with a discharge diagnosis International Classification of Disease-9 of asthma. Length of stay was defined: time from initial triage until the time of the guardian signature on the discharge instructions. An operational definition was used to define a mild asthma exacerbation; those patients requiring only one standard weight based albuterol treatment. Emergency department throughput time points, demographic data, treatment course, and delivery method of albuterol were recorded.

Results:

Three hundred and four patients were analyzed: 94 in the MDI?+?S group and 209 in the NEB group. Mean age in years for the MDI?+?S group was 9.57 vs 5.07 for the NEB group (p?<?0.001). The percentage of patients that received oral corticosteroids was 39.4% in the MDI?+?S group vs 61.7% in the NEB group (p?<?0.001). There was no difference between groups in: race, insurance status, gender, or chest radiographs. The mean ED LOS for patients in the MDI?+?S group was 170 minutes compared to 205 minutes in the NEB group. On average, there was a 25.1 minute time savings per patient in ED treatment time (p?<?0.001; 95% CI?=?3.8–31.7). Significant predictors of outcome for treatment time were chest radiograph, steroids, and treatment mode. Opportunity cost analysis estimated a potential cost savings of $213,532 annually using MDI?+?S vs NEB.

Conclusion:

In mild asthma exacerbations, administering albuterol via MDI?+?S decreases ED treatment time when compared to administering nebulized albuterol. A metered dose inhaler with spacer utilization may enhance opportunity cost savings and decrease the left without being seen population with improved throughput.

Limitations:

The key limitations of this study include its retrospective design, the proxy non-standard definition of mild asthma exacerbation, and the opportunity cost calculation, which may over-estimate the value of ED time saved based on ED volume.     

如何提高会计信息的质量

会计信息失真是当前我国经济生活中较为普遍的现象和十分突出的问题.它直接动摇了人们对会计信息的信任,干扰了党和政府的经济决策,导致国有资产的流失,造成社会经济生活的紊乱,萌生政治、经济、社会和管理风险,严重腐蚀社会经济的健康躯体.提高会计信息的质量已成为当务之急.