Case management: key to access, quality, and financial success

Several strategic, organizational, and operational variables drive successful case management programs. Organizational goals and accountability for support by administrative and medical staff leaders set the stage for a comprehensive program. The integration of utilization review, discharge planning, and other functions into the role of the case manager improves productivity and continuity. Choosing a model for assigning patients, a variable unique to the institution, should be carefully considered. Regardless of the power of strategic goals or the creative selection of a model, daily practices that promote daily review and communication will reveal all of the opportunities for improved performance. Complications are avoided one patient at a time and patients deserve vigilance. Length of stay is shortened 1 day at a time and we can no longer afford to miss these opportunities. In the period of high census, an unnecessary day for one patient at the end of his/her stay may mean another patient being diverted to another hospital away from his/her physician and past medical records. Creating constructive physician partnerships and cooperative relationships with postacute care providers can bring a case management program to higher level of performance. While many organizations have employees called "case managers," fewer have a comprehensive approach that has the potential to drive so many important indicators of performance.     

Australia Demonstrates the Rise of Populism is About More than Economics

Votes for established centre‐right and centre‐left political parties are falling across the developed world. Australia is not immune from this trend: in the 2016 federal election, more people voted for minor parties than at any point since the Second World War. Australia is an interesting case study for the rest of the world on the origins of populist support. Political scientists have struggled to separate the effects of cultural shifts and poor economic outcomes (low wages and rising inequality) in many countries because these shifts have occurred simultaneously. However, in Australia the economy was relatively healthy during the period of rising minor party support. Our analysis suggests that falling trust in government and a backlash against the pace of social change explain much of the collapse in support for the political mainstream.     

Openness, income-tax progressivity, and inflation

This paper considers a model of an open economy in which the degree of income-tax progressivity influences the interaction among openness, central bank independence, and the inflation rate. Our model suggests that an increase in the progressivity of the tax system induces a smaller response in real output to a change in the price level. This implies that increased income-tax progressivity reduces the equilibrium inflation rate and that the effect of increased income-tax progressivity on inflation is smaller when the central bank places a higher weight on inflation or when there is greater openness. Examination of cross-country inflation data provides empirical support for these key predictions.     

On Gravity,Specialization and Intra‐industry Trade

Contrary to the popular belief, specialization is not necessary for gravity equations. This paper shows that the simple gravity equation holds if and only if the market share of an exporting country is constant across all importing countries. Specialization is just one special case satisfying this condition. The constant‐share condition can hold in a variety of situations where multiple producers compete with a homogeneous good. Further, this paper shows that the ratio of bilateral trade to the product of partner incomes is increasing in the extent of specialization and in the intensity of intra‐industry trade. Since the relationship is not model‐specific, the correlations among these variables do not support any specific model.     

Economies of scale,school violence and the optimal size of schools

This article argues that policy in relation to education has relied too extensively on the more easily measured costs of production to support a common conclusion of economies of scale in school and/or district size. It argues that there are external costs that increase with size but that can be measured less easily that offset this case. This would imply that the tendency within the education profession to advocate ever-larger school sizes is premature at best. To make the case, it models the choice of school size to emphasize that costs, such as school violence, born by both students and their parents but not (necessarily) by education administrators may result in school sizes that are too big from the perspective of school users. The second and third parts of the article introduces evidence to suggest that school violence is one of these external costs.     

计量经济学案例教学的统一化、本土化和情境化

计量经济学是财经类学生较难掌握的学科,课程教学难度相对较大。理论教学和应用教学脱节,案例教学和实验教学顾此失彼。案例教学存在碎片化现象,实验教学经常陷入程式化。案例教学的关键是案例的统一化、本土化和情境化。案例和实验教学在统一化的前提下,相互支持,互为补充。     

Ethics and economics

The author suggests that one way to better manage the burgeoning costs in acute care settings and improve patient care is by the earlier use of ethics case consultations and end-of-life support from ethics teams. This study determined that, in several very diverse clinical scenarios, timely facilitation of meaningful communication and decision making between patients, families, and health care providers can result in the more appropriate use of health care resources. While few of the patients in this study had recorded advanced directives in place, and there was initially a lack of family consensus in some cases, compliance with the ethics team recommendations led to a more appropriate clinical unit placement; and improved family support helped manage the costs of care and focus on the patients' quality of life. The decrease in the use of medical interventions and therapies after ethics consultations was consistent in all cases presented here.     

Office productivity: the impacts of staffing, intellectual specialization and technology

This paper reports on a series of 20 case studies of office productivity and office technology in major US corporations. The case studies were carried out between the mid-1980s and he early 1990s, and involved over 1700 employees in 95 distinct offices. These studies were shaped by a new conceptual model of the office which focuses on the inteleectual content, rather than the physical attributes, of office work. Our major finding is a significan lack of intellectual specialization among managers and professionals. That is, managers and professionals devote a relatively small fraction of their work time to management and professional level work, and a relatively large fraction of their time to support and non-productive tasks. In addition, we found significant staffing imbalances throughout our cases: in nearly every office, there were more manaers and professionals, and fewer support workers, than were required to perform the work cost-effectively. Out analysis suggests that a typical organization could reduce its annual office payroll costs by 15% by recalibrating its staffing mix and increasing the intellectual specialization of its office workers. Further, we find that the apparent failure of massive corporate investments in office technology to achieve commensurate in white-collar productivity is likely to be due, in large decisions. The paper offers a specific methodology for measuring and tracking office productivity, for developing a coherent office productivity strategy, and for improving office staffing and technology decisions.     

Puzzles in the economic institutions of capitalism: production coordination, contracting and work organisation in the Irish linen trade, 1750-1850

Pre-Famine Ireland is a byword for market failure and path dependence.Production of flax yarn and linen cloth was highly regulatedand coordinated by the market rather than by firms. Contemporarypolitical economists suggested that these institutional featuresprovided evidence of organisational inefficiency. The historicalevidence suggests that they were a rational response to transactionand production costs. The Irish case provides a test of thehypotheses that firms emerge to reduce the cost of market transactions.It suggests that institutions other than the firm can modifytransaction costs, coordination of production can affect bothtransaction and production costs, and that agents choose betweenmarket and firm coordination given technology and factor prices.Finally, centralisation of production was driven by technology.     

Office productivity: the impacts of staffing,intellectual specialization and technology

This paper reports on a series of 20 case studies of office productivity and office technology in major US corporations. The case studies were carried out between the mid-1980s and he early 1990s, and involved over 1700 employees in 95 distinct offices. These studies were shaped by a new conceptual model of the office which focuses on the inteleectual content, rather than the physical attributes, of office work. Our major finding is a significan lack of intellectual specialization among managers and professionals. That is, managers and professionals devote a relatively small fraction of their work time to management and professional level work, and a relatively large fraction of their time to support and non-productive tasks. In addition, we found significant staffing imbalances throughout our cases: in nearly every office, there were more manaers and professionals, and fewer support workers, than were required to perform the work cost-effectively. Out analysis suggests that a typical organization could reduce its annual office payroll costs by 15% by recalibrating its staffing mix and increasing the intellectual specialization of its office workers. Further, we find that the apparent failure of massive corporate investments in office technology to achieve commensurate in white-collar productivity is likely to be due, in large decisions. The paper offers a specific methodology for measuring and tracking office productivity, for developing a coherent office productivity strategy, and for improving office staffing and technology decisions.     

Realism,Regularities, and Prediction

Problems are identified with the transcendental argument that Lawson uses to make a case for realism in economics: this argument relies heavily upon an unproblematized conception of Free Will. Lawson's substantive conclusions are not vitiated, but the argument presented here suggests that he underestimates the role of regularities and prediction in economics.     

Differentiated Products,Divided Industries: Firm Preferences over Trade Liberalization

The recent focus on firms in international trade suggests two conjectures about preferences over trade policy – only the most productive firms should support freer trade, and industries can be internally divided over reciprocal liberalization. This paper clarifies the content and scope of these claims. The most productive firms are generally not the greatest beneficiaries from trade liberalization and may oppose further liberalization due to increased competition in export markets from compatriot firms. Exporting industries will feature no support for trade if foreign competition is too strong or barriers too unequal. The key analytic factor generating intra‐industry division is product differentiation, both directly, by increasing export opportunities for less efficient firms, and by inducing home market effects wherein larger countries are more competitive. The implications of these findings for the distributional effects of liberalization and the study of trade politics are discussed.     

Economic prosperity, biodiversity conservation, and the environmental Kuznets curve

Many conservationists contend that economic growth and biodiversity conservation are incompatible goals. Some economists contest this viewpoint, arguing that wealthier countries have the luxury of investing more heavily in efforts to conserve biodiversity. Under this assumption, we expect a U-shaped relationship between per capita wealth and proportion of species conserved. We test this environmental Kuznets curve (EKC) using estimates of per capita income and deforestation rates (index of biodiversity threat) for 35 tropical countries. A prior analysis [Dietz, S., Adger, W.N., 2003. Economic growth, biodiversity loss and conservation effort. Journal of Environmental Management, 68:23-35] using conventional regression techniques failed to provide any support for the parabolic relationship predicted by the EKC hypothesis. Here, we introduce the use of quantile regression and spatial filtering to reanalyze this data, addressing issues of heteroskedasticity and spatial autocorrelation. We note that preliminary analysis using these methods provides some initial evidence for an EKC. However, a series of panel analyses with country-specific dummy variables eliminated or even reversed much of this support. A closer examination of conservation practices and environmental indicators within the countries, particularly those countries that drove our initial support, suggests that wealth is not a reliable indicator of improved conservation practice. Our findings indicate that an EKC for biodiversity is overly simplistic and further exploration is required to fully understand the mechanisms by which income affects biodiversity.     

Terms-of-Trade Shocks, Labor-Market Adjustment, and Safeguard Measures

This paper explores a simple model of labor-market adjustment where intersectoral transfer in response to terms-of-trade shocks involves both sector-specific skill acquisition and workplace disruption. Externalities arise because the marginal migrant does not consider the congestion costs imposed on intramarginal migrants or the disruption costs imposed on the incumbent workers in both sectors. While these externalities give rise to a case for temporary adjustment assistance, the analysis does not support the use of trade measures such as tariffs.     

Can Technology-Specific Deployment Policies Be Cost-Effective? The Case of Renewable Energy Support Schemes

While there is relatively limited disagreement on the general need for supporting the deployment of renewable energy sources for electricity generation (RES-E), there are diverging views on whether the granted support levels should be technology-neutral or technology-specific. In this review paper we question the frequently stressed argument that technology-neutral schemes will promote RES-E deployment cost-effectively. We use a simple partial equilibrium model of the electricity sector with one representative investor as a vehicle to synthesize the existing literature, and review potential rationales for technology-specific RES-E support. The analysis addresses market failures associated with technological development, long-term risk taking, path dependencies as well as various external costs, all of which drive a wedge between the private and the social costs of RES-E deployment. Based on analytical insight and a review of empirical literature, we conclude that the relevance of these market failures is typically heterogeneous across different RES-E technologies. The paper also discusses a number of possible caveats to implementing cost-effective technology-specific support schemes in practice, including the role of various informational and politico-economic constraints. While these considerations involve important challenges, neither of them suggests an unambiguous plea for technology-neutral RES-E support policies either. We close by highlighting principles for careful RES-E policy design, and by outlining four important avenues for future research.     

Uncertainty, human action and scenarios

The “scenario method,” “scenario building,” or “multiple futures analysis” emerged during the last decades as a premier instrument for strategic planning and decision making in conditions of uncertainty. This article demonstrates that there is an intrinsic link between the scenario method and Austrian theory not only at the level of basic epistemological principles but also at the methodological and applied levels. The article also argues that the scenario method could easily be embraced as a part of the Austrian family of ideas and more precisely as one of the key policy applications or decision support tools informed by that school of thought. Blending explicitly and systematically the scenario method with the Austrian ideas and forcefully making the case for the scenario approach as a policy and business administration tool, is thus one of the most effective ways of reasserting the importance of Austrian insights in areas such as business studies, public policy, and organizational theory, areas that currently have a limited exposure to Austrian ideas.     

Bandwagon mergers,international competitiveness,and government policy

This paper suggests that while the static welfare losses of merger predilections among Western firms may not be dramatic, they may lead to substantial dynamic losses when merger-prone firms need to compete with firms which instead focus on equipment investment and investments in R&D. It is suggested that such diverging investment priorities have been the real cause of the deteriorating competitiveness of many of the largest Western enterprises vis-à-vis their Japanese rivals. While mergers are generally taken to be determined by either efficiency or monopoly considerations, this paper argues that Western merger predilections are likely to be generated by a combination of imitative and defensive routines as well. That would make it difficult for firms to unilaterally break away from these competitiveness-threatening investments. If correct, this would imply that competition policies would need to be refocused. However, it is also suggested that the implications for international competitiveness should make merger questions a subject of industrial policies too. In that respect, the paper suggests some basic attitudinal changes.Earlier versions of this paper were presented at a Global Forum for Competition and Trade Policy conference in Vienna and at a EUNIP workshop at Åbo Akademi University, Finland. Financial support from the Dutch Ministry of Economic Affairs (contract nos. 54473 and 57305) and the European Commission (contract no. ERB CHRX CT94-0454), research assistance from Michel Renirie and Chee-Wai Chan, and helpful comments from the conference and workshop participants, especially Kurt Bayer and Keith Cowling, are gratefully acknowledged. Only the author is responsible for the contents of, and any flaws in the paper.     

The Structure of Financial Markets and the 'First Principles' of Monetary Economics

There has been a significant degree of financial restructuring over the last few decades, which has prompted a rethinking of the first principles of monetary economics. The focus here is on how four specifications of these principles address such issues as the need for central banks and the potential for separation of the monetary functions. The case is made for one approach, which suggests that the need to establish trustworthy credit relations, in an environment subject to fundamental uncertainty, is at the heart of monetary systems. It is argued that monetary history demonstrates that monetary standards and central banking have indeed tended to be the outcome of the competitive process in the financial sector.     

B2C—bubble to cluster: the dot-com boom, spin-off entrepreneurship, and regional agglomeration

This article studies entrepreneurial activities emerging out of one of Germany’s most prominent dot-com firms, Intershop, a maker of e-commerce software. We show that Intershop spawned about 40 new ventures. Most spin-offs entered locally, giving rise to a small but growing software cluster and counteracting the job losses that accompanied the parent firm’s drastic downsizing after 2000. We trace the knowledge transfer from Intershop to the spin-offs and relate it to recent theorizing on the spin-off process as well as spin-off-based cluster formation. The Intershop case suggests that temporarily successful dot-coms could exert lasting effects on regional development.     

Leaders,laggards and technology seeking strategies

We analyze the conditions determining optimal technology seeking strategies for leader and laggard firms. We extend existing theories by differentiating leaders and laggards in terms of absorptive capacity and intra-firm technology transfer skills, next to productivity levels. In addition, both Foreign Direct Investment (FDI) as well as exports function as two alternative technology seeking strategies. Our theoretical results demonstrate that for a wide range of parameter settings, leaders optimally seek technology through FDI, whereas laggards do so through exports. Confronting these findings with some original exploratory industry-level analysis complemented by insights derived from case studies, we find broad overall support for our theoretical predictions.