A labor relations research agenda for health care settings

Inadequate attention has been given to labor-management relations in health care organizations. Bacause of the labor-intensive nature of health care and the great dependence on human resources, health services researchers should place greater emphasis on labor-management issues. This article develops a framework and suggests methodologies for examining labor relations in health care organizations. Specifically, six cirtical issues are suggested for attention by researchers: (1) the quality of the union-management relationship; (2) union organizing drives; (3) collective bargaining and contract negotiations; (4) impasse resolution; (5) contract administration and grievance handling; and (6) labor-management cooperation. These areas of research have been dominated by industrial relations researchers who have focused primarily on the manufacturing sector. Given cost containment and competitive pressures, it is timely to bridge the gap between the health services research community and the accumulating body of knowledge in industrial relations.     

Incorporating the Operating Environment Into a Nonparametric Measure of Technical Efficiency

The ability of a production unit to transform inputs into outputs is influenced by its technical efficiency and external operating environment. This paper introduces a nonparametric, linear programming, frontier procedure for obtaining a measure of managerial efficiency that controls for exogenous features of the operating environment. The approach also provides statistical tests of the effects of external conditions on the efficient use of each individual input (for an input oriented model) or for each individual output (for an output oriented model). The procedure is illustrated for a sample of nursing homes.     

Welcome waste – interpreting narratives of radioactive waste disposal in two small towns in Ontario,Canada

After briefly reviewing the production of nuclear energy and waste in Canada, this paper uses two small Ontario towns as case studies to examine the treatment of low-level radioactive waste and the communities’ responses and narratives to it. Both towns, Port Hope and Kincardine, have long histories of dealing with such waste. Using interviews, relevant websites and past accounts, this paper employs a discourse analysis to understand the differences in risk perceptions and living with the presence of these materials. Ideas from landscape narratives are employed to show that responses in Port Hope are dominated by death, elegy and crime, whereas those in Kincardine are predominately linked to progressivism and optimism. We explore the characteristics of each case to highlight the reasons for these differences. We conclude by emphasizing the potential role of narrative analysis in informing policymaking.     

Accounting for Environmental Effects and Statistical Noise in Data Envelopment Analysis

In this paper we propose a new technique for incorporating environmental effects and statistical noise into a producer performance evaluation based on data envelopment analysis (DEA). The technique involves a three-stage analysis. In the first stage, DEA is applied to outputs and inputs only, to obtain initial measures of producer performance. In the second stage, stochastic frontier analysis (SFA) is used to regress first stage performance measures against a set of environmental variables. This provides, for each input or output (depending on the orientation of the first stage DEA model), a three-way decomposition of the variation in performance into a part attributable to environmental effects, a part attributable to managerial inefficiency, and a part attributable to statistical noise. In the third stage, either inputs or outputs (again depending on the orientation of the first stage DEA model) are adjusted to account for the impact of the environmental effects and the statistical noise uncovered in the second stage, and DEA is used to re-evaluate producer performance. Throughout the analysis emphasis is placed on slacks, rather than on radial efficiency scores, as appropriate measures of producer performance. An application to nursing homes is provided to illustrate the power of the three-stage methodology.     

Do VCs use inside rounds to dilute founders? Some evidence from Silicon Valley

In the bank-borrower setting, a firm's existing lender may exploit its positional advantage to extract rents from the firm in subsequent financings. Analogously, a startup's existing venture capital investors (VCs) may dilute the founder through a follow-on financing from these same VCs (an “inside” round) at an artificially low valuation. Using a hand-collected dataset of Silicon Valley startup firms, we find little evidence that VCs use inside rounds to dilute founders. Instead, our findings suggest that inside rounds are generally used as “backstop financing” for startups that cannot attract new money, and these rounds are conducted at relatively high valuations (perhaps to reduce litigation risk).     

Economic consequences of mandatory GAAP changes: The case of SFAS No. 158

This study examines management's reaction to the SFAS No. 158 requirement to recognize previously disclosed post-retirement benefit obligations on the balance sheet. The results indicate that managers attempted to mitigate the impact of the standard by increasing the assumed pension discount rate in subsequent periods. Further, the discount rate choice was related to the magnitude of the SFAS No. 158 balance sheet adjustment. Specifically, firms with larger required liability adjustments and more volatile pension assets and obligations were more likely to increase their discount rates. The findings have important implications for research regarding the economic consequences of accounting regulations and in particular the debate surrounding recognition versus disclosure since they indicate that managers react to the relocation of information from the financial statement footnotes to the balance sheet.