Physician acquisition: what to avoid after the deal is complete

After a hospital acquires a physician practice, relations can become strained between the parties in any of four areas: Governance and decision making. Technology. Payment structures. Emotional factors related to the acquisition.     

Prácticas de compra predatorias en las cadenas mundiales de suministro de la industria de la confección: tensión en las relaciones laborales en la India

Desde hace tiempo se viene documentando en múltiples estudios la vulneración de los derechos de los trabajadores en las cadenas mundiales de suministro de la industria de la confección; sin embargo, se ha prestado menos atención al reciente empeoramiento de algunos déficits de trabajo decente y sus causas, que el presente artículo asocia a las prácticas de compra predatorias derivadas de las crecientes asimetrías de poder. Estas prácticas, ilustradas aquí a través de las empresas indias del sector del vestido orientadas a la exportación, ejercen presiones salariales a la baja y favorecen la proliferación de formas atípicas de empleo y la banalización de la violencia física y verbal contra los trabajadores, al tiempo que aumentan las exigencias de productividad. Para frenar esta evolución, es necesario establecer mecanismos de fijación de precios que tengan en cuenta el costo que entraña el cumplimiento del principio del trabajo decente, adoptar una reglamentación estatal adecuada y contar con la participación de los trabajadores.     

A sequential Monte Carlo approach to inference in multiple‐equation Markov‐switching models

Vector autoregressions with Markov‐switching parameters (MS‐VARs) offer substantial gains in data fit over VARs with constant parameters. However, Bayesian inference for MS‐VARs has remained challenging, impeding their uptake for empirical applications. We show that sequential Monte Carlo (SMC) estimators can accurately estimate MS‐VAR posteriors. Relative to multi‐step, model‐specific MCMC routines, SMC has the advantages of generality, parallelizability, and freedom from reliance on particular analytical relationships between prior and likelihood. We use SMC's flexibility to demonstrate that model selection among MS‐VARs can be highly sensitive to the choice of prior.     

Top-down Production Management: A Recent Trend in the Japanese Productivity-enhancement Movement

It is well known that many of the manufacturing practices advanced in Japan in the 1970s and 1980s emphasize bottom-up decision processes characterized by teams, the empowerment of multi-skilled workers on the shopfloor, demand-pull and horizontal decision mechanisms. These practices include Just-in-Time (JIT) and quality management practices such as quality circles (QC) and total quality management (TQM). While these practices continue to be effective under appropriate circumstances, the drastic appreciation of the Japanese yen that has taken place since the mid-1980s and the prolonged recession following the burst of the bubble have forced many Japanese manufacturers to adopt new methods to improve their production efficiency. In this paper we discuss one of such methods called Total Productivity Management (TPM). Unlike JIT or TQM, implementing TPM requires a top-down approach. TPM provides direct connections between corporate-wide objectives such as the overall cost reduction and shopfloor practices. It is possible that TPM has contributed significantly to Japanese manufacturers' recent success in reducing their cost of operation. © 1997 John Wiley & Sons, Ltd.     

Are EU budget deficits stationary?

In this paper, we test for the stationarity of European Union budget deficits over the period 1971–2006, using a panel of thirteen member countries. Our testing strategy addresses two key concerns with regard to unit root panel data testing, namely (1) the presence of cross-sectional dependence among the countries in the panel and (2) the identification of potential structural breaks that might have occurred at different points in time. To address these concerns, we employ an AR-based bootstrap approach that allows us to test the null hypothesis of joint stationarity with endogenously determined structural breaks. In contrast to the existing literature, we find that the EU countries considered are characterised by fiscal stationarity over the full sample period irrespective of us allowing for structural breaks. This conclusion also holds when analysing sub-periods based on before and after the Maastricht treaty.     

Voting on meritocracy

This paper considers a setting where a resource such as education budget is to be distributed among agents. The latter differ in their ability to make use of the resource, and the issue is that of determining the allocation rule whereby the individual shares of the resource (may) depend on their relative efforts of obtaining it. The paper's focus is on endogenous determination, through voting, of the degree of meritocracy in the resource allocation system, which determines the marginal productivity of one's effort. It is found that a meritocratic system is expected to be supported by highly productive individuals and opposed by those with low productivity. When the decision making becomes less elitist and involves broader participation of population groups the support for meritocracy decreases.     

Effectiveness and safety of betrixaban extended prophylaxis for venous thromboembolism compared with standard-duration prophylaxis intervention in acute medically ill patients: a systematic literature review and network meta-analysis

Abstract

Aims: To determine the clinical effectiveness and safety of venous thromboembolism (VTE) prophylaxis using US- and Europe-approved anticoagulants relative to extended-duration VTE prophylaxis with betrixaban. Low molecular weight heparins (LMWHs), unfractionated heparin (UFH), fondaparinux sodium and placebo were each compared to betrixaban, as standard-duration VTE prophylaxis for hospitalized, non-surgical patients with acute medical illness at risk of VTE.

Materials and methods: A systematic literature review was conducted up to June 2019 to identify randomized controlled trials (RCTs) of VTE prophylaxis in hospitalized, non-surgical patients with acute medical illness at risk of VTE. Studies that reported the occurrence of VTE events (including death) and, where possible, major bleeding, from treatment initiation to 20–50?days thereafter were retrieved and extracted. A Bayesian fixed effect network meta-analysis was used to estimate efficacy and safety of betrixaban compared with standard-duration VTE prophylaxis.

Results: Seven RCTs were analyzed which compared betrixaban, LMWHs, UFH, fondaparinux sodium, or placebo. There were significantly higher odds (median odds [95% credible interval]) of VTE with LMWHs (1.38 [1.12–1.70]), UFH (1.60 [1.05–2.46]), and placebo (2.37 [1.55–3.66]) compared with betrixaban. There were significantly higher odds of VTE-related death with placebo (7.76 [2.14–34.40]) compared with betrixaban. No significant differences were observed for the odds of major bleeding with all comparators, VTE-related death with any active standard-duration VTE prophylaxis, or of VTE with fondaparinux sodium, compared with betrixaban.

Limitations and conclusions: In this indirect comparison, betrixaban was shown to be an effective regimen with relative benefits compared with LMWHs and UFH. This indicates that betrixaban could reduce the burden of VTE in at-risk hospitalized patients with acute medical illness who need extended prophylaxis, though without direct comparative evidence, stronger conclusions cannot be drawn.     

Institutional framing and perceptions of fairness

This paper's goal is to construct a positive theory of economic fairness. Using the theoretical schema developed by Hurwicz and others, the paper makes precise the notions of an “institution,” “fairness fraiming,” and “institutional framing.” Four fairness propositions yield an important corollary: the economic environment, the operative institution and history give meaning to the often used FORMAL PRINCIPLE OF DISTRIBUTIVE JUSTICE (“equals should be treated equally, and unequals unequellay, in proportion to relevant similarities and differences”). We support these four propositions and corollary by an analysis of laboratory, survey, and anecdotal evidence. Finally we describe a number of areas for future research. The authors would like to thank Allen Buchanan, James Buchanan, Joel Feinberg, Elizabeth Hoffman, David Schmitz, Linda Schnabel Stizer, Vernon Smith, Richard Wagner, the participants in the Aspen Institute's Conference on “Local Justice and Fair Allocation”, the members of the Industrial Organization Workshop of the Department of Economics at the University of Arizona, and panel participants at the Public Choice Society Meeting for their help and comments at various stages of this paper's preparation. Responsibility for errors is the authors' alone.