This paper seeks to provide the services sector with a focus on the assessment of quality and for this purpose, a technique that may able a quantitative approach to evaluating quality is proposed. The use of the fuzzy sets theory to process data was used, thus allowing a more flexible and suitable insight into the characteristics of the service sector. An extension of the technique for order performance by similarity to the ideal solution was used. This informs managers of the distance from the company$\prime $s current level of quality, if compared to a company of perfect quality by means of an overall evaluation. The same technique was used to detect changes in the level of quality during the period surveyed by using a stratified assessment. Finally, a practical application of the approach proposed is presented. 相似文献
In this paper we estimate the DEA technical efficiency for 4796 Brazilian municipalities, by applying a recently proposed
“Jackstrap” method, which combines Bootstrap and Jackknife resampling techniques, to reduce the effect of outliers and possible
errors in the data set. We perform calculations to identify and eliminate high leverage municipalities, using different variants
of Data Envelopment Analysis (DEA), as well as Free Disposal Hull (FDH). Corroborating previous results, efficiency results
for the Brazilian municipalities show a clear relationship between the size of the municipality and its efficiency scores.
Indeed, under both DEA variants, smaller cities tend to be less efficient than larger ones hence indicating that the quality
of the frontier adjustment improves significantly as the size of the municipality increases. We present arguments that may
explain to some extent these findings, such as economies of scale and the excess spending due to revenue from royalties. However,
such effects require further, more careful examination. 相似文献
Objective: Omalizumab add-on to standard-of-care therapy has proven to be efficacious in severe asthma patients for whom exacerbations cannot be controlled otherwise. Moreover, evidence from different healthcare settings suggests reduced healthcare resource utilization with omalizumab. Based on these findings, this study aimed to assess the cost-effectiveness of the addition of omalizumab to standard-of-care therapy in patients with uncontrolled severe allergic asthma in a Brazilian healthcare setting.
Methods: A previously published Markov model was adapted using Brazil-specific unit costs to compare the costs and outcomes of the addition of omalizumab to standard-of-care therapy vs standard-of-care therapy alone. Model inputs were largely based on the eXpeRience study. Costs and health outcomes were calculated for lifetime-years and were annually discounted at 5%. Both one-way and probabilistic sensitivity analyses were performed.
Results: An additional cost of R$280,400 for 5.20 additional quality-adjusted life-years was estimated with the addition of omalizumab to standard-of-care therapy, resulting in an incremental cost-effectiveness ratio of R$53,890. One-way sensitivity analysis indicated that discount rates, standard-of-care therapy exacerbation rates, and exacerbation-related mortality rates had the largest impact on incremental cost-effectiveness ratios.
Limitations: Assumptions of lifetime treatment adherence and rate of future exacerbations, independent of previous events, might affect the findings. The lack of Brazilian patients in the eXpeRience study may affect the findings, although sample size and baseline characteristics suggest that the modeled population closely resembles Brazilian severe allergic asthma patients.
Conclusion: Results indicate that omalizumab as an add-on therapy is more cost-effective than standard-of-care therapy alone for Brazilian patients with uncontrolled severe allergic asthma, based on the World Health Organization’s cost-effectiveness threshold of up to 3-times the gross domestic product. 相似文献
This paper investigates the effect of nearby nature substitute sites on preferences for nature restoration. Contrary to prior studies, we use a respondent-centric approach to control for substitute sites. We assess each respondent-specific spatial context by computing densities of nature substitute sites within various ranges from each respondent’s home. This approach considers the use and non-use values of nature together. Data from three similar discrete choice experiments carried out in Flanders (Belgium) are compared. Different spatial discounting factors are tested to explore how the substitution effect behaves with regard to distance. Latent class analyses are performed to account for preference heterogeneity among respondents. We observe divergent behaviours across groups of respondents. The “distance-to-substitutes” affects how respondents gauge substitute sites. We find a significant influence of the squared average buffer distance but this effect varies in sign across case studies and classes of respondents. Our results demonstrate that individual-specific GIS data can significantly improve the representation of the spatial context and the transferability of value functions. However, the roles played by preference heterogeneity and nature perception on respondents’ capacity to value nature still deserves further attention in future research. 相似文献
Almost every theory of human behavior is based upon some assumption of rationalty. Such an assumption is commonly believed to be necessary in order to distinguish rational behavior, which is, from non-rational behavior, which is not amenable to scientific investigation. This article presents a thorough re-examination of this assumption, an inquiry which turns out to raise all the central issues of both the methodology and the theory of behavioral inquiry generally. It leads to the somewhat surprising conclusion that the notion of rationality does not have any meaningful role to play in behavioral inquiry, and that there is no sense in distinguishing rational from non-rational or irrational behavior. It also shows that the generalization of the utility notion in terms of information makes it into a much more powerful and subtle tool of analysis than it commonly appears to be taken for. 相似文献
This note reports the results of a survey of firms operating in Britain concerning the impact on their costs and operations of the Social Action Programme. We find that the realised and anticipated adverse impacts of the legislation are rather limited, although both do appear to be greater for firms which are relatively large, skill intensive, and which have a substantial amount of trade with other EU countries. In particular, the survey results provide little evidence to suggest that the imposition of a minimum wage of £3.50 per hour would have a substantial adverse impact on employment. Evidence does, however, suggest that firms which pay relatively low wages are likely to be affected more than others by the legislation. 相似文献
We study the business‐cycle behavior of segmented labor markets with flexibility at the margin (e.g., just affecting fixed‐term contracts). We present a matching model with temporary and permanent jobs (i) where there is a gap in the firing costs associated with these types of jobs and (ii) where there are restrictions in the creation and duration of fixed‐term contracts. We show that a labor market with ``flexibility at the margin'' increases the unemployment volatility with respect to one that is fully regulated. This analysis yields new insights into the interpretation of the recent volatility changes witnessed in the OECD area. 相似文献
We apply the collective consumption model of Browning et al. (2010) to analyse economic well-being and poverty among the elderly. The model focuses on individual preferences, a consumption technology that captures the economies of scale of living in a couple, and a sharing rule that governs the intra-household allocation of resources. The model is applied to a time series of Dutch consumption expenditure surveys. Our empirical results indicate substantial economies of scale and a wife's share that is increasing in total expenditures. We further calculated two sets of poverty rates: one based on the collective consumption model and one based on the traditional approach with a standard equivalence scale. Poverty among widowers is underestimated by the traditional approach. The same is true for women (men) in elderly couples for the first (later) time periods in our analysis. Finally, we analysed the impact of becoming a widow(er). Based on cross-sectional evidence, we find that the drop in material well-being following the husband's death is rather substantial for women. For men, the picture is reversed. 相似文献
We examine systemic risk in the Chinese banking system by estimating the conditional value at risk (CoVaR), the marginal expected shortfall (MES), the systemic impact index (SII) and the vulnerability index (VI) for 16 listed banks in China for the 2007–2014 period. We find that these measures show different patterns, capturing different aspects of systemic risk of Chinese banks. However, rankings of banks based on these measures are significantly correlated. The time‐series results for the CoVaR and MES measures suggest that systemic risk in the Chinese banking system decreased after the global financial crisis but started rising in 2014. 相似文献