A LONGITUDINAL STUDY OF CHANGE IN THE ENGLISH NATIONAL HEALTH SERVICE

This paper reports the findings of a longitudinal comparative case study of three National Health Service (NHS) hospital Trusts in England, investigating the perceptions of clinical, managerial and accounting professionals towards changing cost accounting and performance measurement practices. It incorporates both qualitative and quantitative data analysis, and is based on a contextualist understanding of change management, utilising the content‐process‐context approach (Pettigrew and Lapsley, 1994) to investigate the influence of receptive versus non‐receptive contexts on change. The analysis reveals limited success in improving performance measurement practices (the content of change) in Trusts. Nevertheless the specific context within which change was operationalised was found to be very important, with central mangers playing a key role in influencing change. The process of change indicated slow shifts in clinical‐accountant‐managerial relations, partly driven by changes in financial flows within the organisations.     

Individual attitudes towards the impact of multinational corporations on local businesses: how important are individual characteristics and country-level traits?

We study the importance of individual characteristics and national factors influencing individual attitudes towards the impact of multinational corporations on local businesses. Our sample includes more than 40 000 respondents in 29 countries from the 2003 National Identity Survey conducted by the International Social Survey Programme. We find that individual demographic factors and socioeconomic status, such as gender, age, income and education, are strong predictors of their attitudes. For example, income and education are positively associated with favourable attitudes towards the impact of multinational corporations (MNCs) on local businesses while age is negatively associated with individual attitudes towards MNCs. In addition, hierarchical ordered logit model results show that approximately 8% of total variations in individual attitudes around our sample mean are not explained by differences in personal traits. Instead, they are due to country-level heterogeneity such as, but not limited to, different degrees of openness or different aggregate income.     

Hospital costs associated with thyroidectomy performed with a Harmonic device compared to conventional techniques: a systematic review and meta-analysis

Objectives: Harmonic devices have become a world-wide standard for dissection and hemostasis in thyroidectomy. Numerous systematic reviews have reported superior operating times, blood loss, post-operative pain, length of stay, and overall safety outcomes. What has not been extensively evaluated in a robust manner is their economic impact. The purpose of this study is to evaluate the hospital costs associated with open thyroidectomy using Harmonic devices compared with conventional techniques for hemostasis. Methods: A systematic review of Medline, Scopus, and CENTRAL was performed from January 1, 2000 to May 23, 2014 without language restrictions for randomized clinical trials comparing Harmonic surgical devices to conventional methods in thyroidectomy. The main outcome measure was total reported costs. Costs were pooled using the ratio of means and a random effects model. Sensitivity analyses assessed whether differences in patient and trial characteristics, healthcare setting, or choice of statistical model affected outcomes. Results: Seven studies met the inclusion criteria. A total of 476 participants had procedures performed with Harmonic devices and 478 with conventional monopolar electrosurgery and clamp, cut and tie techniques. Compared with conventional techniques, Harmonic devices reduced total reported costs by 10% (p?=?0.007), resulting in a $229?US dollars (USD) absolute reduction from mean baseline costs. Results remained relatively robust to additional sensitivity analyses. Conclusions: This systematic review and meta-analysis demonstrates that the Harmonic family of surgical devices is associated with a reduction in total reported costs in thyroidectomy compared with conventional techniques. A large portion of the overall savings derives from a reduction in operative costs.     

Econometric Methods for Modelling Systems With a Mixture of i(1) and i(0) Variables

This paper considers structural models with both I(1) and I(0) variables. The structural shocks associated with either set of variables could be permanent or transitory. We classify the shocks as (P1,P0) and (T1,T0), where P/T distinguishes permanent/transitory, while 1/0 means they are attached to structural equations with either I(1) or I(0) variables as their ‘dependent’ variable. We show that P0 shocks can affect cointegration analysis and provide a formula to compute the permanent component if they are present. Finally, we reformulate a well‐known empirical structural vector autoregression showing the impact of P0 shocks when there are just long‐run parametric and sign restrictions. Copyright © 2015 John Wiley & Sons, Ltd.     

Raising the Bar (3)

This editorial summarizes and comments on the papers published in issue 11(3) so as to raise the bar in applied spatial economic research and highlight new trends. The first paper proposes spatial and a-spatial indicators to describe the networks of airline companies around the world. The second paper sets forth a two-regime gravity-type model with an endogenous threshold parameter to assess the effect of labour market conditions on interregional migration flows. The third paper utilizes micro-data to explain student migration flows to higher education institutions. The fourth paper is among the first to make use of simulation-based location quotients in a multiregional input–output model. Finally, the last paper provides a purely economic–theoretical model on cooperative limit pricing in the context of spatial competition.     

Vertical syndication-proof competitive prices in multilateral assignment markets

We consider a market comprising a number of perfectly complementary and homogeneous commodities. We concentrate on the incentives for firms producing these commodities to merge and form a vertical syndicate. The main result establishes that the nucleolus of the associated market game corresponds to the unique vector of prices with the following properties: (i) they are vertical syndication-proof, (ii) they are competitive, (iii) they yield the average of the buyers- and the sellers-optimal allocations in bilateral markets, and (iv) they depend on the traders’ bargaining power but not on their identity. The proof uses an isomorphism between our class of market games and the entire class of bankruptcy games.     

Who Uses Facts Up Front? A Baseline Examination of Who is Using Standardized Front‐of‐Package Nutrition Disclosures

The Facts Up Front front‐of‐package (FOP) nutrition system is currently displayed on packaged foods in the United States. This initiative is being implemented by more than 50 manufacturers, retailers, and wholesalers in the United States on their branded and private‐label packaged food products. The in‐store presence of Facts Up Front is supported by a recently launched consumer education campaign. This study employs a sample of 1,400 female primary household shoppers with children, with oversamples of Hispanic and African American ethnic subgroups, to examine initial awareness and evaluations of Facts Up Front. Results show that Hispanics are more aware of and engaged with Facts Up Front than Caucasians. African Americans report higher levels of engagement and understanding of Facts Up Front vs. Caucasians. Importantly, Hispanic and African American mothers also report using this FOP system to make decisions. Based on these findings, important implications are offered for consumer welfare and public policy.