Small firms,business dynamics and differential development of economic well-being

In recent years a growing stream of research has examined the relationships between structural characteristics of regions and their levels of new firm formation. This empirical study aims at supplementing such findings with analyses that include other forms of business dynamics, and also the possible well-being effects of such dynamics. From a unique and comprehensive data set that tracks all births, deaths, expansions, and contractions of commercial business establishments in Sweden 1985–89, six groups of regions with different patterns of dynamics are extracted by means of cluster analysis. The clusters' structural characteristics and their development of economic well-being are also compared. The results suggesta) that the patterns of business dynamics are contingent on the structural characteristics of regions,b) that high formation and turnover of establishments are associated with a relative increase in economic well-being, andc) that small, autonomous firms have a vital role in this process.     

Operational Research and the environment

The discipline of Operational Research (OR) is primarily concerned with improving the effectiveness and efficiency of decision processes. These processes take place everywhere in society: industry, banking, agriculture, government, politics. Frequent use of mathematical optimization models is typical of OR. Since the early '80s these models are increasingly packaged in a user-friendly way, as Decision Support Systems. In the following we will illustrate how OR can be used to describe and solve a number of environmental problems.     

The relationship between wellness participation and health care benefit utilization

To examine the relationship between participation in a wellness program and the amount of absenteeism and medical claims, seven years of retrospective absenteeism and medical claims records were collected for 207 employees (pre- and postwellness intervention) and entered into a database. A proportional stratified random sample of workers by wellness participation was selected. While there was no significant change in the amount of sick leave taken over time, a log transformation revealed a significant increase in the dollar amount of medical claims over time, particularly for the middle-aged group of employees. This confirms that wellness intervention slowed the rate of increasing claims among middle-aged participants after just three years of wellness intervention.     

Prospective screening of diagnostic testing: a valuable tool

The elimination of unneeded services is a key to reducing medical costs and enhancing quality of care. Diagnostic tests have been a target of efforts to reduce costs primarily because they are discretionary and often appear to be unnecessary. Believing that the concept of prior review for many diagnostic tests is a good one, this pilot study sought to evaluate prospectively the propriety of diagnostic tests ordered during the first half of 1989 on individuals insured through a major insurance carrier. A physician review found that 21% of the tests were deemed inappropriate, leading to the conclusion that prospective review can be an effective means of screening inappropriately ordered tests.     

The right cure for health care

An aging population with nearly unlimited access to high-priced doctors and technology is pushing medical costs skyward. Managed care is the best way to bring them down.     

Struggling to save our kids

Many more than ever face the crises of childhood: violence, drugs, bad schools, poverty, divorce, or two parents at work. And no one seems to care.