Efficiency,access, and the mixed delivery of health care services

Universal health systems often rely on both pubic provision and contracting arrangements with private hospitals. This paper studies the optimal mix of public and private provision of health care services. We propose a model in which the regulator acts as athird-party payer, and aims to ensure universal access to treatment at minimal cost. Patients need one unit of medical services and differ in the severity of illness. A private and a public hospital are available. Under incomplete contracts, ownership affects the regulatory constraints and the power of managerial incentives. Only the private manager internalizes profits, and has incentives to reject costly patients and to exert effort in cost reduction. Contracting with the private hospital is optimal when managerial effort is relatively effective in reducing costs. By using the public hospital as a last resort provider, the regulator can ensure access, provide incentives to the private manager, and internalize part of the resulting cost savings. Imposing a no-dumping constraint on the private hospital reduces the power of incentives and is not always optimal.     

Emotional support from a digital assistant in technology-mediated services: Effects on customer satisfaction and behavioral persistence

In their traditional role, digital assistants in technology-mediated services provide customers with information, guidance, and suggestions. However, as the opportunities offered by technology and artificial intelligence increase, digital assistants can also provide emotional support, which refers to empathetic, reassuring expressions for customers who have failed or succeeded in fulfilling a task. We show across four experiments that emotional support offered by a digital assistant increases customer satisfaction (Study 1 and 2) and persistence (Study 3 and 4) in using technology-mediated services. The increase in satisfaction occurs via the perceived warmth of the digital assistant, and the increase in persistence via the serial mediation of perceived warmth and satisfaction. Further, the results of a moderated serial mediation show that the effect on persistence only occurs when a digital (but not when a human) assistant provides emotional support in technology-mediated services. Finally, the effect of emotional support on persistence occurs independently of the digital assistant's embodiment. Practitioners learn how to imbue technology-mediated services with a human touch, inducing favorable customer outcomes.     

Trade effects of geographical indication policy: The EU case

Using a new detailed dataset on country-product information on European Union (EU) Geographical Indications (GIs), we study the impact of this food quality policy on trade margins over the 1996–2014 period. We consider the effect of GIs on both intra- and extra-EU trade margins (extensive and intensive), as well as on export (and import) unit values. Our main results show that GIs affect trade flows differently depending on whether GIs are produced by the exporter or importer country. The presence of GIs in the exporter country systematically exerts a positive trade effect on both the extensive and intensive trade margin. When registered only in the importer country, GIs seem to act weakly as a trade-reducing measure, at least at the intensive trade margin. In addition, GIs positively affect export prices, consistent with the idea that GI products are perceived by consumers as higher quality goods. Importantly, extra-EU trade margins react similarly to those on intra-EU trade. These results have clear and interesting implications concerning the EU strategy of promoting the protection of GIs worldwide.     

Pitfalls in the modeling of labor market flows: a reappraisal

ABSTRACT

We discuss the relevance of the internationally adopted methodology for modelling labour market flows and comparing labour market flexibility. This is based on a two-state labour market model that neglects inactivity and uses aggregate stock data to derive transition rates. Traditionally, the results suggest that continental European labour markets are inflexible and unable to adjust quickly to aggregate demand or supply shocks compared with their Anglo-Saxon counterparts. This evidence has driven us to gain a better understanding of the relevance of such a modelling approach and critically discuss its main methodological hypothesis. We relax its assumptions by including inactivity and by using flow data for the period 2010–2017. We compare the results thus obtained with transition rates derived using a three-state labour market model for France, Italy, Spain and the United Kingdom. These countries represent the institutional settings of continental Europe on the one hand and Anglo-Saxon nations on the other. The implied transition rates are much higher, even in continental Europe, when inactivity is considered, thus suggesting that conclusions derived using an incomplete representation of the labour market are misleading. Inactivity therefore plays a crucial role and its inclusion provides a more exhaustive picture of labour mobility.     

Banks' noninterest income and securities holdings in a low interest rate environment: The case of Italy

Using a sample of 440 Italian banks over the period 2007–2016, we find that low interest rates motivate banks to expand their fee and commission income and to restructure their securities portfolios. A granular breakdown suggests that banks grow noninterest income in various ways, including portfolio management, brokerage and consultancy services and increase fee income from current account and payment services. In addition, banks rebalance securities portfolios away from those “held for trading” to securities “available for sale” and “held to maturity.” Our findings allude to different behavior between large and small banks: while larger banks increase brokerage, consultancy and portfolio management services, smaller banks generate fees from customer current accounts.     

Foreign Ownership and Performance: Evidence from Italian Firms

This paper studies the impact of foreign ownership on a firm’s economic performance. We use a unique panel data set to test the foreign ownership premium by comparing our sample of firms based in Italy and owned by a foreign subject to a sample of purely domestic firms that, in order to have a proper counterfactual, were selected using propensity score matching. Our difference-in-differences results show the existence of a premium for the size, profitability, and financial soundness of the foreign-owned companies. The premium increases with time, is concentrated in the service sector, and disappears if the foreign investor is based in a fiscal haven.     

Competition and Innovation in Luxembourg

This paper studies the empirical relation between market competition and innovation using Luxembourg’s Structural Business Statistics. The competitive pressure in Luxembourg’s markets is assessed by computing a profit elasticity measure, based on the idea of cost-efficiency. From this, the paper analyses the relation between competition and innovation performance by estimating an equation for the determinants of R&D expenditure. The results show that Luxembourg’s industries are characterised by low levels of competition intensity, especially in markets relevant to competition policy and regulation. The relation between competition and innovation is non-linear and depends crucially on the efficient use of inputs to production. The impact of the distribution of technological efficiency on innovation is assessed by measuring both average technology gap and technology spread. The innovation effort is increasing as industries are closer to the frontier, and decreasing in the technology spread.     

Global commodity cycles and linkages: a FAVAR approach

In this article, we examine linkages across non-energy commodity price developments by means of a factor-augmented VAR model (FAVAR). From a set of non-energy commodity price series, we extract two factors, which we identify as common trends in metals and food prices. These factors are included in a FAVAR model together with selected macroeconomic variables, which have been associated with developments in commodity prices. Impulse response functions confirm that exchange rates and economic activity affect individual non-energy commodity prices, but we fail to find strong spillovers from oil to non-oil commodity prices or an impact of the interest rate. In addition, we find that individual commodity prices are affected by common trends captured by the food and metals factors.     

Measures of cost containment, impact of the economical crisis, and the effects perceived in nursing daily practice: an Italian crossover study

A qualitative/quantitative study in two phases was undertaken to describe the economical crisis intensity, cost-containment interventions adopted locally, and their effects perceived in daily practice by Italian nurses. The main economic crisis effects reported by nurses were (a) the staff stress level has increased, (b) patients with social problems have increased, and (c) the workload has increased. Overall, nurses perceived moderate disadvantages due to the economical crisis; several cost-containment measures have been adopted at different levels of the National Health Service. atients in general seem frailer and nurses working in the community centers also seem frailer compared with nurses working at the hospital level. Changes in daily nursing practice both at the hospital and community levels are warning signs that should be monitored carefully for both their short and long-term negative impacts on patients, nurses, and the National Health Service.