Reforming the Financial Health Care System： The Case of the Republic of Albania

The Albanian health care system is currently in a period of deep transformation as well as the country is reflecting the future reforms after the turbulent development of the most recent years. The admission of Albania among future members of the European Union requires also an innovation in the health care system in order to build a model more compliant with the European performance and standards. These innovations are required also in the managerial approach to the health care and in its financing system. The aim of this paper is to analyze the actual financing model of the Albanian health care sector while highlighting the possible future managerial development. First of all, this article presents a history review of the Albanian health-care system, analyzing the current governance model. The goal of this approach is to describe the starting point of the reform paths for the future policy makers. Afterwards the research underlines the transition from a financing model based on historical public expenditure to a system based on the performance as one of the main innovation in the managerial approach to the health care. The introduction of management thinking will then allow developing a cost-based financing model, an accounting system in the teaching hospital and, finally, a financing system able to pay for services provided by private health care entities. The article then offers also a contribution to policy makers in order to define the ＂paths＂ of the Albanian health care system in the next years.     

Conference Report: BEST Education Network Think Tank V: Managing Risk and Crisis for Sustainable Tourism: Research and Innovation

Crisis Management in the Tourism Industry. D. Glaesser. Amsterdam: Butterworth Heinemann. 2003. 0-7506-5976-9     

Common information asymmetry factors in syndicated loan structures

This paper provides a comprehensive study of the syndicate structure and its relationship to information asymmetry and loan spread by using principal component analysis on a large set of 40 structure-related variables. A total of six structure components are identified and related to syndicate quality, syndicate members’ heterogeneity or share concentration, lead arranger’s characteristics, lead lender’s or syndicate’s location, lender–borrower relationships, and lead institution type. In multivariate settings, all six components are significant determinants of loan spread, either directly or indirectly through their impact on other components. Lead share retention, previous lender–borrower relationships and syndicate quality are shown to be bilaterally related to loan spread. Structure components differ regionally, which can provide an explanation for the European pricing discount observed in the literature. An Asian discount is observed and cannot be explained by structure differences.     

Combining backcasting and adaptive management for climate adaptation in coastal regions: A methodology and a South African case study

Developing adaptation strategies for deltaic and coastal regions is a major challenge, due to future uncertainties of climate change and complexity of the social–ecological systems to be managed. This paper investigates how desirable futures or normative scenarios approaches, in particular backcasting, can be used to develop more robust climate strategies in coastal regions. The paper develops a methodology in which participatory backcasting and adaptive management are combined, and its applicability is demonstrated for the Breede–Overberg coastal region in South Africa where a catchment management strategy has been developed. It is concluded that the methodology offers an adequate framework for developing and implementing long-term climate adaptation strategies and policies, including a transition management scheme for intermediate assessments.     

The Impact of Past Syndicate Alliances on the Consolidation of Financial Institutions

The impact of past syndicate alliances on the consolidation of financial institutions is examined. The odds of two lenders combining increases with the intensity and exclusivity of their prior syndicated loan alliances. The impact is higher for international mergers and acquisitions (M&As) and for prior syndicate co-relationships where the acquirer and target were participant and lead, respectively. The odds of a particular lender being a target decreases as its return on equity (ROE) and earnings/price (E/P) ratios increase and as its size and growth opportunities decrease. The intensity and exclusivity of the syndicated loan alliances leading up to M&A announcements are significantly higher for non-US versus US M&As. The significantly lower short- and long-term performances for both acquirers and targets with prior syndicate co-involvements disappear in the presence of control variables that account for the less frequent use of cash payments, the greater incidence of divestitures, and the higher percentage of shares acquired through their M&As. Acquirers with versus those without past syndicate target co-involvements exhibit greater outperformance for control-firm benchmarked ROEs and lower underperformance for control-firm and prior-to-M&A benchmarked ROEs.     

Comparing system visions of farmers and experts

The goal of this paper is to identify farmers’ future in terms of the pesticide management of potato growing farmers in Vereda la Hoya (Boyacá, Colombia).To achieve this goal we applied the Future-Structured Mental Model Approach (Future-SMMA) and interviewed 10 farmers concerning their future perspectives and expectations to derive their future visions. Subsequently, 10 experts were interviewed about the feasibility and the consequences of farmers’ future visions.Applying the Future-SMMA, we analyzed farmers’ future visions and found that farmers take account of social and environmental threats and that their visions are optimistic. In addition we compared farmers’ and experts’ perceptions of external constraints on farmers’ future and discovered that the future visions of farmers and experts were inconsistent. Finally, we determined how farmers’ livelihood assets and self-perception influence the formation of farmers’ future visions and found that the more a person was able to differentiate his livelihood assets the more differentiated were the future visions of that person.In discussing our findings, we deduce that the inconsistency of future visions found is due to diverging attitudes towards future scenarios and differing opinions about who should take responsibility for the knowledge management of farmers.     

The dynamic of financial crises and its non-monotonic effects on earnings quality

Despite the wealth of research examining earnings quality and earnings management, we still have much to learn about the effects of macroeconomic factors on accounting discretion’s decisions; the recent financial crises may be one of such factors. Nevertheless, the extant literature is inconclusive about the direction of the relationship between earnings quality and economic downturn. In this study, we focus on the extent to which organizational survival may be an objective of earnings management. In this manner, we add to research considering earnings target as an objective of earnings manipulation. Furthermore, our results suggest that these objectives likely change as crisis becomes worse. Consequently, we argue that the relationship between financial crises and earnings management is non-monotonic. Earnings management decreases when the intensity of the crisis is low, while it increases when the crisis is acute.