The impact of nursing on patient and organizational outcomes

The impact of nursing on patient and organizational outcomes has received significant attention from researchers in the past 10 years. Although some research has been based on a theoretical framework, to date, there has not been one, consistent framework that can guide this research. In addition, the frameworks that have been used do not identify nursing as the pivotal concept in the model. The purpose of this article is to identify a framework to guide such research with an emphasis on nursing as the essential concept. Unit culture, nurse staffing, staffing mix, and other variables do not have a direct effect on outcomes. It is only through these variables' influence on the delivery of nursing care that outcomes are affected.     

The stability of decision making in committees: The one-core

We study the stability of decision making in committees. A policy proposal introduced by a committee member is either adopted or abandoned in favor of a new proposal after deliberations. If a proposal is abandoned, it is in spite of the committee member who introduced it, who does not cooperate in any effort to defeat it. Shenoy (1980) proposes the one-core as a solution concept for this game, and shows that this solution may be empty. We provide a necessary and sufficient condition for the existence of a stable policy under the majority rule. This result highlights a trade-off between the size of a committee, the number of competing policy options, and the existence of a stable outcome. Our findings imply a tension between political stability and the existence of a large number of competing interests in democracies.     

Cost-utility analyses of targeted immunomodulators in rheumatoid arthritis: systematic review

Abstract

Aims: Cost-utility (CU) modeling is a common technique used to determine whether new treatments represent good value for money. As with any modeling exercise, findings are a direct result of methodology choices, which may vary widely. Several targeted immuno-modulators have been launched in recent years to treat moderate-to-severe rheumatoid arthritis (RA) which have been evaluated using CU methods. Our objectives were to identify common and innovative modeling choices in moderate-to-severe RA and to highlight their implications for future models in RA.

Materials and methods: A systematic literature search was conducted to identify CU models in moderate-to-severe RA published from January 2013 to June 2019. Studies must have included an active comparator and used quality-adjusted life-years (QALYs) as the common measure of effectiveness. Modeling methods were characterized by stakeholder perspective, simulation type, mapping between parameters, and data sources.

Results: Thirty-one published modeling studies were reviewed spanning 13 countries and 9 drugs, with common methodological choices and innovations observed among them. Over the evaluated time period, we observed common methods and assumptions that are becoming more prominent in the RA CU modeling landscape, including patient-level simulations, two-stage models combining trial results and real-world evidence, real-world treatment durations, long-term health consequences, and Health Assessment Questionnaire (HAQ)-related hospitalization costs. Models that consider the societal perspective are increasingly being developed as well.

Limitations: This review did not consider studies that did not report QALYs as a utility measure, models published only as conference abstracts, or cost-consequence models that did not report an incremental CU ratio.

Conclusions: CU modeling for RA increasingly reflects real-world conditions and patient experiences which are anticipated to provide better information in the assessment of health technologies. Future CU models in RA should consider applying the observed advances in modeling choices to optimize their CU predictions and simulation of real-world outcomes.     

Sector and importer determinants of prices for traded intermediates

While the literature on traded goods prices emphasizes final goods prices and related consumer theory to explain variation in goods prices with importer characteristics, trade in intermediates actually constitutes about two thirds of total trade. We propose a mechanism for explaining variations in the prices of intermediates as a function of importer characteristics, wherein production is vulnerable to failure and the probability of failure declines in the quality of intermediates. Higher wages mean a greater opportunity cost of failure, leading to a stronger demand for high-quality intermediates where firms face higher wages. We find empirical support for this mechanism in the case of intermediate goods using IV regressions. In addition, our findings indicate that while the cost of labour explains about one fifth of variation in imported intermediate prices, it is a non-significant determinant of imported final goods prices.     

Characterizing the Common Prior Assumption

Logical characterizations of the common prior assumption (CPA) are investigated. Two approaches are considered. The first is called frame distinguishability, and is similar in spirit to the approaches considered in the economics literature. Results similar to those obtained in the economics literature are proved here as well, namely, that we can distinguish finite spaces that satisfy the CPA from those that do not in terms of disagreements in expectation. However, it is shown that, for the language used here, no formulas can distinguish infinite spaces satisfying the CPA from those that do not. The second approach considered is that of finding a sound and complete axiomatization. Such an axiomatization is provided; again, the key axiom involves disagreements in expectation. The same axiom system is shown to be sound and complete both in the finite and the infinite case. Thus, the two approaches to characterizing the CPA behave quite differently in the case of infinite spaces. Journal of Economic Literature Classification Numbers: C70, D80.     

Intra- and inter-country bank branch assessment using DEA

Increasingly globalized financial markets with considerable activity in the multinational sector have created the need to understand inter-country bank branch performance. This topic is relatively unstudied, primarily due to the immense difficulty encountered in gathering reliable data. Fortunately, we have been able to obtain data on a group of banks operating in one geographical market area, but in different countries. In this paper we critically assess bank branch profitability and productivity in seven national branch networks owned and operated by a multi-national financial services corporation. The corporate head office (owner) imposes its management philosophy equally on all of its subsidiaries, thus removing executive managerial and corporate disparity. Results suggest that countries in which branch performance is quite consistent amongst domestic branches are less productive and less profitable when compared to other countries that have more disparity in their efficiency scores. In addition, we discovered that, surprisingly, branches do not have to be productive in order to be profitable and this led us to somewhat of a major breakthrough in inter-country branch analysis. Significant managerial advice may be derived from these results vis-à-vis trans-national benchmarking and opportunity for performance improvements both at the branch level and nationally as well.

Openness, centralized wage bargaining, and inflation

This paper develops a model of an open economy containing both sectors in which wages are market-determined and sectors with wage-setting arrangements. A portion of the latter group of sectors coordinate their wages, taking into account that their collective actions influence the equilibrium inflation outcome in an environment in which the central bank engages in discretionary monetary policymaking. Key predictions forthcoming from this model are (1) increased centralization of wage setting initially causes inflation to increase at low degrees of wage centralization but then, as wage centralization increases, results in an inflation drop-off; (2) a greater degree of centralized wage setting reduces the inflation-restraining effect of greater central bank independence; and (3) increased openness is more likely to reduce inflation in nations with less centralized wage bargaining. Analysis of data for seventeen nations for the period 1970–1999 provides generally robust empirical support for all three of these predictions.     

Subperfect Game: Profitable Biases of NBA Referees

This paper empirically investigates three hypotheses regarding biases of National Basketball Association referees. Identification of basketball referee bias is typically difficult as changes in observed statistics may be caused by either changes in referee bias or player behavior. We identify bias by exploiting the fact that referees have varying degrees of discretion over different types of a particular statistic‐turnovers. This allows us to conduct a treatment and control‐style analysis, using the less discretionary turnovers as the player behavior control. The results provide evidence that referees favor home teams, teams losing during games, and teams losing in playoff series. All three biases are likely to increase consumer demand.