Do physician incentives affect hospital choice? A progress report

The US health reforms of March 2010 introduced new provisions for physicians providing Medicare and Medicaid services to be given financial incentives to control costs. Physician payment mechanisms generating similar incentives are currently used by some health maintenance organizations in California. We describe an ongoing research project in which we investigate physician responses to these payment schemes. The question is whether patients whose physicians have incentives to control hospital costs are admitted to lower-priced hospitals than other patients, all else equal. We provide an initial analysis of California hospital discharge data from 2003, documenting evidence consistent with this hypothesis.     

Water-Based Recreational Benefits of Conservation Programs: The Case of Conservation Tillage on U.S. Cropland

Conservation programs are a significant part of farm legislation. The recent farm bill increases funding of conservation programs. One result will likely be the increased adoption of basic environmentally benign farming practices, such as conservation tillage. This would lead to improvements in surface water quality. In this paper, we examine the magnitude of the nonmarket use value benefits of these improvements. The findings indicate that moderate to widespread adoption of practices such as conservation tillage would result in significant nonmarket benefits.     

An Investigation of Policy Administrative Costs Using Panel Data for the English Environmentally Sensitive Areas

This paper explores transactions costs in the context of agri‐environmental policy schemes based on management agreements. While transactions costs encompass a wide range of organisational costs, the focus here is on the public‐sector administrative costs of policy implementation. Empirical administrative cost functions were estimated to investigate the factors affecting the magnitude of such costs, using panel data spanning five years for the 22 English Environmentally Sensitive Areas. The extent of participation appears to be important in explaining administrative cost variability across areas. The data suggested the existence of size economics with regard to the numbers of agreements made in any one ESA, and a significant effect of scheme experience in exerting downwards‐pressure on administrative costs. Policy budgeting and evaluation should take into account the non‐trivial costs of organisation, particularly if agri‐environmental schemes based on the procurement of conservation goods through management agreements are to be extended in future.     

Not just understudies: The dynamics of short-term leadership

Contrary to the stereotype that the period between CEOs is a hiatus, interim and acting executives serve during an important strategic window. A model is presented to illustrate the dynamics of short-term leadership, including the precipitating circumstances for the temporary administration, the tasks of short-term leadership, and the moderating factors seen to affect the selection and success of the next chief executive. Researchers and practitioners are urged to consider more carefully the potential that a well-managed interregnum has to repair damage from a traumatic departure, buffer between administrations, and prepare the organization to accept and work with new leadership. © 1995 by John Wiley & Sons, Inc.     

Women Trailblazers in the Statistical Profession

A brief historical introduction to nine women who were trailblazers in the statistical sciences is presented. During their times, men dominated the profession. Yet we see how these women in their various ways blazed trails and as such became mentors and inspirations for generations of women practitioners who worked with them and followed in their footsteps.     

Developing a tutoring module for presentation of computerized patient management problems

The simulation problem is one of the most commonly used formats in computer-assisted instruction (CAI). In medical education, a patient simulation problem is known as a patient management problem (PMP). A number of computerized PMP systems are currently available. However, to date, there is no record of PMP systems having been developed using artificial intelligence. This is noteworthy since artificial intelligence techniques could help in the generation of more effective and intelligent instructional systems.

This paper analyzes and evaluates existing instructional simulation software in clinical medicine in terms of effective educational design attributes. Components of effective PMP systems thus identified are incorporated into a computerized instructional system which uses artificial intelligence techniques for teaching problem-solving and diagnostic skills to undergraduate medical students.     

How do leaders' perceptions of organizational health climate shape employee exhaustion and engagement? Toward a cascading-effects model

Although researchers and practitioners increasingly focus on health promotion in organizations, research has been mainly fragmented and fails to integrate different organizational levels in terms of their effects on employee health. Drawing on organizational climate and social identity research, we present a cascading model of organizational health climate and demonstrate how and when leaders' perceptions of organizational health climate are linked to employee well-being. We tested our model in two multisource studies (N_{Study 1} = 65 leaders and 291 employees; N_{Study 2} = 401 leader–employee dyads). Results showed that leaders' perceptions of organizational health climate were positively related to their health mindsets (i.e., their health awareness). These in turn were positively associated with their health-promoting leadership behavior, which ultimately went along with better employee well-being. Additionally, in Study 1, the relationship between perceived organizational health climate and leaders' health mindsets was moderated by their organizational identification. High leader identification strengthened the relationship between perceived organizational health climate and leaders' health mindsets. These findings have important implications for theory and practice as they show how the dynamics of an organizational health climate can unfold in organizations and how it is related to employee well-being via the novel concept of health-promoting leadership.