Shifting from Undersupply to Oversupply: Does NHS Workforce Planning Need a Paradigm Shift?

The National Health Service in England is currently halfway through the most austere decade in its history. Finding ways to improve health care efficiency is crucial to ensure the sustainability of the health system. While evidence of supply‐induced demand (SID) has often been used as an economic argument to restrict labour supply, in the UK the risks of SID may be much less than in health care systems with more deregulated entry into the market post‐qualification and with fee‐for‐service payment systems. This article focuses on the problem of staff shortages in nursing. We argue that, although an oversupply of some types of labour can add to cost pressures by increasing demand for health care services and that the cost of training staff is high, undersupply and poor labour planning lead to unintended consequences such as poor labour productivity. As a result there is a case for public policy to target an oversupply of nurses in the future. If government reforms to nurse funding help, they are to be welcomed.     

Economies of scale and gender discrimination in transition: the case of the Republic of Tajikistan

This article tests for economies of scale and for evidence of discrimination based on gender lines in intra-household consumption allocations using data from the Living Standards Survey in the Republic of Tajikistan (TLSS). Overall results support the existence of household economies of scale in Tajikistan; however, empirical evidence supporting boy–girl discrimination is limited despite anecdotal evidence otherwise.     

The tourist experience of domestic VFR travellers: the case of Hungary

Visiting friends and relatives (VFR) is the main driver of domestic travel in many countries. This study is one of the first to analyse VFR travel from a perspective of tourist experience. This study aims to investigate the complex dynamics behind VFR-related travel, especially in aspects of trip activities and tourist experience formation. Based on a survey (N?=?879) examining domestic VFR travellers’ trip activities in Hungary, the paper discusses the formation of a tourist experience in context of short-haul domestic VFR travel, especially the role of influencing factors. The results reveal differences between the segments with trip motivation of visiting friends (VF) and visiting relatives (VR) – the two main types of VFR tourists. It was found that independent variables such as VF, staying for longer and participating in leisure and tourism-type activities have a positive effect on tourist experience evolvement; however, factors such as VR, being rather passive during such a visit and focusing on social acts and bonding negatively affect the formulation of a tourist experience. The paper’s novelty and uniqueness lies in applying a new perspective of analysing and discussing VFR travel: the theoretical concept of tourist experience formation.     

The role of actual,ideal, and ought self‐congruence in the consumption of hedonic versus utilitarian brands

To emotionally attach consumers to a brand and inspire brand loyalty, marketers often target the brand personality towards the consumer's actual or ideal self. The self is not limited to its actual and ideal dimension, however, and motivation to approach a desired self may vary depending on the consumer's personality. Thus, the current research is the first to link self‐congruence to self‐discrepancy theory by incorporating the ought self into the self‐congruence framework and taking into account self‐discrepancies as potential moderators of the self‐congruence effect. Additionally, hedonic brand nature is discussed as important condition for self‐congruence and self‐discrepancies exhibiting their fullest effect. The conducted study focuses on how actual, ideal, and ought self‐congruence influence emotional brand attachment and consequently brand loyalty. For brands of primary hedonic nature, findings confirm actual and ideal self‐congruence as drivers of emotional brand attachment, which in turn increases brand loyalty, while ought self‐congruence influences brand loyalty directly. Moreover, self‐discrepancies moderate the described relations, albeit their effect is contrary to theory‐based expectations. From these findings, the authors derive important implications for business practice and future research.     

The impact of China's imports on European Union industrial employment

As the EU's biggest supplier of imported goods and a second trading partner, China has become an increasingly important actor on the global economic scene. This paper reports new evidence through analyzing whether the EU labour market is affected by exposure to imports from China. Drawing on a panel dataset of 27 EU countries, over the 2003–2013 period, and using the pooled mean group estimator, the results show that imports from China have a negative effect on industrial employment. This result holds separately for the all analyzed categories: all products, manufactured products as well as for the sub‐groups.     

Clinical outcomes and economic impact of transcatheter mitral leaflet repair in heart failure patients

Background: Mitral regurgitation (MR) is a common valvular heart disorder requiring intervention once it becomes severe. Transcatheter mitral repair with the MitraClip device is a safe and effective therapy for selected patients denied surgery. The authors sought to evaluate the clinical outcomes and economic impact of this therapy compared to medical management in heart-failure patients with symptomatic mitral regurgitation.

Methods and results: The study was comprised of two phases; an observational study of patients with heart failure and mitral regurgitation treated with either medical therapy or the MitraClip, and an economic model. Results of the observational study were used to estimate parameters for the decision model, which estimated costs, and benefits in a hypothetical cohort of patients with heart failure and moderate-to-severe mitral regurgitation treated with either standard medical therapy or MitraClip. The cohort of patients treated with the MitraClip was propensity matched to a population of heart failure patients, and their outcomes compared. At a mean follow-up of 22 months, all-cause mortality was 21% in the MitraClip cohort and 42% in the medical management cohort (p?=?.007). The decision model demonstrated that MitraClip increased life expectancy from 1.87–3.60 years and quality-adjusted life years (QALY) from 1.13–2.76 years. The incremental cost was $52,500 Canadian dollars, corresponding to an incremental cost-effectiveness ratio (ICER) of $32,300.00 per QALY gained. Results were sensitive to the survival benefit.

Conclusion: In heart failure patients with symptomatic moderate–severe mitral regurgitation, therapy with the MitraClip is associated with superior survival and is cost-effective compared to medical therapy.