Developing a tool to measure pharmacoeconomic outcomes of post-surgical pain management interventions

Background:

Financial pressures have limited the ability of providers to use medication that may improve clinical outcomes and patient satisfaction. New interventions are often fraught with resistance from individual cost centers. A value realization tool (VRT) is essential for separate cost centers to communicate and comprehend the overall financial and clinical implications of post-surgical pain management medication interventions (PSMI). The goal was to describe development of a VRT.

Methods:

An evaluation of common in-patient PSMI approaches, impacts, and costs was performed. A multidisciplinary task force guided development of the VRT to ensure appropriate representation and relevance to clinical practice. The main outcome was an Excel-based tool that communicates the overall cost/benefit of PSMI for the post-operative patient encounter.

Results:

The VRT aggregated input data on costs, clinical impact, and nursing burden of PSMI assessment and monitoring into two high-level outcome reports: Overall Cost Impact and Nurse & Patient Impact. Costs included PSMI specific medication, equipment, professional placement, labor, overall/opioid-related adverse events, re-admissions, and length of stay. Nursing impact included level of practice interference, job satisfaction, and patient care metrics. Patient impact included pain scores, opioid use, PACU time, and satisfaction. Reference data was provided for individual institutions that may not collect all variables included in the VRT.

Conclusions:

The VRT is a valuable way for administrators to assess PSMI cost/benefits and for individual cost centers to see the overall value of individual interventions. The user-friendly, decision-support tool allows the end-user to use built-in referenced or personalized outcome data, increasing relevance to their institutions. This broad picture could facilitate communication across cost centers and evidence-based decisions for appropriate use and impacts of PSMI.     

The impact of team‐member exchange,differentiation, team commitment,and knowledge sharing on R&D project team performance

This paper integrates team‐member exchange (TMX), affective commitment, and knowledge sharing to examine how work unit TMX influences employees' R&D project team commitment and intention to share knowledge, and how team knowledge‐sharing intention and TMX differentiation influences team performance. The results support the relationships between work unit TMX and employees' intention to share knowledge and team commitment. In addition, the results show that work unit TMX increases intention to share knowledge through increasing group members' team commitment. At the group level, the results support the relationships between team knowledge‐sharing intention and team performance. The results also show that TMX differentiation moderates the relationship between work unit TMX and team performance. That is, greater work unit TMX is more likely to achieve higher team performance in a team with low TMX differentiation as opposed to a team with high TMX differentiation. Implications for theory building, future research, and R&D management are discussed.     

Discretionary accounting choices: the case of IAS 19 pension accounting

Based on a sample of 3207 firm-year observations for the years 2005–2013, we investigate how stock-listed companies in France, Germany and the UK use two discretionary choices in their accounting for defined benefit pension plans under International Accounting Standard (IAS) 19 Employee Benefits. We first analyse companies’ decision whether to voluntarily early adopt the equity method of accounting for actuarial gains and losses. Second, we analyse companies’ choice to present pension interest cost and expected return on plan assets, or, in 2013, net pension interest cost, in operating or financial income. Our findings provide evidence that companies’ decisions to early adopt the equity method in 2005, the first year this accounting choice was available, were motivated by short-term effects on equity. Our analyses also indicate that the choice regarding where to present interest cost and expected return on plan assets in the income statement is associated with the resulting effect on Earnings before Interest and Tax. Finally, we document country-specific differences in the use of the discretion provided under IAS 19, suggesting that discretionary pension accounting choices may impede comparability.     

Board Characteristics and Involvement in Strategic Decision Making: Evidence from Swiss Companies*

abstract Boards of directors have a number of roles. The board's monitoring function has been the subject of much work. Less examined is the role that the board has in setting company strategy. This paper uses agency and network perspectives in developing and testing the relationship between board characteristics and involvement in strategic decision making. Using primary and secondary data, our results suggest that the level of board involvement in strategic decision making is related to a number of governance variables. We demonstrate that involvement is generally lower where boards are highly interlocked. We also show that certain types of board interlocks – namely horizontal (same industry) and those involving direct links with the banking sector – are particularly associated with this negative effect. There is weaker evidence that board strategic involvement is lower where the roles of company chief executive and chair are combined. We find no evidence that factors such as board size, or the percentage of outside directors per se are related to board involvement in strategic decision making. In doing so, this paper adds to the growing literature synthesizing the structural features and processes of boards.     

A SUMMARY AND ANALYSIS OF MULTI‐ITEM SCALES USED IN LOGISTICS RESEARCH

Academic disciplines are strengthened through many years of theoretical research leading to significant knowledge advancements in the field. One primary technique for measuring concepts important for theory development is the use of multi‐item scales. This research documents the multi‐item scales utilized throughout the history of leading logistics journals. The test results for validity and reliability with respect to each scale are disclosed. Results indicate a need for logistics researchers to continue developing new measures and refining existing measures by employing rigorous methods to establish scales having highly acceptable psychometric properties.     

The origin of spatial interaction

This paper uses spatial empirical methods to detect and analyze trade patterns in a historical data set on Chinese rice prices. Our results suggest that spatial features were important for the expansion of interregional trade. Geography dictates, first, over what distances trade was possible in different regions, because the costs of ship transport were considerably below those for land transport. Spatial features also influence the direction in which a trading network is expanding. Moreover, our analysis captures the impact of new trade routes both within and outside the trading areas.     

A new class of limited-information estimators for simultaneous equations systems

The TSLS and LIML estimators are evaluated by means of a new class of limited-information estimators, the so-called Ω-class estimators. Under certain assumptions the Ω-class estimator is a maximun-likelihood estimator. These assumptions are superfluous, however, if we view the Ω-class as a class of minimun-distance estimators; all the members are shown to be consistent under general conditions. Besides the TSLS and the LIML estimators some other interesting members are introduced, and it is shown that, under certain conditions, the Ω-class estimators are weighted averages of different TSLS estimators. The use of TSLS in small samples is criticized; an alternative estimator is proposed.