More preventive care, and fewer emergency room visits and prescription drugs--health care utilization in a consumer-driven health plan

Although consumer-driven health plans (CDHPs) have grown dramatically, the question of whether CDHPs have reduced health care costs has not been answered definitively. This article presents what the authors believe to be the first study to analyze a large sample of claims data and to look in detail at different types of utilization among enrollees in a CDHP and those in a traditional comprehensive major medical (CMM) plan. After adjusting for the finding that CDHP enrollees are both younger and healthier than those in CMM plans, the authors found that CDHP enrollees show no consistent or significant utilization differences for measures over which consumers have little control (e.g., inpatient stays); lower utilization for measures over which consumers have greater control (e.g., emergency room visits); and higher utilization of preventive services.     

Evolution of the Infant Health Production Function

Michael Grossman's seminal publication on the demand for health and health production (Grossman 1972) has spawned a substantial body of research focusing on the production of infant health. This article provides a systematic review of the published literature to date on infant health production and how it has evolved over the past 3–4 decades as data have become more available, computing has improved, and econometric methods have become more sophisticated. While empirical research in most fields has expanded in corresponding ways, the infant health production research has become an important part of the broader and inherently multidisciplinary literature on intergenerational health. The strongest and most robust findings are that policies matter for infant health, particularly those affecting access to health care, and that prenatal smoking and other chemical exposures substantially compromise infant health. Promising directions for future research include elucidating relevant pathways, reconciling the largely inconsistent estimated effects of nutrition and education, and exploring the roles of preconceptional and lifetime health care, paternal factors, social support, housing, complementarity and substitutability of inputs, factors that modify effects of inputs, and evolving medical technologies.     

Some Parallels Between Currency and Banking Crises

There is a sizeable literature on the causes of speculative attacks on fixed exchange rates and a large literature on the determinants of bank runs. Surprisingly, these two literatures rarely overlap, even though both types of crises involve attacks on asset price-fixing schemes. This paper draws a number of parallels between the work on currency crises and the work on banking crises and examines some of the new insights that are coming out of a more integrated approach in the aftermath of the Asian financial crises.     

Improved integration of LOPA with HAZOP analyses

Integrating Layer of Protection Analysis (LOPA) with Hazard and Operability Analysis (HAZOP) has many advantages over performing these studies separately. The merits include: fewer actions from the combined effort compared to performing only a HAZOP; team continuity resulting from the combined effort as opposed to two separate teams having possibly differing points of view; and, ultimately, a time and cost savings realized by the combination. This integration defines the risk associated with a given scenario, enabling better decisions that impact business assurance. By using the Center for Chemical Process Safety guidelines to define the independent protection layers upfront, the gray areas can often be reduced or eliminated; thereby enabling a more thorough LOPA. Examples include taking credit if a unit has two independent operators (outside and inside) responding to critical alarms, or taking credit for centralized control rooms that may allow immediate operator interaction and response. This article shows how the guidelines have been used successfully in joint HAZOP/LOPA studies, and describes an initial preparation protocol that can ensure high-quality results. © 2009 American Institute of Chemical Engineers Process Saf Prog, 2009     

Antecedents of growth through mergers and acquisitions: Empirical results from Belgium

This paper empirically investigates the antecedents of growth through mergers and acquisitions (M&As) in a typical continental European country, Belgium. The article reports on a study using data on 484 private and listed bidders engaging in 990 M&As during 1997-2007, and matches this sample with companies that did not pursue any external growth. By analyzing firm characteristics, industry, and aggregate financial market variables, the study can also discern the motives that are important in the decision to acquire. The results show that neither the firm's cash position nor its cash-generating abilities influence its choice to grow externally. Yet, intangible assets affect the M&A decision positively, whereas ownership concentration and bank loans have a negative effect. In industries where incumbents are operating at a lower scale and in more highly concentrated industries, the odds of firms participating in M&As are larger. Industry deregulation, industry growth, and financial market conditions have no influence. These findings are largely comparable across listed and private firms. Yet, the data do reveal that the operating scale of industry incumbents and industry concentration matter only in horizontal and domestic takeover decisions.     

Trade Policy and Productivity Growth in OECD Manufacturing *

Trade liberalization may promote economic growth in a number of ways, including by accelerating the rate of technological change. Firms that face more intense import competition may be spurred to greater rates of innovation; firms which export may absorb new technologies through their contact with international markets. This paper examines evidence on trade policy and productivity growth for a sample of thirteen OECD countries and including eighteen manufacturing sectors, using data primarily from the 1980s. Within individual sectors, there are strong productivity convergence effects within the OECD. After controlling for convergence, we find a positive association between high rates of productivity growth and low tariffs, and between high productivity growth and strong export performance. We found no particular association between high productivity growth and import penetration. The results are consistent with the possibility of positive linkages between trade liberalization and accelerated productivity growth. [F1, O4]     

The Military Occupation of Burma

In this article we study diverse ways and means by which the military controls and oppresses the people, Burman and other ethnic groups, in the name of achieving the Tatmadaw’s (Burmese military’s) three main national causes, ‘non-disintegration of the union, non-disintegration of national solidarity, and perpetuation of national solidarity’. We explore the ways the State uses their power to dominate civilian life and forms of resistance to this. State power is not uniformly practiced but occurs at different spatial scales of body, family, home, and village. Understanding the instrumentality of the State acts of violence through study of interrogation of political prisoners, offers ways to recognize the broader aspects of State pressure in the form of destruction of homes, villages, and means of livelihood. The private space of the body, home and the public village meant to shelter it has become the focus of Burmese State attempts to control the population.     

Means-end chain analysis explains soil fertility management decisions by peri-urban vegetable growers in Kenya

Past studies of the use of soil fertility management strategies by farmers usually model input use decisions based on the neoclassical utility/profit maximization principle in which farmers use soil fertility management inputs primarily to increase revenues and profits. However, there is, to date, no study that explains exactly how this decision-making process occurs and the role which personal values play in driving the choice of soil fertility management inputs. This article systematically maps the relationship between choice of soil fertility management strategy (attributes), its outcomes (consequences) and the personal values that motivate the choice. It specifically uses the means-end chain approach to construct hierarchical value maps that relate the attributes to consequences, and ultimately to the personal values. The study finds that the use of soil fertility management strategies by peri-urban fresh vegetable growers is driven by five personal values, namely happiness, comfortable life, independence, good/healthy life and achievement of life goals. It also finds that while farmers seek to increase profit (hence incomes), profit maximization is not the end driver of the use of soil fertility management inputs. It concludes that a lot more goes into farmers’ decision-making process relating to the use of soil fertility management practices than can be explained by the neoclassical profit/utility maximization principle. The study discusses the policy implications of these findings.     

A decision model for outsourcing training functions: distinguishing between generic and firm-job-specific training content

Employee training plays a crucial role in the success of most organizations. Due to its developmental aspect, training is closely linked to core competencies and strategic focus. However, it is also one of the most widely outsourced HR functions in most Western economies.

This article attempts to illustrate and propose a decision model for the factors that shape the expected benefits and subsequently the extent of outsourcing training functions. A distinction is made among generic training (for the development of competencies) and job- or company- specific training (for example, induction training, job specialization, etc.).

Two decision models are extracted with structural equation modelling. Asset specificity, market availability, in-house development of training and firm size are discussed. The factors shaping the decision to outsource, as well as the perceived benefits from outsourcing employee training, are different for each of the two types of training (generic and specific). The reasons underlying those differences are discussed. For both types of training service it is proposed that the expected quality benefits, not cost ones, induce companies to outsource training.

Thus, this study attempts to offer a useful insight into the factors shaping the extent and the expected benefits from outsourcing training services. The outcomes can further assist HRM professionals (managers and providers of HRM services), as well as academics to gain a better understanding of the nature of HRM outsourcing decisions in general, and a ‘basic’ HRM outsourcing practice – training – in particular.     

Does excessive buying for self relate to spending on pets?

Using two studies, this article explores how a tendency to buy excessively for self relates to spending on one's pet. Existing research on excessive buying reports that these buyers spend money primarily on themselves. Excessive buying is the tendency to be preoccupied with buying and, consequently, to buy relatively more and more often than others. The first study, using a qualitative research approach, provides insights into the relationship of excessive buying for self and for pets. This study reveals that excessive buyers consider their pets as full family members and extensions of themselves. The second study, a national survey conducted via the Internet, provides a quantitative test of the relationship between excessive buying for self and spending on pets. Respondents who score high on an excessive buying index also tend to spend more on their pets for toys, food treats, clothing, accessories, and grooming products.