Understanding local entrepreneurship and small enterprises in the tourism–development nexus: The case of western Uganda

Most studies of the tourism–development nexus in developing countries tend to focus on short-term and monetary tourism effects, while understating non-monetary and longer-term effects of tourism on local and regional development. Although less tangible and weakly understood, non-monetary and/or long-term tourism effects can both reinforce and undermine short-term and monetary tourism effects. This article analyses how tourism stimulates local entrepreneurship and small enterprise development, and to what extent these small enterprises fuel non-monetary aspects of regional development. Evidence from career pathways of different types of local entrepreneurs in western Uganda suggests that tourism can enlarge peoples’ capabilities, awareness and assets to control their own well-being. This study indicates that tourism can act as a catalyst for small enterprise development in the local economy without inducing major skills’ leakages.     

WEARING OUT YOUR WELCOME: EXAMINING DIFFERENTIAL MEDICAID ELIGIBILITY OF NEW ENTRANTS AND CONTINUING RECIPIENTS

Until recently, states were permitted to have different “new entrant” and “continuing recipient” income limits for parental Medicaid eligibility by implementing income disregards that changed with spell length. Some states utilized this option—either tightening income limits for the same family over time or loosening them. In this article, we construct a theoretical model of utility‐maximizing workers facing different time‐dependent eligibility thresholds to predict the Medicaid participation and employment behavior of workers with varying wage levels. The model reveals some inter‐temporally perverse incentives created by linking eligibility thresholds to Medicaid duration. Then, we empirically test these predictions using the Survey of Income and Program Participation and a unique compilation of state‐by‐family size Medicaid thresholds for both new and continuing recipients. We find that patterns of Medicaid participation and spell duration are consistent with the predictions of our model. There is also evidence that the individuals predicted by our model to lower their work hours may supply fewer hours of labor. As of January 2014, the Affordable Care Act disallows time‐varying income disregards; our findings suggest that states previously using this strategy will experience an adjustment in Medicaid caseloads and possibly labor market outcomes because of the change. (JEL H4, I1, J2)     

Medical resource utilization and costs among Australian patients with genotype 1 chronic hepatitis C: results of a retrospective observational study

Objective: To evaluate medical resource utilization (MRU) and associated costs among Australian patients with genotype 1 chronic hepatitis C (GT1 CHC), including both untreated patients and those receiving treatment with first-generation protease inhibitor-based regimens (telaprevir, boceprevir with pegylated interferon and ribavirin).

Methods: Medical records were reviewed for a stratified random sample of GT1 CHC patients first attending two liver clinics between 2011–2013 (principal population; PP), supplemented by all GT1 CHC patients attending one transplant clinic in the same period (transplant population; TP). CHC-related MRU and associated costs are reported for the PP by treatment status (treated/not treated) stratified by baseline fibrosis grade; and for the TP for the pre-transplant, year of transplant and post-transplant periods.

Results: A total 1636 patients were screened and 590 patients (36.1%) were included. Comprehensive MRU data were collected for 276 PP patients (F0–1 n?=?59, F2 n?=?58, F3 n?=?53, F4 n?=?106; mean follow-up?=?17.3 months). Thirty-eight (13.8%) were treatment-experienced prior to enrolment; 55 (19.9%) received triple therapy during the study. Data were collected for 112 TP patients (mean follow-up?=?29.9 months), 33 (29.5%) received a transplant during the study, and 51 (45.5%) beforehand. The annual direct medical costs, excluding drug costs, were higher among treated PP vs untreated PP (AU$: $1,954 vs $1,202); and year of transplant TP vs pre-/post-transplant TP (AU$: pre-transplant $32,407, transplant $155,138, post-transplant $7,358).

Limitations: To aid interpretation of results, note that only patients with GT1 CHC who are actively managed are included, and MRU data were collected specifically from liver outpatient clinics. That said, movement of patients between hospitals is rare, and any uncaptured MRU is expected to be minimal.

Conclusions: CHC-related MRU increases substantially with disease severity. These real-world MRU data for GT1 CHC will be valuable in assessing the impact of new hepatitis C treatments.     

Healthcare costs in psoriasis and psoriasis sub-groups over time following psoriasis diagnosis

Aims: To quantify healthcare costs in patients with psoriasis overall and in psoriasis patient sub-groups, by level of disease severity, presence or absence of psoriatic arthritis, or use of biologics.

Methods: Administrative data from Truven Health Analytics MarketScan Research Database were used to select adult patients with psoriasis from January 2009 to January 2014. The first psoriasis diagnosis was set as the index date. Patients were required to have ≥6 months of continuous enrollment with medical and pharmacy benefits pre-index and ≥12 months post-index. Patients were followed from index until the earliest of loss to follow-up or study end. All-cause healthcare costs and outpatient pharmacy costs were calculated for the overall psoriasis cohort and for the six different psoriasis patient sub-groups: (a) patients with moderate-to-severe disease and mild disease, (b) patients with psoriatic arthritis and those without, and (c) patients on biologics and those who are not. Costs are presented per-patient-per-year (PPPY) and by years 1, 2, 3, 4, and 5 of follow-up, expressed in 2014?US dollars.

Results: A total of 108,790 psoriasis patients were selected, with a mean age of 46.0 years (52.7% females). Average follow-up was 962 days. All-cause healthcare costs were $12,523 PPPY. Outpatient pharmacy costs accounted for 38.6% of total costs. All-cause healthcare costs were highest for patients on biologics ($29,832), then for patients with psoriatic arthritis ($23,427) and those with moderate-to-severe disease ($21,481). Overall, all-cause healthcare costs and outpatient pharmacy costs presented an upward trend over a 5-year period.

Conclusions: Psoriasis is associated with significant economic burden, which increases over time as the disease progresses. Patients with moderate-to-severe psoriasis, those with psoriatic arthritis, or use of biologics contributes to higher healthcare costs. Psoriasis-related pharmacy expenditure is the largest driver of healthcare costs in patients with psoriasis.     

Strategies for creating value through individual and collective customer experiences

Despite tremendous interest in how online communities create value, existing research tends to focus on limited means through which such value is generated. In this article, we develop a conceptual model of customer value formation. This model rests on two dimensions, namely whether value is formed in the customer or provider domain and whether the value is individual or collective in nature. This enables value formation to be characterized in four ways and enables a more nuanced view of value formation to emerge. Firms are encouraged to reflect on their efforts to support each of the four value formation types. In particular, our conceptualization challenges companies to consider customer contexts outside of customer-firm interaction as important sources of value creation for customers. Such reflection enables practitioners to develop strategies for supporting individual and collective value creation across both the customer and provider domains.     

Employer branding and CSR communication in online recruitment advertising

While multiple studies have discussed the importance of corporate social responsibility (CSR) in recruiting, two important but unaddressed questions constrain the understanding and practice of presenting firms’ socially conscious efforts to their prospective employees. First, are companies engaged in CSR communicating their CSR practices effectively in online recruitment advertising? And second, what CSR information should companies include in online job advertisements to improve their employer attractiveness to prospective candidates? The findings of this study show that CSR communication in recruitment advertising is often limited, an ad-hoc practice, and mostly focused on company practices concerning employee participation and development. Even companies with a great CSR reputation take surprisingly little advantage of their CSR image when it comes to attracting job candidates. To improve employer attractiveness, we recommend that human resources managers consider (1) optimizing the structure of online job advertisements by including a company overview section in which CSR information can be presented easily, (2) expanding the scope of CSR dimensions in job advertisements to include environmental performance and community relations, (3) offering information about opportunities for employee engagement with CSR, and (4) adopting a strategic approach to the inclusion of CSR content in online job advertisements.     

Cattle Feeder Perceptions of Livestock Mandatory Price Reporting

Mandatory livestock price reporting was designed to increase available price information with the intent of facilitating price discovery. Has the program been effective? This study determines how cattle feeders, a primary target of the program, feel about mandatory price reporting (MPR) effectiveness. Results from a survey of cattle feeders reveal a diversity of opinion. Producers tend to be neutral to slightly negative regarding the value of MPR. Some of the dissatisfaction appears to have been associated with unrealistic expectations. Most feedlot characteristics have little systematic relationship to the manager's perceptions regarding usefulness of MPR.     

The Social Norms of Discrete Consumer Exchange

Abstract Social norms have been recognized as an important influence in long-term relational exchange between firms. It is here argued that social norms are equally important in short-term discrete exchange that takes place between firms and consumers. The norms of consumer exchange are, however, of a different kind. To clarify the difference, a classification system is presented. Based on the classification, the social norms of discrete consumer exchange are defined and a method of quantifying these norms is proposed. This method should help in the ongoing effort to understand how the social macro-environment influences individual behavior in dyadic exchange. Gundlach, Achrol, and Mentzer (1995)) note a recent shift in the marketing research paradigm toward a concern for the social determinants of economic exchange behavior. As they point out, this shift requires the analysis of often ambiguous concepts. One of these concepts is that of the social norm. Marketing researchers have recognized that social norms are a valuable explanatory variable. Their influence has been depicted in marketing models (e.g., Bagozzi 1978: Kalapurakal. Urbany, and Dickson 1992), tested in relational exchanges (e.g., Dant and Schul 1992; Heide and John 1992; Kaufmann and Stern 1988), and cited in the marketing orientation literature (e.g. Hurley and Hull 1998: Slater and Narver 1995). The focus here is on the social norms of economic exchange, a subset of the social norms of a given society. In economic exchange, the investigation of social norms has considered primarily the norms of long-term, relational transactions common in inter-firm exchange. Little-research has considered the social norms of the more short-term, discrete transactions common in exchanges between businesses and consumers. However, Kaufmann and Stern (1988: 535) suggest that norms “exist in all exchange behavior, from very discrete transactions to highly relational exchange.” The identification of the social norms of discrete consumer exchange is important to the understanding of the social structure of markets. On a practical level, it also helps marketers minimize consumer hostility. For example, consumers were outraged when Merck distributed its AIDS drug through a channel that charged a 37% markup (Wall Street Journal,May 7, 1996: B1). Merck did not consider the social norms that evidently sanction a 300% markup by consulting firms but not a 37% markup by distributors of pharmaceuticals. To avoid such blundering infractions of social norms. it behooves sellers to understand the social norms of discrete consumer exchange.