Incentives and targets in hospital care: Evidence from a natural experiment

Performance targets are commonly used in the public sector, despite their well known problems when organisations have multiple objectives and performance is difficult to measure. It is possible that such targets may work where there is considerable consensus that performance needs to be improved. We investigate this possibility by examining the response of the English National Health Service to high profile waiting time targets. We exploit a natural policy experiment between two countries of the UK (England and Scotland) to establish the global effectiveness of the targets. We then use a within-England hospital analysis to confirm that responses vary by treatment intensity and to control for differences in resources which may accompany targets. We find that targets met their goals of reducing waiting times without diverting activity from other less well monitored aspects of health care and without decreasing patient health on exit from hospital.     

MEDICARE AND INEQUALITIES IN HEALTH OUTCOMES: THE CASE OF BREAST CANCER

This article evaluates whether expanding Medicare to cover those between ages 55 and 64 will improve the health status of these near-elderly individuals. We compare the experiences of near-elderly and elderly women with breast cancer and pay special attention to those demographic groups traditionally thought to be disadvantaged. Using unique individual-level data from the National Cancer Institute, we find that expanding Medicare does not improve the probability that a black woman will have her cancer diagnosed early. However, if she does happen to be diagnosed early, a discretE-time hazard model of survival finds that the price effects of insurance will improve her odds of survival.     

Developments in social accounting methods as applied to the analysis of income distribution and employment issues

Research into the design, construction and use of social accounting matrices (SAMs) for the analysis of income distribution issues in development policy and planning is generally discussed. Specific case studies for Swaziland, Botswana and Kenya are considered and the accounting classifications are compared, especially those for households. The use of the Swaziland and Botswana SAMs to analyse some of the distributional effects of certain exogenous impacts (such as the outbreak of a foot and mouth epidemic in Botswana) is also discussed. This includes a presentation of methodology as well as some results of the analyses.     

Saving your rookie managers from themselves

Most organizations promote employees into managerial positions based on their technical competence. But very often, that kind of competence does not translate into good managerial performance. Many rookie managers fail to grasp how their roles have changed: that their jobs are no longer about personal achievement but about enabling others to achieve, that sometimes driving the bus means taking a backseat, and that building a team is often more important than cutting a deal. Even the best employees have trouble adjusting to these new realities, and that trouble can be exacerbated by the normal insecurities that may make rookie managers hesitant to ask for help. The dynamic unfolds something like this: As rookie managers internalize their stress, their focus, too, becomes increasingly internal. They become insecure and self-focused and cannot properly support their teams. Invariably, trust breaks down, staff members become alienated, and productivity suffers. In this article, coach and management consultant Carol Walker, who works primarily with rookie managers and their supervisors, addresses the five problem areas that rookie managers typically face: delegating, getting support from senior staffers, projecting confidence, thinking strategically, and giving feedback. You may think these elements sound like Management 101, and you'd be right, Walker writes. But these basic elements are also what trip up most managers in the early stages of their careers (and even, she admits, throughout their careers). The bosses of rookie managers have a responsibility to anticipate and address these problems; not doing so will hurt the rookie, the boss, and the company overall.     

Agriculture in the EEC taking stock

The focus of this assessment is the European Community's ‘Stocktaking of the Common Agricultural Policy’. While the CAP has attracted considerable scrutiny and controversy, the Stocktaking represents the most authoritative review of agricultural policy from within the EEC bureaucracy. The authors evaluate first the extent to which the Stocktaking's own analysis is a fair reflection of achievements under the objectives which the CAP has set for itself. Second, they ask whether the proposals for policy reform advocated in the Stocktaking are appropriate. They conclude that the Stocktaking's proposals — and their subsequent interpretation within the EEC — are not adequate to tackle the problems facing EEC agriculture.     

East Asian investment and reinvestment in the 1990s: implications for regional development

There has been considerable debate in recent literature concerning the regional implications of corporate organization based on complex forms of networking. In particular, it has been suggested that recent international investments are more sophisticated and more beneficial to host economies. This article explores the relevance of these ideas using case studies of reinvestments within East Asian plants located in the North East of England. Examples show how reinvestment decisions can create incremental improvements in the status of production locations. The implications of this for the design and delivery of aftercare services through regional development organizations are explored.     

Seeding the clouds for industrial relations climate change in emerging economies

As manufacturing businesses increasingly move labor‐intensive production to emerging economies, it is important for international managers to understand the sociopolitical factors that shape the climate in which management and labor interact. We present a conceptual “weather map” of industrial relations climates and use indices to plot the climates of 33 emerging, 11 transition, and 21 developed economies. As hypothesized, emerging economies, compared with transition and developed economies, are characterized by a relatively adversarial industrial relations climate and a high incidence of industrial action. Implications for international managers and future research directions are discussed. © 2009 Wiley Periodicals, Inc.