The impact of patient choice and waiting time on the demand for health care: results from the London Patient Choice project

In a number of countries where health care is publicly funded, policies to introduce greater patient choice are being implemented. In most cases patient choice is seen as an instrument to reduce waiting times for elective (non-emergency) hospital services. An important issue is whether facilitating greater patient choice will increase the demand for health care and thereby undermine the achievement of reduced waiting times. A large scale pilot of choice in the London metropolitan area permits a test of the hypothesis that choice will affect demand. This paper estimates a model of the demand for elective surgery using a panel of 150 English acute hospitals over the period 1995 to 2004 for three surgical specialties. It examines whether demand shifted following the introduction of the London Patient Choice Project in 2002. The results suggest that the choice project only shifted NHS inpatient demand in orthopaedics and that this shift was inwards.     

Review of Economic indicators for professionals by Charles Steindel

Business Economics -     

To Centralise or Disperse – A Question for Interpretation: A Case Study of Interpretive Planning in the Brecks

The connections between interpretation and sustainable tourism are gradually being realised and it is now generally accepted that interpretation, if planned carefully and sensitively, can contribute in a variety of ways to sustainable tourism development. This paper reports on a case study of sustainable interpretive planning in the Brecks countryside straddling the Norfolk–Suffolk border in the UK. The key question raised is: if interpretation is to be fully accepted as a mechanism in developing sustainable tourism practices should interpretation be planned and implemented in a dispersed or in a centralised fashion? A review of several projects undertaken in a variety of UK destinations illustrates that this question is far from straightforward, and that the results are far from conclusive. The paper discusses the way in which this question was addressed in the Brecks and why the dispersal option was adopted.     

Reacting to the demands of service work: emotional resistance in the Coaching Inn Company

This paper discusses employee resistance to the emotional labour of face-to-face service work. It identifies a difficulty with the extension of the concept of resistance from the more traditional manufacturing industries to service work, asking how far apparently resistant behaviours can sensibly be conceptualised as a challenge to management control of the labour process. This difficulty is explored through a discussion of data drawn from ethnographic research into a chain of public houses. Various forms of resistant behaviour are identified, although the precise nature of this resistance is often blurred by the complex relations between employee, management and customer.     

It's All in the Game: A 3D Learning Model for Business Ethics

How can we improve business ethics education for the twenty first century? This study evaluates the effectiveness of a visual case exercise in the form of a 3D immersive game given to undergraduate students at two UK Universities as part of a mandatory business ethics module. We propose that due to evolving learning styles, the immersive nature of interactive games lends itself as a vehicle to make the learning of ethics more ‘concrete’ and ‘personal’ and therefore more engaging. To achieve this, we designed and built an immersive 3D simulation game in the style of a visual case. The effectiveness of the game was evaluated using a mixed methods approach measuring recognised and adapted constructs from the technology acceptance model. Results demonstrate that students found the game beneficial to their learning of ethics with the development of knowledge and skills applicable to the real world and that they engaged with the process due to game elements. Findings demonstrate the potential for the development of simulated games to teach ethics at all levels and modes of delivery and the contribution of this type of visual case model as a pedagogic method.     

A Gender‐Aware Study of Self‐Leadership Strategies among High‐Growth Entrepreneurs

We apply a gender‐aware framework to examine the self‐leadership strategies men and women early stage high‐growth entrepreneurs employ as they develop innovations. Utilizing a matched‐pair sample of early stage entrepreneurs operating firms in high‐technology business incubators, our results suggest that female and male entrepreneurs have significantly different self‐goal‐setting and self‐cueing behaviors. Results also suggest male entrepreneurs who use stronger goal‐setting behaviors increase their intellectual property development to a greater extent than female founders. Further, for female entrepreneurs who use greater self‐cueing, the negative relationship realized with intellectual property development is lower than for male entrepreneurs.     

Fueling the Credit Crisis: Who Uses Consumer Credit and What Drives Debt Burden?

Excessive household debt contributed to the worst recession in decades. Insights about borrowing and spending behavior can inform economic recovery forecasts, policy decisions, and financial education. This study identifies life cycle and credit attitude as key determinants of who uses debt. Younger households are more likely to borrow for consumption, as are those who believe that it is all right to borrow to purchase luxury goods or cover living expenses. Furthermore, households that condone borrowing for these purposes have a higher consumer debt burden. Debt capacity (or creditworthiness) and financial discipline are also significant factors in determining household debt use.     

Cost-Sharing Incentive Programs for Source Water Protection: The Grand River's Rural Water Quality Program

Over the last few years, Canadian provinces have come to see watershed-based source protection as a means of improving water quality that has been subject to upstream agricultural contamination. Cost-sharing incentive programs—whereby farmers are reimbursed for some portion of out-of-pocket expenses when they voluntarily adopt Best Management Practices—have been identified as possible means of achieving the goal. This paper uses data from the first seven years of operation of Ontario's Rural Water Quality Program for the Grand River to examine the role of financial incentives in encouraging participation. Program data supplemented with Statistics Canada's Census of Agriculture data are used to estimate a Heckman two-stage model of participation rates. Program-specific cost-sharing incentive factors, along with farm income and computer usage, are important determinants in the first-stage discrete participation decision. The most significant factor in the second-stage degree of participation decision is the maximum dollar value of grant that can be obtained by the farm; however, participation response elasticities are inelastic, ranging between 0.02 and 0.25. Au cours des dernières années, les provinces canadiennes en sont venues à considérer la protection des sources d’eau à l’échelle des bassins versants comme un moyen d’améliorer la qualité de l’eau susceptible d’être contaminée par les activités agricoles en amont. Les programmes d’incitatifs à frais partagés – dans le cadre desquels une partie des dépenses que les producteurs engagent leur sont remboursées lorsqu’ils adoptent volontairement de meilleures pratiques de gestion – sont perçus comme des moyens qui pourraient permettre d’atteindre l’objectif. Dans le présent article, nous avons utilisé les données des sept premières années d’application du Rural Water Quality Program, mis en place par l’Ontario pour la protection de la rivière Grand, afin d’examiner le rôle des incitatifs financiers dans l’encouragement à la participation. Nous avons utilisé les données de ce programme ainsi que des données tirées du Recensement de l’agriculture de Statistique Canada pour analyser les taux de participation à l’aide du modèle en deux étapes de Heckman. À la première étape, les incitatifs à frais partagés spécifiques à un programme, de même que le revenu agricole et l’utilisation d’un ordinateur, sont des facteurs importants dans le choix de participer ou non. À la deuxième étape, la valeur maximale de la subvention que peut obtenir une exploitation agricole représente le facteur le plus important. Toutefois, l’élasticité des réponses de participation est inélastique, et varie de 0,02 à 0,25.     

Profit and Price Effects of Multi‐species Individual Transferable Quotas

Regulators in many countries have adopted individual transferable quotas as a means of dealing with the open access problem inherent in fisheries. Using individual vessel data prior to and after the introduction of ITQs in Canada's multi‐species Scotia‐Fundy mobile gear fishery, the paper uses an index number profit decomposition to compare vessel performance over time and across individual vessels. The approach allows us to undertake both an ex post evaluation of short‐term impacts of ITQs and an ex ante evaluation of longer term impacts. With respect to short‐term impacts, the results suggest that larger vessels have benefited the most from the introduction of ITQs, but that all vessels have enjoyed increases in the prices received for those fish species that are included in the quota program. With respect to longer‐term impacts, the transferability provisions of the ITQ program have encouraged exit and more efficient operations to prevail.