Interim Realities

Abstract

This paper presents findings from a study of information technology implementation practices in National Health Service hospitals in England. The results suggest that there is a general direction of travel, which involves the progressive linking together of individual systems, so that they are interoperable. We argue that the findings are consistent with meta-governance arguments, but that it is necessary to complement this perspective with an understanding of the nature of information technologies in order to understand them properly. We suggest that ‘interim systems’ will be the reality on the ground for many health care organizations for the foreseeable future.     

Social Return on Investment (SROI) and Performance Measurement

Abstract

Social enterprises are being promoted as responsive and innovative way to deliver public services. As part of this promotion, these organizations are being required to demonstrate the social and economic value they generate. Social return on investment (SROI) is a performance measurement tool currently being encouraged to capture this impact. This paper draws on survey and interview data to analyse how SROI is used and understood in health and social care settings. It indicates that despite being accepted as an internationally recognized measurement tool for social enterprise, SROI is underused and undervalued due to practical and ideological barriers.     

Interactive identity work of professionals in management: a hospital case study

ABSTRACT

Hybrid professional managers appear less effective in introducing management into public professional settings than policymakers hope. To date, research has offered little understanding of professionals’ identity transition challenge and the role of social interactions underpinning this process. We studied the identity work of hybrid doctors inside a large public health-care organization, finding that it takes place through processes of familiarizing with management, rationalizing being a hybrid, and legitimizing the new role-identity. We contribute to the literature by showing that identity work is distributed and enabled by social interactions beyond the professional group. Implications for policymakers and executives are discussed.     

试述用人单位在职业病防治中易忽视的问题及对策

用人单位是《职业病防治法》所规定的各项职业病防治措施的主要落实者,是劳动者职业健康及其相关权益保护的第一责任人。明目张胆违反《职业病防治法》的用人单位减少了,但在具体工作中,办事不严、忽视、执行不到位的情况依然存在。文章列举了这些问题并提出了解决措施。     

幼儿教师心理健康研究现状及展望

教育大计,教师为本。有好的教师,才有好的教育。当前不断发生的幼儿教师"虐童"事件警示社会应该关注幼儿教师心理健康问题。本文总结近年来幼儿教师心理健康的有关研究并做出展望,希望能促进对这一群体的研究。     

Environmental standards as barriers to trade

This paper examines the case of a good, polluting in consumption, whose pollutive content is restricted by a government with strong environmental policies. When foreign producers are unable to comply with the restrictive environmental standard of such a country, to which they wish to export, they often allege that those standards constitute illegal barriers to free trade. An example of such a good is gasoline, excessively pollutive formulations of which are prohibited from importation into the United States by the 1970 Clean Air Act. Rather than banning them, such imports should be taxed, along with the domestically produced substitute good, according to their respective pollutant contents. This would foster economic efficiency and should be more acceptable to foreign producers than the outright prohibition mandated by the Clean Air Act. The results of this paper reaffirm the argument in a previous article in this journal (Socio-Economic Planning Sciences 29 (1995) 187), though the countries’ roles in the two papers are reversed, that free trade and Pigouvian environmental policies increase international welfare.     

基于信息系统的航天发射场设备健康管理架构研究

有效的设备健康管理需要推进更完整的信息获取、更全面的互联互通、更深入的信息应用。对基于信息系统的航天发射场设备管理的需求进行了分析,主要有:智能化的管理手段、专业化的管理队伍、配套化的管理机制和信息化的管理环境。根据上述需求,分析了航天发射场设备健康管理的总体架构,主要包括资源管理架构、业务逻辑架构、应用表现架构和基础设施架构;设计和描述了航天发射场设备健康管理的层次架构。基于信息系统的航天发射场设备健康管理架构,能够为航天发射场实现科学的设备健康管理奠定基础。     

完善我国重大疾病商业健康保险的若干建议

本文通过对我国社会医疗保险和商业健康保险的比较,揭示重大疾病商业健康保险的必要性和重要性,并基于我国当前商业健康保险的种种缺失提出若干意见和建议。     

Small system dynamics model for alleviating the general practitioners rural care gap in Ontario,Canada

The disproportionate concentration of healthcare professionals in urban areas is a concern in many countries, including Canada. A need to address this rural care gap has driven a large number of government led initiatives worldwide over the years. This paper presents a model that can be used as a tool to examine the efficacy of such policies on the workforce distribution in the long term. A small system dynamics model is employed to simulate the current and future distribution of general physicians at a jurisdictional level. The model represents the transition of general practitioners to provide insight into the dynamics of care provision over time. The movement, and competition, between rural and urban areas is modeled to enable detailed exploration of the ability for proposed measures to alleviate the care gap in the future. Among the tested policies are such commonly used initiatives as financial incentives to rural professionals, promotion of medical education in rural areas, expansion of rural education programs and the engagement of international medical graduates etc. We demonstrate how the model can be used as a tool to determine an efficient and well-chosen combination of policies which can help alleviate the rural care gap in the future, given that some policies are more effective than others alone but also combined with other initiatives. The presented small system dynamics model is tested on Canada's reality, but its simple nature lends itself to easy application to other countries that experience a similar problem.     

Prioritization of government expenditure on health in India: A fiscal space perspective

Unequal distribution of fiscal resources and lower prioritization of budget towards healthcare are the most important challenges in achieving universal health coverage in India. This study has examined relationships between government health expenditure and fiscal space (i.e. tax revenue, non-tax revenue, fiscal transfer, and borrowings) in twenty-one states of India for the period of 1980–2014. Our panel regression results imply that mobilization of tax revenue has a positive impact, while borrowings have a negative impact on the allocation of government expenditure on healthcare in the long-run. The panel quantile regression results show that states associated with the low and middle level of revenue growth have been mobilizing finance through central government transfer and borrowings in short-run. Further, the panel vector error correction models show that sum of the lagged coefficients of borrowings have a greater impact on health financing process as compared to other sources of fiscal space at short-run, and the speed of adjustment towards long-run equilibrium is relatively slower. The overall analysis concludes that less domestic revenue mobilization and higher dependency of borrowings for healthcare financing may create fiscal stress on state finances in the long-run, and thereby it could possibly reduce the prioritization of spending. Therefore, improvement in revenue growth and proper utilization of fiscal transfer would be appropriate policy implications from this study.