Accounting and Medicine: An Exploratory Investigation into Physicians’ Attitudes Toward the Use of Standard Cost-Accounting Methods in Medicine

Research studies demonstrate wide variation in how physicians diagnose and treat patients with similar medical conditions and suggest that at least some of the variation reflects inefficiencies and unnecessary medical costs. Health care researchers are actively examining ways to reduce variations in practice through standardization of medicine to reduce the cost of treatment and ensure the quality of outcomes. The most widely accepted form of this standardization is Evidence Based Best Practices (EBBP). Furthermore, financial health care providers such as hospitals and managed care organizations are investigating methods to tie resource usage to medical protocols in their efforts to monitor and control health care costs. Such proposals are contentious because they report on physicians’ medical practice behaviors (such as the number of tests ordered, use of specific therapies, etc.) and such reports could potentially be used to influence their clinical behaviors. The intent of this exploratory study was to examine physicians’ perceptions about linking a standard costing system to EBBP guidelines. The authors interviewed nine practicing physicians asking each physician to respond to the question, ‘As a physician working in a hospital environment, what are your reactions to and concerns with combining standard costing techniques with EBBP?’ The interviews were in-depth and free form in nature. The physicians’ responses were recorded and analyzed using Grounded Theory Methodology. Using this methodology the field data was categorized into two major themes. The most important theme centered on ethics and the second theme was concerned with the implementation and use of a standard cost system in regard to EBBP. If physicians’ worries about ethical dilemmas and implementation issues are not resolved, then it is likely that doctors would be unwilling to participate in any efforts to develop or use a standard cost-reporting system in medicine. While this study was exploratory in nature, it should provide future guidance to accountants, health care researchers and health care providers about physicians’ issues with the use of standard costing methods in medicine.     

The Euro Changeover and Numerical Intuition for Prices in the Old and New Currencies

This study examines how numerical intuition for prices in euros and in the Portuguese currency escudos developed in Portugal after the euro changeover. Estimates of prices of 40 different products were collected in the two currencies and at four different times from November 2001 to April 2004. The results regarding price estimates in euros were more in accordance with a relearning hypothesis considering that price estimates become progressively more accurate by a process that is related to purchase frequency. It was also suggested that this is a very slow process and that prices in the former currency are not simply forgotten. On the contrary, the escudos remained a general benchmark for an extended period. The results regarding estimated price intuition and use of intuition in estimating prices are also consistent with a slow adaptation process. Implications for future euro changeovers are discussed.     

信息不对称与第三方物流服务有形化

文章分析了信息不对称给第三方物流企业业务开拓带来的不利影响,认为物流服务企业借助各种有形要素发送信号以区别于劣质服务,有助于消除物流需求方的逆向选择和各种担忧,并就第三方物流企业如何实施服务有形化提出了具体对策。     

辩护人、诉讼代理人毁灭、伪造证据，妨害作证罪考察

现行刑法第306条——判处辩护人、诉讼代理人毁灭、伪造证据,妨害作证罪的立法根据在于,该罪行具有侵害国家司法作用的高度危险。由于辩护人、诉讼代理人在刑事诉讼中的特殊作用,决定了该罪行应当从重处罚。引诱行为的实质内容在于使证人违背事实改变证言或者作伪证,而不在于引诱的具体行为方式,即使是诱导式询问的某些特别类型也存在构成刑法第306条罪行的余地。刑法第306条与第307条是特别犯与一般犯的关系。辩护人、诉讼代理人藏匿、隐避证人的,属于本罪的毁灭证据的行为;辩护人、诉讼代理人明知是他人伪造、变追的证据而使用的,应当属于本罪的伪造证据的行为。     

水电施工企业的索赔管理

水电施工企业在工程建设中加强成本控制、加强索赔管理、提高索赔意识，对水电工程合同管理具有重要意义。文章对如何加强水电施工企业的索赔管理进行了论述。     

论民事诉讼中的证据共通原则——辩论主义与自由心证之协同

在民事诉讼中,为了获取胜诉判决,当事人通常会竭尽全力主张和举证。由于纠纷案件的复杂性、当事人以及代理人的诉讼技能参差不齐,当事人偶尔也会提出与己方主张相反,有利于对方当事人的证据。依据自由心证原则,在不违反辩论主义原则的情况下,法官可以通过证据共通原则做出自由的事实认定。证据共通原则是法官自由裁量权在证据认定程序中的体现,是民事诉讼中的一项重要的证据制度。     

基于证据推理的家用轿车综合评价研究

针对消费者在挑选家用轿车时遇到的"不确定"和"不知道"信息,研究了基于证据推理(ER)的家用轿车综合评价体系。建立递归证据推理的算法及相应的推理合成步骤,通过分析消费者选车时的考虑因素,建立家用轿车指标体系。最后,通过案例分析,说明该方法的有效性和实用性。     

On marginal estimation in a semiparametric model for longitudinal data with time-independent covariates

We consider M-estimators for a class of semiparametric mixed-effect models without time-dependent covariates and show that the simple marginal estimation method is generally better than the same M-estimator applied to the de-correlated response based on a known or estimated covariance matrix for each subject.     

The evaluation of forest crop damages due to climate change. An application of Dempster–Shafer method

In order to assess damage risk caused by climate change in forest areas, Dempster–Shafer theory of evidence and fuzzy measures were applied to develop a framework for the estimation of economic forest damage. According to the definition of risk supported by the Intergovernmental Panel on Climate Change, a function of hazard and resilience lines of evidence was defined. The results of the hazard and resilience assessment were used to develop an economic framework based on Faustmann studies. The evaluation model, implemented through a spatial analysis procedure, was carried out linking Faustmann formula with hazard and resilience raster maps. The model permitted to estimate in monetary terms two possible costs to be supported: the first one is expressed as the expected damage to the forest crop on the basis of the current obtainable woody assortments and the second one referred to the potential expenses to pay in order to mitigate the risk. Finally, the framework was tested on an area of central Italy (Tuscany region).