Efficiency outcomes of market concentration and managed care

The paper examines how hospital cost efficiency has reacted to extensive horizontal integrations of hospitals and rapid growth of managed care in the US health care industry. Cost efficiency is estimated by using panel data approaches to relax the assumptions for the hospital effects imposed in earlier studies. The paper shows that higher managed care penetration over time is associated with greater hospital efficiency, and higher market concentration is positively associated with efficiency when markets are highly competitive or highly concentrated.     

Does investor protection affect the choice of earnings management methods through real activity manipulation and accrual manipulation？ Asian comparison

This paper examines systematic differences in earnings management through real activity manipulation and accrual manipulation across 7 Asia countries. The study proposes arguments that in economies with high investor protection, managers prefer to manage earnings through real activity manipulation rather than through accrual manipulation because accrual manipulation is more likely to draw auditors or regulators scrutiny than real decisions about pricing and production. The study findings are consistent with prediction. Despite being in economies with high investor protection, managers still have bigger discretion in managing earnings through real activities rather than accrual manipulation.     

Tunneling, overlapping owner and investor protection： Evidence from merger and acquisition in Asia

Tunneling is to describe transfer resource out of the firm for benefit of their controlling shareholders. Better legal protection and stronger social norms improve minority shareholders＇ protection from expropriation. They consequently reduce the private benefits of controlling shareholders （La Porta, 1999）. This study aims to investigate tunneling in the context merger and acquisition （M＆A） and to examine whether tunneling occurs only in emerging markets with poor law enforcement or whether it also occurs in developed countries. This study documents that managers are more likely to overpay target in merger and acquisition with high overlapped owner which have stakes in bidder and target firm. That overpayment, a transfer of wealth from owners of bidder＇s firm to overlapping owners, is a type of tunneling. This study concludes that tunneling occurs in nations not only with low investor protection, but also with high investor protection.     

World Heritage Sites: The Purposes and Politics of Destination Branding

ABSTRACT

Stakeholder management and politics have been described as key component of destination branding (Balakrishnan, 2009 Balakrishnan, M. S. 2009. Strategic branding of destinations: A framework. European Journal of Marketing, 43(5–6): 611–629. [Crossref], [Web of Science ®] , [Google Scholar]). This article investigates the impact of political influences on destination branding by examining a sample of 94 United Nations Educational, Scientific and Cultural Organization (UNESCO) World Heritage Sites (WHS) in 54 countries to determine whether democracy and political instability have a significant influence on the decisions of national tourism offices (NTOs) to promote their WHS as tourist destinations. It also examines the relative importance of political instability and democracy on the promotion of WHS by NTOs in comparison to other influences such as stewardship, economic development, and tourism. One of the key contributions of this article is that it applies a multivariate analysis to a field dominated by case study methodologies and suggests the potential complementarities between the two approaches. Democracy, it is hypothesized, facilitates the give and take inherent in reaching a common consensus among stakeholders on the nature and special meaning of a destination. It increases a society or country's civic capacity for collective action. Political instability, by contrast, is assumed to complicate the building of a consensus that enables nations to invest in and promote their heritage sites. The findings of this study suggest that the degree of democracy in a society has a significant role in encouraging the promotion of WHS as destinations. Political instability, by contrast, does not appear to have a significant impact in that regard. Democracy also appears to have a greater influence on the promotion of WHS by NTOs than influences such as economic development, quality of stewardship, and tourism.     

Work–family conflict/family–work conflict,job stress,burnout and intention to leave in the hotel industry in Quebec (Canada): moderating role of need for family friendly practices as “resource passageways”

Abstract

This study examines how the need for family friendly practices contribute in increasing the effects of work–family conflict (WFC) and family–work conflict (FWC) on job stress, burnout, and intention to leave in the hotel industry in Quebce (258 staff). The essential results indicate that the perception of a need for childcare moderates the relationship between FWC, job stress, and burnout. Also, employees wanting to have a compressed workweek and part time measures are exposed to more stress related to WFC/FWC. Finally, the four measures can constitute resources passageways in order to reduce the work-family interference, job stress, burnout and therefore the intention to leave. Theoretically, he results extend this line of theorizing by highlighting the importance of subjective needs for family friendly policies, as ‘resource caravan passageways’, in the work–family interface and job outcome processes. The perception of a desire or need for these measures offers a new understanding of these practices. Practically, identifying who is more sensitive to family friendly measures would enable organizations or employers to allocate supportive resources more adequately by targeting those employees who are most in need of such practices.     

Aggregate economic fluctuations and regional convergence: the Finnish case 1988-95

This paper analyses the connection between aggregate economic fluctuations and regional productivity convergence in Finland during the period 1988–95. Markov chain transition matrices and mobility indices were used to examine the regional distribution of productivity. The results indicated that high intra-distribution mobility occurred during booms, when regional convergence potential was also at its highest. Conversely, recession years were characterized by much lower mobility and a more divergent regional pattern. These findings bear important implications in terms of regional policy planning, as it seems that poor regions do not manage to keep up with the rich ones during slumps, whereas regional disparities diminish naturally during boom years.     

Returns to scale in a matching model: evidence from disaggregated panel data

The returns to scale in the matching function play an important role in models with endogenous search effort. Due to positive externalities, increasing returns to scale in matching can support high or low activity equilibrium in the labour market. In this study, we examine this issue using panel data from Finnish employment offices. The study finds that the results from the Cobb–Douglas and translog specification are qualitatively different. The CD specification of the matching function exhibits constant returns to scale. The translog specification, in turn, exhibits increasing returns to scale. The elasticity estimate for returns, using the preferred specification and minimum and maximum sample values for job seekers and vacancies, fall in the range of 1.1 to 1.6.     

Does site-of-care for oncology infusion therapy influence treatment patterns,cost, and quality in the United States?

Background: The increase in hospital acquisition of community oncology clinics in the US has led to a shift in the site-of-care (SOC) for infusion therapy from the physician office (PO) to the hospital outpatient (HO) setting.

Objective: To investigate differences by SOC in treatment patterns, quality, and cost among patients with cancer undergoing first-line infusion therapy.

Research design and methods: This retrospective analysis identified adult patients from Humana medical claims who initiated infusion therapy from 2008–2012 for five common cancer types in which infusion therapy is likely, including early stage breast cancer; metastatic breast, lung, and colorectal cancers; and non-Hodgkin’s lymphoma or chronic lymphocytic leukemia. Differences by SOC in first-line treatment patterns and quality of care at end-of-life, defined as infusions or hospitalizations 30 days prior to death, were evaluated using Wilcoxon-Rank Sum and Chi-square tests where appropriate. Differences in cost by SOC were evaluated using risk-adjusted generalized linear models.

Main outcome measures: Treatment patterns, quality of care at end of life, healthcare costs.

Results: There were differences in duration of therapy and number of infusions for some therapy regimens by SOC, in which patients in the HO had shorter duration of therapy and fewer infusions. There were no differences in quality of care at end-of-life by SOC. Total healthcare costs were 15% higher among patients in HO ($55,965) compared with PO ($48,439), p?<?.0001.

Limitations: Analyses was restricted to a claims-based population of cancer patients within a health plan.

Conclusion: This study, in an older, predominantly Medicare Advantage oncology cohort, found differences by SOC in treatment patterns and cost, but not quality. Where differences were found, patients receiving care in the HO had shorter duration of therapy and fewer infusions for specific treatment regimens, but higher healthcare costs than those treated in a PO.     

Multiple Objective Approach as an Alternative to Radial Projection in DEA

Radial projection is a standard technique applied in data envelopment analysis (DEA) to calculate efficiency scores for input and/or output variables. In this paper, we have studied the appropriateness of radial projection for target setting. We have created a situation where the decision making units (DMUs) are free to choose their own target values on the efficient frontier and then compared the results to those of radial projection. In practice, target values are primarily used for future goal attainment; hence, not only preferences but also, and on the whole, change in time frame, affect the choice of target values. Based on that, we conducted an empirical experiment with an aim to study how the DMUs choose their most preferred target values on the efficient frontier. The subjects, who all were students of the Helsinki School of Economics, were given the freedom to explore their personalized efficient frontiers by using a multiple objective linear programming (MOLP) approach. To study various and relevant scenarios, the personalized efficient frontiers for all students were constructed in such a way that the current position of each student in relation to the frontier made him/her inefficient, efficient, or super-efficient. The results show that the use of radial projection for target setting is too restrictive.