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Persistent problems feature prominently in transition management and system innovation literature. They serve both as a point of departure, and as justification for the contention that a system innovation is needed. The concept ‘persistent problem’ however is underdeveloped; it is used to label (symptoms of) problems that appear to be complex, uncertain, difficult to manage, and difficult to grasp, but as such provides no way for unravelling how the persistence of these problems actually works. A better understanding can help new practices, like niche-innovations, to overcome enduring problems, contributing to a transition or system innovation. Drawing on the work of Giddens and others, this paper proposes a conceptualisation that can be used to identify and unravel persistent problems. The conceptual framework is built on the notion of systemic reproduction, and further operationalised by iteratively combining a historically informed system analysis with an actor-guided system analysis. The historically informed analysis focuses on features that are exactly the strongholds of the current system, but are said to have negative side effects. In concurrence with that, the systemic reproduction of these negative side effects can be unravelled by analysing how new practices shape their agency in relation to their direct environment. A persistent problem then is a systemically reproduced negative side effect of a success factor of the system in focus. The operationalisation brings the conceptual framework to the actor level, and opens up possibilities for investigating how systemically embedded problems manifest themselves in the daily practice of actors that try to take on enduring problems. In the second part of the paper, this approach is illustrated by using it to unravel problems of tenability of the Dutch health care system. A historically informed analysis is integrated with an analysis of a new practice in health care that deals with patients who suffer from medically unexplained physical symptoms.  相似文献   
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This paper analyses the implementation of the ‘dual system’ in Dutch municipalities which was part of a package of New Public Management‐reforms. This system was stimulated by Dutch central government and called for more accountability for performance of municipal managers and the board of mayor and aldermen, as well as for the use of more output and outcome information. Interviews of participants on four different hierarchical levels in 12 municipalities show that the practices of output management at different hierarchical levels are only loosely coupled to each other (‘vertical loose coupling’). We also found some degree of ‘horizontal loose coupling’ at each hierarchical level between result orientation, the development of output indicators and the use of output information for performance evaluation. The paper analyses the reasons why municipalities encounter difficulties in designing a comprehensive and coherent performance management system.  相似文献   
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Changes in World Real Interest Rates and Inflationary Expectations. —One of the major macroeconomic puzzles has been that the real interest rates were persistently low in the seventies and persistently high in the eighties. The authors use a news framework to investigate the extent to which shocks in real output, money supply, world trade, oil prices, stock prices and expected inflation affect the world and national real interest rates. They find dominant effects on real interest rates from movements in expected inflation rates. This suggests the presence of persistent misperceptions about future inflation and the need of further research into the formation of inflationary expectations.  相似文献   
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In this paper we describe the main characteristics of NPM and illustrate the current state of affairs in three main areas: (a) the effectiveness of NPM reforms, (b) NPM's impact on planning and control in government entities, and (c) the implementation and use of accrual accounting methods in government. We use the responses of 105 (mostly Dutch) practitioners in government and non‐profit organizations. Most respondents recognize performance improvements, but only a minority attribute these improvements directly to NPM reforms. Improved planning and control systems are seen to have only a limited impact on the work of professionals, while accrual accounting is considered to have only limited potential to support political decision making.  相似文献   
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This study examines the relationships between stakeholders’ information needs, cost system design, and cost system effectiveness in local government, using a dataset of survey responses from 71 Dutch municipalities. Three cost system design characteristics are examined: (a) the complexity and (b) the inclusiveness of cost systems, and (c) their understandability for non‐financial internal users. These characteristics are shown to be only partly related to each other, and to differ in the extent to which they are related to the information needs of internal and external stakeholders, as well as to three cost system effectiveness characteristics.  相似文献   
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