26 resultados para Hospitals -- Outpatient services
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A number of European countries, among which the UK and Spain, have opened up their Directory Enquiry Services (DQs, or 118AB) market to competition. We analyse the Spanish case, where both local and foreign firms challenged the incumbent as of April 2003. We argue that the incumbent had the ability to abuse its dominant position, and that it was a perfectly rational strategy. In short,the incumbent raised its rivals' costs directly by providing an inferior quality version of the (essential) input, namely the incumbent's subscribers' database. We illustrate how it is possible to quantify the effect of abuse in situation were the entrant has no previous history in the market. To do this, we use the UK experience to construct the relevant counterfactual, that is the "but for abuse" scenario. After controlling for relative prices and advertising intensity, we find that one of the foreign entrants achieved a Spanish market share of only half of what it would have been in the absence of abuse.
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The European Commission Report on Competition in Professional Services found that recommended prices by professional bodies have a significant negative effect on competition since they may facilitate the coordination of prices between service providers and/or mislead consumers about reasonable price levels. Professional associations argue, first, that a fee schedule may help their members to properly calculate the cost of services avoiding excessive charges and reducing consumers’ searching costs and, second, that recommended prices are very useful for cost appraisal if a litigant is condemned to pay the legal expenses of the opposing party. Thus, recommended fee schedules could be justified to some extent if they represented the cost of providing the services. We test this hypothesis using cross‐section data on a subset of recommended prices by 52 Spanish bar associations and cost data on their territorial jurisdictions. Our empirical results indicate that prices recommended by bar associations are unrelated to the cost of legal services and therefore we conclude that recommended prices have merely an anticompetitive effect.
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[EN]The present research work, based on some of the components of the Common Assessment Framework, sets to analyse the influence held by leadership in specific factors that constitute the organisational climate, and also the impact that these factors have on the quality of municipal public services. For the purposes of this study, we propose Likert’s exploitative autocratic and participative leadership styles to explain the genesis, structure and workflow. As far as the organisational climate is concerned, the variables used are motivation, satisfaction, empowerment, conflict and stress. The main conclusions that arose was that a participative leader confers higher relevance to the quality of service, through motivation, satisfaction, empowerment and human resources positive results, than an exploitative autocratic leader. Performed contributions are based on the empiric research hereby presented, and new research guidelines are proposed. The research methodology used was qualitative, based on the case study.
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Radar services are occasionally affected by wind farms. This paper presents a comprehensive description of the effects that a wind farm may cause on the different radar services, and it compiles a review of the recent research results regarding the mitigation techniques to minimize this impact. Mitigation techniques to be applied at the wind farm and on the radar systems are described. The development of thorough impact studies before the wind farm is installed is presented as the best way to analyze in advance the potential for interference, and subsequently identify the possible solutions to allow the coexistence of wind farms and radar services.
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Background: Patients with chronic obstructive pulmonary disease (COPD) often experience exacerbations of the disease that require hospitalization. Current guidelines offer little guidance for identifying patients whose clinical situation is appropriate for admission to the hospital, and properly developed and validated severity scores for COPD exacerbations are lacking. To address these important gaps in clinical care, we created the IRYSS-COPD Appropriateness Study. Methods/Design: The RAND/UCLA Appropriateness Methodology was used to identify appropriate and inappropriate scenarios for hospital admission for patients experiencing COPD exacerbations. These scenarios were then applied to a prospective cohort of patients attending the emergency departments (ED) of 16 participating hospitals. Information was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up after admission or discharge home. While complete data were generally available at the time of ED admission, data were often missing at the time of decision making. Predefined assumptions were used to impute much of the missing data. Discussion: The IRYSS-COPD Appropriateness Study will validate the appropriateness criteria developed by the RAND/UCLA Appropriateness Methodology and thus better delineate the requirements for admission or discharge of patients experiencing exacerbations of COPD. The study will also provide a better understanding of the determinants of outcomes of COPD exacerbations, and evaluate the equity and variability in access and outcomes in these patients.
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Numerous problems are frequently observed when nursing competency assessment systems (NCAS) are implemented. How to effectively implement a nursing competency assessment system, according to academic and practical contributions, is poorly reported in the literature. The purpose of this paper is to present a set of recommendations for public hospitals and nursing management in order to facilitate the implementation of a NCAS. To achieve this objective we have revised the existing literature and conducted a Delphi study with nursing managers and human resource managers of the public hospitals of the Basque Health Service. The results are that the implementation of a NCAS requires a well-planned strategy that managers must consider before implementing any NCAS. This strategy must include, at minimum, the following aspects: communication, training, leadership, and content where the NCAS is concerned. The context of the organisations and the cultural dimensions may also influence the results of the application of the system.
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4 p.
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32 p.
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30 p.
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52 p.
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29 p.
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24 p.
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25 p.