For public service or money: Understanding geographical imbalances in the health workforce in Ethiopia

Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analyzing data obtained from contingent valuation questions, we find that household consumption and the student s motivation to help the poor, which is our proxy for intrinsic motivation, are the main determinants of willingness to work in a rural area. We investigate whoe is willing to help the poor and find that women are significantly more likely than men. Other variables, including a rich set of psychosocial characteristics, are not significant. Finally, we carry out some simulation on how much it would cost to make the entire cohort of starting nurses and doctors chooseto take up a rural post.

Market structure and hospital efficiency: Evaluating potential effects of deregulation in a national health service

In this article we examine the potential effect of market structureon hospital technical efficiency as a measure of performance controlled byownership and regulation. This study is relevant to provide an evaluationof the potential effects of recommended and initiated deregulation policiesin order to promote market reforms in the context of a European NationalHealth Service. Our goal was reached through three main empirical stages.Firstly, using patient origin data from hospitals in the region of Cataloniain 1990, we estimated geographic hospital markets through the Elzinga--Hogartyapproach, based on patient flows. Then we measured the market level ofconcentration using the Herfindahl--Hirschman index. Secondly, technicaland scale efficiency scores for each hospital was obtained specifying aData Envelopment Analysis. According to the data nearly two--thirds of thehospitals operate under the production frontier with an average efficiencyscore of 0.841. Finally, the determinants of the efficiency scores wereinvestigated using a censored regression model. Special attention waspaid to test the hypothesis that there is an efficiency improvement in morecompetitive markets. The results suggest that the number of competitors inthe market contributes positively to technical efficiency and there is someevidence that the differences in efficiency scores are attributed toseveral environmental factors such as ownership, market structure andregulation effects.

Location of multiple server common service centers or public facilities for minimizing general congestion and travel cost functions

We propose a model and solution methods, for locating a fixed number ofmultiple-server, congestible common service centers or congestible publicfacilities. Locations are chosen so to minimize consumers congestion (orqueuing) and travel costs, considering that all the demand must be served.Customers choose the facilities to which they travel in order to receiveservice at minimum travel and congestion cost. As a proxy for thiscriterion, total travel and waiting costs are minimized. The travel costis a general function of the origin and destination of the demand, whilethe congestion cost is a general function of the number of customers inqueue at the facilities.

The Handheld Library: Developments at the Rector Gabriel Ferraté Library, UPC

The purpose of this paper is to highlight the mobile services developed by the Rector Gabriel Ferraté Library (BRGF) of the Universitat Politècnica de Catalunya (UPC Barcelona Tech) in Barcelona, Spain.We hope this paper will be of use to other libraries exploring new technologies for communicating and delivering their services to users at a time when mobile services are an emerging topic in librarianship and information science literature. By setting out the successive steps involved in the as yet unfinished process of building our mobile services portfolio, we aim to offer a detailed picture of the mobile services and features offered by a university library from a case study perspective.The main topics to be discussed include:- The BRGF’s mobile website, including the information available, its interactivecapabilities and the services it provides to its users.- The mobile-friendly version of UPCommons (the UPC Library Service’s institutionalrepositories).- The UPC Library Service’s mobile OPAC.- The mobile version of u-win (BRGF’s videogame service).- The use of QR codes to deliver information to mobile devices.- Text message notifications.Additional topics for discussion include:- The library’s organisation and the organisational concepts that underpin andmake possible its technological developments (including mobile).- BRGF’s concern regarding the reduction of investment in the development of mobile services.- The criteria and tools used to guide the library’s decisions regarding thedesign and orientation of current and future mobile services.- How mobile services can help to improve the image of the library as a leadingtechnology site.- Selected mobile features that BRGF plans to offer in the near future.Ultimately, this paper aims to delineate the effectiveness and potential of deliveringlibrary services by the preferred means of communication of a new generation of studentsand teachers.