Cost efficiency in primary care contracting: A stochastic frontier cost function approach

The principal aim of this paper is to estimate a stochastic frontier costfunction and an inefficiency effects model in the analysis of the primaryhealth care services purchased by the public authority and supplied by 180providers in 1996 in Catalonia. The evidence from our sample does not supportthe premise that contracting out has helped improve purchasing costefficiency in primary care. Inefficient purchasing cost was observed in thecomponent of this purchasing cost explicitly included in the contract betweenpurchaser and provider. There are no observable incentives for thecontracted-out primary health care teams to minimise prescription costs, whichare not explicitly included in the present contracting system.

Overconfidence and market efficiency with heterogeneous agents

We study financial markets in which both rational and overconfident agents coexist and make endogenous information acquisition decisions. We demonstrate the following irrelevance result: when a positive fraction of rational agents (endogeneously) decides to become informed in equilibrium, prices are set as if all investors were rational, and as a consequence the overconfidence bias does not aect informational efficiency, price volatility, rational traders expected profits or their welfare. Intuitively, as overconfidence goes up, so does price infornativeness, which makes rational agents cut their information acquisition activities, effectively undoing the standard effect of more aggressive trading by the overconfident.

Expertise and finance: Mergers motivated by technological change

This paper argues that a large technological innovation may lead to a merger wave by inducing entrepreneurs to seek funds from technologically knowledgeable firms -experts. When a large technological innovation occurs, the ability of non-experts (banks) to discriminate between good and bad quality projects is reduced. Experts can continue to charge a low rate of interest for financing because their expertise enables them to identify good quality projects and to avoid unprofitable investments. On the other hand, non-experts now charge a higher rate of interest in order to screen bad projects. More entrepreneurs, therefore, disclose their projects to experts to raise funds from them. Such experts are, however, able to copy the projects and disclosure to them invites the possibility of competition. Thus the entrepreneur and the expert may merge so as to achieve product market collusion. As well as rationalizing mergers, the model can also explain various forms of venture financing by experts such as corporate investors and business angels.

Technological change and the wealth of nations

We discuss a unified theory of directed technological change and technologyadoption that can shed light on the causes of persistent productivity differencesacross countries. In our model, new technologies are designed in advanced countries and diffuse endogenously to less developed countries. Our framework is richenough to highlight three broad reasons for productivity differences: inappropriatetechnologies, policy-induced barriers to technology adoption, and within-countrymisallocations across sectors due to policy distortions. We also discuss the effectsof two aspects of globalization, trade in goods and migration, on the wealth ofnations through their impact on the direction of technical progress. By doing so,we illustrate some of the equalizing and unequalizing forces of globalization.

European research funding and regional technological capabilities: Network composition analysis

We use network and correspondence analysis to describe the compositionof the research networks in the European BRITE--EURAM program. Our mainfinding is that 27\% of the participants in this program fall into one oftwo sets of highly ``interconnected'' institutions --one centered aroundlarge firms (with smaller firms and research centers providing specializedservices), and the other around universities--. Moreover, these ``hubs''are composed largely of institutions coming from the technologically mostadvanced regions of Europe. This is suggestive of the difficulties of attainingEuropean ``cohesion'', as technically advanced institutions naturally linkwith partners of similar technological capabilities.

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.

Bargaining efficiency and screening: An experimental investigation

This paper investigates whether information about fairness types canbe useful in lowering dispute costs and enhancing bargaining efficiency.An experiment was conducted in which subjects were first screened usinga dictator game, with the allocations chosen used to separate participantsinto two types. Mutually anonymous pairs of subjects then bargained, witha dispute cost structure imposed. Sorting with identification reducesdispute costs; there are also significant differences in bargainingefficiency across pairing types. Information about types is crucial forthese differences and also strongly affects the relative bargainingsuccess of the two types and the hypothetical optimal bargaining strategy.

Pension plan funding and stock market efficiency

The paper argues that the market signifficantly overvalues firms with severely underfunded pension plans. These companies earn lower stock returns than firms with healthier pension plans for at least five years after the first emergence of the underfunding. The low returns are not explained by risk, price momentum, earnings momentum, or accruals. Further, the evidence suggests that investors do not anticipate the impact of the pension liability on future earnings, and they are surprised when the negative implications of underfunding ultimately materialize. Finally, underfunded firms have poor operating performance, and they earn low returns, although they are value companies.

The quasi-judicial role of large retailers: An efficiency hypothesis of their relation with suppliers

The paper explores an efficiency hypothesis regarding the contractual process between large retailers, such as Wal-Mart and Carrefour, and their suppliers. The empirical evidence presented supports the idea that large retailers play a quasi-judicial role, acting as "courts of first instance" in their relationships with suppliers. In this role, large retailers adjust the terms of trade to on-going changes and sanction performance failures, sometimes delaying payments. A potential abuse of their position is limited by the need for re-contracting and preserving their reputations. Suppliers renew their confidence in their retailers on a yearly basis, through writing new contracts. This renovation contradicts the alternative hypothesis that suppliers are expropriated by large retailers as a consequence of specific investments.

Eficiència energètica aplicada a les instal·lacions de la Universitat de Vic

En termes generals, es pot definir l’Eficiència Energètica com la reducció del consum d’energia mantenint els mateixos serveis energètics, sense disminuir el nostre confort i qualitat de vida, protegint el medi ambient, assegurant el proveïment i fomentant un comportament Sostenible al seu ús. L’objectiu principal d’aquest treball, és reduir el consum d’energia i terme de potència contractat a la Universitat de Vic, aplicant un programa d’estalvi amb mesures correctores en el funcionament de les seves instal·lacions o espais. Per tal de poder arribar a aquest objectiu marcat, prèviament s’ha realitzat un estudi acurat, obtenint tota la informació necessària per poder aplicar les mesures correctores a la bossa més important de consum. Un cop trobada, dur a terme l’estudi de la viabilitat de la inversió de les mesures correctores més eficients, optimitzant els recursos destinats. L’espai on s’ha dut a terme l’estudi, ha estat a l’edifici F del Campus Miramarges, seguint les indicacions d’Arnau Bardolet (Cap de Manteniment de la UVIC). Aquest edifici consta d’un entresol, baixos i quatre plantes. L’equip de mesura que s’ha fet servir per realitzar l’estudi, és de la marca Circutor sèrie AR5-L, aquests equips són programables que mesuren, calculen i emmagatzemen en memòria els principals paràmetres elèctrics en xarxes trifàsiques. Els projectes futurs complementaris que es podrien realitzar a part d’aquest són: instal·lar sensors, instal·lar mòduls convertidors TCP/IP, aprofitar la xarxa intranet i crear un escada amb un sinòptic de control i gestió des d’un punt de treball. Aquest aplicatiu permet visualitzar en una pantalla d’un PC tots els estats dels elements controlats mitjançant un sinòptic (encendre/parar manualment l’enllumenat i endolls de les aules, estat d’enllumenat i endolls de les aules, consums instantanis/acumulats energètics, estat dels passadissos entre altres) i explotar les dades recollides a la base de dades. Cada espai tindria la seva lògica de funcionament automàtic específic. Entre les conclusions més rellevants obtingudes en aquest treball s’observa: · Que és pot reduir la potència contractada a la factura a l’estar per sota de la realment consumida. · Que no hi ha penalitzacions a la factura per consum de reactiva, ja que el compensador funciona correctament. · Que es pot reduir l’horari de l’inici del consum d’energia, ja que no correspon a l’activitat docent. · Els valors de la tensió i freqüència estan dintre de la normalitat. · Els harmònics estan al llindar màxim. Analitzant aquestes conclusions, voldria destacar les mesures correctores més importants que es poden dur a terme: canvi tecnològic a LED, temporitzar automàticament l’encesa i apagada dels fluorescents i equips informàtics de les aules “seguint calendari docent”, instal·lar sensors de moviment amb detecció lumínica als passadissos. Totes les conclusions extretes d’aquest treball, es poden aplicar a tots els edificis de la facultat, prèviament realitzant l’estudi individual de cadascuna, seguint els mateixos criteris per tal d’optimitzar la inversió.

A reflection about the social and technological aspects in flood risk management - the case of the Italian Civil Protection

The right of a person to be protected from natural hazards is a characteristic of the social and economical development of the society. This paper is a contribution to the reflection about the role of Civil Protection organizations in a modern society. The paper is based in the inaugural conference made by the authors on the 9th Plinius Conference on Mediterranean Storms. Two major issues are considered. The first one is sociological; the Civil Protection organizations and the responsible administration of the land use planning should be perceived as reliable as possible, in order to get consensus on the restrictions they pose, temporary or definitely, on the individual free use of the territory as well as in the entire warning system. The second one is technological: in order to be reliable they have to issue timely alert and warning to the population at large, but such alarms should be as "true" as possible. With this aim, the paper summarizes the historical evolution of the risk assessment, starting from the original concept of "hazard", introducing the concepts of "scenario of event" and "scenario of risk" and ending with a discussion about the uncertainties and limits of the most advanced and efficient tools to predict, to forecast and to observe the ground effects affecting people and their properties. The discussion is centred in the case of heavy rains and flood events in the North-West of Mediterranean Region.

Complementarity between human capital and trade in regional technological progress

The effect of openness and trade orientation on economic growth remains a highly contentious issue in the literature. Trade facilitates the spread of knowledge and the adoption of more advanced and efficient technologies, which hastens total factor productivity (TFP) growth and, hence, per capita income. New technologies that spread through trade require a sufficiently skilled labour force to adapt them to the domestic productive environment. Thus, openness and human capital accumulation will lead to TFP growth and the greater the complementarity between both variables, the higher the TFP growth. This paper discusses the implications of these assumptions and tests their empirical validity, using a pool of data for manufacturing industry in Spanish regions in a period in which both the stock of human capital and openness experienced a notable increase.

Citizens' control and the efficiency of local public services

Està àmpliament acceptat que la descentralització fiscal incrementa el control dels ciutadans sobre els polítics, fomenta el rendiment de comptes i augmenta l¿eficiència. Aquest treball té per objectiu identificar les característiques socio-econòmiques dels ciutadans (votants potencials) que generen un major control sobre els responsables polítics locals provocant, així, un major nivell d'eficiència en un context descentralitzat.També s'analitzen les característiques fiscals dels governs locals que fomenten aquest control i eficiència. L'estudi s'ha aplicat a una mostra de municipis catalans seguint la metodologia convencional basada en l'estimació en dues etapes. A la primera etapa s'estima l'eficiència en que operen els municipis mitjançant la tècnica DEA. La novetat rau en el càlcul d'una nova versió d'indicador global d¿output municipal. En la segona etapa, a través d¿una estimació tipus Tobit (models censurats) i de mètodes bootstrap, es mostra com els factors abans comentats poden influir sobre l¿eficiència. Els resultats suggereixen que la forta presencia de comerciants, jubilats i persones amb dret a vot afavoreixen el control dels ciutadans, el rendiment de comptes i l¿eficiència. Un factor que facilita aquest control, i per tant una major eficiència, és la presència de baixos costos d'oportunitat d'obtenir informació sobre la gestió local dels serveis públics.

Measuring the efficiency in Spanish municipal refuse collection services

The objective of this study is to analyse the technical or productive efficiency ofthe refuse collection services in 75 municipalities located in the Spanish regionof Catalonia. The analysis has been carried out using various techniques. Firstly we have calculated a deterministic parametric frontier, then a stochastic parametric frontier, and finally, various non-parametric approaches (DEA and FDH). Concerning the results, these naturally differ according to the technique used to approach the frontier. Nevertheless, they have an appearance of solidity, at least with regard to the ordinal concordance among the indices of efficiency obtained by the different approaches, as is demonstrated by the statistical tests used. Finally, we have attempted to search for any relation existing between efficiency and the method (public or private) of managing the services. No significant relation was found between the type of management and efficiencyindices

Thermal modeling and management in ultrathin chip stack technology

This paper presents a thermal modeling for power management of a new three-dimensional (3-D) thinned dies stacking process. Besides the high concentration of power dissipating sources, which is the direct consequence of the very interesting integration efficiency increase, this new ultra-compact packaging technology can suffer of the poor thermal conductivity (about 700 times smaller than silicon one) of the benzocyclobutene (BCB) used as both adhesive and planarization layers in each level of the stack. Thermal simulation was conducted using three-dimensional (3-D) FEM tool to analyze the specific behaviors in such stacked structure and to optimize the design rules. This study first describes the heat transfer limitation through the vertical path by examining particularly the case of the high dissipating sources under small area. First results of characterization in transient regime by means of dedicated test device mounted in single level structure are presented. For the design optimization, the thermal draining capabilities of a copper grid or full copper plate embedded in the intermediate layer of stacked structure are evaluated as a function of the technological parameters and the physical properties. It is shown an interest for the transverse heat extraction under the buffer devices dissipating most the power and generally localized in the peripheral zone, and for the temperature uniformization, by heat spreading mechanism, in the localized regions where the attachment of the thin die is altered. Finally, all conclusions of this analysis are used for the quantitative projections of the thermal performance of a first demonstrator based on a three-levels stacking structure for space application.