Is there a trade-off between quality and productivity? The case of diagnostic technologies in Portugal

The purpose of this paper is twofold: first, we compute quality-adjusted measures of productivity change for the three most important diagnostic technologies (i.e., the Computerised Tomography Scan, Electrocardiogram and Echocardiogram) in the major Portuguese hospitals. We use the Malmquist–Luenberger index, which allows to measure productivity growth while controlling for the quality of the production. Second, using non-parametric tests, we analyse whether the implementation of the Prospective Payment System may have had a positive impact on the movements of productivity over time. The results show that the PPS has helped hospitals to use these tools more efficiently and to improve their effectiveness.

Factors affecting e-payment adoption in Nigeria

The payment system of a country plays a crucial role in its economy; however, despite the benefits of e-Payment and efforts by financial authorities, Nigeria still has a low e-Payment adoption rate. In this regard, there is an urgent need to investigate the factors that affect individuals’ intention to adopt e-Payment. Drawing on the unified theory of acceptance and use of technology (UTAUT) model, this paper develops a theoretical model for e-Payment adoption in Nigeria. Additionally, a survey was conducted on 500 respondents with 213 complete responses received to test the model, and results show that perceived benefits, effort expectancy, social influence, trust, awareness, and demographic variables affected individuals’ intention to adopt e-Payments. Based on the findings, managerial and theoretical implications are deliberated.

Factors affecting e-payment adoption in Nigeria

For e-commerce to be successful, an efficient e-payment system is the key. The use of formal payment systems also enhances the ability to execute and manage monetary policies, which is essential for a country’s financial sector. Although Nigeria is a regional leader, the usage of e-Payments is still very low despite its many benefits and also attempts by the financial authorities. This therefore calls for an urgent need to investigate the factors that affect individual’s intention to adopt e-payment in Nigeria so that steps can be fashioned out to improve the situation. A survey was conducted to get individual perceptions of e-payments through the use of questionnaires designed based on the theoretical model developed. The results showed that awareness, knowledge of benefits, ease of use, reliability, trust and security, acceptability, accessibility and social influence are the main factors that influence individuals’ intention to adopt e-payments.

Has DRG payment influenced the technical efficiency and productivity of diagnostic technologies in Portuguese public hospitals? An empirical analysis using parametric and non‐parametric methods

The use of Diagnosis Related Groups (DRG) as a mechanism for hospital financing is a currently debated topic in Portugal. The DRG system was scheduled to be initiated by the Health Ministry of Portugal on January 1, 1990 as an instrument for the allocation of public hospital budgets funded by the National Health Service (NHS), and as a method of payment for other third party payers (e.g., Public Employees (ADSE), private insurers, etc.). Based on experience from other countries such as the United States, it was expected that implementation of this system would result in more efficient hospital resource utilisation and a more equitable distribution of hospital budgets. However, in order to minimise the potentially adverse financial impact on hospitals, the Portuguese Health Ministry decided to gradually phase in the use of the DRG system for budget allocation by using blended hospitalspecific and national DRG casemix rates. Since implementation in 1990, the percentage of each hospitals budget based on hospital specific costs was to decrease, while the percentage based on DRG casemix was to increase. This was scheduled to continue until 1995 when the plan called for allocating yearly budgets on a 50% national and 50% hospitalspecific cost basis. While all other nonNHS third party payers are currently paying based on DRGs, the adoption of DRG casemix as a National Health Service budget setting tool has been slower than anticipated. There is now some argument in both the political and academic communities as to the appropriateness of DRGs as a budget setting criterion as well as to their impact on hospital efficiency in Portugal. This paper uses a twostage procedure to assess the impact of actual DRG payment on the productivity (through its components, i.e., technological change and technical efficiency change) of diagnostic technology in Portuguese hospitals during the years 1992–1994, using both parametric and nonparametric frontier models. We find evidence that the DRG payment system does appear to have had a positive impact on productivity and technical efficiency of some commonly employed diagnostic technologies in Portugal during this time span.

Herman Chinery-Hesse:the Bill Gates of Ghana?

Herman Chinery-Hesse considers his plans for a new venture, a virtual mall that would enable African producers to sell their products worldwide through a new international payment system based on mobile phones and pre-paid scratch cards. In 2010, his operating company, Black Star Lines (BSL) Ghana Ltd is considering plans to launch shopAfrica53.com, and associated payment and distribution services in Ghana and the UK. This case teaches new approaches to poverty reduction through the realisation of entrepreneurial opportunities at the Bottom of the Pyramid (BoP) and is suitable for courses on social enterprise, entrepreneurship in general, and development studies seeking to incorporate more private sector approaches. It can also be adapted for courses such as international strategy or technology business.

First-line therapy with latanoprost 0.005% results in improved ocular circulation in newly diagnosed primary open-angle glaucoma patients: a prospective, 6-month, open-label study

Purpose To evaluate the effect of latanoprost 0.005% on the optic nerve head (ONH) and retinal circulation of newly diagnosed and previously untreated primary open-angle glaucoma (POAG) patients. Methods Twenty-two newly diagnosed and previously untreated POAG patients (mean age±SD: 68.38±11.92 years) were included in this longitudinal open-label study. Patients were treated with latanoprost 0.005% once a day. Intraocular pressure (IOP), systemic blood pressure (BP), mean ocular perfusion pressure (MOPP), and ocular perfusion parameters ‘volume’, ‘velocity’, and ‘flow’ measured at the optic nerve head (ONH) and retina by means of Heidelberg Retina Flowmeter system were evaluated during a 6-month follow-up period. Results Treatment with latanoprost 0.005% resulted in a significant decrease in IOP (P<0.0001) and increase in MOPP (P<0.0001). After correcting for changes in MOPP, the blood velocity measured at the ONH level was significantly higher after 6 months of treatment than at baseline (P=0.0310). In addition, blood volume and flow measured at the peripapillary retina level improved after 3 and 6 months of treatment (P=0.0170; P=0.0260, and P=0.0170; P=0.0240 respectively). Conclusion Previously untreated POAG patients exhibit reduced IOP, increased MOPP and improved ocular perfusion at the ONH and retina levels when treated with Latanoprost 0.005%. These effects could be beneficial for glaucoma patients suffering from ocular vascular dysregulation.