Helyhez kötött kapcsolatok. Egy társadalmi kapcsolathálókon alapuló magyarázat a földrajzi munkamegosztás kialakulására = Ties of locality. An explanation of the development of the geographical division of labour based on social networks

A „földrajzi munkamegosztás” vagy „elhelyezkedés probléma” arra a kérdésre utal, miért alakulnak ki egy-egy gazdasági tevékenységre szakosodott földrajzi egységek, regionális gazdasági rendszerek. A hagyományos közgazdasági megközelítések a területek racionálisan kalkulálható komparatív előnyeit, a nyersanyagok vagy a piac közelségét, infrastrukturális adottságokat, útfüggőséget stb. szokták hangsúlyozni. A tanulmány szerzője a társadalmi kapcsolatok jelentőségét emeli ki, azt sugallja, hogy a területi specializálódás az egymással kapcsolatban álló, hasonlóan specializálódott többi szereplő nyomására alakul ki. A hipotézist két külföldön végzett eset tanulmány tapasztalatai alapján járja körül. ______________________ The question of "regional economic systems", "geographical division of labour" or "location problem" has an important literature. Economic approaches emphasize the rationally calculated advantages of the specialized industrial areas: the benefit of the exploitation of discovered resources, more cooperative relations, etc. The paper stresses the role of social networks in the location problem: economically specialized areas formed because of the suggestions and tips of connected enterprises, cooperative partners. The hypothesis is based on the experiences of two case studies, made in a Peruvian rural area and a Mexican modern industrial area.

Properties of risk capital allocation methods: Core Compatibility, Equal Treatment Property and Strong Monotonicity

In finance risk capital allocation raises important questions both from theoretical and practical points of view. How to share risk of a portfolio among its subportfolios? How to reserve capital in order to hedge existing risk and how to assign this to different business units? We use an axiomatic approach to examine risk capital allocation, that is we call for fundamental properties of the methods. Our starting point is Csóka and Pintér (2011) who show by generalizing Young (1985)'s axiomatization of the Shapley value that the requirements of Core Compatibility, Equal Treatment Property and Strong Monotonicity are irreconcilable given that risk is quantified by a coherent measure of risk. In this paper we look at these requirements using analytic and simulations tools. We examine allocation methods used in practice and also ones which are theoretically interesting. Our main result is that the problem raised by Csóka and Pintér (2011) is indeed relevant in practical applications, that is it is not only a theoretical problem. We also believe that through the characterizations of the examined methods our paper can serve as a useful guide for practitioners.

Formal professional relationships between general practitioners and specialists: possible associations with patient health and pharmacy costs

This article investigates whether the strength of formal professional relationships between general practitioners (GPs) and specialists (SPs) affects either the health status of patients or their pharmacy costs. To this end, it measures the strength of formal professional relationships between GPs and SPs through the number of shared patients and proxies the patient health status by the number of comorbidities diagnosed and treated. In strong GP–SP relationships, the patient health status is expected to be high, due to efficient care coordination, and the pharmacy costs low, due to effective use of resources. To test these hypotheses and compare the characteristics of the strongest GP–SP connections with those of the weakest, this article concentrates on diabetes—a chronic condition where patient care coordination is likely important. Diabetes generates the largest shared patient cohort in Hungary, with the highest traffic of specialist medication prescriptions. This article finds that stronger ties result in lower pharmacy costs, but not in higher patient health statuses. Key points for decision makers • The number of shared patients may be used to measure the strength of formal professional relationships between general practitioners and specialists. • A large number of shared patients indicates a strong, collaborative tie between general practitioners and specialists, whereas a low number indicates a weak, fragmented tie. • Tie strength does not affect patient health—strong, collaborative ties between general practitioners and specialists do not involve better patient health than weak, fragmented ties. • Tie strength does affect pharmacy costs—strong, collaborative ties between general practitioners and specialists involve significantly lower pharmacy costs than weak, fragmented ties. • Pharmacy costs may be reduced by lowering patient care fragmentation through channelling a general practitioner’s patients to a small number of specialists and increasing collaboration between general practitioner and specialists. • Limited patient choice is financially more beneficial than complete freedom of choice, and no more detrimental to patient health.

A gyógyszerkiadás és a betegek egészségi állapota a háziorvosi és szakorvosi kapcsolatok függvényében = Formal professional relations between general practitioners and specialists. Possible links with patient health and pharmacy cost

Arra a kérdésre keressük a választ, hogy a szoros háziorvosi-szakorvosi szakmai kapcsolatoknak van-e hatásuk a betegek gyógyszerkiadására, illetve egészségi állapotára. Az orvosok közötti szakmai kapcsolatok szorosságát a közösen gondozott betegek száma alapján határoztuk meg, míg a betegek egészségügyi állapotát a diagnosztizált és kezelt társbetegségek számával mértük. Hipotézisünk egyrészt az volt, hogy a hatékonyabb koordinációnak köszönhetően a szoros kapcsolatban kezelt betegek jobb egészségi állapotúak, másrészt kezelésük az erőforrások hatékonyabb felhasználása miatt kisebb gyógyszerköltséggel jár. E két hipotézist a cukorbetegekre teszteltük. Azért esett erre a krónikus betegségre a választásunk, mert itt a háziorvosok és a szakorvosok együttműködése elsődleges fontosságú. Magyarországon a cukorbetegek esetében a legnagyobb a közösen kezelt betegek populációja, valamint itt a legmagasabb a szakorvosi javaslatra felírt háziorvosi receptek száma. Azt az eredményt kaptuk, hogy a szoros kapcsolatban kezelt betegek nem rendelkeznek sem jobb, sem rosszabb egészségi állapottal, miközben a kapcsolódó gyógyszerkiadásuk szignifikánsan alacsonyabb. ____ The article considers whether strong formal professional relations between GPs and specialists in shared care affect either the health of patients or the pharmacy costs they incur. The strength of such relations is measured by the number of shared patients; patient health is proxied by number of co-morbidities diagnosed and treated. The first hypothesis is that patients treated amid strong GP-specialist relations have better health status than those treated amid weak ones, due to enhanced efficiency of care coordination. The second is that patients treated in such strong relations incur lower pharmacy costs high numbers of shared patients are assumed to promote appropriate, effective use of resources. The article tests these hypotheses and compares the outcomes of the strongest and weakest GP-specialist relations through the example of diabetes, a chronic condition where patient-care coordination is important. Diabetes generates the largest shared patient cohort in Hungary, with the highest number of specialist medication prescriptions. This article finds that stronger ties result in significantly lower pharmacy costs, but not a higher patient health status.