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.

Theoretic analysis of IEEE 802.11 rate adaptation algorithm SampleRate

In this paper we investigate rate adaptation algorithm SampleRate, which spends a fixed time on bit-rates other than the currently measured best bit-rate. A simple but effective analytic model is proposed to study the steady-state behavior of the algorithm. Impacts of link condition, channel congestion and multi-rate retry on the algorithm performance are modeled. Simulations validate the model. It is also observed there is still a large performance gap between SampleRate and optimal scheme in case of high frame collision probability.

Balancing expectations in engineering education:enhancing student experiences through empirical research - a comparative analysis

This paper draws upon the findings of an empirical study comparing the expectations and concerns of engineering students with students enrolled on business and management programs. It argues that whilst the two groups of students have very similar expectations, motivations and concerns before their start their studies, once at university, engineering students are twice as likely to drop-out than are their compatriots in business studies. Drawing upon the study findings, recommendations are made as to what might be done to counteract this. The conclusion argues that there is a need for more in-depth research to be conducted in this area in order to identify the reasons behind the different attrition rates and to further enhance engineering undergraduate experience.

Performance analysis of ONOE protocol - an IEEE 802.11 link adaptation algorithm

Link adaptation (LA) plays an important role in adapting an IEEE 802.11 network to wireless link conditions and maximizing its capacity. However, there is a lack of theoretic analysis of IEEE 802.11 LA algorithms. In this article, we propose a Markov chain model for an 802.11 LA algorithm (ONOE algorithm), aiming to identify the problems and finding the space of improvement for LA algorithms. We systematically model the impacts of frame corruption and collision on IEEE 802.11 network performance. The proposed analytic model was verified by computer simulations. With the analytic model, it can be observed that ONOE algorithm performance is highly dependent on the initial bit rate and parameter configurations. The algorithm may perform badly even under light channel congestion, and thus, ONOE algorithm parameters should be configured carefully to ensure a satisfactory system performance. Copyright © 2011 John Wiley & Sons, Ltd.

Design and analysis of distributed utility maximization algorithm for multihop wireless network with inaccurate feedback

Distributed network utility maximization (NUM) is receiving increasing interests for cross-layer optimization problems in multihop wireless networks. Traditional distributed NUM algorithms rely heavily on feedback information between different network elements, such as traffic sources and routers. Because of the distinct features of multihop wireless networks such as time-varying channels and dynamic network topology, the feedback information is usually inaccurate, which represents as a major obstacle for distributed NUM application to wireless networks. The questions to be answered include if distributed NUM algorithm can converge with inaccurate feedback and how to design effective distributed NUM algorithm for wireless networks. In this paper, we first use the infinitesimal perturbation analysis technique to provide an unbiased gradient estimation on the aggregate rate of traffic sources at the routers based on locally available information. On the basis of that, we propose a stochastic approximation algorithm to solve the distributed NUM problem with inaccurate feedback. We then prove that the proposed algorithm can converge to the optimum solution of distributed NUM with perfect feedback under certain conditions. The proposed algorithm is applied to the joint rate and media access control problem for wireless networks. Numerical results demonstrate the convergence of the proposed algorithm. © 2013 John Wiley & Sons, Ltd.

IT as enabler of sustainable farming:an empirical analysis of farmers' adoption decision of precision agriculture technology

Precision agriculture (PA) describes a suite of IT based tools which allow farmers to electronically monitor soil and crop conditions and analyze treatment options. This study tests a model explaining the difficulties of PA technology adoption. The model draws on theories of technology acceptance and diffusion of innovation and is validated using survey data from farms in Canada. Findings highlight the importance of compatibility among PA technology components and the crucial role of farmers' expertise. The model provides the theoretical and empirical basis for developing policies and initiatives to support PA technology adoption.

Regional competitiveness:theories and methodologies for empirical analysis

A significant forum of scholarly and practitioner-based research has developed in recent years that has sought both to theorize upon and empirically measure the competitiveness of regions. However, the disparate and fragmented nature of this work has led to the lack of a substantive theoretical foundation underpinning the various analyses and measurement methodologies employed. The aim of this paper is to place the regional competitiveness discourse within the context of theories of economic growth, and more particularly, those concerning regional economic growth. It is argued that regional competitiveness models are usually implicitly constructed in the lineage of endogenous growth frameworks, whereby deliberate investments in factors such as human capital and knowledge are considered to be key drivers of growth differentials. This leads to the suggestion that regional competitiveness can be usefully defined as the capacity and capability of regions to achieve economic growth relative to other regions at a similar overall stage of economic development, which will usually be within their own nation or continental bloc. The paper further assesses future avenues for theoretical and methodological exploration, highlighting the role of institutions, resilience and, well-being in understanding how the competitiveness of regions influences their long-term evolution.

Design and analysis of distributed utility maximization algorithm for multihop wireless network with inaccurate feedback

Distributed network utility maximization (NUM) is receiving increasing interests for cross-layer optimization problems in multihop wireless networks. Traditional distributed NUM algorithms rely heavily on feedback information between different network elements, such as traffic sources and routers. Because of the distinct features of multihop wireless networks such as time-varying channels and dynamic network topology, the feedback information is usually inaccurate, which represents as a major obstacle for distributed NUM application to wireless networks. The questions to be answered include if distributed NUM algorithm can converge with inaccurate feedback and how to design effective distributed NUM algorithm for wireless networks. In this paper, we first use the infinitesimal perturbation analysis technique to provide an unbiased gradient estimation on the aggregate rate of traffic sources at the routers based on locally available information. On the basis of that, we propose a stochastic approximation algorithm to solve the distributed NUM problem with inaccurate feedback. We then prove that the proposed algorithm can converge to the optimum solution of distributed NUM with perfect feedback under certain conditions. The proposed algorithm is applied to the joint rate and media access control problem for wireless networks. Numerical results demonstrate the convergence of the proposed algorithm. © 2013 John Wiley & Sons, Ltd.

Market value, R&D and intellectual property:an empirical analysis of large Australian firms

This paper considers the value of innovation to large Australian firms. Specifically, we investigate how R&D and intellectual property activity influences the market value of firms, using a Tobin’s q approach. R&D data are available for the period 1994–96 and data on patent, trade mark and design applications for 1996. The findings suggest that R&D and patent activity are positively and significantly associated with market value. The results also suggest that private returns to R&D in Australia are low by international standards.

Az ellátási lánc disztribúció oldalának menedzsment eszközei – empirikus elemzés = Management tools of the demand chain – an empirical analysis

A tanulmány célja, hogy bemutassa a Magyarországon működő vállalatok gyakorlatát az ellátási lánc disztribúció oldalának menedzsmentje területén egy empirikus kutatás eredményeinek segítségével. A dolgozat két részből épül fel. Az első részben egy elméleti áttekintés olvasható azokról a menedzsment eszközökről, amelyeket a vállalatok disztribúciós folyamataik során alkalmazhatnak az ellátási láncban. A második rész az empirikus kutatás eredményeit mutatja be. A felmérés során 92 vállalat (amelyből az elemzésbe 79 volt ténylegesen bevonható) vett részt, és válaszaik és a statisztikai elemzés alapján kirajzolódik egy kép, hogy milyen mértékben alkalmazzák a disztribúciós lánc menedzsment eszközeit, valamint milyen fejlettségi szintek különböztethetők meg az alkalmazás volumene alapján. = Aim of the paper is to present the operational practice of Hungarian companies in managing the distribution side of the supply chain (the demand chain), with the help of the results of an empirical research. The paper consists of two parts. In the first part, a literature review is presented about the management tools which companies may use while managing their distribution processes in the supply chain. In the second part I introduce the results of the empirical research. The survey was participated by 92 companies (of which 79 could be analysed) and according to their responses and the statistical analyses, a picture was formulated about how intensely they use the demand chain management tools, how developed they are in the application of those.

Sales tax enforcement: An empirical analysis of compliance enforcement methodologies and pathologies

Most research on tax evasion has focused on the income tax. Sales tax evasion has been largely ignored and dismissed as immaterial. This paper explored the differences between income tax and sales tax evasion and demonstrated that sales tax enforcement is deserving of and requires the use of different tools to achieve compliance. Specifically, the major enforcement problem with sales tax is not evasion: it is theft perpetrated by companies that act as collection agents for the state. Companies engage in a principal-agent relationship with the state and many retain funds collected as an agent of the state for private use. As such, the act of sales tax theft bears more resemblance to embezzlement than to income tax evasion. It has long been assumed that the sales tax is nearly evasion free, and state revenue departments report voluntary compliance in a manner that perpetuates this myth. Current sales tax compliance enforcement methodologies are similar in form to income tax compliance enforcement methodologies and are based largely on trust. The primary focus is on delinquent filers with a very small percentage of businesses subject to audit. As a result, there is a very large group of noncompliant businesses who file on time and fly below the radar while stealing millions of taxpayer dollars. ^ The author utilized a variety of statistical methods with actual field data derived from operations of the Southern Region Criminal Investigations Unit of the Florida Department of Revenue to evaluate current and proposed sales tax compliance enforcement methodologies in a quasi-experimental, time series research design and to set forth a typology of sales tax evaders. This study showed that current estimates of voluntary compliance in sales tax systems are seriously and significantly overstated and that current enforcement methodologies are inadequate to identify the majority of violators and enforce compliance. Sales tax evasion is modeled using the theory of planned behavior and Cressey’s fraud triangle and it is demonstrated that proactive enforcement activities, characterized by substantial contact with non-delinquent taxpayers, results in superior ability to identify noncompliance and provides a structure through which noncompliant businesses can be rehabilitated.^

Does management capacity increase organizational performance? An empirical analysis of public housing agencies

Since the 1990s, scholars have paid special attention to public management’s role in theory and research under the assumption that effective management is one of the primary means for achieving superior performance. To some extent, this was influenced by popular business writings of the 1980s as well as the reinventing literature of the 1990s. A number of case studies but limited quantitative research papers have been published showing that management matters in the performance of public organizations. ^ My study examined whether or not management capacity increased organizational performance using quantitative techniques. The specific research problem analyzed was whether significant differences existed between high and average performing public housing agencies on select criteria identified in the Government Performance Project (GPP) management capacity model, and whether this model could predict outcome performance measures in a statistically significant manner, while controlling for exogenous influences. My model included two of four GPP management subsystems (human resources and information technology), integration and alignment of subsystems, and an overall managing for results framework. It also included environmental and client control variables that were hypothesized to affect performance independent of management action. ^ Descriptive results of survey responses showed high performing agencies with better scores on most high performance dimensions of individual criteria, suggesting support for the model; however, quantitative analysis found limited statistically significant differences between high and average performers and limited predictive power of the model. My analysis led to the following major conclusions: past performance was the strongest predictor of present performance; high unionization hurt performance; and budget related criterion mattered more for high performance than other model factors. As to the specific research question, management capacity may be necessary but it is not sufficient to increase performance. ^ The research suggested managers may benefit by implementing best practices identified through the GPP model. The usefulness of the model could be improved by adding direct service delivery to the model, which may also improve its predictive power. Finally, there are abundant tested concepts and tools designed to improve system performance that are available for practitioners designed to improve management subsystem support of direct service delivery.^