942 resultados para direct healthcare cost
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This paper examines the extent to which foreign direct investment (FDI) in selected UK manufacturing sectors has an impact on reported profits in domestic firms. Foreign manufacturing firms are characterized by relatively high labour productivity and low wage shares. Entry by foreign firms not only impacts on domestic market shares, but also on domestic cost conditions. As a result, profitability in the indigenous sector may be reduced. There are a number of policy implications of this analysis which are explored.
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This article examines variations in local input linkages in foreign transnational corporations in Malaysia. The extent to which transnational corporations foster such linkages, particularly in a developing host economy, has become an important issue for policy makers and others concerned with the long-term benefits associated with foreign direct investment. This article employs a unique data set, covering inward investors in the electrical and electronics industry, and analyzes in detail the determinants of variations in local input uses. The article develops a model of local input linkages, based on a transaction-cost framework using firm-specific factors, such as nationality of ownership, the age of the plant and its technology, and the extent to which firms employ locally recruited managers and engineers. In addition, the impacts of various policy measures on local input levels are discussed, and also the importance of the original motivation for investing in Malaysia. The article demonstrates that policy initiatives that target particular outcomes, such as stimulating exports or technology transfer, will result in a greater beneficial impact on the host country economy than more generic subsidies.
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This paper revisits the issue of intra-industry foreign direct investment (FDI). This issue was considered in Stephen Hymer's early work, but was not subsequently developed, and was largely ignored in the literature for some time. Using the example of the UK, this paper traces the patterns of intra-industry FDI, both across countries and industries, for both the manufacturing and service sectors. Despite the undoubted increase in the integration of goods and factor markets since the time of Hymer's writing, the analysis presented here shows that the pattern has changed little in the last 40 years. The paper then goes on to discuss the motives for intra-industry FDI, relating it to technology flows and factor cost differentials. Finally, we present some analysis relating intra-industry FDI to uneven development, both between developed and developing countries, and between regions of a developed country. It is clear that intra-industry FDI is still very much a developed country phenomenon, as Hymer suggested, with both developing countries and poorer regions of developed countries unlikely to reap any of the benefits. In this context, one-way and two-way FDI must be seen as different phenomena within the debate on globalisation. © The Author 2005. Published by Oxford University Press on behalf of the Cambridge Political Economy Society. All rights reserved.
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In Great Britain and Brazil healthcare is free at the point of delivery and based study only on citizenship. However, the British NHS is fifty-five years old and has undergone extensive reforms. The Brazilian SUS is barely fifteen years old. This research investigated the middle management mediation role within hospitals comparing managerial planning and control using cost information in Great Britain and Brazil. This investigation was conducted in two stages entailing quantitative and qualitative techniques. The first stage was a survey involving managers of 26 NHS Trusts in Great Britain and 22 public hospitals in Brazil. The second stage consisted of interviews, 10 in Great Britain and 22 in Brazil, conducted in four selected hospitals, two in each country. This research builds on the literature by investigating the interaction of contingency theory and modes of governance in a cross-national study in terms of public hospitals. It further builds on the existing literature by measuring managerial dimensions related to cost information usefulness. The project unveils the practice involved in planning and control processes. It highlights important elements such as the use of predictive models and uncertainty reduction when planning. It uncovers the different mechanisms employed on control processes. It also depicts that planning and control within British hospitals are structured procedures and guided by overall goals. In contrast, planning and control processes in Brazilian hospitals are accidental, involving more ad hoc actions and a profusion of goals. The clinicians in British hospitals have been integrated into the management hierarchy. Their use of cost information in planning and control processes reflects this integration. However, in Brazil, clinicians have been shown to operate more independently and make little use of cost information but the potential signalled for cost information use is seen to be even greater than that of their British counterparts.
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Since 1988, quasi-markets have been introduced into many areas of social policy in the UK, the NHS internal market is one example. Markets operate by price signals. The NHS Internal Market, if it is to operate efficiently, requires purchasers and providers to respond to price signals. The research hypothesis is - cost accounting methods can be developed to enable healthcare contracts to be priced on a cost-basis in a manner which will facilitate the achievement of economic efficiency in the NHS internal market. Surveys of hospitals in 1991 and 1994 established the cost methods adopted in deriving the prices for healthcare contracts in the first year of the market and three years on. An in-depth view of the costing for pricing process was gained through case studies. Hospitals had inadequate cost information on which to price healthcare contracts at the inception of the internal market: prices did not reflect the relative performance of healthcare providers sufficiently closely to enable the market's espoused efficiency aims to be achieved. Price variations were often due to differing costing approaches rather than efficiency. Furthermore, price comparisons were often meaningless because of inadequate definition of the services (products). In April 1993, the NHS Executive issued guidance on costing for contracting to all NHS providers in an attempt to improve the validity of price comparisons between alternative providers. The case studies and the 1994 survey show that although price comparison has improved, considerable problems remain. Consistency is not assured, and the problem of adequate product definition is still to be solved. Moreover, the case studies clearly highlight the mismatch of rigid, full-cost pricing rules with both the financial management considerations at local level and the emerging internal market(s). Incentives exist to cost-shift, and healthcare prices can easily be manipulated. In the search for a new health policy paradigm to replace traditional bureaucratic provision, cost-based pricing cannot be used to ensure a more efficient allocation of healthcare resources.
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Healthcare providers and policy makers are faced with an ever-increasing number of medical publications. Searching for relevant information and keeping up to date with new research findings remains a constant challenge. It has been widely acknowledged that narrative reviews of the literature are susceptible to several types of bias and a systematic approach may protect against these biases. The aim of this thesis was to apply quantitative methods in the assessment of outcomes of topical therapies for psoriasis. In particular, to systematically examine the comparative efficacy, tolerability and cost-effectiveness of topical calcipotriol in the treatment of mild-to-moderate psoriasis. Over the years, a wide range of techniques have been used to evaluate the severity of psoriasis and the outcomes from treatment. This lack of standardisation complicates the direct comparison of results and ultimately the pooling of outcomes from different clinical trials. There is a clear requirement for more comprehensive tools for measuring drug efficacy and disease severity in psoriasis. Ideally, the outcome measures need to be simple, relevant, practical, and widely applicable, and the instruments should be reliable, valid and responsive. The results of the meta-analysis reported herein show that calcipotriol is an effective antipsoriatic agent. In the short-tenn, the pooled data found calcipotriol to be more effective than calcitriol, tacalcitol, coal tar and short-contact dithranol. Only potent corticosteroids appeared to have comparable efficacy, with less short-term side-effects. Potent corticosteroids also added to the antipsoriatic effect of calcipotriol, and appeared to suppress the occurrence of calcipotriol-induced irritation. There was insufficient evidence to support any large effects in favour of improvements in efficacy when calcipotriol is used in combination with systemic therapies in patients with severe psoriasis. However, there was a total absence of long-term morbidity data on the effectiveness of any of the interventions studied. Decision analysis showed that, from the perspective of the NHS as payer, the relatively small differences in efficacy between calcipotriol and short-contact dithranol lead to large differences in the direct cost of treating patients with mildto-moderate plaque psoriasis. Further research is needed to examine the clinical and economic issues affecting patients under treatment for psoriasis in the UK. In particular, the maintenance value and cost/benefit ratio for the various treatment strategies, and the assessment of patient's preferences has not yet been adequately addressed for this chronic recurring disease.
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This research develops a low cost remote sensing system for use in agricultural applications. The important features of the system are that it monitors the near infrared and it incorporates position and attitude measuring equipment allowing for geo-rectified images to be produced without the use of ground control points. The equipment is designed to be hand held and hence requires no structural modification to the aircraft. The portable remote sensing system consists of an inertia measurement unit (IMU), which is accelerometer based, a low-cost GPS device and a small format false colour composite digital camera. The total cost of producing such a system is below GBP 3000, which is far cheaper than equivalent existing systems. The design of the portable remote sensing device has eliminated bore sight misalignment errors from the direct geo-referencing process. A new processing technique has been introduced for the data obtained from these low-cost devices, and it is found that using this technique the image can be matched (overlaid) onto Ordnance Survey Master Maps at an accuracy compatible with precision agriculture requirements. The direct geo-referencing has also been improved by introducing an algorithm capable of correcting oblique images directly. This algorithm alters the pixels value, hence it is advised that image analysis is performed before image georectification. The drawback of this research is that the low-cost GPS device experienced bad checksum errors, which resulted in missing data. The Wide Area Augmented System (WAAS) correction could not be employed because the satellites could not be locked onto whilst flying. The best GPS data were obtained from the Garmin eTrex (15 m kinematic and 2 m static) instruments which have a highsensitivity receiver with good lock on capability. The limitation of this GPS device is the inability to effectively receive the P-Code wavelength, which is needed to gain the best accuracy when undertaking differential GPS processing. Pairing the carrier phase L1 with the pseudorange C/A-Code received, in order to determine the image coordinates by the differential technique, is still under investigation. To improve the position accuracy, it is recommended that a GPS base station should be established near the survey area, instead of using a permanent GPS base station established by the Ordnance Survey.
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The paper discusses the characteristics of healthcare supply chains, and puts particular emphasis on the implementation of VMI/CMI in this sector specific context. By the means of case study research the paper provides empirical data on the benefits of the above collaborative practices for both the hospital and vendors. The paper contributes to the stream of research on VMI/CMI in the healthcare sector, where limited research attempts have been conducted so far. In contrast to other surveys this case study shows that specific and measurable cost reductions exist, in addition to other improvements such as better control over the inventories, and also in reduction of administrative work. Results obtained may be also relevant to other hospitals and vendors and as they can form a basis for comparisons. Copyright © 2013 Inderscience Enterprises Ltd.
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This paper reports on buried waveguides fabricated in lithium niobate (LN) by the method of direct femtosecond (fs) laser inscription. 5% MgO doped LiNbO3 was chosen as the host material because of its high quality and damage threshold, as well as relatively low cost. Direct fs inscription by astigmatically shaped beam in crystals usually produces multiple 'smooth' tracks (with reduced refractive index), which encircle the light guiding 'core', thus creating a depressed cladding WG. A high-repetition rate fs laser system was used for inscription at a depth of approximately 500 μm. Using numerical modelling, it was demonstrated that the properties of fs-written WGs can be controlled by the WG geometry. Buried, depressed-cladding WGs in LN host with circular cross-section were also demonstrated. Combining control over the WG dispersion with quasi-phase matching will allow various ultralow-pump-power, highly-efficient, nonlinear light-guiding devices - all in an integrated optics format.
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N-doped ZnO/g-C3N4 hybrid core–shell nanoplates have been successfully prepared via a facile, cost-effective and eco-friendly ultrasonic dispersion method for the first time. HRTEM studies confirm the formation of the N-doped ZnO/g-C3N4 hybrid core–shell nanoplates with an average diameter of 50 nm and the g-C3N4 shell thickness can be tuned by varying the content of loaded g-C3N4. The direct contact of the N-doped ZnO surface and g-C3N4 shell without any adhesive interlayer introduced a new carbon energy level in the N-doped ZnO band gap and thereby effectively lowered the band gap energy. Consequently, the as-prepared hybrid core–shell nanoplates showed a greatly enhanced visible-light photocatalysis for the degradation of Rhodamine B compare to that of pure N-doped ZnO surface and g-C3N4. Based on the experimental results, a proposed mechanism for the N-doped ZnO/g-C3N4 photocatalyst was discussed. Interestingly, the hybrid core–shell nanoplates possess high photostability. The improved photocatalytic performance is due to a synergistic effect at the interface of the N-doped ZnO and g-C3N4 including large surface-exposure area, energy band structure and enhanced charge-separation properties. Significantly, the enhanced performance also demonstrates the importance of evaluating new core–shell composite photocatalysts with g-C3N4 as shell material.
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A novel modulator array integrating eight GaAs electro-optic IQ modulators is characterized and tested over long-reach direct-detected multi-band OFDM-PONs. The GaAs IQ modulators present > 22 GHz bandwidth with 3V Vpi, being suitable for a 100-km 40-Gb/s OOFDM-PON supporting up to 1024 users.
Reductions of peak-to-average power ratio and optical beat interference in cost-effective OFDMA-PONs
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The peak-to-average power ratio (PAPR) and optical beat interference (OBI) effects are examined thoroughly in orthogonal frequency-division multiplexing access (OFDMA)-passive optical networks (PONs) at a signal bit rate up to ∼ 20 Gb/s per channel using cost-effective intensity-modulation and direct-detection (IM/DD). Single-channel OOFDM and upstream multichannel OFDM-PONs are investigated for up to six users. A number of techniques for mitigating the PAPR and OBI effects are presented and evaluated including adaptive-loading algorithms such as bit/power-loading, clipping for PAPR reduction, and thermal detuning (TD) for the OBI suppression. It is shown that the bit-loading algorithm is a very efficient PAPR reduction technique by reducing it at about 1.2 dB over 100 Km of transmission. It is also revealed that the optimum method for suppressing the OBI is the TD + bit-loading. For a targeted BER of 1 × 10-3, the minimum allowed channel spacing is 11 GHz when employing six users. © 2013 Springer Science+Business Media New York.
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A fejlett társadalmak egészségügyi szolgáltató rendszerei napjainkban kettős kihívással néznek szembe: miközben a társadalom a szolgáltatási színvonal emelkedését, a hibák számának a csökkenését várja el, addig a költségvetési terhek miatt a költségcsökkentés is feltétlenül szükséges. Ez a kihívás nagyságában összevethető azzal, amellyel az USA autóipara nézett szembe az 1970-es évektől. A megoldást az autóipar esetében a konkurens „lean” menedzsment elvek és eszközök megértése és alkalmazása jelentette. A tanulmány arra keresi a választ, hogy vajon lehetséges-e ennek a megoldásnak az alkalmazása az egészségügy esetében is. A cikk az egészségügy problémájának bemutatása után tárgyalja a lean menedzsment kialakulását és hogy milyen módon került köztudatba. A tanulmány második felében a szakirodalomban fellelhető, a témával kapcsolatos tapasztalatokat foglalja össze, majd levonja a következtetéseket. = In developed societies healthcare service systems are facing double challenge; society expects service level to rise and the number of mistakes to drop, but at the same time, because of the overloaded budgets, cutting cost is also absolutely necessary. This challenge compares to the one the US automotive industry was facing in the 1970-s. In case of the automotive industry the solution was the comprehension and application of the principles and the tools of lean management. This study aims to answer the question whether it is possible to apply this solution also in the case of the healthcare system. The article first introduces the problems in the healthcare system, than describes the formation of lean management concept and its wide spread. The second half of the study summarizes the available knowledge in the literature and drives conclusions.
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A szerzők tanulmányának középpontjában a közvetlen külföldi befektetések és a korrupció kapcsolata áll. Feltételezésük az, hogy a közvetlen külföldi befektetők a kevésbé korrupt országokat kedvelik, mivel a korrupció egy további kockázati tényezőt jelent a befektetők számára, amely növelheti a befektetések költségeit. Megítélésük szerint ezt kvantitatív módszerekkel érdemes vizsgálni, így elemzésük során 79 országot vizsgálnak meg tíz évre vonatkozó átlagokkal a Gretl-program és az OLS becslőfüggvény segítségével. Több modell lefuttatása után azt az eredményt kapták, hogy a közvetlen külföldi befektetők döntéseiben a korrupció szignifikáns tényező, a két változó között negatív korrelációt figyeltek meg. / === / The study focuses on the connection of Foreign Direct Investment and corruption. The authors assume that investors prefer countries where corruption level is lower, as corruption an additional risk factor that might increase the cost of investment. They believe that the best way to prove the previous statement if they use quantitative methods, so they set up a model where 79 countries are tested for 10 years averages, with the help of the Gretl and OLS estimator. After running several models their finding was that corruption is a significant factor in the decisions of foreign investors, and there is a negative correlation between corruption and FDI.
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Tanulmányunk középpontjában a közvetlen külföldi befektetések és a korrupció kapcsolata áll. Feltételezésünk az, hogy a közvetlen külföldi befektetők a kevésbé korrupt országokat kedvelik, mivel a korrupció egy további kockázati tényezőt jelent a befektetők számára, amely növelheti a befektetések költségeit. Megítélésünk szerint ezt kvantitatív módszerekkel lehet a leginkább vizsgálni, így elemzésünk során 79 országot vizsgálunk meg 10 évre vonatkozó átlagokkal a GRETL program és az OLS becslőfüggvény segítségével. Több modell lefuttatása után azt az eredményt kaptuk, hogy a közvetlen külföldi befektetők döntéseiben a korrupció szignifikáns tényező, a két változó között negatív korrelációt figyelhetünk meg. ____ We assume that investors prefer countries where corruption level is lower, as corruption an additional risk factor that might increase the cost of investment. We believe that the best way to prove the previous statement if we use quantitative methods, so we set up a model where 79 countries are tested for 10 years averages, with the help of the GRETL and OLS estimator. After running several models our finding was that corruption is a significant factor in the decisions of foreign investors, and there is a negative correlation between corruption and FDI.