Impact on costs of a case management intervention for emergency department frequent users

Background: In most of the emergency departments (ED) in developed countries, a subset of patients visits the ED frequently. Despite their small numbers, these patients are the source of a disproportionally high number of all ED visits, and use a significant proportion of healthcare resources. They place a heavy economic burden on hospital and healthcare system budgets overall. In order to improve the management of these patients, the University hospital of Lausanne, Switzerland implemented a case management intervention (CM) between May 2012 and July 2013. In this randomized controlled trial, 250 frequent ED users (visits>5 during previous 12 months) were allocated to either the CM group or the standard ED care (SC) group and followed up for 12 months. The first result of the CM was to reduce significantly the ED visits. The present study examined whether the CM intervention also reduced the costs generated by the ED frequent users not only from the hospital perspective, but also from the healthcare system perspective. Methods: Cost data were obtained from the hospital's analytical accounting system and from health insurances. Multivariate linear models including a fixed effect "group" and socio-demographic characteristics and health-related variables were run.

Creating and implementing a financial management process to an international company

The objectives of this thesis areto identify the best elements from Information Technology Infrastructure Library financial management for an international company. The elements need to be customized to fit existing elements and the thesis needs to provide implementation proposal. The new IT financial management needs to improve cost visibility and bring benefits to the company. In order to find the best elements for IT financial management, there needs to be a research to discover the companys business needs. The ITIL library is used to find answers and solutions to the companys issues in IT financial management. Other IT frameworks can and will be used as well, if they are able to work with ITIL model. ITIL consists from budgeting, accounting and charging in IT financial management, which all needs to be investigated. In addition more ITIL elements such as contract management and supplier management can be used, in order to make IT financial management work better.

IT Financial Management In a Large Industrial Company

IT Service Management plays a key role in many IT organizations today. First IT Service Management principles founded in the early 1980s but the real adaption emerged in the end 2000s. IT Financial Management is one of IT Service Management’s processes. The main purpose of this thesis was study how IT Financial Management approach can be improved in a case company. Budgeting, accounting and charging are IT Financial Management functions. These functions are researched in this thesis. Thesis materials consist of both qualitative and quantitative material. The theoretical part consists mostly of IT Service Management literature while interviews and the case company’s information systems are researched in the empirical part. Thesis also reviews different kind of the systems which supports and automates IT Financial Management functions. The biggest challenge is the cost allocation with the current ERP system in the case company. It is worth to take group based system for allocation in use before there is a holistic system in a market. The case company should also develop its IT service processes forward.

Earnings management in the process of preparing corporate financial reports

Earnings management (EM) literature examines managers’ use of judgment in financial reporting and in structuring transactions to alter financial reports for a specific reason. Mainstream EM literature strongly concentrates on statistical research methodologies and it is driven by positive accounting theory. Although EM occurs in the process of preparing corporate financial reports, that process has so far largely remained a “black box” in prior literature. The purpose of this study is to analyze what EM is, how and why it unfolds and how it is intertwined in the process of preparing corporate financial reports. In order to meet the needs of the study, a qualitative case study method will be used. The contribution of this study is threefold. First, it indicates that the concept of EM is not as unam-biguous as the prior literature has assumed. I find that EM is socially constructed and more open to interpretation than absolutely dichotomous conception given by previous studies. Second, this study contributes to our knowledge of the role and the importance of actors involved in conducting EM, indicating that EM is much more actor-dependent than the prior literature has assumed. Third, this study broadens our knowledge base with regard to the processes and potential for EM in academic research.

Developing the measurement and management of knowledge: applying the constructive research approach in a knowledge intensive service environment

Intellectual assets have attained continuous attention in the academic field, as they are vital sources of competitive advantage and organizational performance in the contemporary knowledge intensive business environment. Intellectual capital measurement is quite thoroughly addressed in the accounting literature. However, the purpose of the measurement is to support the management of intellectual assets, but the reciprocal relationship between measurement and management has not been comprehensively considered in the literature. The theoretical motivation for this study rose from this paradox, as in order to maximise the effectiveness of knowledge management the two initiatives need to be closely integrated. The research approach of this interventionist case study is constructive. The objective is to develop the case organization’s knowledge management and intellectual capital measurement in a way that they would be closely integrated and the measurement would support the management of intellectual assets. The case analysis provides valuable practical considerations about the integration and related issues as the case company is a knowledge intensive organization in which the know-how of the employees is the central competitive asset and therefore, the management and measurement of knowledge are essential for its future success. The results suggest that the case organization is confronting challenges in managing knowledge. In order to appropriately manage knowledge processes and control the related risks, support from intellectual capital measurement is required. However, challenges in measuring intellectual capital, especially knowledge, could be recognized in the organization. By reflecting the knowledge management situation and the constructed strategy map, a new intellectual measurement system was developed for the case organization. The construction of the system as well as its indicators can be perceived to contribute to the literature, emphasizing of the importance of properly considering the organization’s knowledge situation in developing an intellectual capital measurement system.

Lean Accounting

Lean-filosofian keskeinen ajatus on tuottaa asiakkaalle enemmän arvoa vähentämällä turhuuksia tuotannosta. Keskeisessä roolissa lean-filosofiassa ovat arvo, arvovirta, flow, pull ja täydellisyys. Lean accounting on lean-tuotantofilosofiaa tukeva työkalu ja sen avulla voidaan kehittää sekä seurata lean-tuotantoa. Lean accountingissa tuotetaan selkeitä ja yksinkertaisia raportteja, joita koko organisaatio voi ymmärtää. Oleellista lean accountingissa on keskittyä yhden tuotteen kannattavuuden sijaan koko arvovirran kannattavuuteen. Tässä kandidaatintyössä käsitellään lean accountingia yleisesti. Työssä perehdytään perinteisen laskentatoimen ongelmiin lean-tuotannossa sekä esitellään sopivia työkaluja ja menetelmiä, jotka sopivat lean-yritykselle. Työssä on haasteltu Suomessa toimivia lean-yrityksiä heidän lean accounting ja lean-työkalujen tuntemuksesta. Työn tärkeyttä korostaa se, että lean accounting on huonosti tunnettu. Useat yritykset hyödyntävät lean-tuotantoa, mutta hyöty saattaa jäädä huomaamatta ilman lean accountingia. Lean accounting on havaittu hyväksi menetelmäksi ja siitä voi olla apua lean-yrityksille.

Foreign exchange exposure management in a fuel procurement company operating in the commodity markets

Fluctuating commodity prices, foreign exchange rates and interest rates are causing changes in cash flows, market value and the companies’ profit. Most of the commodities are quoted in US dollar. Companies with non-dollar accounting face a double risk in the form of the commodity price risk and foreign exchange risk. The objective of this Master’s thesis is to find out how companies under commodity should manage foreign exchange exposure. The theoretical literature is based on foreign exchange risk, commodity risk and foreign exchange exposure management. The empirical research is done by using constructive modelling of a case company in the oil industry. The exposure is model with foreign exchange net cash flow and net working capital. First, the factors affecting foreign exchange exposure in case company are analyzed, then a model of foreign exchange exposure is created. Finally, the models are compared and the most suitable method is defined. According to the literature, foreign exchange exposure is the foreign exchange net cash flow. However, the results of the study show that foreign exchange risk can be managed also with net working capital. When the purchases, sales and storage are under foreign exchange risk, the best way to manage foreign exchange exposure is with combined net cash flow and net working capital method. The foreign exchange risk policy of the company defines the appropriate way to manage foreign exchange risk.

Sustainable Development through the Environment Management Tool Ecological Footprint Analysis – A Study in Kochi City, India

In the past, natural resources were plentiful and people were scarce. But the situation is rapidly reversing. Our challenge is to find a way to balance human consumption and nature’s limited productivity in order to ensure that our communities are sustainable locally, regionally and globally. Kochi, the commercial capital of Kerala, South India and the second most important city next to Mumbai on the Western coast is a land having a wide variety of residential environments. Due to rapid population growth, changing lifestyles, food habits and living standards, institutional weaknesses, improper choice of technology and public apathy, the present pattern of the city can be classified as that of haphazard growth with typical problems characteristics of unplanned urban development. Ecological Footprint Analysis (EFA) is physical accounting method, developed by William Rees and M. Wackernagel, focusing on land appropriation using land as its “currency”. It provides a means for measuring and communicating human induced environmental impacts upon the planet. The aim of applying EFA to Kochi city is to quantify the consumption and waste generation of a population and to compare it with the existing biocapacity. By quantifying the ecological footprint we can formulate strategies to reduce the footprint and there by having a sustainable living. In this paper, an attempt is made to explore the tool Ecological Footprint Analysis and calculate and analyse the ecological footprint of the residential areas of Kochi city. The paper also discusses and analyses the waste footprint of the city. An attempt is also made to suggest strategies to reduce the footprint thereby making the city sustainable

Dairy farms typology and management of animal genetic resources in the peri-urban zone of Bamako (Mali)

Facing growth in demand, dairy production in peri-urban areas of developing countries is changing rapidly. To characterise this development around Bamako (Mali), this study establishes a typology of dairy production systems with a special focus on animal genetic resources. The survey included 52 dairy cattle farms from six peri-urban sites. It was conducted in 2011 through two visits, in the dry and harvest seasons. The median cattle number per farm was 17 (range 5-118) and 42% of farmers owned cropland (8.3 +/- 7.3 ha, minimum 1 ha, maximum 25 ha). Feeding strategy was a crucial variable in farm characterisation, accounting for about 85% of total expenses. The use of artificial insemination and a regular veterinary follow-up were other important parameters. According to breeders’ answers, thirty genetic profiles were identified, from local purebreds to different levels of crossbreds. Purebred animals raised were Fulani Zebu (45.8%), Maure Zebu (9.2%), Holstein (3.0%), Azawak Zebu (1.3%), Mere Zebu (0.5%) and Kuri taurine (0.1%). Holstein crossbred represented 30.5% of the total number of animals (19.0% Fulani-Holstein, 11.2% Maure-Holstein and 0.3% Kuri-Holstein). Montbéliarde, Normande and Limousin crossbreds were also found (6.6%, 0.7% and 0.3%, respectively). A multivariate analysis helped disaggregate the diversity of management practices. The high diversity of situations shows the need for consideration of typological characteristics for an appropriate intervention. Although strongly anchored on local breeds, the peri-urban dairy systems included a diversity of exotic cattle, showing an uncoordinated quest of breeders for innovation. Without a public intervention, this dynamic will result in an irremediable erosion of indigenous animal genetic resources.

Moderating effects of management control systems and innovation on performance. Simple methods for correcting the effects of measurement error for interaction effects in small samples

In the accounting literature, interaction or moderating effects are usually assessed by means of OLS regression and summated rating scales are constructed to reduce measurement error bias. Structural equation models and two-stage least squares regression could be used to completely eliminate this bias, but large samples are needed. Partial Least Squares are appropriate for small samples but do not correct measurement error bias. In this article, disattenuated regression is discussed as a small sample alternative and is illustrated on data of Bisbe and Otley (in press) that examine the interaction effect of innovation and style of use of budgets on performance. Sizeable differences emerge between OLS and disattenuated regression

An ATM distributed simulator for network management research

Due to the high cost of a large ATM network working up to full strength to apply our ideas about network management, i.e., dynamic virtual path (VP) management and fault restoration, we developed a distributed simulation platform for performing our experiments. This platform also had to be capable of other sorts of tests, such as connection admission control (CAC) algorithms, routing algorithms, and accounting and charging methods. The platform was posed as a very simple, event-oriented and scalable simulation. The main goal was the simulation of a working ATM backbone network with a potentially large number of nodes (hundreds). As research into control algorithms and low-level, or rather cell-level methods, was beyond the scope of this study, the simulation took place at a connection level, i.e., there was no real traffic of cells. The simulated network behaved like a real network accepting and rejecting SNMP ones, or experimental tools using the API node

Definition of an it project portfolio management methodology for a pharmaceutical company

Con la creciente popularidad de las soluciones de IT como factor clave para aumentar la competitividad y la creación de valor para las empresas, la necesidad de invertir en proyectos de IT se incrementa considerablemente. La limitación de los recursos como un obstáculo para invertir ha obligado a las empresas a buscar metodologías para seleccionar y priorizar proyectos, asegurándose de que las decisiones que se toman son aquellas que van alineadas con las estrategias corporativas para asegurar la creación de valor y la maximización de los beneficios. Esta tesis proporciona los fundamentos para la implementación del Portafolio de dirección de Proyectos de IT (IT PPM) como una metodología eficaz para la gestión de proyectos basados en IT, y una herramienta para proporcionar criterios claros para los directores ejecutivos para la toma de decisiones. El documento proporciona la información acerca de cómo implementar el IT PPM en siete pasos, el análisis de los procesos y las funciones necesarias para su ejecución exitosa. Además, proporciona diferentes métodos y criterios para la selección y priorización de proyectos. Después de la parte teórica donde se describe el IT PPM, la tesis aporta un análisis del estudio de caso de una empresa farmacéutica. La empresa ya cuenta con un departamento de gestión de proyectos, pero se encontró la necesidad de implementar el IT PPM debido a su amplia cobertura de procesos End-to-End en Proyectos de IT, y la manera de asegurar la maximización de los beneficios. Con la investigación teórica y el análisis del estudio de caso, la tesis concluye con una definición práctica de un modelo aproximado IT PPM como una recomendación para su implementación en el Departamento de Gestión de Proyectos.

An assessment of the benefits and limitations of the shamba agroforestry system in Kenya and of management and policy requirements for its successful and sustainable reintroduction

The shamba system involves farmers tending tree saplings on state-owned forest land in return for being permitted to intercrop perennial food crops until canopy closure. At one time the system was used throughout all state-owned forest lands in Kenya, accounting for a large proportion of some 160,000 ha. The system should theoretically be mutually beneficial to both local people and the government. However the system has had a chequered past in Kenya due to widespread malpractice and associated environmental degradation. It was last banned in 2003 but in early 2008 field trials were initiated for its reintroduction. This study aimed to: assess the benefits and limitations of the shamba system in Kenya; assess the main influences on the extent to which the limitations and benefits are realised and; consider the management and policy requirements for the system's successful and sustainable operation. Information was obtained from 133 questionnaires using mainly open ended questions and six participatory workshops carried out in forest-adjacent communities on the western slopes of Mount Kenya in Nyeri district. In addition interviews were conducted with key informants from communities and organisations. There was strong desire amongst local people for the system's reintroduction given that it had provided significant food, income and employment. Local perceptions of the failings of the system included firstly mismanagement by government or forest authorities and secondly abuse of the system by shamba farmers and outsiders. Improvements local people considered necessary for the shamba system to work included more accountability and transparency in administration and better rules with respect to plot allocation and stewardship. Ninety-seven percent of respondents said they would like to be more involved in management of the forest and 80% that they were willing to pay for the use of a plot. The study concludes that the structural framework laid down by the 2005 Forests Act, which includes provision for the reimplementation of the shamba system under the new plantation establishment and livelihood improvement scheme (PELIS) [It should be noted that whilst the shamba system was re-branded in 2008 under the acronym PELIS, for the sake of simplicity the authors continue to refer to the 'shamba system' and 'shamba farmers' throughout this paper.], is weakened because insufficient power is likely to be devolved to local people, casting them merely as 'forest users' and the shamba system as a 'forest user right'. In so doing the system's potential to both facilitate and embody the participation of local people in forest management is limited and the long-term sustainability of the new system is questionable. Suggested instruments to address this include some degree of sharing of profits from forest timber, performance related guarantees for farmers to gain a new plot and use of joint committees consisting of local people and the forest authorities for long term management of forests.

Internal rents and corporate property management: a study into the use of internal rents in UK corporate organisations

Research in the late 1980s showed that in many corporate real estates users were not fully aware of the full extent of their property holdings. In many cases, not only was the value of the holdings unknown, but there was uncertainty over the actual extent of ownership within the portfolio. This resulted in a large number of corporate occupiers reviewing their property holdings during the 1990s, initially to create a definitive asset register, but also to benefit from an more efficient use of space. Good management of corporately owned property assets is of equal importance as the management of other principal resources within the company. A comprehensive asset register can be seen as the first step towards a rational property audit. For the effective, efficient and economic delivery of services, it is vital that all property holdings are utilised to the best advantage. This requires that the property provider and the property user are both fully conversant with the value of the property holding and that an asset/internal rent/charge is made accordingly. The advantages of internal rent charging are twofold. Firstly, it requires the occupying department to “contribute” an amount to the business equivalent to the open market rental value of the space that it occupies. This prevents the treating of space as a free good and, as individual profit centres, each department will then rationalise its holdings to minimise its costs. The second advantage is from a strategic viewpoint. By charging an asset rent, the holding department can identify the performance of its real estate holdings. This can then be compared to an internal or external benchmark to help determine whether the company has adopted the most efficient tenure pattern for its properties. This paper investigates the use of internal rents by UK-based corporate businesses and explains internal rents as a form of transfer pricing in the context of management and responsibility accounting. The research finds that the majority of charging organisations introduced internal rents primarily to help calculate true profits at the business unit level. However, less than 10% of the charging organisations introduced internal rents primarily to capture the return on assets within the business. There was also a sizeable element of the market who had no plans to introduce internal rents. Here, it appears that, despite academic and professional views that internal rents are beneficial in improving the efficient use of property, opinion at the business and operational level has not universally accepted this proposition.