The employee policy manual

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Políticas de financiamento de I&D em Portugal [R&D financing policies in Portugal]

Baseado no relatório para a disciplina de “Avaliação de Ciência e Tecnologia” da responsabilidade do Prof. João Crespo (FCT-UNL) do Programa Doutoral em Avaliação de Tecnologia em 2012

Integrated care approaches and skills mix policies in Europe

ABSTRACT - Background: Integration of health care services is emerging as a central challenge of health care delivery, particularly for patients with elderly and complex chronic conditions. In 2003, the World Health Organization (WHO) already began to identify it as one of the key pathways to improve primary care. In 2005, the European Commission declared integrated care as vital for the sustainability of social protection systems in Europe. Nowadays, it is recognized as a core component of health and social care reforms across European countries. Implementing integrated care requires coordination between settings, organizations, providers and professionals. In order to address the challenge of integration in such complex scenario, an effective workforce is required capable of working across interdependent settings. The World Health Report 2006 noted that governments should prepare their workforce and explore what tasks the different levels of health workers are trained to do and are capable of performing (skills mix). Comparatively to other European countries, Portugal is at an early stage in what integrated care is concerned facing a growing elderly population and the subsequent increase in the pressure on institutions and professionals to provide social and medical care in the most cost-effective way. In 2006 the Portuguese government created the Portuguese Network for Integrated Care Development (PNICD) to solve the existing long-term gap in social support and healthcare. On what concerns health workforce, the Portuguese government already recognized the importance of redefine careers keeping professional motivation and satisfaction. Aim of the study: This study aims to contribute new evidence to the debate surrounding integrated care and skills mix policies in Europe. It also seeks to provide the first evidence that incorporates both the current dynamics of implementing integrated care in Portugal and the developments of international literature. The first ambition of our study is to contribute to the growing interest in integrated care and to the ongoing research in this area by identifying its different approaches and retrieve a number of experiences in some European countries. Our second goal of this research is to produce an update on the knowledge developed on skills mix to the international healthcare management community and to policy makers involved in reforming healthcare systems and organizations. To better inform Portuguese health policies makers in a third stage we explore the current dynamics of implementing integrated care in Portugal and contextualize them with the developments reported in the international literature. Methodology: This is essentially an exploratory and descriptive study using qualitative methodology. In order to identify integrated care approaches in Europe, a systematic literature review was undertaken which resulted in a paper published in the Journal of Management and Marketing in Health care titled: Approaches to developing integrated care in Europe: a systematic literature review. This article was recommended and included into a list of references identified by The King's Fund Library. A second systematic literature review was undertaken which resulted in a paper published in the International Journal of Healthcare Management titled: Skills mix in healthcare: An international update for the management debate. Semi-structured interviews were performed on experts representing the regional coordination teams of the Portuguese Network for Integrated Care Development. In a last stage a questionnaire survey was developed based on the findings of both systematic literature reviews and semi-structured interviews. Conclusions: Even though integrated care is a worldwide trend in health care reforms, there is no unique definition. Definitions can be grouped according to their sectorial focus: community-based care, combined health and social care, combined acute and primary care, the integration of providers, and in a more comprehensive approach the whole health system. Indeed, models that seek to apply the principles of integrated care have a similar background and are continually evolving and depend on the different initiatives taken at national level. . Despite the fact that we cannot argue that there is one single set typology of models for integrated care, it is possible to identify and categorize some of the basic approaches that have been taken in attempts to implement integrated care according to: changes in organizational structure, workforce reconfiguring, and changes in the financing system. The systematic literature review on skills mix showed that despite the widely acknowledged interest on skills mix initiatives there is a lack of evidence on skills mix implications, constraints, outcomes, and quality impact that would allow policy makers to take sustained and evidence-based decisions. Within the Portuguese health system, the integrated care approach is rather organizational and financial, whereas little attention is given to workforce integration. On what concerns workforce planning Portugal it is still in the stage of analyzing the acceptability of health workforce skills mix. In line with the international approaches, integration of health and social services and bridging primary and acute care are the main goals of the national government strategy. The findings from our interviews clarify perceptions which show no discrepancy with the related literature but are rather scarce comparing to international experience. Informants hold a realistic but narrow view of integrated care related issues. They seem to be limited to the regional context, requiring a more comprehensive perspective. The questionnaire developed in this thesis is an instrument which, when applied, will allow policy makers to understand the basic set of concepts and managerial motivations behind national and regional integrated care programs. The instrument developed can foster evidence on the three essential components of integrated care policies: organizational, financial, and human resources development, and can give additional input on the context in which integrated care is being developed, the type of providers and organizations involved, barriers and constraints, and the workforce skills mix planning related strategies. The thesis was successful in recognizing differences between countries and interventions and the instrument developed will allow a better comprehension of the international options available and how to address the vital components of integrated care programs.

Determinants of Portuguese bank’s provisioning policies: Discretionary behaviour of generic and specific allowances

In this paper we test for the impact of the regulatory environment on a bank’s discretionary provisioning practices. We develop a model that structures the dynamics of the provision policy for the two classes of provisions: generic provisions and specific provisions. The model is tested using a comprehensive database of all financial institutions operating in Portugal for 1990-2000. This unique dataset comprises banks subject to the Portuguese rules as well as bank subsidiaries subject to their home-country regulation and we were able to identify distinct behaviours between them. Our results show the importance of handling he two types of provisions separately. They support the hypothesis that banks have a discretionary behaviour in setting up their provisions, and find evidence of income smoothing and capital management. We also find that the regulatory regime impacts on discretionary provisioning policies because banks when forced to increase one type of provision react by reducing the iscretionary component of the other, a finding we designated as a substitution effect.

The Impact of income support programs on transitions to employment

The income support programs are created with the purpose of fighting both, the poverty trap and the inactivity trap. The balance between both is fragile and hard to find. Thus, the goal of this work is to contribute to solve this issue by finding how income support programs, particularly the Portuguese RSI, affect transitions to employment. This is made through duration analysis, namely using Cox and Competing Risks models. A particular feature is introduced in this work as it incorporates the possibility of Defective Risks. The estimated hazard elasticity with respect to the amount of RSI received for individuals who move to employment is -0,41. More than a half of RSI receivers stays for more than a year and the probability of never leaving to employment is 44%. The results appear to indicate that RSI has affected negatively transitions to employment.

Performance analysis of an SRI screen based on employment quality in high and low capital industries: International evidence

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics and Maastricht University School of Business and Economics

On the labor share the long-run equilibrium and its adjustment process

This research computes an Equilibrium Labor Share using a VECM for a panel of 19 countries, analyzes what determines the speed at which the labor share adjusts towards that equilibrium and decomposes this adjustment in terms of real wages and employment. Results suggest that the speed at which a country adjusts decreases with employment protection legislation and labor taxes. Most countries’ labor shares adjustment is made through real wages changes instead of changing employment, suggesting that wage moderation policies may play an important role on the adjustment process without harming employment. Keywords: Equilibrium

On the labor share the long-run equilibrium and its adjustment process

This research computes an Equilibrium Labor Share using a VECM for a panel of 19 countries, analyzes what determines the speed at which the labor share adjusts towards that equilibrium and decomposes this adjustment in terms of real wages and employment. Results suggest that the speed at which a country adjusts decreases with employment protection legislation and labor taxes. Most countries’ labor shares adjustment is made through real wages changes instead of changing employment, suggesting that wage moderation policies may play an important role on the adjustment process without harming employment.

Bias in returns to tenure when firm wages and employment comove: A quantitative assessment and solution

It is well known that, unless worker-firm match quality is controlled for, returns to firm tenure (RTT) estimated directly via reduced form wage (Mincer) equations will be biased. In this paper we show that even if match quality is properly controlled for there is a further pervasive source of bias, namely the co-movement of firm employment and firm wages. In a simple mechanical model where human capital is absent and separation is exogenous we show that positively covarying shocks (either aggregate or firm level) to firms employment and wages cause downward bias in OLS regression estimates of RTT. We show that the long established procedures for dealing with "traditional" RTT bias do not circumvent the additional problem we have identified. We argue that if a reduced form estimation of RTT is undertaken, firm-year fixed effects must be added in order to eliminate this bias. Estimates from two large panel datasets from Portugal and Germany show that the bias is empirically important. Adding firm-year fixed effects to the regression increases estimates of RTT in the two respective countries by between 3.5% and 4.5% of wages at 20 years of tenure over 80% (50%) of the estimated RTT level itself. The results extend to tenure correlates used in macroeconomics such as the minimum unemployment rate since joining the firm. Adding firm-year fixed effects changes estimates of these effects also.

Adult learning and education policies in Germany, Portugal and Sweden: An analysis of national reports to CONFINTEA VI

The chapter presents a theoretical proposal of three analytical models of Adult Learning and Education (ALE) policies. Some analytical categories and the corresponding dimensions are organised according to the ALE rationale which is typical of each social policy model. Historical, cultural and educational features are mentioned in connexion with the different policy models and its interpretative capacity to making sense of policies and practices implemented in Germany, Portugal and Sweden. !e analysis includes the states of the art and the official representations of ALE produced by the respective national authorities through national reports which were presented to CONFINTEA VI (2009).

Study of the potential employment of Malvaceae Species in composites materials

The employ of vegetal fibers for textiles and composites represents a great potential in economic and social sustainable development. Some Malvaceae species are considered tropical cosmopolitans, such as from Sida genus. Several species of this genus provide excellent textile bast fibers, which are very similar in qualities to the jute textile fiber. The objective of the present study is present the physicochemical characterization of six Brazilian vegetal fibers: Sida rhombifolia L.; Sida carpinifolia L. f.; Sidastrum paniculatum (L.) Fryxell; Sida cordifolia L.; Malvastrum coromandelianum (L.) Gurck; Wissadula subpeltata (Kuntze) R.E.Fries. Respectively the two first species are from Brazilian Atlantic Forest biome and the four remaining from Brazilian Cerrado biome, despite of present in other regions of the planet. The stems of these species were retted in water at 37oC for 20 days. The fibers were tested in order to determine tensile rupture strength, tenacity, elongation, Young’s modulus, cross microscopic structure, Scanning Electronic Microscopy (SEM), regain, combustion, acid, alkali, organic solvent and cellulase effects, pH of the aqueous extract, Differential Scanning Calorimetry (DSC) and Thermogravimetric Analysis (TGA). The obtained values were compared with those from fibers of recognized applicability in the textile industry including hemp. The results are promising in terms of their employment in thermoset and thermoplastic medium resistance composites.

Employment, turnover and career progress

The severe economic downturn that followed the Global Financial Crisis of 2007 was accompanied by major fluctuations in the labour market. During the Great Recession the rate of job destruction was such that, by 2013, active population was at levels of 1999; employment levels were at an historical minimum; and the unemployment rate soared to 17,5%. This chapter inspects the dynamics behind the aggregate fl uctuations in the labour market and studies the determinants of mobility within (promotions) and between fi rms, and whether these have changed during crisis, using Portuguese (LEED) data. During crisis women became more likely to make between- rm moves with short gaps of unemployment and less likely to find a new job after a long gap or to make a job-to-non-employment transition. More educated workers are less likely to experience between fi rm job mobility, both before and during crisis, and became less likely to make job-to-non-employment transitions during crisis. Young workers are the group that most suffered from crisis: they became less likely to make job-to-job transitions and their hazard of experiencing a transition into unemployment shoot up.

La institucionalización de la Comunidad Regional Punilla (Provincia de Córdoba): estudio y promoción de metodologías de diseño participativo y gestión asociada de políticas públicas para el desarrollo. The institution of Punilla Regional Community: study and promotion of participative metodologies for the associated planning and management of development policies.

Durante el período 2006-2008, las actividades de investigación y asistencia técnica de este equipo enfatizaron en la necesaria práctica social y política de horizontalidad en las relaciones, en la 'dimensión intersubjetiva o relacional de la regionalización' (Cáceres, 2006) en el marco de la Comunidad Regional Punilla (CRP), considerando a la identidad regional como un condicionante relevante de la 'construcción de la región como unidad de acción(Boisier, 2003). Así, durante ese período, se ha ido conformando un espacio 'regional' de composición multiactoral, social y gubernamental, para el trabajo asociativo (PROFIM, SIP, UCC 2007, 2008). Con el propósito de profundizar el Programa, este proyecto propone el fortalecimiento institucional de la CRP a través de la formalización del escenario participativo regional (Poggiese, 2001, 2002) para el diseño y gestión asociada de políticas de desarrollo. Tales propósitos y mecanismos están previstos en la Ley Orgánica de Regionalización de la Provincia de Córdoba (9.206/04) y en las normativas regionales derivadas de ésta a través de la figura del 'Consejo de la Sociedad Civil'. Con base en la observación del proceso desarrollado en Punilla desde el año 2006, esta propuesta suscribe el carácter interdisciplinario e intersectorial de la red social y política en la que se sustentará el Consejo y la lógica 'procesal y consensual' de su construcción, considerando, además, la nueva configuración del mapa político de la CRP a partir de los resultados electorales del año 2008 en tanto cambios estructurales en la relación gobierno y oposición que se presentan como una oportunidad para desarrollar los espacios públicos participativos que la sociedad regional puede ocupar para canalizar institucionalmente sus demandas. El proyecto busca 'analizar' pero también 'promover' el proceso de cambio político y social en marcha para facilitar su 'ampliación democrática' (Redín y Moroni, 2003), reflexionado críticamente y poniendo en cuestión algunos de los supuestos que han caracterizado a la retórica de la regionalización provincial: la existencia de una sociedad civil debidamente organizada en cada una de las regiones, cuya concurrencia al proceso decisorio puede asegurarse una vez 'abiertos' -formalizados- los canales de participación; la superación de la dirección bottom up en los procesos de toma de decisiones y la preeminencia de modalidades de 'articulación intermunicipal' para la gestión de políticas allí donde la Ley y las ordenanzas locales declaran establecida una 'Comunidad Regional'. El cuestionamiento de dichos supuestos sustenta, en definitiva, las preguntas que delimitan los temas- problema que se abordarán a partir de este trabajo.

Producción de información para las políticas públicas: observatorio de salud mental y derechos humanos en la provincia de córdoba. Documented information and indicators for the pubic policies in mental health: human rights obseratory in córdoba

El problema que enfrenta la institucionalidad estatal argentina es que existe un serio déficit de información no solamente en el momento de evaluar un resultado, sino ya al momento de diseñar la política. Las estadísticas oficiales de hechos vitales, salud y educación son difundidas en el mejor de los casos con un año de atraso. La información de indicadores de salud por su nivel de desagregación no permite conocer las realidades locales. Es posible constatar la falta de información sobre las medidas tomadas para asegurar el cumplimiento de las obligaciones del Estado en lo relativo a políticas y programas de salud mental. Del mismo modo que los organismos internacionales determinan los deficits de los sistemas de atención a la salud mental a través de las brechas de tratamiento y aun cuando no se dispone de estimaciones precisas se habla de brechas de información, que expresarían la distancia entre la información necesaria y la efectivamente disponible (OPS, 2009). Desde el mes de diciembre de 2007 se conforma la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos, con el objeto de instalar en agenda la necesidad de contar con una legislación que brinde el marco normativo para la transformación del sector. En los meses de octubre y noviembre de 2010 se aprobaron sendas leyes de salud mental en la Provincia de Córdoba y a nivel nacional. Ambas proponen la transformación progresiva en los sistemas de atención a los problemas de salud mental de la población. Desde la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos se afirma que la legislación es un marco necesario pero no suficiente, en tanto se constata que las princiales violaciones a los derechos humanos se producen en situaciones concretas. El presente proyecto nace de la necesidad de contar con un sistema de información que permita conocer la transformación de los servicios de salud mental en la provincia de Córdoba a partir de la sanción de la ley 9848 de Salud Mental en el mes de octubre de 2010. Una vez logrado este objetivo legislativo, se pretende monitorear la gestión con la formulación de los siguientes interrogantes: ¿a través de qué indicadores medir, evaluar y monitorear si la producción de los servicios de salud mental se lleva adelante desde la perspectiva del enfoque de derechos sancionada en el marco normativo vigente?; ¿cuáles son los indicadores que desde dicha perspectiva los organismos estatales de producción de servicios deben elaborar para el compromiso de acción y la rendición de cuentas frente a la ciudadanía? ¿cuáles son los indicadores que la ciudadanía debe reclamar a los fines de monitorear el cumplimiento de dichos compromisos? La puesta en marcha del Observatorio de Salud Mental y Derechos Humanos permitirá analizar las políticas y programas de salud mental desde la perspectiva de los derechos humanos y avanzar en el monitoreo de la producción de los servicios de salud mental. Objetivo General: analizar y hacer visible el cumplimiento de los objetivos sancionados en la ley 9848 de Salud Mental a través de la observación, el monitoreo y la incidencia en las políticas de salud mental de la provincia de Córdoba. Metodología: la construcción de indicadores de derechos humanos para la salud mental. El Observatorio de Salud Mental y Derechos Humanos pretende dar cuenta de las transformaciones que van a ocurrir a partir de la sanción de la ley 9848. Los resultados esperados están ligados a la producción y difusión de información sistematizada sobre las transformaciones en salud mental, a la vigilancia y el análisis del efecto/impacto de las políticas e incidir en las decisiones. El Observatorio pretende reconocer e integrar la información disponible y proponer indicadores que den cuenta de la situación inicial al momento de la implementación de los marcos normativos y permitir el monitoreo de las transformaciones emergentes. This project stems from the need for an information system designed to show the transformation of mental health services in the province of Cordoba after the enactment of the Mental Health Act 9848 in October 2010. Once achieved this legislative objective is to monitor the management with the formulation of the following questions: through which indicators to measure, evaluate and monitor whether the production of mental health services are carried forward from the perspective of rights-based approach enacted in two laws?, What are the indicators from that perspective the production agencies should develop services for the commitment to action and accountability to the public? What are the indicators that the public should demand that the purpose of monitoring compliance with these commitments? The launch of the Centre for Mental Health and Human Rights will review the policies and mental health programs from the perspective of human rights and progress in monitoring the production of mental health services. General Objective: to analyze and highlight the achievement of the objectives sanctioned by the Mental Health Act 9848 through the observation, monitoring and impact on mental health policy in the province of Cordoba. Methodology: building human rights indicators for mental health Mental Observatory Health and Human Rights aims to account for the changes that will occur after the enactment of Law 9848. The expected results are linked to production and dissemination of systematic information about changes in mental health, surveillance and analysis of the effect / impact and influence policy decisions. The Centre aims to recognize and integrate the available information and propose indicators that account for the initial situation at the time of implementation of regulatory frameworks and allow monitoring of change emerging.

Subsidizing extra jobs : the economics of marginal employment subsidies

Employment subsidies, wage subsidies, unemployment, displacement