Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities

This paper uses a two-sided market model of hospital competition to study the implications of di§erent remunerations schemes on the physiciansí side. The two-sided market approach is characterized by the concept of common network externality (CNE) introduced by Bardey et al. (2010). This type of externality occurs when occurs when both sides value, possibly with di§erent intensities, the same network externality. We explicitly introduce e§ort exerted by doctors. By increasing the number of medical acts (which involves a costly e§ort) the doctor can increase the quality of service o§ered to patients (over and above the level implied by the CNE). We Örst consider pure salary, capitation or fee-for-service schemes. Then, we study schemes that mix fee-for-service with either salary or capitation payments. We show that salary schemes (either pure or in combination with fee-for-service) are more patient friendly than (pure or mixed) capitations schemes. This comparison is exactly reversed on the providersíside. Quite surprisingly, patients always loose when a fee-for-service scheme is introduced (pure of mixed). This is true even though the fee-for-service is the only way to induce the providers to exert e§ort and it holds whatever the patientsívaluation of this e§ort. In other words, the increase in quality brought about by the fee-for-service is more than compensated by the increase in fees faced by patients.

Importance of self-efficacy in psychoendocrine responses to competition and performance in women

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Anisotropic dispersion, space competition, and the slowdown of the Neolithic transition

The front speed of the Neolithic (farmer) spread in Europe decreased as it reached Northern latitudes, where the Mesolithic (huntergatherer) population density was higher. Here, we describe a reaction diffusion model with (i) an anisotropic dispersion kernel depending on the Mesolithic population density gradient and (ii) a modified population growth equation. Both effects are related to the space available for the Neolithic population. The model is able to explain the slowdown of the Neolithic front as observed from archaeological data

Research based design: competition proposal for the Cyprus news agency

The paper attempts to explore the interrelation between a) the architects’ individualism and “pre-structures” b) research- based findings during the design process through experimentation and c)an integrated design approach, where morphology, construction and bioclimatic design are integrated from an early design stage. Through a thorough presentation and analysis of a competition proposal for the Cyprus News Agency, we discuss a number of important findings in relation to the present and possibly future form of the design studio. We suggest that the designer’s “prestructures” may not only be the basis for creative action, but also the basis for understanding and interpretation. Design informed and enriched at every stage by a research-based process, might well be the transmission and transformation of “prestructures”, a process of elaboration and discovery which facilitates and enhances design creativity and possibly allows for a multiplicity of approaches through a range of possibilities. Furthermore, an integrated approach from the early stages of the design process facilitates innovation in materials and systems.

Unleashing Competition in EU Business Services. CEPS Policy Brief No. 284, 24 September 2012

In most EU member states, the business services industry has booked no productivity growth during the last two decades. The industry’s performance in the other member states was weaker than that of its US counterparts. Exploring what may be causing this productivity stagnation, this policy brief reports that weak competition has contributed to the continuing malaise in European business services. The study analyzed the persistence (over time) of firm-level inefficiencies. The evidence further suggests that competition between small firms and large firms in business services is weak. Markets for business services work best in countries with flexible regulation on employment change and with low regulatory costs for firms that start up or close down a business. Countries that are more open to foreign competition perform better in terms of competitive selection and productivity. The policy simulations in this paper show that greater import openness strengthens competition in business services markets. The largest positive impact comes from lower regulatory barriers for growing and shrinking firms. More particularly, competitive selection would be fostered by a reduction of administrative and regulatory costs related to labour contracts, bankruptcy and start-up requirements. A key element of the European Commission’s Europe-2020 strategy is the Single European Market for Services. Business services form one of the largest industries in Europe – and given its productivity stagnation, it deserves to be a priority target of the Europe-2020 strategy. Improving the way the business services market functions may have large positive knock-on effects for the EU economy.

Competition in tree row agroforestry systems. 3. Soil water distribution and dynamics

The purpose of this study was to test the hypothesis that soil water content would vary spatially with distance from a tree row and that the effect would differ according to tree species. A field study was conducted on a kaolinitic Oxisol in the sub-humid highlands of western Kenya to compare soil water distribution and dynamics in a maize monoculture with that under maize (Zea mays L.) intercropped with a 3-year-old tree row of Grevillea robusta A. Cunn. Ex R. Br. (grevillea) and hedgerow of Senna spectabilis DC. (senna). Soil water content was measured at weekly intervals during one cropping season using a neutron probe. Measurements were made from 20 cm to a depth of 225 cm at distances of 75, 150, 300 and 525 cm from the tree rows. The amount of water stored was greater under the sole maize crop than the agroforestry systems, especially the grevillea-maize system. Stored soil water in the grevillea-maize system increased with increasing distance from the tree row but in the senna-maize system, it decreased between 75 and 300 cm from the hedgerow. Soil water content increased least and more slowly early in the season in the grevillea-maize system, and drying was also evident as the frequency of rain declined. Soil water content at the end of the cropping season was similar to that at the start of the season in the grevillea-maize system, but about 50 and 80 mm greater in the senna-maize and sole maize systems, respectively. The seasonal water balance showed there was 140 mm, of drainage from the sole maize system. A similar amount was lost from the agroforestry systems (about 160 mm in the grevillea-maize system and 145 mm in the senna-maize system) through drainage or tree uptake. The possible benefits of reduced soil evaporation and crop transpiration close to a tree row were not evident in the grevillea-maize system, but appeared to greatly compensate for water uptake losses in the senna-maize system. Grevillea, managed as a tree row, reduced stored soil water to a greater extent than senna, managed as a hedgerow.