Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

Re-invent yourself: from London intensive care nursing and the Nigerian oil fields to an an academic library in Brisbane; a career change worth making.

A complete change of career forces a seismic shift in every aspect of your life. From day one, you have to face the loss of long held beliefs, behaviours, the known world of self, and security. We came from professions that themselves are poles apart, and many of the challenges we faced entering the profession were the same: juggling full-time work, part time study, and family commitmemts, taking a pay cut, and loss of social life. But over a short period of time we both transitioned to our new profession successfully. so what make our successful transition possible?

Industry culture: a need for change

Research indicates, one of the last available ‘mechanisms’ left for organisations to improve their competitive position within the construction industry is by considering its people (culture) along with its technology (Schein E. H. 1997). In other words, if one wants to make construction industry organisations, groups and project teams more efficient and effective, then one must better understand the role that culture plays within them.

Report on relationship management and culture change

Brisbane Water (BW), a commercialised business arm of Brisbane City Council (BCC) entered into an alliance with a number of organisations from the private sector in order to design, construct, commission and undertake upgrades to three existing wastewater treatment plants located at Sandgate, Oxley Creek, and Wacol in Brisbane. The alliance project is called the Brisbane Water Environmental Alliance (BWEA). This report details the efforts of a team of researchers from the School of Management at Queensland University of Technology to investigate this alliance. This is the second report on this project, and is called Stage 2 of the research. At the time that Stage 2 of the research project was conducted, the BWEA project was nearing completion with a further 8 months remaining before project completion. The aim of this report is to explore individuals’ perceptions of the effectiveness and functioning of the BWEA project in the latter stages of the project. The second aim of this report is to analyse the longitudinal findings of this research project by integrating the findings from Stage 1 and Stage 2 of the project. This long-term analysis of the functioning and effectiveness of the alliance is important because at the current time, researchers have little knowledge of the group developmental processes that occur in large-scale alliances over time. Stage 2 of this research project has a number of aims including assessing performance of the BWEA project from the point of view of a range of stakeholders including the alliance board and alliance management team, alliance staff, and key stakeholders from the client organisation (Brisbane Water). Data were collected using semi-structured interviews with 18 individuals including two board members, one external facilitator, and four staff members from the client organisation. Analysis involved coding the interview transcripts in terms of the major issues that were reported by interviewees.

Down the aisle : the effects of technological change on retail workers skills

Reconfiguration of corporate structures and the retailer-supplier interface in the retail industry have restructured product markets and supply chains, as well as supermarket employment, over the past decade or so (Baret, Lehndorff & Sparks 2000; du Gay 1996). Various studies have examined the consequent changes in labour usage practices within supermarkets or superstores (Baret et al. 2000; Marchington 1995; Penn & Wirth 1993; Sparks 1992; Dawson, Findlay & Sparks 1987, 1986). Commonly, this literature explores the interplay between shifts in the structure of the labour market, broader societal trends and retailers’ employment strategies. One study found that domestic and gender dimensions, accompanied by industrial relations regimes, exert considerable influence on patterns of labour usage (Baret et al. 2000). However, while the types of labour usage and the drivers of changes to labour usage patterns have attracted significant academic attention, research has largely overlooked the ways in which the nature of supermarket work has evolved as a result of changing technology, which effectively bolsters managerial prerogative, and which has affected the skill levels of workers in the industry (Marchington 1995).

Multiple-choice versus short-response items: Differences in omit behavior

The overall rate of omission of items for 28,331 17 year old Australian students on a high stakes test of achievement in the common elements or cognitive skills of the senior school curriculum is reported for a subtest in multiple choice format and a subtest in short response format. For the former, the omit rates were minuscule and there was no significant difference by gender or by type of school attended. For the latter, where an item can be 'worth' up to five times that of a single multiple choice item, the omit rates were between 10 and 20 times that for multiple choice and the difference between male and female omit rate was significant as was the difference between students from government and non-government schools. For both formats, females from single sex schools omitted significantly fewer items than did females from co-educational schools. Some possible explanations of omit behaviour are alluded to.

Developing capabilities for ongoing learning and change in intermediary programs

In dynamic environments, firms seek to build capabilities which will permit them to become innovation and change ready. Programs offered by intermediaries, while varying greatly in content and format, are designed to support those firms wishing to enhance their competitiveness. Firms which participate in intermediary programs have displayed their willingness to overcome deficiencies or barriers to competitiveness through acquiring knowledge which is external to the firm. This paper reports on interviews with 24 firms who were involved in a MAP or TAP program offered by QMI Solutions. The findings of the research suggest that knowledge intermediaries serve to disrupt organisational paths and in so doing establish mechanisms for ongoing learning and change. They do this first by disrupting the firm with a positive learning experience and also by establishing processes for developing new relationships and access to knowledge which are critical for learning and change. It is the experience of learning through knowledge exchange which can trigger the pursuit of new paths and it is the processes involving new relations and knowledge processing that provides the micro-foundations for ongoing learning and change. This suggests that the role of intermediaries goes well beyond merely knowledge transfer to include longer term effects on the capability of organisations to innovate, which is critical to economic competitiveness and the survival rate of firms.

Construction supply chain economic policy implementation for sectoral change : moving beyond the rhetoric

Construction sector policy makers have the opportunity to create improvements and develop economic, social and environmental sustainability through supply chain economics. The idea of the supply chain concept to improve firm behaviour and industry performance is not new. However there has been limited application and little or no measurement to monitor successful implementation. Often purchasing policies have been developed with sound strategic procurement principles but even these have had limited penetration in to the processes and practices of infrastructure agencies. The research reported in this paper documents an action research study currently being undertaken in the Australian construction sector which aims to explore supply chain economic policy implementation for sectoral change by two government agencies. The theory which informs this study is the emerging area of construction supply chain economics. There are five stages to the project including; demand analysis, chain analysis, government agency organizational audit, supplier strategy and strategic alignment. The overall objective is towards the development of a Supplier Group Strategy Map for two public sector agencies. Two construction subsectors are examined in detail; construction and demolition waste and precast concrete. Both of these subsectors are critical to the economic and environmental sustainability performance of the construction sector and the community as a whole in the particular jurisdictions. The local and state government agencies who are at the core of the case studies rely individually on the performance of these sectors. The study is set within the context of a sound state purchasing policy that has however, had limited application by the two agencies. Partial results of the study are presented and early findings indicate that the standard risk versus expenditure procurement model does not capture the complexities of project, owner and government risk considerations. A new model is proposed in this paper, which incorporates the added dimension of time. The research results have numerous stakeholders; they will hold particular value for those interested in regional construction sector economics, government agencies who develop and implement policy and who have a large construction purchasing imprint and the players involved in the two subsectors. Even though this is a study in Australia it has widespread applicability as previous research indicates that procurement reform is of international significance and policy implementation is problematic.

Sociometric stability and the behavioral correlates of peer acceptance in early childhood

This paper presents findings from an Australian study examining the behavioral correlates and stability of social status for preschool-aged children. The social status of an initial sample of 187 (94 boys and 93 girls) preschool children (mean age 62.4 months, SD = 4.22) was determined through sociometric assessment. Children classified as rejected, neglected and popular (n = 70) were selected for observation. Children were observed for a total of 25 minutes over a three-month period engaging in free play within their preschool centers. Results indicated that children classified as popular were more likely than rejected or neglected children to engage in cooperative play, ongoing connected conversation and to display positive affect. Popular children were less likely than rejected or neglected children to engage in parallel play, onlooker behavior or alone directed behavior. Six months after initial sociometric classification, sociometric interviews were repeated to test for stability and change. Results indicated that preschool-aged children’s social status classifications showed a moderate to high rate of stability for those children classified as popular, rejected and neglected.

Social change grant-making : a failure of innovation?

Focusing primarily on Anglophone countries, this article begins by looking at the changing environment of foundations, the pressures on foundations and some responses to those pressures. It then focuses on the potential of a structural change approach - often known as 'social change' or 'social justice' grant-making - as a solution to some of the modern dilemmas of foundations, and considers why this approach has, with some exceptions, gained relatively little support. This raises the wider issues of why and how resource-independent, endowed foundations change when conventional explanations of organisational change do not easily apply. Researching a 'lack' is clearly difficult; this article adopts an analytic perspective, examining the characteristics of the structural change approach as a mimetic model, and draws on the work of Rogers (2003) on the characteristics required for the successful diffusion of innovations. It suggests that the structural change approach suffers from some fundamental weaknesses as a mimetic model, failing to meet some key characteristics for the diffusion of innovations. In conclusion, the article looks at conditions under which these weaknesses may be overcome.

Conceptualising value creation for social change management

Australian and international governments are increasingly adopting social marketing as a social change management tool to deal with complex social problems. Government decision makers typically need to balance the use of business models and management theories whilst maintaining the integrity of government policy. In taking this approach, decision makers experience management tensions between a social mission to equitably deliver social services and the accountability and affordability of providing quality social and health services to citizens. This is a significant challenge as the nature of the ‘social product’ in government is often more service-oriented than goods-based. In this paper the authors examine value creation in government social marketing services. The contribution of this paper is a value creation process model, which considers the nature of governments to create social good. This is particularly important for governments where consumers still expect value and quality in the service delivered, despite that offering being ‘free’.

Examining the antecedents and consequences of ritualized fan behavior [Abstract]

One of the features of the sporting industry is the ritualized way in which it is consumed across the world. Fans of every sport have rituals and superstitions to help them enjoy the spectacle, socialize with other like-minded fans, and reduce some of the anxiety of watching their team play. These rituals include dress, barracking styles and pre and post match behaviors. What is not known are the factors that lead fans to engage in ritual behaviors and what relationship rituals have with desirable outcomes such as increased attendance, attitudinal loyalty or satisfaction. Given that some ritual behaviors are clearly undesirable, (e.g., hooliganism), understanding these relationships is important to managers who may be questioning whether rituals should be encouraged. Although ritualized behavior amongst fans is clearly visible, the symbolic and emotional nature of ritual poses challenges to researchers. Most previous ritual research is exploratory and qualitative in nature. This study, however, uses a behavior-based scale to measure fan ritual and relates it to desirable outcomes such as commitment and attendance. Over 2,000 season ticket holders of a football (soccer) team in Australia’s professional A-League competition were surveyed to investigate the antecedents and consequences of fan ritual behavior. Cluster analysis was used to explore the characteristics of respondents, and it revealed that those fans that engage in ritual behavior also differed on many other demographic and attitudinal dimensions. The associations between ritual and psychological commitment, and ritual and attendance are positive and significant. When used in conjunction with other constructs, fan ritual also improves the explanation of attendance behavior. The findings support previous research that found a significant and positive relationship between team identification, involvement and attendance, and extend previous research by finding a significant and positive relationship between rituals and attendance. For sports marketing practitioners, the results indicate the importance of developing and managing consumption rituals tied to game day attendance, with a view to generating uncommon loyalty.

The big brother : monitoring urban growth and change for sustainable infrastructure provision

Monitoring urban growth and land-use change is an important issue for sustainable infrastructure planning. Rapid urban development, sprawl and increasing population pressure, particularly in developing nations, are resulting in deterioration of infrastructure facilities, loss of productive agricultural lands and open spaces, pollution, health hazards and micro-climatic changes. In addressing these issues effectively, it is crucial to collect up-to-date and accurate data and monitor the changing environment at regular intervals. This chapter discusses the role of geospatial technologies for mapping and monitoring the changing environment and urban structure, where such technologies are highly useful for sustainable infrastructure planning and provision.