Una Estimación del Impacto del Gasto en Atención a la Dependencia en Andalucía

La atención a la dependencia es, sin lugar a dudas, uno de los grandes retos de futuro de las sociedades que envejecen aceleradamente, al que España y Andalucía no sólo no son ajenos, sino que presentan rasgos que lo amplifican. Sin embargo, es un fenómeno que adolece de importantes lagunas de información, fundamentalmente la carencia de una perspectiva integral que conecte la realidad social, el cambio económico, y la necesidad de transformación de los modelos de bienestar en general y de cuidados en particular, el gasto necesario para su desarrollo y el impacto económico asociado; enfoque holístico que se adopta en este trabajo. Dentro del marco expuesto el objetivo principal del trabajo es cuantificar el impacto en términos de actividad, empleo y retorno fiscal, así como la relación entre la prestación recibida y las características de los dependientes, que permita avanzar en la consideración de este gasto social como una inversión. Para la estimación de los impactos se ha utilizado el Marco Input-Output de Andalucía (MIOAN) de 2010. No obstante, para calcular los incrementos de renta generados por los requerimientos producidos, se ha endogeneizado la demanda de consumo, esto ha implicado construir expresamente para este cálculo una matriz ampliada de Leontief, procediendo a una estimación especifica de la fila adicional ampliada. Finalmente para estimar la relación entre prestación y características de los dependientes se han construido distintos modelos logísticos binarios, y un modelo multinomial. Desarrollado el trabajo de investigación y cuantificado el impacto, la conclusión fundamental no es sólo fuerte efecto arrastre del gasto en dependencia en la actividad y el empleo , sino que se produce en el marco de un cambio irreversible que sitúa a los Cuidados de Larga Duración asociados a la dependencia con un papel central en el contexto de la evolución del Estado el Bienestar. En concreto se ha verificado que: • Andalucía realiza un elevado gasto en atención a la dependencia, 1314 millones de euros, un 85 % del cual total es público y un 15 % privado, y que este gasto genera un fuerte impacto en la economía andaluza, pues su contribución a los grandes agregados macroeconómicos de Andalucía es de un 0,9 % del PIB, superior al impulso de demanda que supone el gasto en atención a la dependencia. • La atención a la dependencia ha mostrado una elevada capacidad de generación de empleo, más de 40.000 empleos, muy concentrado además en personas de difícil inserción en el mercado laboral, mujeres maduras de cualificación media-baja y con poca experiencia acreditable en sector formal de la atención. • La relación entre usuarios, gasto, e impacto para las trasferencias y los servicios muestra un modelo en escalera que caracteriza un sistema de universalización de coste medio con impacto moderado. Un modelo en el que las transferencias suponen el 50 % de los atendidos, el 30 % del gasto y el 20 % del impacto. • El retorno fiscal generado por la dependencia es muy elevado, casi del 45%. • El esfuerzo financiero, tanto bruto como neto, descontado el retorno vía impuestos que obtiene de cada administración, es muy asimétrico lo que puede generar un efecto desincentivador del desarrollo de un modelo con más servicios frente a transferencias. • Las características de los dependientes condicionan la prestación que parece ajustarse a los la características personales y de grado de discapacidad más que las socioeconómicas.

Changing family models in Spain: the impact of the sociodemographic factors

Abstract During the last few decades, there has been an increasing international recognition of the studies related to the analysis of the family models change, the focus being the determinants of the female employment and the problems related to the work family balance (Lewis, 2001; Petit & Hook, 2005Saraceno, Crompton & Lyonette, 20062008; Pfau-Effinger, 2012). The majority of these studies have been focused on the analysis of the work-family balance problems as well as the effectiveness of the family and gender policies in order to encourage female employment (Korpi et al., 2013). In Spain, special attention has been given to the family policies implemented, the employability of women and on the role of the father in the family (Flaquer et al., 2015; Meil, 2015); however, there has been far less emphasis on the analysis of the family cultural models (González and Jurado, 2012; Crespi and Moreno, 2016). The purpose of this paper is to present some of the first results on the influence of the socio-demographic factors on the expectations and attitudes about the family models. This study offers an analytical reflection upon the foundation of the determinants of the family ambivalence in Spain from the cultural and the institutional dimension. This study shows the Spanish family models of preferences following the Pfau-Effinger (2004) classification of the famiy living arrangements. The reason for this study is twofold; on the one hand, there is confirmed the scarcity of studies that have focused their attention on this objective in Spain; on the other hand, the studies carried out in the international context have confirmed the analytical effectiveness of researching on the attitude and value changes to explain the meaning and trends of the family changes. There is also presented some preliminary results that have been obtained from the multinomial analysis related to the influence of the socio-demographic factors on the family model chosen by the individuals in Spain (father and mother working full time; mother part-time father full-time; mother not at work father full-time; mother and father part-time). 3 The database used has been the International Social Survey Programme: Family and Changing Gender Roles IV- ISSP 2012-. Spain is the only country of South Europe that has participated in the survey. For this reason it has been considered as a representative case study.

Detecting Free Riders in Collective Brands through a Hierarchical Choice Process

Free-riding behaviors exist in tourism and they should be analyzed from a comprehensive perspective; while the literature has mainly focused on free riders operating in a destination, the destinations themselves might also free ride when they are under the umbrella of a collective brand. The objective of this article is to detect potential free-riding destinations by estimating the contribution of the different individual destinations to their collective brands, from the point of view of consumer perception. We argue that these individual contributions can be better understood by reflecting the various stages that tourists follow to reach their final decision. A hierarchical choice process is proposed in which the following choices are nested (not independent): “whether to buy,” “what collective brand to buy,” and “what individual brand to buy.” A Mixed Logit model confirms this sequence, which permits estimation of individual contributions and detection of free riders.

Resource endowment and opportunity cost effects along the stages of entrepreneurship

In this paper, the start-up process is split conceptually into four stages: considering entrepreneurship, intending to start a new business in the next 3 years, nascent entrepreneurship and owning-managing a newly established business. We investigate the determinants of all of these jointly, using a multinomial logit model; it allows for the effects of resources and capabilities to vary across these stages. We employ the Global Entrepreneurship Monitor database for the years 2006–2009, containing 8269 usable observations from respondents drawn from the Lower Layer Super Output Areas in the East Midlands (UK) so that individual observations are linked to space. Our results show that the role of education, experience, and availability of ‘entrepreneurial capital’ in the local neighbourhood varies along the different stages of the entrepreneurial process. In the early stages, the negative (opportunity cost) effect of resources endowment dominates, yet it tends to reverse in the advanced stages, where the positive effect of resources becomes stronger.

What to do when K-means clustering fails:a simple yet principled alternative algorithm

The K-means algorithm is one of the most popular clustering algorithms in current use as it is relatively fast yet simple to understand and deploy in practice. Nevertheless, its use entails certain restrictive assumptions about the data, the negative consequences of which are not always immediately apparent, as we demonstrate. While more flexible algorithms have been developed, their widespread use has been hindered by their computational and technical complexity. Motivated by these considerations, we present a flexible alternative to K-means that relaxes most of the assumptions, whilst remaining almost as fast and simple. This novel algorithm which we call MAP-DP (maximum a-posteriori Dirichlet process mixtures), is statistically rigorous as it is based on nonparametric Bayesian Dirichlet process mixture modeling. This approach allows us to overcome most of the limitations imposed by K-means. The number of clusters K is estimated from the data instead of being fixed a-priori as in K-means. In addition, while K-means is restricted to continuous data, the MAP-DP framework can be applied to many kinds of data, for example, binary, count or ordinal data. Also, it can efficiently separate outliers from the data. This additional flexibility does not incur a significant computational overhead compared to K-means with MAP-DP convergence typically achieved in the order of seconds for many practical problems. Finally, in contrast to K-means, since the algorithm is based on an underlying statistical model, the MAP-DP framework can deal with missing data and enables model testing such as cross validation in a principled way. We demonstrate the simplicity and effectiveness of this algorithm on the health informatics problem of clinical sub-typing in a cluster of diseases known as parkinsonism.

Evaluación de costo efectividad de la profilaxis versus tratamiento a demanda en pacientes con Hemofilia A moderada y severa para prevenir sangrado articular de una aseguradora en Colombia

Introducción: En Colombia existe un protocolo de manejo para pacientes con hemofilia A severa sin inhibidores que recomienda el manejo de profilaxis primaria y secundaria con FVIII. Objetivos: Estimar la relación incremental de costo-efectividad (RICE) de la profilaxis con Factor VIII vs tratamiento a demanda para prevenir sangrados articulares en pacientes con hemofilia A moderada y severa de una aseguradora en Colombia. Materiales y Métodos: Se adaptó un modelo de Markov desde la perspectiva del tercer pagador. Las probabilidades de transición se ajustaron mediante un modelo de regresión logística multinomial explicadas por la edad y el peso. Las tasas de eventos son anuales. Las efectividades se extrajeron de la cohorte de la aseguradora y de la literatura. Los costos incluyeron el FVIII, medicamentos, hospitalización, procedimientos quirúrgicos, apoyo diagnóstico y consultas médicas. La tasa de descuento fue del 3%. Resultados: En pacientes con hemofilia A moderada y severa la profilaxis con FVIII evitará en promedio 7 sangrados articulares, el RICE para el sangrado articular es de $303.457. Conclusiones: La profilaxis con Factor VIII es una estrategia costo-efectiva en el manejo de pacientes con hemofilia A moderada y severa para la aseguradora, disminuyendo el número de sangrados articulares al año.

L'identità di Pohozaev come applicazione del teorema della divergenza

In questa tesi verrà enunciato e dimostrato un notevole teorema chiamato identità di Pohozaev, che riguarda le soluzioni di particolari problemi di Dirichlet per il Laplaciano. Questo risultato sarà ottenuto come corollario del classico teorema della divergenza. Dopo alcune nozioni preliminari, si enuncia il teorema della divergenza. Infine, dopo una breve introduzione riguardo le equazioni alle derivate parziali del 2° ordine e problemi di Dirichlet per il Laplaciano, viene enunciata e dimostrata l'identità di Pohozaev. Seguono alcuni corollari, dei quali uno riguarda la non esistenza di soluzioni per un particolare problema di Dirichlet.

Principio del massimo per operatori lineari ellittici

All'interno della tesi viene analizzato il principio del massimo per l'operatore di Laplace e per operatori lineari ellittici differenziali. Attraverso l'utilizzo delle formule di media si dimostra il principio del massimo forte e debole per l'operatore di Laplace e si analizzano le sue applicazioni, quali la disuguaglianza di Harnack, il teorema di Liouville e il teorema fondamentale dell'algebra. Successivamente si vanno a dimostrare il principio del massimo debole e, tramite il lemma di Hopf, il principio del massimo forte, per operatori lineari ellittici differenziali. Infine si studia il caso dell'unicità delle soluzioni dei problemi di Dirichlet per operatori lineari ellittici differenziali, sfruttando il principio del massimo debole.