Hospital performance:efficiency or quality? Can we have both with IT?

The influence of IT investment on hospital efficiency and quality are of great interest to healthcare executives as well as insurers. Few studies have examined how IT investments influence both efficiency and quality or whether there is an optimal IT investment level that influences both in the desired direction. Decision makers in healthcare wonder if there are tradeoffs between their pursuit of hospital operational efficiency and quality. Our study involving a 2-stage double bootstrap DEA analysis of 187 US hospitals over 2. years found direct effects of IT investment upon service quality and a moderating effect of quality upon operational efficiency. Further, our findings indicate a U-shaped relationship between IT investments and operational efficiency suggesting that IT investments have diminishing returns beyond a certain point.

Finding the Relationship between a Search Algorithm and a Class of Functions on Discrete Space by Exhaustive Search

* The work is supported by RFBR, grant 04-01-00858-a.

Data Mining for Software Development Life Cycle Quality Management

Computer software plays an important role in business, government, society and sciences. To solve real-world problems, it is very important to measure the quality and reliability in the software development life cycle (SDLC). Software Engineering (SE) is the computing field concerned with designing, developing, implementing, maintaining and modifying software. The present paper gives an overview of the Data Mining (DM) techniques that can be applied to various types of SE data in order to solve the challenges posed by SE tasks such as programming, bug detection, debugging and maintenance. A specific DM software is discussed, namely one of the analytical tools for analyzing data and summarizing the relationships that have been identified. The paper concludes that the proposed techniques of DM within the domain of SE could be well applied in fields such as Customer Relationship Management (CRM), eCommerce and eGovernment. ACM Computing Classification System (1998): H.2.8.

Impact of severity and type of depression on quality of life in cases identified in the community

BACKGROUND: The impact of different levels of depression severity on quality of life (QoL) is not well studied, particularly regarding ICD-10 criteria. The ICD classification of depressive episodes in three levels of severity is also controversial and the less severe category, mild, has been considered as unnecessary and not clearly distinguishable from non-clinical states. The present work aimed to test the relationship between depression severity according to ICD-10 criteria and several dimensions of functioning as assessed by Medical Outcome Study (MOS) 36-item Short Form general health survey (SF-36) at the population level. METHOD: A sample of 551 participants from the second phase of the Outcome of Depression International Network (ODIN) study (228 controls without depression and 313 persons fulfilling ICD criteria for depressive episode) was selected for a further assessment of several variables, including QoL related to physical and mental health as measured with the SF-36. RESULTS: Statistically significant differences between controls and the depression group were found in both physical and mental markers of health, regardless of the level of depression severity; however, there were very few differences in QoL between levels of depression as defined by ICD-10. Regardless of the presence of depression, disability, widowed status, being a woman and older age were associated with worse QoL in a structural equation analysis with covariates. Likewise, there were no differences according to the type of depression (single-episode versus recurrent). CONCLUSIONS: These results cast doubt on the adequacy of the current ICD classification of depression in three levels of severity.

The effects of attribute quality information and sources of information on consumers' perceptions and behavior: A model of Pre-purchase Information Utilization in Service Physical Environments

The search-experience-credence framework from economics of information, the human-environment relations models from environmental psychology, and the consumer evaluation process from services marketing provide a conceptual basis for testing the model of "Pre-purchase Information Utilization in Service Physical Environments." The model addresses the effects of informational signs, as a dimension of the service physical environment, on consumers' perceptions (perceived veracity and perceived performance risk), emotions (pleasure) and behavior (willingness to buy). The informational signs provide attribute quality information (search and experience) through non-personal sources of information (simulated word-of-mouth and non-personal advocate sources).^ This dissertation examines: (1) the hypothesized relationships addressed in the model of "Pre-purchase Information Utilization in Service Physical Environments" among informational signs, perceived veracity, perceived performance risk, pleasure, and willingness to buy, and (2) the effects of attribute quality information and sources of information on consumers' perceived veracity and perceived performance risk.^ This research is the first in-depth study about the role and effects of information in service physical environments. Using a 2 x 2 between subjects experimental research procedure, undergraduate students were exposed to the informational signs in a simulated service physical environment. The service physical environments were simulated through color photographic slides.^ The results of the study suggest that: (1) the relationship between informational signs and willingness to buy is mediated by perceived veracity, perceived performance risk and pleasure, (2) experience attribute information shows higher perceived veracity and lower perceived performance risk when compared to search attribute information, and (3) information provided through simulated word-of-mouth shows higher perceived veracity and lower perceived performance risk when compared to information provided through non-personal advocate sources. ^

Historical development of residential segregation and black housing quality in Dade County

This paper examines the relationship between the historical development of residential segregation in Black areas of Dade County and the level of housing quality in those areas. Previous literature studies the effect of hypersegregation on housing quality. Instead, this paper analyzes the nature of each Black community and the social process by which they became segregated in contrast with only hypersegregation being considered. Data were drawn from the 1990 Census of Housing and Population at the block group level for Dade County. Two indicators for housing quality were considered: crowding and rent. Six categories for Black areas in Dade County and one residual category were developed for the analysis. Regression's results show that the effect of each community on housing quality varies. For example, overcrowding goes down in first-ghetto areas when compared to second-ghetto areas, although the percentage of Blacks in both communities is about the same. ^

Leadership power bases related to satisfaction, compliance, and program quality

The dissertation examined prekindergarten teachers' perceptions of their supervisory relationship with their educational specialist, and the effect of the prekindergarten teachers' perceptions on the quality of the High/Scope prekindergarten program. The High/Scope educational specialists use their leader power bases (reward, coercive, legitimate, referent, expert and informational) to influence teachers' perceptions of satisfaction and compliance, as well as teachers' actual compliance with the High/Scope prekindergarten program standards. The correlational relationships between the variables were examined using Analysis of Variance and Multivariate Analysis of Variance. Path Analysis was utilized to analyze variables to determine the validity of the correlational model. Expert, legitimate, referent, and informational power bases of the High/Scope educational specialist were found to be the most influential on attitudinal and behavioral compliance of teachers. ^

Best practices in exemplary service delivery: A multiple case study of service quality

The purpose of this study was to explain how exemplary service providers in luxury hotels provide consistently excellent service. Using a case study framework, the study investigated the service provider's strategies and concepts of service delivery, the importance and implementation of organizational and individual controls, and the role of training and learning. The study identified barriers to service provision and characteristics of the exemplary individuals that affect their ability to deliver luxury service. This study sought to better understand how exemplary service providers learn, think about, and do their work. The sample population of three Five-Diamond-Award winning resorts was selected for their potential for learning about the phenomenon of interest. The results demonstrate that exemplary service providers possess individual characteristics that are enhanced by the organizations for which they work. Exemplary service providers are often exemplary communicators who are emotionally generous and genuinely enjoy helping and serving others. Exemplary service organizations treat their employees as they treat their customers, as suggested by the Service-Profit Chain (Heskett, Sasser & Schlesinger, 1997). Further, they have systems and standards to guarantee satisfactory service experiences for every guest. They also encourage their service providers to personalize their service delivery and to seek opportunities to delight their guests, using a combination of controls, traditions and cultural values. Several customer service theories are discussed in relationship to whether they were or were not supported by the data. The study concluded that the delivery of exemplary service is a complex phenomenon that requires successful interactions between guests, service providers and the organization. A Model of Exemplary Service Delivery is presented and discussed that demonstrates the components of service quality as shown in the data. The model can be used by practitioners seeking to create, enhance, or evaluate their service quality, and by researchers seeking insights into the complex concepts in service quality research. Implications for future research are discussed.

Intercollegiate athletics and college rankings: An analysis of the relationship between athletic success and the U.S. News and World Report college rankings

The purpose of this study was to gain a greater understanding of the relationship between athletic success of football and men's basketball and the U.S. News and World Report (USNWR) college rankings. There has been consistent debate among researchers who study institutional quality about whether intercollegiate athletics enhances reputation. This study is similar to other studies attempting to measure the relationship between athletic success and possible indirect benefits to the university from athletics, such as increased admissions applications and increased alumni donations and giving. This study offered a more nuanced model for measuring athletic success, a concept that has been difficult to measure quantitatively. The method used here also measured change over time (in this case, from year-to-year over an eleven year period). The research questions for this study were (a) is there a correlation between athletic success and the USNWR college ranking; and (b) is there a correlation in the change from year-to-year in athletic success with the change from year-to-year in the USNWR college rankings? Spearman Rho correlation and ANOVA tests were used to answer these research questions. The results from the statistical tests demonstrated little correlation between athletic success, whether in football or men's basketball, with the USNWR college rankings. Although the relationships were weak, men's basketball success consistently demonstrated a stronger relationship than football success. This finding differed from what is most often found in the literature, which often favors football success. The ANOVA test results did reveal some results that suggest athletic participation is a factor in the USNWR college rankings. As the debate continues about whether intercollegiate athletics enhances reputation, and as colleges and universities continue spending enormously on athletics, a keener understanding about the possible indirect benefits to the university from athletic programs is needed. The "advertising" provided by spectator sports such as football and men's basketball is often assumed by university leaders to present substantial indirect benefits for the university. However, the existing research along with this study provides little evidence of such opportunities.

Trading democracy for security? The effects of the international drug war on the quality of democracy in the Dominican Republic, 1996–2008

The purpose of the research is to study the relationship between international drug interdiction policies and domestic politics in fragile democracies, and to demonstrate how international drug control policies and the use of force fit the rhetoric of war, are legitimized by the principles of a just war, but may also cause collateral damage and negative unintended consequences. The method used is a case study of the Dominican Republic. The research has found that international drug control regimes, primarily led by the U.S. and narrowly focused on interdiction, have influenced an increasingly militarized approach to domestic law enforcement in the Dominican Republic. The collateral damage caused by militarized enforcement comes in the form of negative perceptions of citizen security, loss of respect for the rule of law and due process, and low levels of civil society development. The drug war has exposed the need for significant reform of the institutions charged with carrying out enforcement, the police force and the judicial system in particular. The dissertation concludes that the extent of drug trafficking in the Dominican Republic is beyond the scope of domestic reform efforts alone, but that the programs implemented do show some potential for future success. The dissertation also concludes that the framework of warfare is not the most appropriate for the international problems of drug traffic and abuse. A broader, multipronged approach should be considered by world policy makers in order to address all conditions that allow drugs to flourish without infringing upon democratic and civil rights in the process.

Glycemic control: Risk factors, quality of life, workforce participation, and mortality among US adults with type 2 diabetes

Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, (1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) .7%), borderline (HbA1c 7-8.9%), and poor (HbA1c .9%) glycemic control and potentially new risk factors (e.g. work characteristics), and (2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with glycemic control; and (3) using prospective data, assess the relationship between mortality risk and glycemic control in US adults with type 2 diabetes. Data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys were used. HbA1c values were used to create dichotomous glycemic control indicators. Binary logistic regression models were used to assess relationships between risk factors, employment status and glycemic control. Multinomial logistic regression analyses were conducted to assess relationships between glycemic control and HRQOL variables. Zero-inflated Poisson regression models were used to assess relationships between missed work days and glycemic control. Cox-proportional hazard models were used to assess effects of glycemic control on mortality risk. Using STATA software, analyses were weighted to account for complex survey design and non-response. Multivariable models adjusted for socio-demographics, body mass index, among other variables. Results revealed that being a farm worker and working over 40 hours/week were risk factors for suboptimal glycemic control. Having greater days of poor mental was associated with suboptimal, borderline, and poor glycemic control. Having greater days of inactivity was associated with poor glycemic control while having greater days of poor physical health was associated with borderline glycemic control. There were no statistically significant relationships between glycemic control, self-reported general health, employment, and missed work. Finally, having an HbA1c value less than 6.5% was protective against mortality. The findings suggest that work-related factors are important in a person’s ability to reach optimal diabetes management levels. Poor glycemic control appears to have significant detrimental effects on HRQOL.^

Improving publicly funded human services: Incorporating capacity building into the contracting relationship between Children's Services Councils and nonprofit organizations

This qualitative two-site case study examined the capacity building practices that Children’s Services Councils (CSCs), independent units of local government, provide to nonprofit organizations (NPOs) contracted to deliver human services. The contracting literature is replete with recommendations for government to provide capacity building to contracted NPOs, yet there is a dearth of scholarship on this topic. The study’s purpose was to increase the understanding of capacity building provided in a local government contracting setting. Data collection consisted primarily of in-depth interviews and focus groups with 73 staff from two CSCs and 28 contracted NPOs. Interview data were supplemented by participant observation and review of secondary data. The study analyzed capacity building needs, practices, influencing factors, and outcomes. The study identified NPO capacity building needs in: documentation and reporting, financial management, program monitoring and evaluation, participant recruitment and retention, and program quality. Additionally, sixteen different types of CSC capacity building practices were identified. Results indicated that three major factors impacted CSC capacity building: CSC capacity building goals, the relationship between the CSC and NPOs, and the level of NPO participation. Study results also provided insight into the dynamics of the CSC capacity building process, including unique problems, challenges, and opportunities as well as necessary resources. The results indicated that the CSCs’ relational contracting approach facilitated CSC capacity building and that CSC contract managers were central players in the process. The study provided evidence that local government agencies can serve as effective builders of NPO capacity. Additionally, results indicated that much of what is known about capacity building can be applied in this previously unstudied capacity building setting. Finally, the study laid the groundwork for future development of a model for capacity building in a local government contracting setting.

Understanding the relationship between the Talented Twenty program and college aspirations for high ranking students at a high priority school

Percentage plans such as the Talented Twenty program purport to assist and motivate high ranking students to attend college and grant access to higher education. This type of plan is particularly important to students enrolled in high priority schools who might not view themselves as potential college students. This study examined the relationship between Florida’s Talented Twenty program that begins intervention with juniors and the college aspirations for high ranking students at a high priority school. Numerous studies have established that increased levels of education lead to higher salaries, career mobility, and an increased quality of life (e.g., Bowen, 1997; Leslie & Brinkman 1988; Pascarella & Terenzini, 1991, Swail, 2000). Given the importance of students’ decisions regarding whether or not they will attend college, understanding how and when they make decisions about attending college is important for them, their parents, advisors, and educational administrators. This research examined students’ perceptions and insights via interviews. The overarching research question was: How do high ranking high school students attending a high priority school in a south Florida district perceive their college opportunities? Sixteen high ranking students, grades nine – 12 from a high priority school in Miami-Dade County participated in the study. Participants were identified by a school counselor and individual semi structured interviews were conducted at the school. Utilizing a student development theoretical framework developed by Hossler and Gallagher (1987) that centered on students’ predisposition, search strategies and choices, data were organized and emergent themes analyzed. The analysis of the data revealed that in alignment with the framework (a) parents were the strongest influence in the development of these students’ college aspirations, (b) these students formalized their higher education plans between eighth and 10th grade, (c) these students actively engaged in academic searches and learning opportunities that increased their chances to be admitted into college, and (d) there was no relationship between knowledge regarding the Talented Twenty program and their educational decisions. This study’s findings suggest that interventions and programs intended to influence the educational aspirations of students are more likely to succeed if they take place by the eighth or ninth grade.

Model of Service Quality: Customer Loyalty for Hotels

The authors investigate the relationship between loyalty and perceived service quality of hotel customers and discus managerial implications to develop strategies to enhance loyalty of hotel customers. A survey was conducted among customers in the San Francisco Bay Area. Results indicate that customer loyalty is dependent on perceived service quality which is observed in terms of timelines, facilities, and ambience.

Personality and job performance: The mediating roles of leader -member exchange quality and action control

The present investigation examined the relationships among personality (as conceptualized by the Big Five Factors), leader-member exchange (LMX) quality, action control, organizational citizenship behaviors (OCB), and overall job performance (OJP). Two mediator variables were proposed and tested in this study: LMX and Action Control. Two-hundred and seven currently employed regular elementary school classroom teachers provided data during the 2000–2001 academic school year. Teachers provided personality, LMX quality (member or subordinate perspective), action control, job tenure, and demographic data. Nine school administrators (i.e., Principals, Assistant Principals) were the source for supervisor ratings of OCB, OJP, and LMX quality (leader or supervisor perspective). In eight of the nine total schools, teachers completed questionnaires during an after-school teacher gathering; in the remaining school location questionnaires were dropped off, distributed to teachers, and re-collected two weeks later. Results indicated a significant relationship between the OCB scale and overall supervisory ratings of OJP. The relationship among the big five factors of personality and OJP did not reach statistical significance, nor did the relationships among personality and OCB. The data indicated that none of the teacher tenure variables (i.e., teacher, school, or time worked with principal tenure) moderated the personality-OCB relationship nor the personality-OJP relationship. Finally, a review of the correlations among the variables of interest precluded conducting a mediation between personality-performance by OCB, mediation of personality-OCB by action control, and mediation of personality-OCB by LMX. In conclusion, the data reveal that personality was not significantly correlated with supervisory ratings of OJP or significantly related to supervisory ratings of overall OCB. Moreover, LMX quality and action control did not mediate the relationships between Personality-OJP nor the Personality-OCB relationship. Significant relationships were found between disengagement and overall LMX quality and between Initiative and overall LMX quality (both LMX-Teacher perspectives) as well as between personality variables and both Disengagement and Initiative action control variables. Despite the limitations inherent in this study, these latter findings suggest “lessons” for teachers and school administrators alike. ^