A cross-sectional study assessing the association between online ratings and structural and quality of care measures : results from two German physician rating websites

BACKGROUND: Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE). METHODS: Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information. RESULTS: Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication. CONCLUSIONS: Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.

Report on the ethanol retailers’ tax credit program and the Research Activities Credit (RAC) tax credit program administered by the Iowa Department of Revenue (IDR) for the period January 1, 2002 through December 31, 2014

Report on the ethanol retailers’ tax credit program and the Research Activities Credit (RAC) tax credit program administered by the Iowa Department of Revenue (IDR) for the period January 1, 2002 through December 31, 2014

Micro-Foundations of Financialization. Status Anxiety and the Market for Consumer Credit in Chile

This project investigates why people in Chile acquired so much consumer debt in contexts of material prosperity, and asks what the role of inequality and commodification is in this process. The case raises an important challenge to the literature. Insofar as existing accounts assume that the financialization of consumption occurs in contexts marked by wage stagnation and a general deterioration of the middle classes, they engender two contradictory explanations: while political economists argue that people use credit in order to smooth their consumption in the face of market volatility, economists maintain that concentration of wealth at the top pushes middle income consumers to emulate the expenditures of the rich and consume beyond their means. These explanations do not necessarily fit the reality of developing countries. Triangulating in-depth interviews with middle class families, multivariate statistical analysis and secondary literature, the project shows that consumers in Chile use credit to finance “ordinary” forms of consumption that do not aim either at coping with market instability or emulating and signaling status to others. Rather, Chileans use department store credit cards in order to acquire a standard package of “inconspicuous” goods that they feel entitled to have. From this point of view, the systematic indebtedness of consumers originates in a major concern with “rank”, “achievement” and "security" that – following De Botton -- I call “status anxiety”. Status anxiety does not stem from the desire to emulate rich consumers, but from the impossibility of complying with normative expectations about what a middle class family should be (and have) that outweigh wage improvements. The project thus investigates the way in which “status anxiety” is systematically reproduced by means of two broad mechanisms that prompt people to acquire consumer debt. The first mechanism generating debt stems from an increase of real wages and high levels of inequality. It is explained by a general sociological principle known as relative deprivation, which points to the fact that general satisfaction with one´s income, possessions or status, is assessed not in absolute terms such as total income, but in relation with reference groups. In this sense, I explore the mechanisms that operate as catalyzers of relative deprivation, by making explicit social inequalities and distorting the perception of others´ wealth. Despite upward mobility and economic improvement, Chileans share the perception of “falling behind,” which materializes in an “imaginary middle class” against which people compare their status, possessions and economic independence. Finally, I show that the commodification of education, health and pension funds does not directly prompt people to acquire consumer debt, but operate as “income draining” mechanisms that demand higher shares of middle class families’ “discretionary income.” In combination with “relative deprivation,” these “income draining” mechanisms leave families with few options to perform their desired class identities, other than learning how to bring resources from the future into the present with the help of department store credit cards.

Senate Documents vol 24 Evolution of Credit and Banks in France

From the Founding of the Bank of France to the Present Time

Local savings and credit organizations : towards an innovative approach for rural Zimbabwe

Résumé : L'épargne et le crédit sont reconnus comme deux éléments clés du développement économique. Or, jusqu'à ce que les membres défavorisés d'une communauté aient accès aux ressources et services financiers, ils seront toujours privés de la participation au processus du développement et des bénéfices qui pourraient s'en suivre. La recherche indique que les services des prêts offerts par les institutions officielles ne parviennent que rarement aux plus pauvres de la société, qui sont obligés par conséquent de dépendre des intermédiaires informels comme les groupes d'épargne et les usuriers. Diverses organisations sur place comme les coopératives ont essayé de répondre aux besoins du développement des communautés défavorisées. Dans ce contexte, nous ferons d'abord le bilan historique et international des coopératives d'épargne et de crédit (i.e. les caisses populaires). Ensuite, nous analyserons quatre autres tentatives récentes qui eurent pour but de créer de nouvelles formes d'institutions financières, de les développer de telle sorte qu'elles offrent un degré d'accès raisonnable, sinon privilégié, aux ménages de revenu inférieur. L'analyse de ces cas-ci (venant du Zimbabwe, de l'Inde, du Ghana, et du Bangladesh) permettra d'identifier leurs caractéristiques communes et divergentes. À partir des résultats de cette analyse, un projet pilote au Zimbabwe fut initié pour élaborer une stratégie appropriée qui faciliterait le développement d'un réseau de caisses rurales. L'analyse théorique, la mise en pratique du projet, ainsi que les conclusions subséquentes soulignent l'importance de la participation directe des communautés à l'élaboration des organisations populaires. Il est évident que ces méthodes sont de loin plus efficaces que celles basées sur des politiques et des structures uniformes et compréhensives.||Abstract : Savings and credit are recognized as key elements of economic development, but until such time as disadvantaged members of the community have access to financial resources and services, they are obstructed from participating fully in the development process. Experience has shown that formal institutional credit bas rarely reached the poorer sectors of society, who have had to rely on informal intermediaries such as savings groups and money-lenders. Local organizations such as co-operatives have attempted to respond to the development needs of disadvantaged communities, and the historical and international record of savings and credit co-operatives (i.e. credit unions) is examined in this context. Four recent initiatives to design and develop new forms of financial institutions that give fair if not favoured access to low-income housebolds are also identified. These cases (from Zimbabwe, India, Bangladesh, and Ghana) are examined in an effort to identify common and divergent characteristics. Following from this analysis, a pilot project in Zimbabwe was initiated in an effort to elaborate an appropriate strategy for development of a network of rural savings and credit organization. The theoretical analysis, field exercise and subsequent reflections highlight the need for participatory methods of organizational design and development, rather than any all-encompassing structural or policy guidelines.

Water quality trading: credit stacking and ancillary benefits

Ecosystems can provide many services. Wetlands, for example, can help mitigate water pollution from point sources as well as non-point sources, serve as habitat for wildlife, sequester carbon and serve as a place for recreation. Studies have found that these services can have substantial value to society. The sale of ecosystem credits has been found to be a possible way to finance construction investments in wetlands and easements to farmers to take their land out of production. At the same time, selling one ecosystem service credit may not always be enough to justify the investment. Traditionally market participants have only been allowed to sell a single credit from one piece of land, but recently there have been discussions about the possibility of selling more than one credit from a piece of land because it potentially could lead to more efficient ecosystem service provision. Selling multiple credits is sometimes referred to as credit stacking. This paper is an empirical study of the potential for credit stacking applied to the services provided by wetlands in the Upper Mississippi River Basin, specifically nitrogen, phosphorus and wildlife credits. In the setting of our study where costs are discrete rather than continuous we found that wetlands are a cost-effective way to reduce the nitrogen loads from wastewater treatment plants and that stacking nitrogen, phosphorus and wildlife credits may improve social welfare while leading to a higher level of ecosystem services. However, for credit stacking to be welfare improving we found that there needs to be a substantial demand for the credit that covers the majority of the investment in wetlands, while the credit aggregator has a choice between what ecosystem projects to undertake. If the credit that covers the majority of investment is sold first and is the sole basis of the investment decision and the objective is to improve welfare, a sequential implementation of ecosystem credits is not recommended; it would not lead to an increase in the total amount of ecosystem services provided though it would increase profit for the credit producer.

Lineup identification accuracy: the effects of alcohol, target presence, confidence ratings, and response time

Despite the intoxication of many eyewitnesses at crime scenes, only four published studies to date have investigated the effects of alcohol intoxication on eyewitness identification performance. While one found intoxication significantly increased false identification rates from target absent showups, three found no such effect using the more traditional lineup procedure. The present study sought to further explore the effects of alcohol intoxication on identification performance and examine whether accurate decisions from intoxicated witnesses could be postdicted by confidence and response times. One hundred and twenty participants engaged in a study examining the effects of intoxication (control, placebo, and mild intoxication) and target presence on identification performance. Participants viewed a simultaneous lineup one week after watching a mock crime video of a man attempting to steal cars. Ethanol intoxication (0.6 ml/kg) was found to make no significant difference to identification accuracy and such identifications from intoxicated individuals were made no less confidently or slowly than those from sober witnesses. These results are discussed with respect to the previous research examining intoxicated witness identification accuracy and the misconceptions the criminal justice system holds about the accuracy of such witnesses.

FERTILISER CREDIT AND AGROECOLOGICAL USE OF ORGANIC SOIL AMENDMENTS IN NORTHERN GHANA

Contemporary African agricultural policy embodies the African Green Revolution’s drive towards modernisation and commercialisation. Agroecologists have criticised this movement on ecological, social and political grounds. Northern Ghanaian fertiliser credit schemes provide a good example through which these critiques can be examined in a context where agricultural policy reflects the African Green Revolution’s ideals. This study aimed to determine the relationship of such credit schemes to farmers’ use of organic amendments, elucidate other factors related to organic amendment use, and comment on the relevance of this modernisation policy and its relationship to agroecology. A first research phase employed semi-structured key informant interviews. Qualitative data from these informed construction of a semi-structured questionnaire that was used in a survey of 205 farmers. Multistage sampling purposively identified five villages and selected farmers within who had joined government and donor-funded fertiliser credit schemes. The use of organic and inorganic amendments was compared to that of peers who had not taken part in such schemes. Quantitative data were used in binomial logistic regression, inferential and descriptive statistics. Qualitative data were content analysed. Credit group membership was associated with higher fertiliser application and yield, but had little influence on the extent of commercialisation. Farmers who applied organic amendments were 40% less likely to belong to a fertiliser credit scheme than not, indicating substitution between organic and inorganic fertilisers. Organic amendments were 40% more likely to be applied to compound farms than outfields and six times more likely to be applied by household heads than other household members. However, household heads also preferentially joined credit groups. This was part of an agroecological soil fertility management strategy. Household heads appreciated the soil moisture retention properties of organic amendments, and applied them to compound farms to reduce risk to their household food supply in a semi-arid environment. They simultaneously accessed fertiliser to enhance this household provisioning strategy. They appreciated the increased yields this achieved, yet complained that the repayment terms of credit schemes were unfair, fertiliser did not enhance yields in dry conditions and fertilisers were supplied late. Farmers’ use of credited fertiliser alongside their existing agroecological strategy is helpful to the extent that it raises yields, yet is problematic in that it conflicts with risk-reduction strategies based on organics. There is some potential for modernised and agroecological management paradigms to coexist. For fertiliser credit to play a role in this, schemes must use fairer repayment terms and involve a focus on simultaneous use of organic amendments.

Role of financial and other information in trade credit decisions in SMEs: An international study

Trade credit is an important source of finance for SMEs and this study investigates the use of the financial statements and other information in making trade credit decisions in smaller entities in Finland, the UK, USA and South Africa. The study adds to the literature by examining the information needs of unincorporated entities as a basis for making comparisons with small, unlisted companies. In-depth, semi-structured interviews in each country were used to collect data from the owner-managers of SMEs and from credit rating agencies and credit insurers. The findings provide insights into similarities and differences between countries and between developed and developing economies. The evidence suggests that there are three main influences on the trade credit decision: formal and report-based information, soft information relating to social capital and contingency factors. The latter dictate the extent to which hard/formal information versus soft/informal information is used.

Household portfolio allocation, risk attitudes and credit constraints : evidence from the eurozone

Mestrado em Economia Monetária e Financeira

Credit risk & forward price models

Doutoramento em Gestão

The credit channel transmission of monetary policy in the European Union

This paper confirms the importance of the financial systems behaviour conditions to the credit channel of monetary policy in the entire European Union (EU). It uses panel fixed- effect estimations and quarterly data for 26 EU countries for the period from Q1 1999 to Q3 2006 in an adaptation of the Bernanke and Blinder (1988) model. The findings also reveal the high degree of foreign dependence and indebtedness of the EU banking institutions and their similar reactions to the macroeconomic and the monetary policy environments.

The economics of credit markets: theory and evidence.

Doutoramento em Economia.