Financial impact of introducing the Swiss-DRG reimbursement system on potentially avoidable readmissions at a university hospital.

QUESTION UNDER STUDY: Thirty-day readmissions can be classified as potentially avoidable (PARs) or not avoidable (NARs) by following a specific algorithm (SQLape®). We wanted to assess the financial impact of the Swiss-DRG system, which regroups some readmissions occurring within 18 days after discharge within the initial hospital stay, on PARs at our hospital. METHODS: First, PARs were identified from all hospitalisations recorded in 2011 at our university hospital. Second, 2012 Swiss-DRG readmission rules were applied, regrouped readmissions (RR) were identified, and their financial impact computed. Third, RRs were classified as potentially avoidable (PARRs), not avoidable (NARRs), and others causes (OCRRs). Characteristics of PARR patients and stays were retrieved, and the financial impact of PARRS was computed. RESULTS: A total of 36,777 hospitalisations were recorded in 2011, of which 3,140 were considered as readmissions (8.5%): 1,470 PARs (46.8%) and 1,733 NARs (53.2%). The 2012 Swiss-DRG rules would have resulted in 910 RRs (2.5% of hospitalisations, 29% of readmissions): 395 PARRs (43% of RR), 181 NARRs (20%), and 334 OCRRs (37%). Loss in reimbursement would have amounted to CHF 3.157 million (0.6% of total reimbursement). As many as 95% of the 395 PARR patients lived at home. In total, 28% of PARRs occurred within 3 days after discharge, and 58% lasted less than 5 days; 79% of the patients were discharged home again. Loss in reimbursement would amount to CHF 1.771 million. CONCLUSION: PARs represent a sizeable number of 30-day readmissions, as do PARRs of 18-day RRs in the 2012 Swiss DRG system. They should be the focus of attention, as the PARRs represent an avoidable loss in reimbursement.

Economic grand rounds: financial burden of medical care and risk of forgoing care among Europeans with depressive symptoms

Little is known about the financial burden of individuals with depressive symptoms. This study explored that burden, using data from the Survey of Health, Ageing, and Retirement in Europe. To assess the association between depressive symptoms and the individuals' financial burden for medical care and whether they forwent medical care because of costs, logistic regressions were performed that adjusted for age, gender, marital status, education, and chronic diseases. A total of 16,696 noninstitutionalized individuals aged 50-79 years were included in the study. Individuals with depressive symptoms and those without such symptoms bore a similar financial burden. However, individuals with depressive symptoms were at increased risk of forgoing care because of costs, which may worsen their health and financial situation

Organizational change - the personnel perpective Case: Nordea - Financial Institutions

Tutkimuksen tavoite Tutkimuksen tavoite oli kerätä FI:n johdolle tietoa henkilöstön suhtautumisesta organisaatiomuutokseen. Tutkimus toimii pohjana muutosprosessin kriittiselle tarkastelulle ja mahdollisille muutoksille resurssien kohdentamisessa. Tutkimusmenetelmä Organisaatiomuutosta käsittelevä kirjallisuus muodosti tutkielman teoriapohjan. Tutkimuksen aineisto kerättiin kyselylomakkeella FI:n henkilöstölle ja neljällä haastattelulla henkilöstön ja johdon kanssa. Johtopäätökset Yleisesti tuloksista on nähtävissä, että vastaajat ovat aluksi vastustaneet muutosta, vaikka muutos itsessään onkin nähty positiivisena kehityksenä. Vastarintaa ovat aiheuttaneet pääasiallisesti muutoksen johtamisen tyyli ja tiedotuksen kokeminen riittämättömänä.

Integrating Financial Perspective to Quality Orientated Management System. Case: ALSTOM Finland Oy

Tutkimuksen päätavoitteena on tutkia taloudellisen näkökulman integroimista laatuajatteluun pohjautuvaan johtamisjärjestelmään esimerkkiyrityksessä. Johtamisjärjestelmän tulee tuottaa tietoa johdon strategiselle päätöksenteolle ja lisäksi täyttää laatujärjestelmän (ISO 9001:2000) asettamat vaatimukset. Tutkimuksen kohteena oleva työkalu on balanced scorecard (tasapainotettu tuloskortti). Työn tarkoituksena on ehdottaa balanced scorecard- talouden tunnuslukuja esimerkkiyritykselle. Tutkimuksen tavoitteisiin päästään empiiristä tutkimusta varten tehdyn teoreettisen viitekehyksen avulla. Empiiristä tutkimustietoa kerätään osallistuvan havainnoinnin, haastattelujen ja keskustelujen avulla. Tutkimusmenetelmänä on laadullinen case -tutkimus. Balanced scorecardin eri näkökulmille ehdotettiin tunnuslukuja empiirisen tutkimuksen pohjalta. Lisäksi talouden näkökulmaa tutkittiin tarkemmin. Tutkimuksen johtopäätöksenä esitettiin, että taloudelliset tunnusluvut mittaavat ensisijaisesti strategiaa eivätkä laatua. Lisäksi huomioitiin, että tuloskorttien tulisi olla koekäytössä ennen bonuspalkkauksen ja balanced scorecardin yhdistämistä.

Desired learning outcomes for the curricula in financial services industry as perceived by professionals in the financial services industry located in the Greater Toronto Area /

This study sought to explore the changing nature of the financial services industry in Toronto, Canada and the impact that these changes will have on the vocational educational outcomes required by Ontario Colleges of Applied Arts and Technology (CAAT) graduates who wish to enter the financial services industry. The study was descriptive and exploratory, based on both quantitative and qualitative data. Triangulation of 3 data sources (a collection of newspaper articles from the Toronto Star between July 1999 and June 2000, the calendars of the 25 CAATs, and a survey questionnaire prepared by me and distributed to subject matter experts who are key practitioners in the financial services industry) was used. The study contains a discussion of how the financial services industry is changing. The first question to be answered was: What do current practitioners in financial services perceive to be the knowledge, skills, and attitudes that will be required of future graduates for employment within the financial services industry? The study found that Ontario CAAT's graduates entering the financial services field need both business and financial services vocational learning outcomes. Colleges should have 2 programs 1 in accounting and 1 in financial services. The report addresses which specific topics should be included in the financial services program. The second question to be answered was: How does this anticipated profile of knowledge, skills, and attitudes change depending on the degree of implementation of the new technologies by the survey respondent? The study found no pattern. The third question to be answered was: In what way do existing programs need to change in the area of accreditation as perceived by the respondents? The study found that for accreditation, 3 credentials should be addressed within the financial services program. These are the Canadian Securities, the Life Underwriters, and the Certified Financial Planner designations. The last question to be answered was: What new knowledge, skills, and attitudes need to be incorporated into college curricula to address changing needs in the employment sector? For each Ontario CAAT which has a financial services program (excluding accounting), their program was reviewed in light of the topics as perceived by professionals in the financial services industry.

Understanding the financial status of a group of high performance athletes

With the 2010 Vancouver Winter Olympic Games quickly approaching, there has been a heightened interest in the performance of Canadian athletes at international competitions (Duffy, 2007; Fidlin, 2005; Longley, 2006). Two significant documents outline Canada's goal to become the number one sporting nation at the 2010 Olympic Games, and improve Canada's performance at the 2008 Olympic Games: Own the Podium and Road to Excellence (Priestner Allinger & Allinger, 2004; Road to Excellence, 2006). These two documents represent heightened interest in the performance of our elite athletes, in conjunction with Canada's hosting status of the Vancouver 2010 Winter Olympic Games. The requirements to train and compete at the international level have become more demanding both in terms of financial resources and time commitment. The need to financially assist athletes with their training and competition costs has been an important topic of debate over the past decades (Beamish & Borowy, 1987; Gatehouse, 2004; Macintosh, 1996; Munro, 1970; Owens, 2004). Two sources of fiinding for high performance athletes in Canada are the Athlete Assistance Program (AAP) provided by the Federal Government and the Canadian Olympic Excellence Fund provided by the Canadian Olympic Committee. The importance of these fiinds for athletes has been discussed in various forums (Ekos, 1992, 1997, 2005; Priestner Allinger & Allinger, 2004; Thibault «& Babiak, 2005). However, alternative sources of funds for high performance athletes have never been the object of research. As such the purpose of this study was to describe a group of athlete applicants from the time period of November 2004 to April 2006, and to contextualize these applications within the development of the Charitable Fund for Athletes.

James D. Tait Company Limited Fonds, 1890-1939 [non-inclusive]

James D. Tait (1836-1907) came to Canada in 1855 from Scotland. He worked in the dry goods business until he established the James D. Tait Company in 1864. The business was first located on Ontario street and specialized in furs. The business expanded to include dry goods and dress-making. After the building was destroyed by fire, Tait established and expanded the business into the Prendergast building on the corner of St. Paul and William Streets. James D. Tait died in 1907 while on vacation in Muskoka. In 1912 upon the resignation (or removal) of Benjamin Brick and Arthur Harbour, Stanley G. Smith joins the company as a director and secretary-treasurer. 1918/1919 vice-president E.J. Dignum dies. 1919 S.J. Inksater becomes a director of the company (His stock was purchased by the J.D. Tait Co.) By the 1930s the business, still in the same location, was under the leadership of Malcolm Stobie, President, Samuel J. Inksater, Vice-President and Stanley G. Smith, Secretary-Treasurer. The James D. Tait Company Limited ceased operations on 17 August 1933. The 1935 St. Catharines city directory records John Stobie, a former manager of the James D. Tait Company, operating a dry goods business at the same location, but with one-third the size of the original store space.

Dynamic Performance Evaluation of Canadian Fixed-Income Funds using Markov Regime Switching Models

This thesis examines the performance of Canadian fixed-income mutual funds in the context of an unobservable market factor that affects mutual fund returns. We use various selection and timing models augmented with univariate and multivariate regime-switching structures. These models assume a joint distribution of an unobservable latent variable and fund returns. The fund sample comprises six Canadian value-weighted portfolios with different investing objectives from 1980 to 2011. These are the Canadian fixed-income funds, the Canadian inflation protected fixed-income funds, the Canadian long-term fixed-income funds, the Canadian money market funds, the Canadian short-term fixed-income funds and the high yield fixed-income funds. We find strong evidence that more than one state variable is necessary to explain the dynamics of the returns on Canadian fixed-income funds. For instance, Canadian fixed-income funds clearly show that there are two regimes that can be identified with a turning point during the mid-eighties. This structural break corresponds to an increase in the Canadian bond index from its low values in the early 1980s to its current high values. Other fixed-income funds results show latent state variables that mimic the behaviour of the general economic activity. Generally, we report that Canadian bond fund alphas are negative. In other words, fund managers do not add value through their selection abilities. We find evidence that Canadian fixed-income fund portfolio managers are successful market timers who shift portfolio weights between risky and riskless financial assets according to expected market conditions. Conversely, Canadian inflation protected funds, Canadian long-term fixed-income funds and Canadian money market funds have no market timing ability. We conclude that these managers generally do not have positive performance by actively managing their portfolios. We also report that the Canadian fixed-income fund portfolios perform asymmetrically under different economic regimes. In particular, these portfolio managers demonstrate poorer selection skills during recessions. Finally, we demonstrate that the multivariate regime-switching model is superior to univariate models given the dynamic market conditions and the correlation between fund portfolios.

DONATION DECISIONS: THE ROLES OF FINANCIAL AND EMOTIONAL INFORMATION

This paper investigates the impact of personal affinity toward a charity and information regarding financial management of potential recipient charitable organizations on decisions to donate. Using an experiment, the study examines how personal donation decisions differ from corporate donation decisions made by managers and how the emotional intelligence of donors affects donation decisions. The results indicate that threshold and financial information on charities assembled by the Better Business Bureau, a charity rating agency, made a significant impact on corporate donation decisions. The study also shows that emotional intelligence plays an important role that aids both individual donors and managers to regulate their donation decisions.

Long Point Company financial memorandum

Long Point Company financial memorandum (1 page, printed). A large portion of this page has been torn off. A good portion of the text is affected, May 1881.

Returns (copy) showing the quantities of each article transported on the Welland Canal during the year 1859-1861 and the amount of tolls collected thereon for each year

Returns (copy) showing the quantities of each article transported on the Welland Canal during the year 1859-1861 and the amount of tolls collected thereon for each year. The title on this document is General Return 1859, but this has been crossed out in pencil within the document and the years have been changed (Port Robinson), 1859-1861.

Investors Impacts on Currency Returns: Theory versus Practice.

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