Risk adjustment for hospital use using social security data: cross sectional small area analysis

Objectives: To identify demographic and socioeconomic determinants of need for acute hospital treatment at small area level. To establish whether there is a relation between poverty and use of inpatient services. To devise a risk adjustment formula for distributing public funds for hospital services using, as far as possible, variables that can be updated between censuses. Design: Cross sectional analysis. Spatial interactive modelling was used to quantify the proximity of the population to health service facilities. Two stage weighted least squares regression was used to model use against supply of hospital and community services and a wide range of potential needs drivers including health, socioeconomic census variables, uptake of income support and family credit, and religious denomination. Setting: Northern Ireland. Main outcome measure: Intensity of use of inpatient services. Results: After endogeneity of supply and use was taken into account, a statistical model was produced that predicted use based on five variables: income support, family credit, elderly people living alone, all ages standardised mortality ratio, and low birth weight. The main effect of the formula produced is to move resources from urban to rural areas. Conclusions: This work has produced a population risk adjustment formula for acute hospital treatment in which four of the five variables can be updated annually rather than relying on census derived data. Inclusion of the social security data makes a substantial difference to the model and to the results produced by the formula.

The training in social and solidarity economy. Analysis of the university offer in Spain

This research analyses the importance of the training for the promotion of the social economy in two ways: 1) focusing on the characteristics of the educational offer of Social Economy and 2) analyzing its differences regarding to those studies from the Management, entrepreneurship, and innovations areas. To this aim, it is carried out as a first step a literature review of the contributions that study the relationships that can exist between the education and Economy. Then, being based on this previous analysis, we already center our research on the Social Economy sector and its relations with the education system. To get this objective, it has been developed a database that includes all the postgraduate titles related to the Economics area. Likewise, a questionnaire has been designed with the aim of characterize the training in social Economy. As a conclusion, it is obtained that the training in social economy in postgraduate studies in the Spanish Universities is very poor. On the other hand, there are significant differences between Social Economy degrees and Business Management, entrepreneurship and innovation degrees with regard to different aspects such as: values to transmit, competencies, skills, the way of understanding the Economy, etc. Based on these conclusions, different recommendations are proposed in order to promote and boost this other way of doing Economy through the training and education in postgraduate studies.

Rejecting the label: A social constructionist analysis

Research has shown that people often do not claim labels associated with mental retardation or learning difficulties. We discussed the interpretation that this rejection is an example of a denial process, the purpose of which is to protect self-esteem. Alternative explanations for this lack of identification were offered, based on an understanding of the socially constructed nature of diagnostic labels and on the distinction between diagnostic labels and social categories. Some of the problems in using the label as a descriptive or explanatory resource are illustrated using quotes from a study in which people who have been labeled discussed the label.

Generalized social trust across 22 European countries: A multi-level analysis of four competing models

Concern with what can explain variation in generalized social trust has led to an abundance of theoretical models. Defining generalized social trust as a belief in human benevolence, we focus on the emancipation theory and social capital theory as well as the ethnic diversity and economic development models of trust. We then determine which dimensions of individuals’ behavior and attitudes as well as of their national context are the most important predictors. Using data from 20 countries that participated in round one of the European Social Survey, we test these models at their respective level of analysis, individual and/or national. Our analysis revealed that individuals’ own trust in the political system as a moral and competent institution was the most important predictor of generalized social trust at the individual level, while a country’s level of affluence was the most important contextual predictor, indicating that different dimensions are significant at the two levels of analysis. This analysis also raised further questions as to the meaning of social capital at the two levels of analysis and the conceptual equivalence of its civic engagement dimension across cultures.

Social Class Variation in Risk: A Comparative Analysis of the Dynamics of Economic Vulnerability

A joint concern with multidimensionality and dynamics is a defining feature of the pervasive use of the terminology of social exclusion in the European Union. The notion of social exclusion focuses attention on economic vulnerability in the sense of exposure to risk and uncertainty. Sociological concern with these issues has been associated with the thesis that risk and uncertainty have become more pervasive and extend substantially beyond the working class. This paper combines features of recent approaches to statistical modelling of poverty dynamics and multidimensional deprivation in order to develop our understanding of the dynamics of economic vulnerability. An analysis involving nine countries and covering the first five waves of the European Community Household Panel shows that, across nations and time, it is possible to identify an economically vulnerable class. This class is characterized by heightened risk of falling below a critical resource level, exposure to material deprivation and experience of subjective economic stress. Cross-national differentials in persistence of vulnerability are wider than in the case of income poverty and less affected by measurement error. Economic vulnerability profiles vary across welfare regimes in a manner broadly consistent with our expectations. Variation in the impact of social class within and across countries provides no support for the argument that its role in structuring such risk has become much less important. Our findings suggest that it is possible to accept the importance of the emergence of new forms of social risk and acknowledge the significance of efforts to develop welfare states policies involving a shift of opportunities and decision making on to individuals without accepting the 'death of social class' thesis.

Welfare regime and social class variation in poverty and economic vulnerability in Europe: an analysis of EU-SILC

In this paper we address a set of interrelated issues. These comprise increasing concerns about reliance on nationally based income poverty measures in the context of EU enlargement, the relative merits of one-dimensional versus multidimensional approaches to poverty and social exclusion and the continuing relevance of class-based explanations of life chances. When identifying economically vulnerable groups we find that, contrary to the situation with national income poverty measures, levels of vulnerability vary systematically across welfare regimes. The multidimensional profile of the economically vulnerable sharply differentiates them from the remainder of the population. While they are also characterised by distinctively higher levels of multiple deprivation, a substantial majority of the economically vulnerable are not exposed to such deprivation. Unlike the national relative income approach, the focus on economic vulnerability reveals a pattern of class differentiation that is not dominated by the contrast between the self-employed and all others. In contrast to a European-wide relative income approach, it also simultaneously captures the fact that absolute levels of vulnerability are distinctively higher among the lower social classes in the less comprehensive and generous welfare regimes while class relativities are significantly sharper at the other end of the spectrum.