Spesa pubblica in Sanità, Istruzione e Ricerca: efficienza, efficacia e determinanti

La ricerca intende analizzare l’efficacia della spesa pubblica, l’efficienza e le loro determinanti nei settori della Sanità, dell’Istruzione e della Ricerca per 33 paesi dell’area OCSE. L’analisi ha un duplice obiettivo: da un lato un confronto cross country e dall’altro un confronto temporale, prendendo in considerazione il periodo che va dal 1992 al 2011. Il tema della valutazione dell’efficacia e dell’efficienza della spesa pubblica è molto attuale, soprattutto in Europa, sia perché essa incide di quasi il 50% sul PIL, sia a causa della crisi finanziaria del 2008 che ha spinto i governi ad una riduzione dei bugdet e ad un loro uso più oculato. La scelta di concentrare il lavoro di analisi nei settori della Sanità, dell’Istruzione e della Ricerca e Sviluppo deriva da un lato dalla loro peculiarità di attività orientate al cliente (scuole, ospedali, tribunali) dall’altro dal ruolo strategico che essi rappresentano per lo sviluppo economico di un paese. Il lavoro è articolato in tre sezioni: 1. Rassegna dei principali strumenti metodologici utilizzati in letteratura per la misurazione della performance e dell’efficienza della spesa pubblica nei tre settori. 2. Valutazione e confronto dell’efficienza e della performance della spesa pubblica dal punto di vista sia temporale sia cross-country attraverso la costruzione di indicatori di performance e di efficienza della spesa pubblica (per approfondire l'indice dell'efficienza ho applicato la tecnica DEA "bootstrap output oriented" con indicatori di output ed input non simultanei mentre l’evoluzione dell’efficienza tra i periodi 2011-2002 e 2001-1992 è stata analizzata attraverso il calcolo dell’indice di Malmquist). 3. Analisi delle variabili esogene che influenzano l’efficienza della spesa pubblica nei settori Salute, Istruzione e Ricerca e Sviluppo attraverso una regressione Tobit avente come variabile dipendente i punteggi di efficienza DEA output oriented e come variabili esogene alcuni indicatori scelti tra quelli presenti in letteratura: l’Indicatore delle condizioni socioeconomiche delle famiglie (costruito e applicato da OCSE PISA per valutare l’impatto del background familiare nelle performance dell’apprendimento), l’Indicatore di fiducia nel sistema legislativo del paese, l’Indicatore di tutela dei diritti di proprietà, l’Indicatore delle azioni di controllo della corruzione, l’Indicatore di efficacia delle azioni di governo, l’Indicatore della qualità dei regolamenti, il PIL pro-capite. Da questo lavoro emergono risultati interessanti: non sempre alla quantità di risorse impiegate corrisponde il livello massimo di performance raggiungibile. I risultati della DEA evidenziano la media dei punteggi di efficienza corretti di 0,712 e quindi, impiegando la stessa quantità di risorse, si produrrebbe un potenziale miglioramento dell’output generato di circa il 29%. Svezia, Giappone, Finlandia e Germania risultano i paesi più efficienti, più vicini alla frontiera, mentre Slovacchia, Portogallo e Ungheria sono più distanti dalla frontiera con una misura di inefficienza di circa il 40%. Per quanto riguarda il confronto tra l’efficienza della spesa pubblica nei tre settori tra i periodi 1992-2001 e 2002-2011, l’indice di Malmquist mostra risultati interessanti: i paesi che hanno migliorato il loro livello di efficienza sono quelli dell’Est come l’Estonia, la Slovacchia, la Lituania mentre Paesi Bassi, Belgio e Stati Uniti hanno peggiorato la loro posizione. I paesi che risultano efficienti nella DEA come Finlandia, Germania e Svezia sono rimasti sostanzialmente fermi con un indice di Malmquist vicino al valore uno. In conclusione, i risultati della Tobit contengono indicazioni importanti per orientare le scelte dei Governi. Dall’analisi effettuata emerge che la fiducia nelle leggi, la lotta di contrasto alla corruzione, l’efficacia del governo, la tutela dei diritti di proprietà, le condizioni socioeconomiche delle famiglie degli studenti OECD PISA, influenzano positivamente l’efficienza della spesa pubblica nei tre settori indagati. Oltre alla spending review, per aumentare l’efficienza e migliorare la performance della spesa pubblica nei tre settori, è indispensabile per gli Stati la capacità di realizzare delle riforme che siano in grado di garantire il corretto funzionamento delle istituzioni.

Information management and the holistic, process-oriented enterprise

This research examines the role of the information management process within a process-oriented enterprise, Xerox Ltd. The research approach is based on a post-positive paradigm and has resulted in thirty-five idiographic statements. The three major outcomes are: 1. The process-oriented holistic enterprise is an organisation that requires a long-term management commitment to its development. It depends on the careful management of people, tasks, information and technology. A complex integration of business processes is required and this can be managed through the use of consistent documentation techniques, clarity in the definition of process responsibilities and management attention to the global metrics and the centralisation of the management of the process model are critical to its success. 2. The role of the information management process within the context of a process-oriented enterprise is to provide flexible and cost-effective applications, technological, and process support to the business. This is best achieved through a centralisation of the management of information management and of the process model. A business-led approach combined with the consolidation of applications, information, process, and data architectures is central to providing effective business and process-focused support. 3. In a process oriented holistic enterprise, process and information management are inextricably linked. The model of process management depends heavily on information management, whilst the model of information management is totally focused around supporting and creating the process model. The two models are mutually creating - one cannot exist without the other. There is a duality concept of process and information management.

Process oriented framework to support PLM implementation

Product lifecycle management (PLM) innovates as it defines both the product as a central element to aggregate enterprise information and the lifecycle as a new time dimension for information integration and analysis. Because of its potential benefits to shorten innovation lead-times and to reduce costs, PLM has attracted a lot of attention at industry and at research. However, the current PLM implementation stage at most organisations still does not apply the lifecycle management concepts thoroughly. In order to close the existing realisation gap, this article presents a process oriented framework to support effective PLM implementation. The framework central point consists of a set of lifecycle oriented business process reference models which links the necessary fundamental concepts, enterprise knowledge and software solutions to effectively deploy PLM. (c) 2007 Elsevier B.V. All rights reserved.

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness.

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management.

Building a holarchy using business process-oriented holonic (PrOH) modeling

The application of systems thinking to designing, managing, and improving business processes has developed a new "holonic-based" process modeling methodology. The theoretical background and the methodology are described using examples taken from a large organization designing and manufacturing capital goods equipment operating within a complex and dynamic environment. A key point of differentiation attributed to this methodology is that it allows a set of models to be produced without taking a task breakdown approach but instead uses systems thinking and a construct known as the "holon" to build process descriptions as a system of systems (i.e., a holarchy). The process-oriented holonic modeling methodology has been used for total quality management and business process engineering exercises in different industrial sectors and builds models that connect the strategic vision of a company to its operational processes. Exercises have been conducted in response to environmental pressures to make operations align with strategic thinking as well as becoming increasingly agile and efficient. This unique methodology is best applied in environments of high complexity, low volume, and high variety, where repeated learning opportunities are few and far between (e.g., large development projects). © 2007 IEEE.

Does management accounting play role in planning process?

This study examines the relationship between management accounting and planning profiles in Brazilian companies. The main goal is to understand the consequences of not including a fully structured management accounting scheme in the planning process. The authors conducted a field research among medium and large-sized companies, using a probabilistic sample from a population of 2281 companies. Using analytic hierarchy process (AHP) and statistical cluster analysis, the authors grouped the entities` strategic budget planning processes into five profiles, after which the authors applied statistical tests to assess the five clusters. The study concludes that poor or fully implemented strategic and budget-planning processes relate to the management accounting profiles of the Brazilian organizations studied. (C) 2009 Elsevier Inc. All rights reserved.

Management of Metals in the Pulping Process

Diplomityön tarkoituksena oli löytää keino korkean mangaanipitoisuuden hallintaan ECF-valkaisussa. Kirjallisuusosassa käsiteltiin eri metallien ja kuidun vuorovaikutuksia sekä niiden vaikutuksia prosessiin. Lisäksi käytiin läpi sellunvalmituksen yleisimpiä metallienhallintamenetelmiä. Työn kokeellisessa osassa tehtiin esikokeina laboratoriokokeita, jotta löydettiin oikeat kelatointistrategiat tehdasmittakaavan koeajoille. Laboratoriovalkaisut suoritettiin kuudella eri kemikaalilla käyttäen DD3-pesurin jälkeistä massaa ja samanlaisia parametrejä kuin tehdasvalkaisussa. Kolmesta eri valkaisusekvenssistä paras tulos saavutettiin D0-QEP-sekvenssillä. Tehdasmittakaavan koeajojen tavoitteena oli saavuttaa alle 1 mg/kg jäännösmangaanipitoisuus valkaistussa massassa ja korkeampi vaaleus EOP-vaiheessa pienemmällä klooridioksidin kulutuksella. Koeajoissa käytettiinDTPA:ta ja EDTA:ta kahdeksassa eri koepisteessä. Pienimpiin jäännöspitoisuuksiin päästiin koepisteissä, joissa kelatointiaine annosteltiin ennen valkaisun viimeistä pesuvaihetta tai sen jälkeen. Samanlaisia tuloksia saavutettiin koepisteissä, joissa kelatointiaine lisättiin suoraan EOP-vaiheeseen. Tällöin kelatointiaineen käyttö johti myös korkeampaan vaaleuteen EOP-vaiheessa pienemmällä kappakertoimella kuin referenssissä. Säästöt klooridioksidin kulutuksessa eivät olleet kuitenkaan tarpeeksi suuret kattaakseen kelatointiaineiden käytön kustannuksia. Kustannustehokkain tapa kontrolloida jäännösmangaanipitoisuutta oli EDTA:n annostelu D2 DD-pesurin jälkeen. Haittapuolena tälläisessä kelatoinnissa oli metallikompleksien palautuminen valkaisuun kuivauskoneen kiertoveden mukana. Tärkeimmät onnistuneeseen kelatointiin vaikuttavat parametrit olivat lajittelussa käytetyn rikkihapon annos, D0-vaiheen pH ja D0 DD-pesurin pesutehokkuus.

Dynamics of Rifting Along the Southwest Continental margin of India Through Coherence and Process oriented Analysis of Gravity Data

Department of Marine Geology and Geophysics,Cochin University of Science and Technology

A strategy for process-oriented validation of coupled chemistry–climate models

Evaluating CCMs with the presented framework will increase our confidence in predictions of stratospheric ozone change.

Effects of Surface Forcing on Interannual Variability of the Fall Phytoplankton Bloom in the Gulf of Maine Revealed Using a Process-Oriented Model

SeaWiFS (Sea-viewing Wide Field-of-view Sensor) chlorophyll data revealed strong interannual variability in fall phytoplankton dynamics in the Gulf of Maine, with 3 general features in any one year: (1) rapid chlorophyll increases in response to storm events in fall; (2) gradual chlorophyll increases in response to seasonal wind-and cooling-induced mixing that gradually deepens the mixed layer; and (3) the absence of any observable fall bloom. We applied a mixed-layer box model and a 1-dimensional physical-biological numerical model to examine the influence of physical forcing (surface wind, heat flux, and freshening) on the mixed-layer dynamics and its impact on the entrainment of deep-water nutrients and thus on the appearance of fall bloom. The model results suggest that during early fall, the surface mixed-layer depth is controlled by both wind-and cooling-induced mixing. Strong interannual variability in mixed-layer depth has a direct impact on short-and long-term vertical nutrient fluxes and thus the fall bloom. Phytoplankton concentrations over time are sensitive to initial pre-bloom profiles of nutrients. The strength of the initial stratification can affect the modeled phytoplankton concentration, while the timing of intermittent freshening events is related to the significant interannual variability of fall blooms.