Costs and Outcomes of an Extra Care Housing Scheme in England

Extra care housing, which provides support and care for people in specially designed accommodations, has now been part of the range of housing and care services available to older people in England for several years. Currently, the United Kingdom evidence base tells us little about the financing, estimation of the costs, or burden to the public purse of housing with care. The United Kingdom has significant state welfare provision in the areas of health and social care. The objective of this in-depth case study was to investigate the cost and outcome consequences for a sample of people who moved into an extra care housing scheme in Bradford, England, and to reflect on the methodological implications for future research in this developing area. The main finding of the study was that the overall cost per person increased after a move to extra care housing, but that this increase was associated with improved social care outcomes and improvements in quality of life.     

Out of Harmony: Health Problems and Young Native American Men

Abstract

Studies of the current health status of healthy young Native American men (American Indians and Alaska Natives) are rare compared with the attention researchers have given the many problems that plague the lives of these young men. Native American men are frequently not included in other studies focusing on men, and information on college-aged, healthy young Native American men is generally not readily available. Despite those drawbacks, this article brings together what is written or known about the health status of young Native American men. The emphasis, based on available information, is placed on some of the major health problems confronting this population.     

Mapping the Elder Mistreatment Iceberg: U.S. Hospitalizations With Elder Abuse and Neglect Diagnoses

Purpose: This study describes U.S. hospitalizations with diagnostic codes indicating elder mistreatment (EM). Method: Using the 2003 Nationwide Inpatient Sample (NIS) of the Healthcare Costs and Utilization Project (HCUP), inpatient stays coded with diagnoses of adult abuse and/or neglect are compared with stays of other hospitalized adults age 60 and older. Results: Few hospitalizations (< 0.02%) were coded with EM diagnoses in 2003. Compared to other hospitalizations of older adults, patients with EM codes were twice as likely to be women (OR = 2.12, 95% CI = 1.63–2.75), significantly more likely to be emergency department admissions (78.0% vs. 56.8%, p < .0001), and, on average, more likely to have longer stays (7.0 vs. 5.6 days, p = 0.01). Patients with EM codes were also three to four times more likely to be discharged to a facility such as a nursing home rather than “routinely” discharged (i.e., to home or self-care) (OR = 3.66, 95% CI = 2.92–4.59). Elder mistreatment–coded hospitalizations compared to all other hospitalizations had on average lower total charges ($21,479 vs. $25,127, p < .001), with neglect cases having the highest charges in 2003 ($29,389). Implications: Knowledge about EM is often likened to the “tip of the iceberg.” Our study contributes to “mapping the EM iceberg”; however, findings based on diagnostic codes are limited and should not be used to minimize the problem of EM. With the so-called graying of America, training is needed in recognizing EM along with research to improve our nation's response to the mistreatment of our elderly population.     

Can we talk about the right to healthcare without language? A critique of key international human rights law,drawing on the experiences of a Deaf woman in Cape Town,South Africa

A case study in Cape Town, South Africa, explores the right to health for signing Deaf ¹ 1. By Deaf (capitalised) we understand those permanently sensorily disabled people who are born deaf or who become deaf as children and whose first language is sign – South African Sign Language (SASL) in this country. View all notes patients attending health services and who are unable to communicate in a language they understand. It argues that, without language, Deaf South Africans’ dignity and right to health is violated, resulting in serious consequences such as incorrect diagnosis, improper treatment and standard of care not being applied. It critiques the provisions of the Convention on the Rights of Persons with Disabilities (CRPD) and the limits of General Comment 14 of the International Covenant on Economic, Social and Cultural Rights. The paper demonstrates that Deaf patients do not have informational access to healthcare. It argues that language via professional interpreter services is essential to their South African constitutional right of access to healthcare. General Comment 14 addresses informational accessibility, but this is insufficient without addressing language as a pre-requisite. The CRPD imposes on the South African government human rights obligations to provide professional interpreter services for Deaf people, but unfortunately it allows a loophole by enabling cost to serve as reasonable grounds to defer action.     

Shipping Fees or Shipping Free? A Tale of Two Price Partitioning Strategies in Online Retailing

In this article, we study the price partitioning decisions of online retailers regarding shipping and handling (S&H) fees. Specifically, we analyze two partitioning formats used by retailers in this context. In the first scenario, retailers present customers with a price that is partitioned into a product price and a separate S&H surcharge (the PS strategy); in the second, customers are offered free shipping through a non‐partitioned format where the product price already includes the shipping cost (the ZS strategy). We first develop a stylized game‐theoretic model that captures the competitive dynamics between (and within) these two formats. Analysis of the model provides insights into how both firm and product level characteristics drive a retailer's strategic choice regarding which partitioning format to adopt and, hence, determines the equilibrium market structure in terms of proportion of ZS and PS retailers. Subsequently, we conduct empirical analyses, based on product and S&H prices data for two different product categories (digital cameras and printers) collected from online retailers, to validate all the results of our theoretical model. We establish that PS retailers charge lower product prices than ZS ones, but the total price (product + S&H) charged is higher for the first group. The S&H charge for PS retailers can be significant—it is, on average, 5.4% (printers) and 3.0% (digital cameras) for our two product categories. Furthermore, retailers which are popular and/or face risky cost environment are more likely to opt for the ZS strategy, while retailers whose portfolio mostly includes large or heavy products with high cost (S&H)‐to‐price ratios usually choose the PS strategy. Lastly, our empirical study also illustrates that the price adjustment behavior of retailers is affected by their shipping‐fee policies—for example, ZS retailers change their product prices almost 1.5 times more frequently than PS ones.     

社员异质性与资金互助合作的稳定运行机制

从我国农村合作经济组织发展实际来看,社员异质性已成为其最重要的内部环境特征。通过分析异质性社员的构成成分,将其分为核心社员和普通社员两类,对比分析他们的行为差异,建立Bertrand博弈模型,探讨异质性社员参与资金互助业务的可能性条件。研究发现异质性社员之间的合作具有节约成本的效用,将合作成本分为组织成本和交易成本进行解读,且合作成本满足一定条件下,异质性社员具有合作的可能性,最后提出了这种合作稳定运行的机制。     

Causes,effects and mitigation of unreliable healthcare supplies

This study investigates the means by which hospitals can improve the reliability of their medical supply value streams. Field research involving pharmacy supplies in eight Australasian public sector hospitals utilised a rigorous, multi-method data collection procedure based around the uncertainty circle model. Value stream maturity, performance inhibitors and pathways to effective improvement are explored. The high levels of value stream uncertainty detected are commonly the result of process immaturity and poor inter-functional integration. Chief among the common root causes is failure by the executive to acknowledge the strategic value of medical supplies management, which ultimately leads to higher materials cost and increased risk of a medical mishap. The study demonstrates how managers can use systems thinking and a context-free performance benchmark to identify effective interventions and potentially transferable best practices.     

论环境公益诉讼费用征收规则的完善

环境公益诉讼制度的入法,标志着我国环境公益诉讼制度从理论层面走向了制度层面。但我国当下环境公益诉讼费用征收规则难以适应环境公益诉讼发展需要,导致环境公益诉讼在司法实践中受阻。运用文献研究法具体分析我国现行环境公益诉讼费用征收规则,发现在诉讼费用征收标准、诉讼激励机制以及司法救助等方面存在若干不足。因此,建议在《诉讼费用交纳办法》中制定关于环境公益诉讼费用征收规则的原则性规定,并出台关于环境公益诉讼费用交纳规则的具体规定和完善相关配套法律法规等措施来完善我国环境公益诉讼费用征收规则。     

Defining the scope of service operations management: an investigation on the factors that affect the span of responsibility of the operations department in service companies

This article deals with the definition of the scope of operations management (OM) in service companies. Operations, in service companies, are often dispersed throughout the organisation and so it is difficult to understand where OM tools and practices can be applied and who should be in charge of their implementation. Starting from the assumption that the actual scope of service operations is influenced by the degree of variety of the offering and of variability of the delivery process, this article analyses three case studies in an attempt to understand whether and why operations, in these companies, include different activities. This article argues that three factors affect the perceived scope of OM, namely: the dominant culture; the existence of industry-specific regulations and the endowment of facilities.