How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.     

Refinement and validation of a comprehensive scale for measuring HR practices aimed at performance-enhancement and employee-support

The purpose of this paper is to refine and validate a Human Resource practices (HRP) scale to measure employees' perceptions and test a two-tier model structured in eight practices and two bundles. In a sample of 554 employees, an EFA (Exploratory Factor Analysis) offered six factors that explained about 70% of the variance. Then, with 1647 employees (from 41 Spanish organizations), first- and second-order models were tested with Confirmatory Factor Analysis (CFA). The former encompasses eight practices. The latter grouped the practices in two bundles, one on enhancing performance and the other on supporting employees. The Cronbach's alpha, Rho coefficient (Composite Reliability Coefficient), Omega coefficient, and Spearman-Brown split half coefficient showed good reliability. Validity evidence was found for construct, criterion, convergent, content, discriminant, and predictive validity. Moreover, the paper integrates different ways of approaching the study of HR management based on employees' perceptions, using a two-tier approach. The two-bundle model showed better fit, pointing out the importance of paying attention to multiple outcomes for employees and organizations. The study makes a relevant theoretical contribution about the role and aims of HRM practices for organizational success and employees' performance and well-being.     

Coalition for a Healthier Community: Lessons learned and implications for future work

The Coalition for a Healthier Community (CHC) initiative was implemented to improve the health and well-being of women and girls. Underpinning CHC is a gender-based focus that uses a network of community partners working collaboratively to generate relevant behavior change and improved health outcomes. Ten programs are trying to determine whether gender-focused system approaches are cost-effective ways to address health disparities in women and girls. Programs implemented through coalitions made up of academic institutions, public health departments, community-based organizations, and local, regional, and national organizations, are addressing health issues such as domestic violence, cardiovascular disease prevention, physical activity, and healthy eating. Although these programs are ongoing, they have made significant progress. Key factors contributing to their early success include a comprehensive needs assessment, robust coalitions, the diversity of populations targeted, programs based on findings of the needs assessments, evaluations taking into consideration the effect of gender, and strong academic–community partnerships. A noteworthy impact of these programs has been their ability to shape and impact public, social, and health policies at the state and local levels. However, there have been challenges associated with the implementation of such a complex program. Lessons learned are discussed in this paper.     

Response strategy to environment context factors using a lean and agile approach: Implications for firm performance

Based on the environment-strategy performance perspective and dynamic capabilities framework, we develop a theoretical model and hypotheses specifying how supply chain collaboration as a response to environment context factors – competitive intensity, supply uncertainty, technological turbulence and market turbulence, using a lean and agile strategy may influence firm performance. We test the model using partial least square structural equation modelling on data collected from a field survey with responses from 152 manufacturing firms representing a variety of industries. Empirical findings generally support the relationship between collaboration and firm performance using a lean and agile strategy. Also, for firms in industries that face environments characterised by high supply uncertainty and competitive intensity with, technological turbulence, the study finds evidence of a direct relationship between these environmental factors and supply chain collaboration. The findings provide an initial strategic response framework for appropriately aligning a lean and agile supply chain strategy through collaboration with environment context factors to achieve firm performance improvements.     

Formal governance,interfirm coordination,and performance in partnerships: An empirical investigation of a mediation model

This study investigates the extent to which formal governance mechanisms such as contracts and equity ownership affect interfirm coordination and partnership performance. We analysed data from a survey of 301 Korean firms to show that interfirm coordination partially mediates the relationship between contract completeness, defined as the extent to which a contract specifies task operations and contingencies, and partnership performance. Furthermore, we find that more complete contracts can attenuate the negative effects of equity ownership on coordination, and that this effect is particularly strong when partner tasks are interdependent and relational norms are weak.     

A New Methodology for Before–After Safety Assessment Using Survival Analysis and Longitudinal Data

The widely used empirical Bayes (EB) and full Bayes (FB) methods for before–after safety assessment are sometimes limited because of the extensive data needs from additional reference sites. To address this issue, this study proposes a novel before–after safety evaluation methodology based on survival analysis and longitudinal data as an alternative to the EB/FB method. A Bayesian survival analysis (SARE) model with a random effect term to address the unobserved heterogeneity across sites is developed. The proposed survival analysis method is validated through a simulation study before its application. Subsequently, the SARE model is developed in a case study to evaluate the safety effectiveness of a recent red‐light‐running photo enforcement program in New Jersey. As demonstrated in the simulation and the case study, the survival analysis can provide valid estimates using only data from treated sites, and thus its results will not be affected by the selection of defective or insufficient reference sites. In addition, the proposed approach can take into account the censored data generated due to the transition from the before period to the after period, which has not been previously explored in the literature. Using individual crashes as units of analysis, survival analysis can incorporate longitudinal covariates such as the traffic volume and weather variation, and thus can explicitly account for the potential temporal heterogeneity.     

汽轮机凝汽器技术状态的故障诊断

介绍了对电站发动机组凝汽器进行状态监测和故障诊断的技术诊断自动化系统的研究和实现，实践证明，开发的系统对改善凝汽器性能、提高电站整体性能具有重要意义。     

缩小城乡差距统筹城乡发展问题研究

笔者系统总结了我国城乡差距、城乡关系失调的具体表现,并进一步分析了城乡发展差距过大对国民经济和社会发展的影响以及统筹城乡发展的现实意义,继而从改革城乡分治的管理体制,加快城镇化进程,推动城乡联动的工业化路线等方面提出了统筹城乡发展的对策建议。     

对新课程实施中学生评价方法的哲学思考——标准化考试与档案袋评定的整合

评价既可能成为课程改革的动力 ,也可能成为其实施的障碍 ,它是课程改革成败的关键。为使基础教育课程改革达到预期目的 ,必须将评价改革作为课程改革的一个重要部分 ,探索出与新课程理念相一致的评价方法。目前国外较为流行的评价学生的方法是档案袋评定 ,这种评价理念与我国的新课程理念相一致 ,它强调学生参与 ,注重学生发展。然而档案袋评定能够作为标准化考试的替代评价法吗 ?笔者从不同哲学观进行分析 ,最后得到结论 :档案袋评定和标准化考试是看似对立、实质互补的两种评价方法 ,教师在实际评价中必须将两种方法结合运用     

企业家素质量化评价方法的研究

首先概括了企业家素质的重要作用和企业家素质对企业能力的重要影响 ,在此基础上提出在评价企业家素质时企业家素质与企业能力的重要关联性 ,然后提出了一种以企业家素质对企业能力的影响为考核对象的企业家素质评价方法