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.     

Translating cross-lagged effects into incidence rates and risk ratios: The case of psychosocial safety climate and depression

Longitudinal studies are the gold standard of empirical work and stress research whenever experiments are not plausible. Frequently, scales are used to assess risk factors and their consequences, and cross-lagged effects are estimated to determine possible risks. Methods to translate cross-lagged effects into risk ratios to facilitate risk assessment do not yet exist, which creates a divide between psychological and epidemiological work stress research. The aim of the present paper is to demonstrate how cross-lagged effects can be used to assess the risk ratio of different levels of psychosocial safety climate (PSC) in organisations, an important psychosocial risk for the development of depression. We used available longitudinal evidence from the Australian Workplace Barometer (N?=?1905) to estimate cross-lagged effects of PSC on depression. We applied continuous time modelling to obtain time-scalable cross effects. These were further investigated in a 4-year Monte Carlo simulation, which translated them into 4-year incident rates. Incident rates were determined by relying on clinically relevant 2-year periods of depression. We suggest a critical value of PSC?=?26 (corresponding to ?1.4 SD), which is indicative of more than 100% increased incidents of persistent depressive disorder in 4-year periods compared to average levels of PSC across 4 years.     

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.     

Comprehensive neighbourhood mapping: developing a powerful tool for child protection

This paper proposes ‘comprehensive neighbourhood mapping’ as a schema for gathering and interpreting information within a given geographical area which is informed by imaginative thinking about the safety of children and young people from sexual crime. It would build upon current forms of profiling by local authorities, health authorities and central Government. CNM would actively involve local people, in partnership with agencies, in ‘mapping’ danger points and support points. Eight components are discussed, including environmental issues, locations of sex offenders, sites where teenagers meet and share information, supportive individuals and organizations. Some issues for pilot projects are discussed, including the need to set up planning and implementation groups and to integrate CNM into wider child protection and community safety strategies. CNM is grounded in an ecological perspective which sees partnership approaches as essential and believes an overarching view of neighbourhood needs, based on detailed local information and understanding of how different forms of harm interconnect, is crucial in developing child protection strategies. At times of acute official anxiety about community ‘lynch‐mob’ reactions to known paedophiles, CNM aims to build communities which instead are informed and thoughtful about child protection. Copyright © 2002 John Wiley & Sons, Ltd.     

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。     

更高层次的迈进——企业相对社会责任的实现

相对社会责任的承担与实现,对企业自身和社会都具有重大意义,但由于缺乏机制的制约和策略的应用,其实现是困难的。正确处理企业利益与社会责任的关系,促使更多企业从履行绝对社会责任,上升到追求更高层次社会责任的实现,一方面需要外在环境的保障,另一方面要求企业在履行社会责任时,注意策略选择。     

城市公众安全文化教育的方法与思路——兼议北京2008“安全奥运文化”普及问题

通过对安全文化发展演变历史的简单回眸,探讨了适用于城市安全减灾的安全文化教育的模式及方法,尤其从文化建设层面上研究了应用安全文化建设方法的特点。作为最现实的应用,还就2008年北京“安全奥运”的系统化建设提出了“安全奥运文化”普及教育的思路。