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Institutional Characteristics (institutional + characteristic)
Selected AbstractsNational Study of Patient, Visit, and Hospital Characteristics Associated With Leaving an Emergency Department Without Being Seen: Predicting LWBSACADEMIC EMERGENCY MEDICINE, Issue 10 2009Julius Cuong Pham MD Abstract Objectives:, The objective was to estimate the national left-without-being-seen (LWBS) rate and to identify patient, visit, and institutional characteristics that predict LWBS. Methods:, This was a retrospective cross-sectional analysis using the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 1998 to 2006. Bivariate and multivariate analyses were performed to identify predictors of LWBS. Results:, The national LWBS rate was 1.7 (95% confidence interval [CI] = 1.6 to 1.9) patients per 100 emergency department (ED) visits each year. In multivariate analysis, patients at extremes of age (<18 years, odds ratio [OR] = 0.80, 95% CI = 0.66 to 0.96; and ,65 years, OR = 0.46, 95% CI = 0.32 to 0.64) and nursing home residents (OR = 0.29, 95% CI = 0.08 to 1.00) were associated with lower LWBS rates. Nonwhites (black or African American (OR = 1.41, 95% CI = 1.22 to 1.63) and Hispanic (OR = 1.25, 95% CI = 1.04 to 1.49), Medicaid (OR = 1.47, 95% CI = 1.27 to 1.70), self-pay (OR = 1.96, 95% CI = 1.65 to 2.32), or other insurance (OR = 2.09, 95% CI = 1.74 to 2.52) patients were more likely to LWBS. Visit characteristics associated with LWBS included visits for musculoskeletal (OR = 0.70, 95% CI = 0.57 to 0.85), injury/poisoning/adverse event (OR = 0.65, 95% CI = 0.53 to 0.80), and miscellaneous (OR = 1.56, 95% CI = 1.19 to 2.05) complaints. Visits with low triage acuity were more likely to LWBS (OR = 3.59, 95% CI = 2.81 to 4.58), whereas visits that were work-related were less likely to LWBS (OR = 0.19, 95% CI = 0.12 to 0.29). Institutional characteristics associated with LWBS were visits in metropolitan areas (OR = 2.11, 95% CI = 1.66 to 2.70) and teaching institutions (OR = 1.33, 95% CI = 1.06 to 1.67). Conclusions:, Several patient, visit, and hospital characteristics are independently associated with LWBS. Prediction and benchmarking of LWBS rates should adjust for these factors. [source] Political characteristics, institutional procedures and fiscal performance: Panel data analyses of Norwegian local governments, 1991,1998EUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 1 2005TERJE P. HAGEN The political leadership is assumed to have an important role in keeping fiscal control and resisting the high-demanders' pressure for increased spending. Three factors of relevance for their success are investigated: political characteristics (political colour and political strength, the strength of relevant interest groups) and two institutional characteristics, committee structure and budgeting procedures. The analyses are based on panel data from up to 434 Norwegian municipalities in the period from 1991 to 1998. The results support the hypothesis that strong political leadership improves fiscal performance. The effect of interest groups is to a high degree community-specific. However, an increased share of elderly reduces fiscal surplus. Differences in budgetary procedures do not seem to affect fiscal performance. A strong committee structure seems, on the other hand, to result in better fiscal performance than a weaker one. [source] Wealth Effects of Private Equity Placements: Evidence from SingaporeFINANCIAL REVIEW, Issue 2 2002Sheng-Syan Chen We examine institutional characteristics and the wealth effects of private equity placements in Singapore. Our findings show that private placements in Singapore generally result in a negative wealth effect and a reduction in ownership concentration. We find that at high levels of ownership concentration, the relation between abnormal returns and changes in ownership concentration is significantly negative. We also show that the market reacts less favorably to placements in which management ownership falls below 50%, but more favorably to issues to single investors. We do not find evidence suggesting that our results are due to an information effect. [source] The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacksHEALTH ECONOMICS, Issue 10 2009Mickael Bech Abstract The Technological Change in Health Care Research Network collected unique patient-level data on three procedures for treatment of heart attack patients (catheterization, coronary artery bypass grafts and percutaneous transluminal coronary angioplasty) for 17 countries over a 15-year period to examine the impact of economic and institutional factors on technology adoption. Specific institutional factors are shown to be important to the uptake of these technologies. Health-care systems characterized as public contract systems and reimbursement systems have higher adoption rates than public-integrated health-care systems. Central control of funding of investments is negatively associated with adoption rates and the impact is of the same magnitude as the overall health-care system classification. GDP per capita also has a strong role in initial adoption. The impact of income and institutional characteristics on the utilization rates of the three procedures diminishes over time. Copyright © 2008 John Wiley & Sons, Ltd. [source] Cost Convergence between Public and For-Profit Hospitals under Prospective Payment and High Competition in TaiwanHEALTH SERVICES RESEARCH, Issue 6p2 2004Sudha Xirasagar Objective. To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses. Data Sources. Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment). Study Design. Retrospective population-based, cross-sectional study. Data Analysis. Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics. Principal Findings. Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses. Conclusions. We find that the empirical evidence supports both our hypotheses. [source] Nurses' Perceptions of Safety Culture in Long-Term Care SettingsJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2009Laura M. Wagner RN Abstract Purpose: To describe perceptions of workplace safety culture among nurses employed in long-term care (LTC) settings. Design: A cross-sectional survey. Respondents were licensed nurses (N=550) with membership in gerontological nursing professional organizations in the United States (n=296), Canada (n=251), and other (n=3). Methods: An anonymous, self-administered, mail-in questionnaire, which included the Hospital Survey on Patient Safety Culture as well as questions about individual and institutional characteristics. The survey included key aspects of safety culture, such as work setting, supervisor support, communication about errors, and frequency of events reported. Findings: Nurse-managers reported significantly more positive safety culture perceptions compared with licensed staff nurses. Additionally, licensed nurses employed in government-run facilities had significantly less positive safety culture perceptions compared with those working in nonprofit organizations. Conclusions: Interventions designed to improve safety culture in LTC settings should be focused on the concerns of licensed staff nurses and the improvement of communication between these nurses and their managers. Clinical Relevance: Enhancing safety culture in long-term care settings may facilitate improvements in resident safety. Assessment of workplace safety culture is the first step in identifying barriers that nurses face to provide safe resident care. [source] A Curriculum-Based Classification System for Community CollegesNEW DIRECTIONS FOR COMMUNITY COLLEGES, Issue 122 2003Gwyer Schuyler The author proposes and tests a community college classification based on curricular characteristics and their association with institutional characteristics. The analysis seeks readily available data correlates to represent the percentage of a college's course offerings that are in the liberal arts. A simple two-category classification system using total enrollment is ultimately found to be the most accurate. [source] College Football and Student Quality: An Advertising Effect or Culture and Tradition?AMERICAN JOURNAL OF ECONOMICS AND SOCIOLOGY, Issue 2 2009Article first published online: 9 APR 200, D. Randall Smith Intercollegiate sports are said to generate positive advertising that produces many benefits to the host school. Donations, applications, and the academic quality of the student body are some of the mission outcomes thought to rise with the fortunes of the football team. The present study tests these claims for three measures of the academic quality of the entering classes on a 12-year panel of the 233 colleges and universities competing at the highest levels of football. Results show clear positive effects attributable to the football program, though those effects are more the result of the football culture and tradition at the school than the on-field performance of the team. Any sports advertising effects of the football program are minimal when compared to the effects of nonathletic institutional characteristics on the quality of students enrolling at the school. [source] BANK COMPETITION, CONCENTRATION AND EFFICIENCY IN THE SINGLE EUROPEAN MARKET,THE MANCHESTER SCHOOL, Issue 4 2006BARBARA CASU The deregulation of financial services in the European Union (EU), together with the establishment of the Economic and Monetary Union, aimed at the creation of a level playing-field in the provision of banking services across the EU. The plan was to remove entry barriers and to foster both competition and efficiency in national banking markets. However, one of the effects of the regulatory changes was to spur a trend towards consolidation, resulting in the recent wave of mergers and acquisitions. To investigate the impact of increased consolidation on the competitive conditions of the EU banking markets, we employ both structural (concentration ratios) and non-structural (Panzar,Rosse statistic) concentration measures. Using bank-level balance sheet data for the major EU banking markets, in a period following the introduction of the Single Banking Licence (1997,2003), this paper also investigates the factors that may influence the competitive conditions. Specifically, we control for differences in efficiency estimates, structural conditions and institutional characteristics. The results seem to suggest that the degree of concentration is not necessarily related to the degree of competition. We also find little evidence that more efficient banking systems are also more competitive. The relationship between competition and efficiency is not a straightforward one: increased competition has forced banks to become more efficient but increased efficiency does not seem to be fostering more competitive EU banking systems. [source] National Study of Patient, Visit, and Hospital Characteristics Associated With Leaving an Emergency Department Without Being Seen: Predicting LWBSACADEMIC EMERGENCY MEDICINE, Issue 10 2009Julius Cuong Pham MD Abstract Objectives:, The objective was to estimate the national left-without-being-seen (LWBS) rate and to identify patient, visit, and institutional characteristics that predict LWBS. Methods:, This was a retrospective cross-sectional analysis using the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 1998 to 2006. Bivariate and multivariate analyses were performed to identify predictors of LWBS. Results:, The national LWBS rate was 1.7 (95% confidence interval [CI] = 1.6 to 1.9) patients per 100 emergency department (ED) visits each year. In multivariate analysis, patients at extremes of age (<18 years, odds ratio [OR] = 0.80, 95% CI = 0.66 to 0.96; and ,65 years, OR = 0.46, 95% CI = 0.32 to 0.64) and nursing home residents (OR = 0.29, 95% CI = 0.08 to 1.00) were associated with lower LWBS rates. Nonwhites (black or African American (OR = 1.41, 95% CI = 1.22 to 1.63) and Hispanic (OR = 1.25, 95% CI = 1.04 to 1.49), Medicaid (OR = 1.47, 95% CI = 1.27 to 1.70), self-pay (OR = 1.96, 95% CI = 1.65 to 2.32), or other insurance (OR = 2.09, 95% CI = 1.74 to 2.52) patients were more likely to LWBS. Visit characteristics associated with LWBS included visits for musculoskeletal (OR = 0.70, 95% CI = 0.57 to 0.85), injury/poisoning/adverse event (OR = 0.65, 95% CI = 0.53 to 0.80), and miscellaneous (OR = 1.56, 95% CI = 1.19 to 2.05) complaints. Visits with low triage acuity were more likely to LWBS (OR = 3.59, 95% CI = 2.81 to 4.58), whereas visits that were work-related were less likely to LWBS (OR = 0.19, 95% CI = 0.12 to 0.29). Institutional characteristics associated with LWBS were visits in metropolitan areas (OR = 2.11, 95% CI = 1.66 to 2.70) and teaching institutions (OR = 1.33, 95% CI = 1.06 to 1.67). Conclusions:, Several patient, visit, and hospital characteristics are independently associated with LWBS. Prediction and benchmarking of LWBS rates should adjust for these factors. [source] Bioeconomic analysis of protected area use in fisheries management,AUSTRALIAN JOURNAL OF AGRICULTURAL & RESOURCE ECONOMICS, Issue 4 2007Jared Greenville Protected areas in fishery management have been suggested to hedge management failures and variation in harvests. In this paper, a stochastic bioeconomic model of a two-species fishery in the Manning Bioregion is used to test the performance of protected areas as a management tool in a fishery. The establishment of a protected area is analysed under the assumption of heterogenous environments that are linked via density-dependent or sink-source stock dispersal relationships. The sensitivity of the results to different degrees of management is also explored. The model is applied to the Ocean Prawn Trawl, and Ocean Trap and Line fisheries within Manning Bioregion in New South Wales, Australia. The focus of the study is placed on the biological and institutional characteristics that yield benefits to the fishery. It was found that protected area use in the Manning Bioregion is likely to have differing effects on the two fisheries examined, benefiting Ocean Trap and Line fishers but adversely affecting Ocean Prawn Trawl fishers. Overall, it is unlikely that protected area use will lead to an increase resource rent in the fishery. [source] | ||||||||||||||||