1,721,567 research outputs found
Essays on economics of health and social care
Full text linkTechnical progress, prevention and patient health outcomes: a new look of technical
progress in health care
-L’obiettivo di questo lavoro e’ la stima quantitativa del diverso ruolo che pazienti, medici
e tecnologia medica hanno sull’esito dei trattamenti sanitari. L’analisi e’ basata sull’uso
di una vasta e dettagliata banca dati di pazienti italiani raccolta dalla SIMG (Società
Italiana di Medicina Generale) per il periodo 2001-2006. Nel caso particolare di pazienti
in terapia statinica per malattie cardio-vascolari, i dati mostrano l’esistenza di
eterogeneità per quanto riguarda la velocità con la quale essi raggiungono il livello di
colesterolo ottimale. L’analisi empirica si concentra su due livelli: il primo di essi
analizza se pazienti che mostrano una convergenza più rapida al livello di colesterolo
ottimale, ottengono anche benefici in termine di riduzione dell’ospedalizzazione. I
risultati confermano che un incremento del 10% della velocità di convergenza riduce
dello 0,8% la probabilita’ di ospedalizzazione. Ad un secondo livello, si dimostra
empiricamente che tale convergenza e’ un fenomeno nel quale ognuno degli attori in
causa (paziente, medico e tecnologia) gioca un ruolo significativo, con la la tecnologia
che riesce a spiegare fino al 62% dell’effetto totale. I risultati ottenuti forniscono spunti
di discussione in termini di politica sanitaria.
Stochastic Frontiers and Technical Efficiency: evidences from a panel of Italian
hospitals
-In questo paper si studia come l’efficienza tecnica ospedaliera venga influenzata della
struttura produttiva e del livello di specializzazione. I dati disbonibili provengono dal
Ministero della Sanita’ e si basano sulle schede di dimissione ospedaliera (SDO) raccolte
nel periodo 2000-2005 nella Regione Lazio. L’analisi empirica effettuata utilizza un
approccio di fontiera stocastica con funzione di distanza output e input oriented. Il
modello adottato controlla per un gruppo di variabili ambientali e per il case-mix
ospedaliero. L’inefficienza stimata risulta associata negativamente con la
specizlizzazione e positivamente con la capitalizzazione delle strutture. La
capitalizzaztione della struttura produttiva e’ tipica degli ospedali privati i quali, in
media, utilizzano le risorse in maniera meno efficiente rispetto a quelli pubblici e nonprofit.
Infine, dall’osservazione dell’elasticita’ di scala, e’ possibile notare come ci sia
evidenza di economie di scala inesplorate, suggerendo l’ipotesi di un maggiore
accorpamento delle strutture.
A stochastic frontier approach to assess the efficiency of English councils with social
services responsibility
-Attraverso l’uso di un modello di frontiera stocastica, in questa analisi vengono esplorate
le dinamiche dell’efficienza relative al commissioning dei servizi sociali da parte di 148
municipalita’ inglesi, per gli anni inclusi tra il 2002 ed il 2007. Nel lavoro viene creato un
modello specifico per il caso dell’assistenza di tipo residenziale, nei centri polivalenti e a
domicilio. Stimare l’efficienza di questa componente della spesa pubblica risulta
fondamentale nell’ambito dell’ottimizzazione delle decisioni relative all’organizzazione e
alla gestione dei servizi sociali. I risultati suggeriscono una leggera riduzione
dell’inefficienza media nel tempo, la quale passa da un valore di 1,080 nel primo anno a
un valore di 1,076 nell’ultimo. L’elasticita’ stimata della spesa rispetto al livello
dell’assistenza residenziale e’ sette volte superiore a quella domiciliare e quindici volte
superiore rispetto agli altri tipi di assistenza non-residenziale. Si evidenzia inoltre che
maggiori risparmi di spesa sono ottenuti quando il mercato e’ allargato in misura
maggiore agli operatori privati e appartenenti al terzo settore.Technical progress, prevention and patient health outcomes: a new look of technical
progress in health care
-The aim of the paper is to disentangle the roles that patients, physicians and technology
can have on patient health outcomes using a large and detailed dataset of Italian patients
collected by the Italian College of General Practitioners (SIMG) over the period 2001-
2006. As our data show the existence of heterogeneity in the time needed to reach an
optimal level of health stock, we concentrate on this measure of health outcome rather
than simply on the level of patient health stock. The empirical work will then be based on
two different analyses. We first explore whether patients recovering faster (in terms of
time needed to reach cholesterol levels suggested by international clinical guidelines)
exhibit a lower hospitalization rate for cardiovascular diseases and then the determinants
of the speed of recovery to a good health status. The results confirm that a 10% increase
in the speed of recovery can reduce hospitalization rates by 0.8%. Furthermore, we show
that recovering to a good health status is a multifaceted phenomenon and that each single
actor plays an important role in reducing the time needed to achieve the therapeutic goal,
with technology that explain at the best 62% of the combined effect. These results are
then discussed in terms of policy.
Stochastic Frontiers and Technical Efficiency: evidences from a panel of Italian
hospitals
-We evaluate how the productive structure and level of specialization of a hospital affect
technical efficiency by analyzing a six-year panel database (2000/2005) drawn from
hospital discharge records and Ministry of Health data. We adopt a distance function
approach, while measuring the technical efficiency level with stochastic frontier
techniques. After controlling for environmental variables and hospital case-mix,
inefficiency is negatively associated with specialization and positively associated with
capitalization. Capitalization is typical of private structures which, on average, use
resources less efficiently with respect to public and not-for-profit hospitals. Finally, by
looking at scale elasticities, we find some evidence of unexploited economies of scale,
leaving room for centralization.
A stochastic frontier approach to assess the efficiency of English councils with social
services responsibility
-Using a stochastic frontier approach, this paper explores efficiency in the commissioning
of publicly funded social services among 148 English Councils through a six-year panel
database (2002-2007). It creates a specific framework for the analysis of social services
commissioning, covering institutional care, day-care centres and care at home services.
Our estimates of economic inefficiency provide key policy evidence about how to
organise and commission social care in a context in which optimization is critical both for
social and financial purposes. The results suggest a slight decrease through time in the
average inefficiency score, whose sample average moves from 1.080 in the first year to
1.076 in the last year of the panel. Residential and nursing care show a cost-output
elasticity around 7 times greater than that of home care and 15 times greater than that of
other community care services. Significantly, greater savings are obtained when the
market is open to private and voluntary providers
Who is responsible for your health: You, your doctor or new technologies?
No full textThe aim of the paper is to disentangle the roles
that patients, physicians and technology can have on
patient health outcomes. The analysis focuses on patients
suffering from hypercholesterolemia. Using a large and
detailed dataset of patients collected by the Italian College
of General Practitioners (SIMG) over the period
2001–2006, we observe the existence of heterogeneity in
the time needed to reach an optimal level of health stock.
We firstly explore whether patients recovering faster
exhibit lower hospitalization rates. Secondly, we study the
determinants of the speed of recovery to a good health
status. Results suggest that a 10 % increase in the speed of
recovery reduces hospitalization rates by 1 % in the general
sample and by 1.25 % in patients in primary prevention.
Furthermore, we show that recovering to a good
health status is a multifaceted phenomenon, with technology
explaining from 54 to 68 % of the total effect
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Tullio Pericoli. Nature
No full textSi tratta del catalogo della mostra (Pisa, Palazzo Lanfranchi, 2002) dedicata a Tullio Pericol
Guido Strazza. Opere 1958-2008
No full textSi tratta del catalogo della mostra (Pisa, Museo della Grafica, 2009) dedicata a Guido Strazz
Computing the NMR spectrum of a bulk ionic liquid phase by QM/MM methods
No full textThe dependence of (1)H and (13)C NMR chemical shifts of 1-butyl-3-methylimidazolium ([bmim])-based room-temperature ionic liquids on the counteranion ([BF(4)], [MeSO(4)]) is investigated experimentally and computationally. The local structure of the ionic liquids is investigated by means of DFT calculations of the structure of ion pairs and molecular dynamics simulations. Clusters extracted from the simulation runs are used to calculate (1)H and (13)C chemical shifts by means of QM/MM methods with various partition schemes. Proton H2 of the imidazolium ring is the most sensitive to the counteranion; its chemical shift is strongly dependent on subtle details of the arrangement of the two closest anions. It is shown that a correct
spacing of signals can be attained by including the two anions closest to C2 and H2 in the QM layer
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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