1,721,341 research outputs found
Justice, fairness and equity in health care : exploring the social value of health care interventions
No full textThis thesis is motivated by the need in many health care systems, but especially in the UK NHS, to make difficult choices over the use of limited resources. The starting point forthe thesis is that when making difficult choices over the provision of health care, the overall value of health care interventions to society is a function not only of the total benefits available from health care, but also the distribution of health care resources across different groups in society. The thesis investigates this proposition that 'distribution matters' and presents research to consider the social value of health care interventions. The research in the thesis is undertaken within the analytical framework of health economics, and in the context of health policy decisions over the funding of health care interventions in the UK NHS. The health technology appraisal process is used as an example of an allocation problem, and the thesis uses the UK National Institute for Health and Clinical Excellence (NICE) as an example of the health technology appraisal process. A variety of methods are usedj including an assessment of general theories of justice, a systematic review of the literature on empirical assessment of distributive preferences, an empirical study to investigate issues around the specific social value related to the severity of health condition, a discrete choice experiment (DCE) to explore a range of key social values and the relative weights placed on these social values. The research is drawn together in a policy-relevant analysis of social preferences and NHS decision-making. The thesis makes a contribution to the health economics literature and to the health policy literature. It relates general theories of justice to the process of health technology appraisal. It draws together a broad and complex literature, and characterises the literature according to the general quality of the methods used. The thesis contributes to the empirical evidence base on severity of health as an important social value. It develops a hypothesis that the empirical evidence against the importance of severity of health may be a proxy preference for giving priority to a worst off group of patients in health care priority setting; providing empirical evidence to support this hypothesis. The DCE, in a sample of the general public, finds support for using the social values around level of health improvement, value for money, severity of health, 'and the availability of other treatments, to offer an insight to the societal value of health care interventions. The level of health improvement and value for money had the greatest impact, in the discrete choice analysis, with severity of health condition also shown to have 'an important role in distributive preferences. The research contributes to the empirical evidence on the relative importance of social values in the context of difficult priority setting decisions, and it contributes to the literature on the use of the DCE framework to elicit social preferences. The thesis, extends the current evidence base by using the results from the DCE to derive a measure cif 'strength of preference' across health care interventions described using the experimental design used. The thesis demonstrates how such data may be used in a policy-relevant manner. The research in the thesis provides a greater understanding over what may be meant by equity in the allocation of health care resources, in the framework of health technology. appraisal, through consideration of equity as a balance between competing social values, amidst consideration of opportunity costs.EThOS - Electronic Theses Online ServiceGBUnited Kingdo
The Effect of Far Right Parties on the Location Choice of Immigrants: Evidence from Lega Nord Mayors
Full text linkImmigration has increasingly taken centre-stage in the political landscape. Part of this has been rise in far-right, anti-immigration parties in a range of countries. Existing evidence suggests that the presence of immigrants has a substantial effect on the political views of the electorate, generating an advantage to these parties with anti-immigration or nationalist platforms. This paper explores a closely related issue but overlooked issue: how immigrant behavior is influenced by these parties. We focus on immigrant location decisions in Northern Italy which has seen the rise of the anti-immigration party Lega Nord. We construct a dataset of mayoral elections in Italy for the years 2002-2014, and calculate the effect of electing a mayor belonging to, or supported by Lega Nord. To identify this relationship we focus on mayors who have been elected with narrow margins of victory in a Regression Discontinuity framework. The election of Lega Nord mayor discourages immigrants from moving into the municipality
Financing UK democracy : a stocktake of 20 years of political donations
Full text linkPolitical donations in the UK have been subject to comprehensive disclosure since 2001. We study the data produced as part of this disclosure policy to evaluate the role of private and public political finance over time. Total political donations have grown by 250% since 2001, reaching over £100 million in real terms for the first time in 2019. This increase has been driven by donations from private individuals, who now account for approximately 60% of donations in election years compared to 40-50% up to the late 2010s. Furthermore,
‘superdonors’ (those contributing more than £100,000) have been a prominent driver of the rise, increasing their own share from approximately 36% in 2017 to 46% in 2019. We also show that private donations to Labour fell sharply in the final stages of Jeremy Corbyn’s leadership. Overall, these trends have benefited the Conservative Party, leading to an historic resource gap between the two main parties emerging circa 2019. We calculate that the ‘resource gap’ between parties now stands at approximately £27 million compared to an
historic average of £8-10 million (even when taking account of publicly-funded ‘Short’ money provided to the Opposition
Exploring the social value of health-care interventions: a stated preference discrete choice experiment
No full textMuch of the literature on distributive preferences covers specific considerations in isolation, and recent reviews have suggested that research is required to inform on the relative importance of various key considerations. Responding to this research recommendation, we explore the distributive preferences of the general public using a set of generic social value judgments. We report on a discrete choice experiment (DCE) survey, using face-to-face interviews, in a sample of the general population (n=259). The context for the survey was resource allocation decisions in the UK National Health Service, using the process of health technology appraisal as an example. The attributes used covered health improvement, value for money, severity of health, and availability of other treatments, and it is the first such survey to use cost-effectiveness in scenarios described to the general public. Results support the feasibility and acceptability of the DCE approach for the elicitation of public preferences. Choice data are used to consider the relative importance of changes across attribute levels, and to model utility scores and relative probabilities for the full set of combinations of attributes and levels in the experimental design used (n=64). Results allow the relative social value of health technology scenarios to be explored. Findings add to a sparse literature on social preferences, and show that DCE data can be used to consider the strength of preference over alternative scenarios in a priority-setting context
Incorporated in Westminster : Channels and Returns to Political Connection in the United Kingdom
Full text linkWe present a simple agency model with a revenue-maximizing government and many public officials (agents) in charge of collecting payments from citizens. Agents are of two types, honest and potentially dishonest, with the latter having an inherent propensity to demand bribes from citizens. This propensity may eventually turn into actual (perceived) corruption depending on the strategy pursued by the government. In equilibrium, we derive a non-linear relationship between potential and perceived corruption and, specifically, three distinct policy regimes in which the opportunistic behaviour is curbed, eradicated or tolerated. Different regimes are characterized by different bureaucracy sizes, and we conjecture that low levels of perceived corruption may, in some circumstances, be due to a dilution effect of bribery cases on large numbers of public employees. Some simple descriptive evidence on European regions appears to confirm our theoretical insights
Female Directors, Board Committees and Firm Performance
Full text linkA number of studies have found little economic impact of board gender diversity on firm performance. We return to this issue in the context of large European firms. Our contribution is twofold. First, using information on the gender of CEOs children as a source of exogenous variation in female director appointments, we demonstrate a robust positive effect of female board representation on firm performance. Second, while previous work has considered female representation broadly, we focus on membership of board committees as a proxy for active involvement in corporate governance. We demonstrate economically meaningful positive effects on performance of female representation on board committees. Our evidence is supportive of an economic rationale for increased female representation on corporate boards
Long Lasting Differences in Civic Capital: Evidence from a Unique Immigration Event in Italy
Full text linkA range of evidence exists demonstrating that social capital is associated with a number of important economic outcomes such as economic growth, trade and crime. A recent literature goes further to illustrate how historical events and variation can lead to the development of differing and consequential social norms. This paper examines the related questions of how persistent initial variations in social capital are, and the extent to which immigrant groups, do or do not converge to the cultural and social norms of their recipient country by examining a unique and geographically concentrated immigration event in 16th century Italy. We demonstrate that despite the substantial time since migration these communities still display different behaviour consistent with higher civic capital than other comparable Italian communities. Moreover, we demonstrate that this difference does not appear to have changed over the last 70 years. For instance, differences in voter turnout apparent in the late 1940s remain in the 21st century. This latter finding has implications for our view of the likelihood of assimilation of immigrant groups to local norms, particularly in cases of large-scale migration
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
- …
