62 research outputs found
Voucher privatization with investment funds : an institutional analysis
No full textCommon wisdom among post-socialist reformers has beento use voucher investment funds to provide the corporate governance needed to restructure newly privatized enterprises after mass privatization efforts. The idea has been that mass privatization would spread the ownership too wide and make corporate governance difficult. The author examines the likely institutional behavior of voucher funds and the possible effects of their development on a transition economy. Since most policy advice has been in favor of voucher privatization with investment funds, the author can be seen as playing the devil's advocate, but his argument is institutional, not statistical. Policymaking requires insight and foresight into how institutions will tend to function. He concludes that voucher funds will introduce a bias in the economy away from the real industrial sector toward an ersatz"financial sector"that will have little if any positive financial role but will be well-protected by friendly regulators. One long-term consequence of voucher privatization with investment funds, according to this view, is a de facto"industrial policy"of real sector decapitalization in favor of short-term rent-seeking by fund managers through board sinecures and lucrative side deals with portfolio companies and through financial market manipulation and paper entrepreneurship in the"financial sector."Without strong corporate governance from the funds and without stable ownership of their own, many enterprise managers will exploit the post-socialist version of the"separation of ownership and control"to grab what they can in the form of salaries, bonuses, perquisites, and side deals. The most likely results of the strategy of voucher privatization with investment funds may be a two-sided grab fest by fund managers and enterprise managers -- together with the accompanying drift, stagnation, and decapitalization of the privatized industrial sector.Economic Adjustment and Lending,Payment Systems&Infrastructure,International Terrorism&Counterterrorism,Economic Theory&Research,Banks&Banking Reform,International Terrorism&Counterterrorism,Banks&Banking Reform,Economic Adjustment and Lending,Environmental Economics&Policies,Economic Theory&Research
Revenue-productive income tax structures and tax reforms in emerging market economies - evidence from Bulgaria
No full textUsing a household budget survey for 1992, The author shows the poor revenue performance and distributional impact of Bulgaria's personal income tax system. He explores the implications for revenue and income distribution of two alternative tax systems - a flat tax and a progressive but simpler three-brackets tax system. He demonstrates that simpler tax structures with lower tax rates could achieve at least equal revenue and distributional objectives and are superior in terms of efficiency and equity. (The findings are robust when Bulgaria's significant tax evasion is included). But tax changes since 1992 have, if anything, moved Bulgaria even further from a simple income tax system: the number of rates and brackets increased from 7 to 10, and the levels of exemption remain unchanged. (Complex, higher rates complicate administration and enforcement and provide incentives for tax evasions. And in the alternative systems the author explores, the poor are protected with higher exemptions.) Fortunately, the country's personal income tax structure began to move toward less nominal progressivity after Bulgaria's 1997 tax reform program. The tax rate in thetop income bracket was reduced from 52 percent to 40 percent, the number of tax brackets was halved, and the exemption level was increased 20 percent (reducing tax burdens on the poor).Environmental Economics&Policies,Public Sector Economics&Finance,Regional Governance,Tax Policy and Administration,Economic Theory&Research,Governance Indicators,Economic Theory&Research,Public Sector Economics&Finance,Environmental Economics&Policies,Tax Policy and Administration
How adverse selection affects the health insurance market
No full textAdverse selection can be defined as strategic behavior by the more informed partner in a contract against the interest of the less informed partner(s). In the health insurance field, this manifests itself through healthy people choosing managed care and less healthy people choosing more generous plans. Drawing on theoretical literature on the problem of adverse selection in the health insurance market, the author synthesizes concepts developed piecemeal over more than 20 years, using two examples and revisiting the classical contribution of Rothschild and Stiglitz. He highlights key insights, especially from the literature on"equilibrium refinements"and on the theory of"second best."The government can correct spontaneous market dynamics in the health insurance market by directly subsidizing insurance or through regulation; the two forms of intervention provide different results. Providing partial public insurance, even supplemented by the possibility of opting out, can lead to second-best equilibria. The same result holds as long as the government can subsidize contracts with higher-than-average premium-benefit ratios and can tax contracts with lower-than-average premium-benefit ratios. The author analyzes the following policy options relating to the public provision of insurance: a) Full public insurance. b) Partial public insurance with or without the possibility of acquiring supplementary insurance and with or without the possibility of opting out. In recent plans implemented in Germany and the Netherlands, where competition among several health funds and insurance companies was promoted, a public fund was created to discourage risk screening practices by providing the necessary compensation across riks groups. But only"objective"risk adjusters (such as age, gender, and region) were used to decide which contracts to subsidize. Those criteria alone cannot correct the effects of adverse selection. Regulation can exacerbate the problem of adverse selection and lead to chronic market instability, so certain steps must be taken to prevent risk screening and preserve competition for the market. The author considers the following three policy options for regulating the private insurance market: 1) A standard contract with full coverage. 2) Imposition of a minimum insurance requirement. 3) Imposition of premium rate restrictions.Health Economics&Finance,Environmental Economics&Policies,Insurance&Risk Mitigation,Insurance Law,Financial Intermediation
Agricultural extension for women farmers in Africa
No full textWomen are responsible for at least 70 percent of food staple production in Africa. They are also important in other agricultural activities, including food processing and marketing, cash cropping and animal husbandry. Women's involvement is significant not only in terms of their labor input, but also in terms of their decision-making authority. This paper proposes a series of operational guidelines on how to provide agricultural extension services in a cost-effective way to women farmers. All small-scale farmers, regardless of gender, face constraints, but the focus here is on women farmers in order to foster a better understanding of the particular gender-related barriers confronting women and the strategies needed to overcome them. Attention is concentrated on sub-Saharan Africa in view of the crucial role of women in agriculture throughout the sub-continent. This paper addresses the question of why women need help -- the role women have in agriculture and the particular constraints they face in terms of access to resources and information. It examines the information needed to modify extension systems to better reach women farmers, to modify the focus of research to address women's activities and to monitor and evaluate programs. The paper also deals with the transmission of the extension message to women farmers and the formulation of the message to be delivered, and the linkage between extension and agricultural research and technology.Agricultural Research,Health Monitoring&Evaluation,Crops&Crop Management Systems,Primary Education,Agricultural Knowledge&Information Systems
Half a century of development economics : a review based on the"Handbook of Development Economics"
No full textDevelopment economics has made remarkable progress in 50 years, says the author, summarizing changes in the field since Nehru's first proposals for an independent India. Synthesizing insights about changes in the field from the many contributors to the"Handbook of Development Economics,"the author observes (among other things): 1) Different schools of thought may dominate, but the range of research has broadened. Economics has"hardened"as its practitioners have learned to use data more carefully and to reason more rigorously. 2) The policy message has been turned upside down. Gone is the idea that development is industrialization and that the main policy problem is to manage the interface between country and city. Today urbanization and industrialization are viewed as mere components of an integrated transformation, in which the expansion of foreign trade is central. Traditional institutions are viewed with far more understanding, because overhasty modernization has often proved counterproductive. 3) More than ever, development is seen as a"whole replacement"process, the key to which is mastery of Northern technology--now understood to be both simpler and more complex than previously thought. Simpler, because much technology is uncomplicated, and complex because even simple technology requires ingenuity and a costly investment in adaptations. 4) There has been a radical change in economists'view of market agents and policymakers. Gone are the days when economists thought their advice should be aimed mainly at planners. Policymakers are utility maximizers, too. Employees of state enterprises coalesce into powerful interest groups that block efforts to raise productivity. The new thinking is sometimes modified by evoking the vague concept of"governance,"under which the economist's view is to help design a system of interacting state and private institutions that, led by the state, cooperate in achieving social goals. Whether something useful will come from this line of thinking remains to be seen. The author detects major gaps in economists'undrstanding of development, suggesting a particular need for further study of collective action (a far more pervasive component of human action than is realized) and the selection of roles by individuals and the costly investment this entails (a concept that may shed light on Schumpeter's well-known but little-studied entrepreneur).Labor Policies,Economic Theory&Research,Health Economics&Finance,Environmental Economics&Policies,Decentralization,Health Economics&Finance,Poverty Assessment,Achieving Shared Growth,Economic Theory&Research,Environmental Economics&Policies
Análise crítica dos pacientes cirúrgicos internados na unidade de terapia intensiva Critical analysis of hospital surgical patients in intensive care unit
No full textJUSTIFICATIVA E OBJETIVOS: A performance de cada unidade de terapia intensiva (UTI) precisa ser observada no contexto dos cuidados médicos, assim como pela instituição que ela faz parte. Existem vários tipos sistemas de índices prognósticos em terapia intensiva. O APACHE II foi introduzido por Knaus e col. em 1985, sendo um sistema amplamente usado para avaliar a gravidade dos pacientes em tratamento intensivo. O objetivo deste estudo foi avaliar o índice prognóstico (APACHE II) dos pacientes submetidos a cirurgia do aparelho digestivo de urgência ou eletiva encaminhadas para a UTI. MÉTODO: Foram coletados os seguintes dados: idade, sexo, tempo de internação, indicação de UTI, tipo de cirurgia (eletiva ou de urgência), complicações, índice de massa corpórea (IMC), APACHEII e risco de óbito. RESULTADOS: Foram analisados dados de 38 pacientes, no período de abril de 2005 a abril de 2006, dentre os quais 18 faleceram e 20 sobreviveram. A idade no grupo dos não sobreviventes variou de 44 a 92 com média de 66,61 anos; enquanto no grupo dos sobreviventes a idade variou de 28 a 78 com média de 59,15 anos. Já em relação ao IMC no grupo dos não sobreviventes variou de 22 a 29 com média de 26; enquanto nos sobreviventes a média foi de 25,6. Não houve diferença significativa entre idade e IMC no grupo dos sobreviventes em relação ao grupo dos não sobreviventes. O tempo de internação variou de 2 a 52 dias no grupo dos não sobreviventes com média de 11,3 dias. Enquanto no grupo dos sobreviventes a variação foi de 1 a 30 dias com média de 4,9. Em relação ao APACHE II no grupo dos não sobreviventes variou de 5 a 32 com média de 19,14. Ao passo que no grupo dos sobreviventes o APACHE variou de 1 a 18 com média de 8,6. O tempo de internação e o APACHE II apresentaram diferenças significativas em ambos os grupos, sendo maior no grupo dos não sobreviventes. O risco de óbito no grupo dos não sobreviventes variou de 3,1 a 84,9 com média de 38,8; enquanto no grupo dos sobreviventes a média foi de 7,5 Neste estudo foi calculada a Standardized Mortality Rate (SMR razão da mortalidade observada pela predita), que teve como resultado 1,22. CONCLUSÕES: Os pacientes não sobreviventes apresentaram APACHE II significativamente maior que os sobreviventes; maior tempo de internação dos pacientes não sobreviventes em relação aos sobreviventes; a SMR encontrou-se dentro da observada na literatura; não houve diferença estatística em relação ao IMC nos dois grupos.BACKGROUND AND OBJECTIVES: Each intensive care units result has to be observed in the context of medical care, as well as the institution witch it belongs. There are many types of prognostic index in intensive care. The APACHE II was introduced by Knaus et al. in 1985, being a widely used system to evaluate the illness severity in intensive care patients. This objective was evaluated the prognostic index (APACHE II) in patients submitted to elective or emergency gastrointestinal surgery admitted to the ICU. METHODS: Medical school intensive care unit. It was collected the following data: age, sex, length of stay, intensive care indication, type of surgery (elective or emergency), body mass index (BMI) APACHE II and predicted mortality. RESULTS: A total of 38 patients data were collected during the period of April 2005 to April 2006. Eighteen patients died and twenty survived. The age of the non-survivors varied from 44 to 92 (mean age 66.6); while the age of the survivors varied from 28 to 78 (mean age 59. 1). The BMI of the non-survivors varied from 22 to 29 (mean body mass index 26) while in the other group the mean body mass index was 25. 6. No significant difference was noted in the age and body mass index of both groups. The length of stay varied from 2 to 52 days in the non-survivors group (mean 11.3 days), while in the survivors group varied from 1 to 30 days (mean 4.9). The APACHE II varied from 5 to 32 in the non-survivors group (mean 19.14). While in the survivors group varied from 1 to 18 (mean 8.6). The length of stay and APACHE II demonstrated a significant difference in both groups, being higher in the non-survivors group. The non-survivors predicted mortality varied from 3.1 to 84.9 (mean 38.8); while the survivors mean was 7.5. The Standardized Mortality Rate in this study was 1.22. CONCLUSIONS: Non-survivors patients APACHE II was higher than the survivors; the SMR was similar to others studies; the length of stay was longer in the non-survivors group; no statistic difference was noted in the body mass index
Traité pratique complet d'impression photographique aux encres grasses et de phototypographie et photogravure /
No full textErrata: page 198.Cover title.Mode of access: Internet
Estudo comparativo entre traqueostomia precoce e tardia em pacientes sob ventilação mecânica A comparative study between early and late tracheostomy in patients ongoing mechanical ventilation
No full textJUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi calcular a incidência de traqueostomia em pacientes submetidos à ventilação mecânica invasiva (VMI) e comparar o tempo de internação, de VMI, APACHE II e a mortalidade entre os pacientes submetidos à traqueostomia, segundo o momento de sua realização (precoce ou tardia). MÉTODO: Através de estudo retrospectivo observacional tipo coorte, avaliou-se, de abril a outubro de 2005, 190 pacientes internados na UTI adulto do Hospital Estadual do Grajaú. RESULTADOS: Dos 190 pacientes, 32 (16,84%) foram submetidos à traqueostomia, permanecendo maior período na unidade de terapia intensiva (UTI) (30,16 dias) quando comparados àqueles que não o foram (p 13 dias) 53,13% (n = 17). De maneira significativa, os pacientes com traqueostomia precoce obtiveram escore APACHE II superior àqueles com traqueostomia tardia (18,2 versus 13,47), no entanto, não houve diferença entre eles quanto à taxa de mortalidade, devendo-se lembrar que este índice leva em consideração apenas as primeiras 24h. Não houve diferenças quanto aos tempos de internação na UTI (28,9 versus 31,28 dias) e VMI (29,73 versus 32,23 dias) nos dois grupos. CONCLUSÕES: A incidência de traqueostomia foi elevada, associando-se a menor mortalidade na UTI, mas com maior duração da internação e de complicações. Não houve diferença significativa quanto ao destino e tempo de VMI dos pacientes quando submetidos à traqueostomia precoce ou tardia.BACKGROUND AND OBJECTIVES: To assess the incidence of tracheostomy in patients submitted to mechanic ventilation (MV); to compare the length of stay (LOS), duration of MV, APACHE II and mortality among patients submitted to tracheostomy, according to the moment of its application (early or late). METHODS: A retrospective observation study type cohort was done from April thru October 2005 including 190 patients at the adult intensive care unit (ICU) of Hospital Estadual do Grajaú. RESULTS: Among the 190 patients, 32 (16.84%) were submitted to tracheostomy with a longer LOS (30.16 days) as compared to those that were not (p 13 days) was 53.13% (n = 17). In a meaningful way, the patients with early tracheostomy obtained APACHE II superior to those with late tracheostomy (18.2 versus 13.47), however there was no difference regarding the mortality rate. There was no difference regarding the time of ICU LOS (28.9 versus 31.28 days) and the MV time (29.73 versus 32.23 days) for both groups. CONCLUSIONS: The incidence of tracheostomy was high, being associated to a smaller ICU mortality but with a longer LOS and more complications. There was no significant difference regarding the destination of the patients when submitted to early or late tracheostomy
A typology of farm households for the Umutara Province in Rwanda
No full textRwanda, Farm household, Farm typology, Technology adoption, Multivariate analysis,
One size fits all? Female Headed Households, Income Risk, and Access to Resources
No full textStudies dealing with productivity in female (FHH) and male headed households (MHH) find that FHH appear to be either less, equally, or more productive compared to MHH. Lower productivity of FHH is often explained by insecure access to land, while the findings of higher productivity largely remain unexplained. This paper is an attempt to reconcile these contrasting findings by constructing a model that accounts for productivity effects arising from secure land rights and the risk of falling short of income. Both affect productivity, but they do so in opposite directions. While tenure insecurity tends to decrease labor effort, income risks increase it as subsistence farmers want to avoid falling (deeper) into poverty. Depending on which of these risks prevails in the perception of farmers, they become either more or less productive than a benchmark farmer who faces none of these constraints. The model is tested using data from Kenya where FHH are categorized by different land tenure security schemes. The results from a stochastic cost frontier model establish that FHH facing tenure insecurity are less productive compared to MHH. However, this result only obtains in case households do not face income risks.Female headed households, tenure insecurity, income risk, Consumer/Household Economics,
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