5,289 research outputs found
Can we improve the health system with pay-for-performance?
No full textAdvanced healthcare systems are moving toward greater efficiency, transparency and accountability, and this trend is not likely to change
There is no single measure that will improve service delivery and patient outcomes, ensure financial sustainability and increase accountability and transparency in a health system
The jury is still out on whether financial incentive mechanisms, such as pay-for-performance, work as intended and deliver value for money
The research literature is rich in lessons policymakers need to keep in mind when developing and rolling out pay-for-performance programs:
Program design
Build on what already exists
Formulate a clear business case that defines the objectives of the program in terms of the desired outcomes
Define performance using absolute and relative thresholds, ensure target can be adjusted over time and attribute credit for performance to participants in ways that foster care across serviced populations and not on a case-by-case basis
Ensure methodologies for risk adjustment are developed prior to the program’s introduction
Model and evaluate the program carefully before implementation and at regular intervals afterward. Pilot the program before rolling it out in a phased approach
Consider regional disparities when modelling and evaluating the program prior and post implementation
Design the program to drive improvement and quality across a range of service providers performing at various levels and not just reward current high performers
Performance targets must be perceived as being achievable although not without some additional effort
Allow room for innovation and flexibility
Data collection
Ensure strong health information systems are in place
Use rigorous and verifiable data collection methods and analysis, allow for health service providers to review/correct/supplement data and determine rewards using long-term data trends
Incentives
Incentives should be sufficient, equitable and transparent in order to have any effect
Incentives should reach various levels within an organisation
Financial incentives are more likely to have the intended effect where there is one single funder
Stakeholders
Secure strong political and management support
Design the program collaboratively with health service providers and professional health associations and organisation
Keep in mind
Pay-for-performance can yield small gains at large costs, particularly when targets are set in the absence of a good baseline
Potential perverse and unintended consequences need to be carefully considered
Not everything can be measured. Current pay-for-performance programs focus on clinical and organisational measures, which may be relatively easy to measure through objective data or observation, but there are other aspects that are less easily quantified and are only briefly considered in many pay-for-performance programs such as: continuity of care, ease of access to care, strength of the patient-doctor relationship and patient satisfaction
Beyond pay-for-performance
Payment systems and financial incentive programs cannot do everything. Many of their key objectives, such as lowering costs, improving quality and driving appropriate change, are goals that are achievable in concert with other policy initiatives
Invest in outcomes and health service researc
Translation and interpretation: Translation redundancy reconsidered
No full textInterpretation is an integral part of the process of translating. This article raises the question of whether interpretation fo a literary work by a translator should be guided by extratextual factors or not. The discussion is illustrated with examples taken from David Hawkes' translation of a Chinese classic, A Dream of Red Mansions. As the work of a scholar-translator, Hawkes' version is richly supplemented with disclosures concerning the characters and explanations of the cultural environment embodied in the novel. In many cases, however, this translation procedure is redundant and explanatory, enlightening the readers but at the same time robbing them of the pleasure of literary interpretation and cultural exploration. By means of this illustration of translation redundancy, the author points out that there is difference between a scholar who helps the interpretation fo a work and a translator who presents a work close to its original version. It is particularly important to pay attention tot his difference in literary translations in a cross-cultural situation involving two enormously different cultures.Language & LinguisticsA&HCI0ARTICLE1,SI115-12
Willingness to pay for environmental attributes of non-food agricultural products: a real choice experiment
No full textThis paper investigates consumers’ willingness to pay (WTP) a price premium for two environmental attributes of a non-food agricultural product. We study individual preferences for roses associated with an eco-label and a carbon footprint using an economic experiment combining discrete choice questions and real economic incentives involving real purchases of roses against cash. The data are analyzed with a mixed logit model and reveal significant premiums for both environmental attributes of the product.WILLINGNESS TO PAY;ENVIRONMENTAL ATTRIBUTES;NON-FOOD PRODUCT;REAL CHOICE EXPERIMENT;MIXED LOGIT
Willingness and Ability to Pay for Artemisinin-Based Combination Therapy in Rural Tanzania.
No full textThe aim of this study was to analyse willingness to pay (WTP) and ability to pay (ATP) for ACT for children below five years of age in a rural setting in Tanzania before the introduction of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria. Socio-economic factors associated with WTP and expectations on anti-malaria drugs, including ACT, were also explored. Structured interviews and focus group discussions were held with mothers, household heads, health-care workers and village leaders in Ishozi, Gera and Ishunju wards in north-west Tanzania in 2004. Contingent valuation method (CVM) was used with "take-it-or-leave-it" as the eliciting method, expressed as WTP for a full course of ACT for a child and households' opportunity cost of ACT was used to assess ATP. The study included descriptive analyses with multivariate adjustment for potential confounding factors. Among 265 mothers and household heads, 244 (92%, CI = 88%-95%) were willing to pay Tanzanian Shillings (TSh) 500 (US 6.0, which would represent 0.9% of the average total consumption expenditures as estimated from official data in 2001. The cost of non-subsidized ACT represented 7.0% of reported total annual expenditure on food and 33.0% of total annual expenditure on health care."Rapid effect," "no adverse effect" and "inexpensive" were the most desired features of an anti-malarial drug. WTP for ACT in this study was less than its real cost and a subsidy is, therefore, needed to enable its equitable affordability. The decision taken in Tanzania to subsidize Coartem fully at governmental health care facilities and at a consumer price of TSh 300-500 (US$ 0.28-0.46) at special designated shops through the programme of Accredited Drug Dispensing Outlets (ADDOs) appears to be well founded
The SSC of the Generalised Jahangir’s Graph Jm,k and its Algebraic Characterizations
No full textIn this article, we present important combinatorial and algebraicproperties of spanning simplicial complex (SSC) of the generalised Jahangir’sgraph Jm,k. We describe the relation to find f−vectors associatedto Δs(Jm,k) and determine the Hilbert series for the SR-ring KΔs(Jm,k).In the end, we present the associated primes of the facet ideal IF(Δs(Jm,k))and the Cohen-Macaulay characterization of the SR-ring of Δs(Jm,k).AMS (MOS) Subject Classification Codes: Primary 13-P10, Secondary 13-F20, 13-C14, 13-H10.Corresponding Author: Agha KashifKey Words: Simplicial Complexes, f-vectors, Spanning Trees, Face Ring, Hilbert Series, CohenMacaulay
To <i>JM</i> on Its 75th Anniversary
No full text This article discusses how Journal of Marketing ( JM) has influenced marketing science and practice by publishing articles on substantive topics relevant to customers, managers, organizations, markets, and society. The journal's 75th anniversary coincides with the 50th anniversary of the Marketing Science Institute (MSI). Frequently, JM and MSI have collaborated to address important substantive marketing issues identified in MSI's Research Priorities. The author highlights seminal articles on brand equity; business-to-business marketing (including sales force management); connecting marketing information, metrics, and strategy; consumer behavior; innovation, new product development. and product management; marketing orientation and capabilities; and market research, methodology and services. She also draws attention to articles that have won the Sheth Foundation/ JM Award and the H. Paul Root Award. The article describes how JM‘s knowledge dissemination is amplified by powerful social network effects. Ideas in JM articles diffuse through the business community, influencing the mind-set of managers worldwide. </jats:p
JM-20, a Benzodiazepine-Dihydropyridine Hybrid Molecule, Inhibits the Formation of Alpha-Synuclein-Aggregated Species
No full text\ua9 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.Studies showed that JM-20, a benzodiazepine-dihydropyridine hybrid molecule, protects against rotenone and 6-hydroxydopamine neurotoxicity. However, its protective effects against cytotoxicity induced by endogenous neurotoxins involved in Parkinson’s disease (PD) pathogenesis have never been investigated. In this study, we evaluated the ability of JM-20 to inhibit alpha-synuclein (aSyn) aggregation. We also evaluated the interactions of JM-20 with aSyn by molecular docking and molecular dynamics and assessed the protective effect of JM-20 against aminochrome cytotoxicity. We demonstrated that JM-20 induced the formation of heterogeneous amyloid fibrils, which were innocuous to primary cultures of mesencephalic cells. Moreover, JM-20 reduced the average size of aSyn positive inclusions in H4 cells transfected with SynT wild-type and synphilin-1-V5, but not in HEK cells transfected with synphilin-1-GFP. In silico studies showed the interaction between JM-20 and the aSyn-binding site. Additionally, we showed that JM-20 protects SH-SY5Y cells against aminochrome cytotoxicity. These results reinforce the potential of JM-20 as a neuroprotective compound for PD and suggest aSyn as a molecular target for JM-20
FINANCIAL CONDITION DI KALANGAN GEN Z: EKSPLORASI TREN PAY LATER DARI PERSPEKTIF HUKUM ISLAM
No full textPenelitian ini mengeksplorasi tren pembayaran Pay Later dari perspektif hukum Islam, dengan fokus pada penggunaannya di kalangan generasi Z. Melalui metode kualitatif deskriptif dan melibatkan wawancara pengguna, penelitian ini menyimpulkan bahwa Pay Later tetap diharamkan dalam Islam jika terdapat sistem bunga dan cicilan, sehingga dijatuhi hukum riba. Hasil penelitian menunjukkan bahwa fitur Pay Later memang menawarkan kemudahan bagi konsumen dalam melakukan pembelian dengan cicilan tanpa kartu kredit. Namun, penggunaan bunga sebagai biaya tambahan dan denda keterlambatan bertentangan dengan prinsip Islam tentang riba. Penelitian ini menganalisis praktik Pay Later berdasarkan konsep akad ijarah dan ju'alah dalam fikih muamalah, serta memberikan panduan agar transaksi Pay Later dapat sesuai dengan hukum Islam. Penelitian lanjutan dapat dilakukan dengan memperluas dengan objek kajian dengan menelaah fitur Pay Later pada platform e-commerce lainnya dari sisi akad, skema bunga, dan kesesuaiannya dengan prinsip – prinsip hukum Islam.Kata kunci: Generasi Z, Hukum Islam, Pay Late
The marginal willingness-to-pay for attributes of a hypothetical HIV vaccine
No full textThis paper estimates the marginal willingness-to-pay for attributes of a hypothetical HIV vaccine using discrete choice modeling. We use primary data from 326 respondents from Bangkok and Chiang Mai, Thailand, in 2008–2009, selected using purposive, venue-based sampling across two strata. Participants completed a structured questionnaire and full rank discrete choice modeling task administered using computer-assisted personal interviewing. The choice experiment was used to rank eight hypothetical HIV vaccine scenarios, with each scenario comprising seven attributes (including cost) each of which had two levels. The data were analyzed in two alternative specifications: (1) best-worst; and (2) full-rank, using logit likelihood functions estimated with custom routines in Gauss matrix programming language. In the full-rank specification, all vaccine attributes are significant predictors of probability of vaccine choice. The biomedical attributes of the hypothetical HIV vaccine (efficacy, absence of VISP, absence of side effects, and duration of effect) are the most important attributes for HIV vaccine choice. On average respondents are more than twice as likely to accept a vaccine with 99% efficacy, than a vaccine with 50% efficacy. This translates to a willingness to pay US$383 more for a high efficacy vaccine compared with the low efficacy vaccine. Knowledge of the relative importance of determinants of HIV vaccine acceptability is important to ensure the success of future vaccination programs. Future acceptability studies of hypothetical HIV vaccines should use more finely grained biomedical attributes, and could also improve the external validity of results by including more levels of the cost attribute
Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono District, Uganda.
No full textIn Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures
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