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Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers 你能得到你所付出的吗?按绩效付费和医疗保健提供者的质量
Pub Date : 2009-04-01 DOI: 10.2139/ssrn.1381463
Kathleen J. Mullen, R. Frank, M. Rosenthal
Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness. We use data from published performance reports of physician medical groups contracting with a large network HMO to compare clinical quality before and after the implementation of P4P, relative to a control group. We consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, we fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.
尽管作为一种提高医疗质量的工具,按绩效付费(P4P)在卫生政策制定者和私人保险公司中很受欢迎,但其有效性却缺乏经验基础。我们使用与大型网络HMO签约的医师医疗集团发表的绩效报告中的数据来比较实施P4P前后与对照组的临床质量。我们考虑了P4P对奖励和非奖励质量维度的影响。最后,我们没有找到证据表明,大规模的P4P计划既导致了质量的重大改善,也导致了护理的显著中断。
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引用次数: 214
Natural Disasters, Self-Insurance and Human Capital Investment: Evidence from Bangladesh, Ethiopia and Malawi 自然灾害、自我保险与人力资本投资:来自孟加拉国、埃塞俄比亚和马拉维的证据
Pub Date : 2009-04-01 DOI: 10.1596/1813-9450-4910
Futoshi Yamauchi, Y. Yohannes, A. Quisumbing
This paper examines the impacts of disasters on dynamic human capital production using panel data from Bangladesh, Ethiopia, and Malawi. The empirical results show that the accumulation of biological human capital prior to disasters helps children maintain investments in the post-disaster period. Biological human capital formed in early childhood (long-term nutritional status) plays a role of insurance with resilience to disasters by protecting schooling investment and outcomes, although disasters have negative impacts on investment. In Bangladesh, children with more biological human capital are less affected by the adverse effects of floods, and the rate of investment increases with the initial human capital stock in the post-disaster recovery process. In Ethiopia and Malawi, where droughts are rather frequent, exposure to highly frequent droughts in some cases reduces schooling investment but the negative impacts are larger among children embodying less biological human capital. Asset holdings prior to the disasters, especially the household's stock of intellectual human capital, also helps maintain schooling investments at least to the same degree as the stock of human capital accumulated in children prior to the disasters.
本文利用孟加拉国、埃塞俄比亚和马拉维的面板数据考察了灾害对动态人力资本生产的影响。实证结果表明,灾前生物人力资本的积累有助于儿童在灾后保持投资。尽管灾害对投资有负面影响,但幼儿期形成的生物人力资本(长期营养状况)通过保护学校投资和结果,发挥了抵御灾害的保险作用。在孟加拉国,拥有更多生物人力资本的儿童受到洪水不利影响的影响较小,并且随着灾后恢复过程中初始人力资本存量的增加,投资率也会增加。在干旱相当频繁的埃塞俄比亚和马拉维,在某些情况下,遭受高度频繁的干旱会减少学校投资,但对儿童的负面影响更大,体现出较少的生物人力资本。灾害前的资产持有,特别是家庭的智力人力资本存量,也有助于维持教育投资,至少与灾害前儿童积累的人力资本存量相同。
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引用次数: 43
Diasporas
Pub Date : 2009-04-01 DOI: 10.1596/1813-9450-4984
M. Beine, Frédéric Docquier, C. Ozden
Migration flows are shaped by a complex combination of self-selection and out-selection mechanisms. In this paper, the authors analyze how existing diasporas (the stock of people born in a country and living in another one) affect the size and human-capital structure of current migration flows. The analysis exploits a bilateral data set on international migration by educational attainment from 195 countries to 30 developed countries in 1990 and 2000. Based on simple micro-foundations and controlling for various determinants of migration, the analysis finds that diasporas increase migration flows, lower the average educational level and lead to higher concentration of low-skill migrants. Interestingly, diasporas explain the majority of the variability of migration flows and selection. This suggests that, without changing the generosity of family reunion programs, education-based selection rules are likely to have a moderate impact. The results are highly robust to the econometric techniques, accounting for the large proportion of zeros and endogeneity problems.
移民流动是由自我选择和外选择机制的复杂组合形成的。在本文中,作者分析了现有的散居者(出生在一个国家并生活在另一个国家的人的存量)如何影响当前移民流动的规模和人力资本结构。该分析利用了1990年和2000年195个国家到30个发达国家按教育程度划分的国际移民双边数据集。基于简单的微观基础和对移民的各种决定因素的控制,分析发现散居增加了移民流量,降低了平均教育水平,并导致低技能移民的高度集中。有趣的是,散居者解释了移民流动和选择的大部分可变性。这表明,在不改变家庭团聚计划的慷慨程度的情况下,以教育为基础的选择规则可能会产生适度的影响。结果是高度稳健的计量技术,占很大比例的零和内生性问题。
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引用次数: 1238
Creativity from Interaction: Artistic Movements and the Creativity Careers of Modern Painters 互动中的创造力:艺术运动与现代画家的创作生涯
Pub Date : 2009-03-21 DOI: 10.2139/ssrn.1396415
Fabien Accominotti
This article revisits David W. Galenson’s work on the relationship between artistic creativity and the life cycle of artists. Galenson introduces a simple classification of creativity careers (early vs. late-bloomers), relates it to a bipartite typology of creativity (conceptual vs. experimental innovators) and builds on this typology to explain the decreasing trend of age at which artists were most creative over several generations in the 19th and 20th centuries. Drawing on Galenson’s measures, the present paper uses a different approach to overcome possible criticisms to his design. Applying sequence analysis to creativity careers of 41 major modern painters, it also yields a fairly different story from the one Galenson proposes. In particular, I show that a typology of creativity should distinguish between creativity occurring within artistic movements and other forms of creativity. This distinction is important, for the decrease in age at peak creativity over time seems actually driven by the evolution of movement-related creativity alone. Investigating the specific issue of creativity over the life cycle of artists, and showing that movements and interactions play an important part in the picture, the paper thus suggests there is something more than the mere individual involved in artistic creativity.
本文回顾了David W. Galenson关于艺术创造力与艺术家生命周期之间关系的研究。Galenson介绍了一个简单的创造力职业分类(早期和晚期),将其与创造力的两部分类型(概念创新者和实验创新者)联系起来,并在此类型的基础上解释了19世纪和20世纪几代艺术家最具创造力的年龄下降趋势。根据Galenson的测量方法,本文采用了一种不同的方法来克服对他的设计可能存在的批评。将序列分析应用于41位主要现代画家的创作生涯,也得出了一个与盖伦森提出的完全不同的故事。我特别指出,创造力的类型学应该区分艺术运动中的创造力和其他形式的创造力。这一区别很重要,因为随着时间的推移,创造力峰值年龄的下降似乎仅仅是由与运动相关的创造力的进化所驱动的。研究了艺术家生命周期中创造力的具体问题,并表明运动和互动在画面中起着重要作用,因此,这篇论文表明,在艺术创造力中,不仅仅有个人参与。
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引用次数: 69
Age, Human Capital and the Quality of Work: New Evidence from Old Masters 年龄、人力资本和工作质量:来自古代大师的新证据
Pub Date : 2009-03-14 DOI: 10.2139/ssrn.1364417
John R. Page, Thomas M. Bayer, Y. Raviv, J. Rosett
The links between individual ability, human capital investment, and quality of output are generally hard to examine because in most situations output results from multiple inputs and often through complex contracting processes. We overcome these problems by examining life-cycle artistic output quality as reflected in art auction prices. First, we observe an inverted U-shaped age-quality of work profile similar to the conventional age–wage profile. Second, we find that the degree of concavity increases for those with higher native ability. Third, we find that working for a patron rather than selling directly to the market is associated with a flatter age profile. Fourth, we find evidence that formal education increases the concavity of the age-quality of work profile. These results are consistent with the theory and demonstrate that artists respond to incentives to invest in human capital.
个人能力、人力资本投资和产出质量之间的联系通常很难检验,因为在大多数情况下,产出来自多种投入,往往是通过复杂的签约过程产生的。我们通过检查反映在艺术品拍卖价格上的生命周期艺术产出质量来克服这些问题。首先,我们观察到一个倒u型的年龄-工作质量曲线,类似于传统的年龄-工资曲线。第二,我们发现,先天能力越高,其凹度越高。第三,我们发现,为顾客工作而不是直接向市场销售,与更扁平的年龄特征有关。第四,我们发现有证据表明,正规教育增加了年龄-工作质量曲线的凹度。这些结果与理论一致,并表明艺术家对人力资本投资的激励作出反应。
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引用次数: 5
Intellectual Assets & Knowledge Due Diligence 知识资产和知识尽职调查
Pub Date : 2009-03-14 DOI: 10.2139/ssrn.1359663
Noah Farhadi
The ability of the acquirer and the acquired firm in managing new capabilities and skills following a transaction is considered to be one of the most important purchasing criteria in takeovers and mergers. Practitioners claim that M&A deals, which involve practices with strong knowledge management discipline, are better candidates for acquisition. Experience reveals that world-class organizations that are managing knowledge assets effectively increase innovation, accelerate speed to market, increase organizational competence, and improve productivity.

In M&A deals, companies go through a chain of activities: (1) crafting inorganic growth strategy; (2) screening market for acceptable growth opportunities; (3) targeting the candidates; (4) conducting due diligence investigations and post-acquisition integration planning; (5) allocating purchase price and negotiating; (6) signing and closing; and notably (7) implementing and finalizing post-merger integration.

In our contribution, we will provide insight on the importance of intellectual capital in inorganic growth. Among other due diligence investigations, we argue that knowledge management due diligence audit is supposed to explain the relationship between (1) intangible knowledge assets (including the related processes, technologies and organisational culture) and (2) inorganic business growth through mergers and acquisitions.
收购方和被收购方在交易后管理新能力和技能的能力被认为是收购和合并中最重要的购买标准之一。实践者声称,并购交易涉及到具有强大知识管理纪律的实践,是更好的收购对象。经验表明,有效管理知识资产的世界级组织能够增加创新,加快上市速度,增强组织能力,提高生产力。在并购交易中,公司要经历一系列活动:(1)制定无机增长战略;(2)筛选市场,寻找可接受的增长机会;(三)针对候选人;(4)进行尽职调查和收购后整合规划;(五)确定收购价格并进行谈判;(六)签收;值得注意的是(7)实施和完成并购后的整合。在我们的贡献中,我们将阐述智力资本在无机增长中的重要性。在其他尽职调查中,我们认为知识管理尽职调查审计应该解释(1)无形知识资产(包括相关流程、技术和组织文化)与(2)通过并购实现的无机业务增长之间的关系。
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引用次数: 0
Social Return on Investment, Value Added and Volunteer Work 社会投资回报、增值和志愿工作
Pub Date : 2009-03-13 DOI: 10.2139/ssrn.1359306
Eduardo Segio Ulrich Pace, L. C. Basso
This study aims to evaluate the return on investments and its capacity to add value in Third Sector entities, enlarged by the inclusion of aspects of volunteer work. It consists of a descriptive survey of an intentional sample, which identifies multiples that form an integral part of accounting and financial values with social indicators. Investments in volunteer work show that the broader its base, the higher the return by real invested, with a contribution above 43 %, besides the financial values. The value added by this activity at the entities surveyed accounts for 67.6 % of the financial and social value allocated to human resources and for 15.6% of the hours worked. There is economy for society derived from the secondary results of the functional qualification of this labor with training and education, generating a market value 5.6 times the financial value invested in its training. The conclusion presents the preeminent need to value the undisclosed contribution of volunteer work.
本研究旨在评估第三部门实体的投资回报及其增值能力,通过纳入志愿工作的各个方面来扩大。它包括对意向样本的描述性调查,该调查确定了构成会计和财务价值不可分割部分的倍数与社会指标。志愿工作的投资表明,其基础越广,实际投资回报越高,除了财务价值外,贡献超过43%。在被调查的实体中,这一活动所增加的价值占分配给人力资源的财政和社会价值的67.6%,占工作时间的15.6%。通过培训和教育,这些劳动力的功能资格的二次结果为社会带来了经济效益,产生的市场价值是培训投入的金融价值的5.6倍。结论表明,我们非常需要重视志愿者工作中未披露的贡献。
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引用次数: 4
Education Across the Life Course 终身教育
Pub Date : 2009-03-01 DOI: 10.2139/ssrn.1447885
H. Blossfeld
There is a huge demand for high-quality longitudinal educational research in Germany. In particular, there is a clear need for both analytical and methodological progress in order to understand educational pathways through the life course and how they lead to different outcomes. This paper identifies the theoretical and methodological challenges of studying education across the life course and describes the structure of the National Educational Panel Study (NEPS) in Germany.
德国对高质量的纵向教育研究有着巨大的需求。特别是,显然需要在分析和方法上取得进展,以便了解贯穿一生的教育途径以及它们如何导致不同的结果。本文确定了在整个生命过程中研究教育的理论和方法挑战,并描述了德国国家教育小组研究(NEPS)的结构。
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引用次数: 3
Emulation in Teams and Families 团队和家庭中的模仿
Pub Date : 2009-03-01 DOI: 10.2139/ssrn.1369209
D. Léonard, Ngo van Long
We present a model where the probability distribution over the space of an agent's achievements depends not only on her ability and effort, but also on the goals set for her. The agent chooses her effort according to her utility net of perceived cost of effort. This cost is inversely proportional to an `emulation function' that depends on the training undertaken by rival agents. The principal also incurs costs in setting goals. In the first part of the paper we analyse the cases of coaches setting goals for rival athletes and that of a coach in charge of a team. We can sometimes rank the outcomes. In the second part of the paper we turn our attention to families where parents do not treat their children as perfect substitutes, as coaches did. We show that in many circumstances the emulation process reverses our naive intuition. There are now two distinct ways of prodding children to success: direct coaching, and emulation through sibling rivalry. Nous presentons un modele ou la distribution de la valeur du succes d'un agent depend non seulement de son aptitude et de son effort, mais aussi des objectifs qui lui sont fixes par le principal. L'agent choisit son effort en tenant compte de son utilite et du cout percu de l'effort. Ce cout est inversement proportionel a une 'fonction d'emulation' qui depend des objectifs fixes a ses rivaux. Dans une premiere partie, nous analysons les choix d'entraineurs d'athletes rivaux et celui de l'entraineur d'une equipe. Nous pouvons parfois ordonner leurs resultats. Une deuxieme partie analyse le cas des familles qui, contrairement aux entraineurs, ne considerent pas leurs enfants comme de parfaits substituts. Nous demontrons que souvent le processus d'emulation aboutit a des resultats contraires a une intuition naive. Il y a maintenant deux voies distinctes pour pousser les enfants vers le succes : une voie directe par la formation, et une voie indirecte s'appuyant sur la rivalite entre freres et soeurs.
我们提出了一个模型,在这个模型中,agent的成就在空间上的概率分布不仅取决于她的能力和努力,还取决于为她设定的目标。代理根据感知努力成本的效用网选择努力。该成本与“仿真函数”成反比,该函数依赖于竞争代理所进行的训练。本金在设定目标时也会产生成本。在本文的第一部分,我们分析了教练员为对手运动员设定目标的案例和领队教练员为球队设定目标的案例。我们有时可以对结果进行排序。在论文的第二部分,我们将注意力转向那些父母不像教练那样把孩子当作完美替代品的家庭。我们表明,在许多情况下,模拟过程逆转了我们的天真直觉。现在有两种截然不同的方式来刺激孩子们走向成功:直接指导,以及通过兄弟姐妹之间的竞争来模仿。现有的表现形式不是基于成功的价值分布模型,而是基于非累积性的能力和努力,主要是基于目标,而不是基于固定的原则。代理选择的努力,在租户完成的效用,并计算的百分比的努力。“函数与仿真”的比值取决于对象的固定值和竞争值。在一个首映晚会上,我们的分析可以让我们选择“运动员”,而不是“运动员”,而不是“运动员”。许多人的工作都是为了获得更好的结果。一个dedexieme缔约方分析了家庭成员的情况、契约和参与者的情况,并考虑了参与者和参与者的替代情况。事实证明,在模拟过程中,结果与单一的直觉相矛盾。两种不同的声音会导致不同的成功:一种声音是直接的,一种声音是间接的,一种声音是直接的,一种声音是间接的,一种声音是直接的,一种声音是间接的。
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引用次数: 0
Natural Disasters and Human Capital Accumulation 自然灾害与人力资本积累
Pub Date : 2009-03-01 DOI: 10.1093/WBER/LHQ008
J. Cuaresma
The author assesses empirically the relationship between natural disaster risk and investment in education. Although the results in the empirical literature tend to be inconclusive, using model averaging methods in the framework of cross-country and panel regressions, this paper finds an extremely robust negative partial correlation between secondary school enrollment and natural disaster risk. This result is exclusively driven by geological disasters. Natural disaster risk exposure is a robust determinant of differences in secondary school enrollment between countries, but not within countries, which implies that the effect can be interpreted as a long-run phenomenon.
本文对自然灾害风险与教育投资之间的关系进行了实证分析。虽然实证文献的结果往往不确定,但本文采用跨国和面板回归框架下的模型平均方法,发现中学入学率与自然灾害风险之间存在极其显著的负偏相关。这种结果完全是由地质灾害造成的。自然灾害风险暴露是国家间中学入学率差异的一个强有力的决定因素,但不是国家内部的决定因素,这意味着这种影响可以被解释为一种长期现象。
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引用次数: 83
期刊
Labor: Human Capital
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