The Organisation for the Prohibition of Chemical Weapons (OPCW) is a significant component of the global governance structure and considered a gold standard international body with 193 member states and scientific divisions expected to adhere rigorously to objectivity and political neutrality. However, OPCW's reputation has recently been tarnished. Dissenting scientists from within the organization have raised serious questions about the integrity of an OPCW fact-finding mission (FFM) investigating the alleged chemical attack in Douma, Syria on April 7, 2018. The OPCW FFMs are tainted in three ways: (1) they rely upon information provided via intermediaries connected to states that are belligerents in the war in Syria; (2) the organizational structure of an FFM excludes scientific and verification divisions of the OPCW; and (3) control of FFMs is held by a bureaucratic office staffed by career diplomats who are from states involved with the Syrian war. Furthermore, officials involved with the Douma FFM investigation report the following anomalies: (a) an original interim report was secretly altered in order to make an unsubstantiated suggestion that an alleged attack had occurred; (b) A U.S. delegation was allowed to brief the FFM, an action prohibited by the Chemical Weapons Convention; and (c) formal attempts by the inspectors to obtain transparency and dialog was rejected by the OPCW. Meanwhile, the United States and its allies have dismissed questions as Russian “disinformation” or as a “conspiracy theory.” Overall, analysis of the alleged Douma attack and the OPCW's FFM supports the thesis that key international organizations have been effectively captured, or at the very least heavily influenced, by particular states that assume their own impartiality. This shortcoming poses a risk to international peace and security.
{"title":"The corrupt politics of chemical weapons","authors":"Piers Robinson","doi":"10.1111/ajes.12530","DOIUrl":"10.1111/ajes.12530","url":null,"abstract":"<p>The Organisation for the Prohibition of Chemical Weapons (OPCW) is a significant component of the global governance structure and considered a gold standard international body with 193 member states and scientific divisions expected to adhere rigorously to objectivity and political neutrality. However, OPCW's reputation has recently been tarnished. Dissenting scientists from within the organization have raised serious questions about the integrity of an OPCW fact-finding mission (FFM) investigating the alleged chemical attack in Douma, Syria on April 7, 2018. The OPCW FFMs are tainted in three ways: (1) they rely upon information provided via intermediaries connected to states that are belligerents in the war in Syria; (2) the organizational structure of an FFM excludes scientific and verification divisions of the OPCW; and (3) control of FFMs is held by a bureaucratic office staffed by career diplomats who are from states involved with the Syrian war. Furthermore, officials involved with the Douma FFM investigation report the following anomalies: (a) an original interim report was secretly altered in order to make an unsubstantiated suggestion that an alleged attack had occurred; (b) A U.S. delegation was allowed to brief the FFM, an action prohibited by the Chemical Weapons Convention; and (c) formal attempts by the inspectors to obtain transparency and dialog was rejected by the OPCW. Meanwhile, the United States and its allies have dismissed questions as Russian “disinformation” or as a “conspiracy theory.” Overall, analysis of the alleged Douma attack and the OPCW's FFM supports the thesis that key international organizations have been effectively captured, or at the very least heavily influenced, by particular states that assume their own impartiality. This shortcoming poses a risk to international peace and security.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"82 5","pages":"481-492"},"PeriodicalIF":0.8,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43561056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study empirically examines the impact of leverage and capital structure on firm value for the US hotel industry from 1991 to 2017. We find strong evidence that leverage positively relates to firm value for firms in the hotel industry. This relationship is most robust for hotel firms with low financial health, consistent with the theory that firms signal positive information through capital structure. We also find that the relationship between leverage and firm value was weakened during the financial crisis, particularly for firms close to financial distress. Our results suggest that hotel management, creditors, and investors should pay attention to the magnifying effect of leverage on firm performance and the impact of financial crises on the value of debt. This study's empirical results also support the idea that firms in the hotel industry signal to outside investors through debt.
{"title":"How hotel firm value fluctuates with alternative leveraging strategies","authors":"Ying Chen, Eric Valenzuela, Don Capener","doi":"10.1111/ajes.12528","DOIUrl":"10.1111/ajes.12528","url":null,"abstract":"<p>This study empirically examines the impact of leverage and capital structure on firm value for the US hotel industry from 1991 to 2017. We find strong evidence that leverage positively relates to firm value for firms in the hotel industry. This relationship is most robust for hotel firms with low financial health, consistent with the theory that firms signal positive information through capital structure. We also find that the relationship between leverage and firm value was weakened during the financial crisis, particularly for firms close to financial distress. Our results suggest that hotel management, creditors, and investors should pay attention to the magnifying effect of leverage on firm performance and the impact of financial crises on the value of debt. This study's empirical results also support the idea that firms in the hotel industry signal to outside investors through debt.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"83 1","pages":"177-197"},"PeriodicalIF":0.8,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43210833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prison overcrowding is a major public policy issue with roughly 2.2 million individuals currently incarcerated in the United States. In the absence of reductions in the prison population, the only way to address overcrowding are the expansion of current facilities or the construction of new prisons. Previous research has demonstrated that factors unrelated to the law can affect the decisions made by prosecutors and judges. We investigate the effect of newly constructed prisons in Florida on the probability of defendants being sentenced to prison within 6 months of the prison receiving inmates. The results reveal that these defendants have a greater likelihood of being incarcerated in prison compared to similar defendants whose cases were resolved before the prison became operational. This indicates the potential for a regional-level substitution between jail and prison incarceration.
{"title":"The impact of new prison construction on the likelihood of incarceration","authors":"Daniel D. Bonneau, Joshua C. Hall","doi":"10.1111/ajes.12529","DOIUrl":"10.1111/ajes.12529","url":null,"abstract":"<p>Prison overcrowding is a major public policy issue with roughly 2.2 million individuals currently incarcerated in the United States. In the absence of reductions in the prison population, the only way to address overcrowding are the expansion of current facilities or the construction of new prisons. Previous research has demonstrated that factors unrelated to the law can affect the decisions made by prosecutors and judges. We investigate the effect of newly constructed prisons in Florida on the probability of defendants being sentenced to prison within 6 months of the prison receiving inmates. The results reveal that these defendants have a greater likelihood of being incarcerated in prison compared to similar defendants whose cases were resolved before the prison became operational. This indicates the potential for a regional-level substitution between jail and prison incarceration.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"83 1","pages":"199-222"},"PeriodicalIF":0.8,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajes.12529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46129373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luis Monroy-Gómez-Franco, Paloma Villagómez-Ornelas
Stratification economics has emerged as a field that puts historically and institutionally determined intergroup hierarchies at the forefront of distributive analysis. However, most of the existing theoretical and empirical literature has focused on studying the US stratification regime, limiting the potential application of this analytical framework to other geographies. This paper applies the theoretical framework of stratification economics to analyze the Mexican distributive regime. In the process, we show that expanding the regional focus of stratification economics requires incorporating several insights from other traditions of stratification analysis. Furthermore, we show that a stratification economics approach overcomes several pitfalls of more traditional approaches to analyzing the Mexican distributive regime, such as the human capital approach that anchored several public policy interventions deployed at the beginning of the XXIst century.
{"title":"Stratification economics in the land of persistent inequalities","authors":"Luis Monroy-Gómez-Franco, Paloma Villagómez-Ornelas","doi":"10.1111/ajes.12527","DOIUrl":"10.1111/ajes.12527","url":null,"abstract":"<p>Stratification economics has emerged as a field that puts historically and institutionally determined intergroup hierarchies at the forefront of distributive analysis. However, most of the existing theoretical and empirical literature has focused on studying the US stratification regime, limiting the potential application of this analytical framework to other geographies. This paper applies the theoretical framework of stratification economics to analyze the Mexican distributive regime. In the process, we show that expanding the regional focus of stratification economics requires incorporating several insights from other traditions of stratification analysis. Furthermore, we show that a stratification economics approach overcomes several pitfalls of more traditional approaches to analyzing the Mexican distributive regime, such as the human capital approach that anchored several public policy interventions deployed at the beginning of the XXIst century.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"83 1","pages":"157-175"},"PeriodicalIF":0.8,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42827815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Musiita, Leward Jeke, Dickson Turyareeba, Mugambe Kenneth, Ben Boyi, Thomas Kisaalita, Richard Richard Mwesige, Geoffrey Kahangane
Purpose: It is well documented that the manufacturing industry plays a vital role in a country's economic growth and progress. This study benchmarks the endogenous growth paradigm in order to assess the productivity drivers that may affect the output growth of the manufacturing sector in East African Community member states. The empirical model covering the years 2000–2020 was constructed using panel data. Methodology: The study adopts a longitudinal research design and tables used to present summary estimates. Analysis has been achieved using stata statistical package version 17.0. A D-GMM estimator was employed to estimate the underlying empirical model. Findings: Foreign direct investments, inflation, trade openness, and lending interest rates were shown to be the most influential variables in the rise of manufacturing sector production among EAC member states out of a large sample of productivity indicators analyzed in the study. Recommendations: The results show that EAC countries can boost their manufacturing output by attracting more FDI, keeping inflation low, boosting cross-border trade, and enacting policies to lower the costs associated with credit access. Unique in this study is the analysis, first of its kind, of the productivity drivers of the growth in manufacturing sector output in the East African Community member states within the general framework of endogenous growth theory.
{"title":"Productivity Factors and the Growth of the Manufacturing Sector among the East African Community Members States: Testing the Adequacy of the Endogenous Growth Hypothesis","authors":"Benjamin Musiita, Leward Jeke, Dickson Turyareeba, Mugambe Kenneth, Ben Boyi, Thomas Kisaalita, Richard Richard Mwesige, Geoffrey Kahangane","doi":"10.47672/aje.1512","DOIUrl":"https://doi.org/10.47672/aje.1512","url":null,"abstract":"Purpose: It is well documented that the manufacturing industry plays a vital role in a country's economic growth and progress. This study benchmarks the endogenous growth paradigm in order to assess the productivity drivers that may affect the output growth of the manufacturing sector in East African Community member states. The empirical model covering the years 2000–2020 was constructed using panel data. \u0000Methodology: The study adopts a longitudinal research design and tables used to present summary estimates. Analysis has been achieved using stata statistical package version 17.0. A D-GMM estimator was employed to estimate the underlying empirical model. \u0000Findings: Foreign direct investments, inflation, trade openness, and lending interest rates were shown to be the most influential variables in the rise of manufacturing sector production among EAC member states out of a large sample of productivity indicators analyzed in the study. \u0000Recommendations: The results show that EAC countries can boost their manufacturing output by attracting more FDI, keeping inflation low, boosting cross-border trade, and enacting policies to lower the costs associated with credit access. Unique in this study is the analysis, first of its kind, of the productivity drivers of the growth in manufacturing sector output in the East African Community member states within the general framework of endogenous growth theory. \u0000 ","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"48 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76979204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper first develops a theoretical model of the returns to daycare, which attempts to show that families enroll their children into daycare based on its expected benefits and costs. The paper then moves to an empirical study that seeks to determine whether enrolling an infant in daycare affects his or her later-in-life employment and poverty status. To identify the causal effect of interest, the econometric approach employs a recently developed panel estimator that accommodates the dynamic nature of later-in-life employment and income, while also controlling for unobserved heterogeneity. The main finding is that, although infant daycare enrollment appears to correlate with positive later-in-life outcomes, addressing potential bias in that link renders the estimated effects highly imprecise, such that one cannot confidently conclude whether daycare helps or hinders later-in-life outcomes.
本文首先建立了日托回报的理论模型,试图表明家庭根据其预期收益和成本让孩子进入日托。然后,论文转向一项实证研究,试图确定让婴儿进入日托中心是否会影响他或她以后的就业和收入。为了确定利益的因果影响,计量经济学方法采用了最近开发的面板估计器,该估计器适应了晚年就业和收入的动态性质,同时也控制了未观察到的异质性。主要的结论是,尽管婴儿日托的注册似乎与以后积极的生活结果相关,但这种联系在很大程度上源于孩子的父母,他们无论如何都会经历积极的结果,让孩子进入日托。JEL代码:C23;D13关键词:固定效果;动态儿童保育david.zimmer@wku.edu;肯塔基州鲍灵格林西肯塔基大学Grise Hall 426
{"title":"The effects of infant daycare on later-in-life employment outcomes","authors":"David M. Zimmer","doi":"10.1111/ajes.12524","DOIUrl":"10.1111/ajes.12524","url":null,"abstract":"<p>This paper first develops a theoretical model of the returns to daycare, which attempts to show that families enroll their children into daycare based on its expected benefits and costs. The paper then moves to an empirical study that seeks to determine whether enrolling an infant in daycare affects his or her later-in-life employment and poverty status. To identify the causal effect of interest, the econometric approach employs a recently developed panel estimator that accommodates the dynamic nature of later-in-life employment and income, while also controlling for unobserved heterogeneity. The main finding is that, although infant daycare enrollment appears to correlate with positive later-in-life outcomes, addressing potential bias in that link renders the estimated effects highly imprecise, such that one cannot confidently conclude whether daycare helps or hinders later-in-life outcomes.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"83 1","pages":"143-156"},"PeriodicalIF":0.8,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49418277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard J. Cebula, Christopher M. Duquette, G. Jason Jolley
In the United States, there exist enormous geographic differentials in the cost of living. A sound, basic understanding of factors that influence such geographic living-cost differentials is important to help formulate useful policies to address various contemporary economic and social problems such as public-school funding across counties. In this exploratory study of the effects of tax freedom on geographic living-cost differentials, the following hypothesis is investigated using panel data for the period 2009 through 2020. The higher the average overall freedom from taxation in a state in the forms of personal income taxation, property taxation, and sales taxation, the lower the overall cost of living in the state. In this exploratory study, strong empirical support is obtained for this heretofore effectively overlooked hypothesis.
{"title":"An exploratory study of the impact of tax freedom on geographic living-cost differentials","authors":"Richard J. Cebula, Christopher M. Duquette, G. Jason Jolley","doi":"10.1111/ajes.12525","DOIUrl":"10.1111/ajes.12525","url":null,"abstract":"<p>In the United States, there exist enormous geographic differentials in the cost of living. A sound, basic understanding of factors that influence such geographic living-cost differentials is important to help formulate useful policies to address various contemporary economic and social problems such as public-school funding across counties. In this exploratory study of the effects of tax freedom on geographic living-cost differentials, the following hypothesis is investigated using panel data for the period 2009 through 2020. The higher the average overall freedom from taxation in a state in the forms of personal income taxation, property taxation, and sales taxation, the lower the overall cost of living in the state. In this exploratory study, strong empirical support is obtained for this heretofore effectively overlooked hypothesis.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"82 4","pages":"365-375"},"PeriodicalIF":0.8,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42543144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction to symposium: Dimensions of US economic freedom at the sub-national level","authors":"James E. Payne, James W. Saunoris","doi":"10.1111/ajes.12526","DOIUrl":"10.1111/ajes.12526","url":null,"abstract":"","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"82 4","pages":"287-288"},"PeriodicalIF":0.8,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47322825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To establish the relationship between status of available financial services and economic growth of households in Mbarara municipality in Uganda. Methodology: The study adopted cross sectional research design. Out of the 16,861 household of in Mbarara municipality, 100 households were selected using Yaro Yamane’s Statistical formula which gives a better representative sample size out of a big population size as compared to other methods (Yamane, 1969).A Standard linear regression analysis was carried out. Findings: The study findings revealed that there is a substantial positive relationship between status of financial services available and level of economic growth of households in Mbarara Municipality with 41.4% of high level the economic growth of people Mbarara Municipality is because of the good status of financial services available. Other factors such as inflation and government policy accounted for 58.6% of the level of Economic growth of people Mbarara Municipality in Uganda Recommendations: The study also recommends that the government and other stake holders such as Mbarara municipal council and other non-governmental organizations should increase on the status of financial services available buy increasing accessibility, quality and usage since they account for 41.4% of the level the economic growth of people Mbarara Municipality Strategies to control other factors like inflation and political instability such as encouraging industrialization and exports should be put in place so since they account for 58.6% of the level of Economic growth of people Mbarara Municipality
{"title":"The Transformative Power of Financial Services on Economic Growth among Households in Mbarara Municipality","authors":"N. Frederick, Mugisha Kyoma","doi":"10.47672/aje.1497","DOIUrl":"https://doi.org/10.47672/aje.1497","url":null,"abstract":"Purpose: To establish the relationship between status of available financial services and economic growth of households in Mbarara municipality in Uganda. \u0000Methodology: The study adopted cross sectional research design. Out of the 16,861 household of in Mbarara municipality, 100 households were selected using Yaro Yamane’s Statistical formula which gives a better representative sample size out of a big population size as compared to other methods (Yamane, 1969).A Standard linear regression analysis was carried out. \u0000Findings: The study findings revealed that there is a substantial positive relationship between status of financial services available and level of economic growth of households in Mbarara Municipality with 41.4% of high level the economic growth of people Mbarara Municipality is because of the good status of financial services available. Other factors such as inflation and government policy accounted for 58.6% of the level of Economic growth of people Mbarara Municipality in Uganda \u0000Recommendations: The study also recommends that the government and other stake holders such as Mbarara municipal council and other non-governmental organizations should increase on the status of financial services available buy increasing accessibility, quality and usage since they account for 41.4% of the level the economic growth of people Mbarara Municipality Strategies to control other factors like inflation and political instability such as encouraging industrialization and exports should be put in place so since they account for 58.6% of the level of Economic growth of people Mbarara Municipality \u0000 ","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"42 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83205831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Paulo Magalhães, Joana Pestana, Renato Lourenço Silva, António Pereira, André Biscaia
Primary healthcare (PHC) governance model, namely its financing scheme, might impact the health outcomes, particularly in chronic conditions, through avoidable hospital admissions (AvH). Therefore, the study aims to assess how the PHC financial governance model determines AvH, as well as how this interacts with the health system financing (HSF) scheme. An observational study comparing the GP employment type (publicly and self/privately) with asthma and COPD, and Diabetes AvH per 100,000 habitants in 26 countries of the European Region, was performed. It considered 4 regression models with structural determinants, service delivery and HSF schemes. GP self/privately employed group associated with social health insurance scheme was significantly associated with higher total AvH (OR = 28.27 [CI 95% 2.34–77.54]), and for asthma and COPD AvH (OR = 21.88 [CI 95% 6.69–180.18]). Diabetes AvH were significantly associated with increasing GP outpatient coverage (model 1) and GP availability (model 2) under a GP self/privately employed group (respectively, OR = 17.01 [CI 95% 3.67–20.63] and OR = 17.80 [CI 95% 8.12–130.35]). The study evidenced that publicly employed GPs working in a tax-based HSF scheme ensure better health outcomes for the population. Although some limitations of equity and categorisation, the results show that the governance model might influence population health outcomes.
{"title":"Avoidable hospital admissions depend on the primary healthcare governance model? A global health perspective from Europe countries","authors":"João Paulo Magalhães, Joana Pestana, Renato Lourenço Silva, António Pereira, André Biscaia","doi":"10.1111/ajes.12523","DOIUrl":"10.1111/ajes.12523","url":null,"abstract":"<p>Primary healthcare (PHC) governance model, namely its financing scheme, might impact the health outcomes, particularly in chronic conditions, through avoidable hospital admissions (AvH). Therefore, the study aims to assess how the PHC financial governance model determines AvH, as well as how this interacts with the health system financing (HSF) scheme. An observational study comparing the GP employment type (publicly and self/privately) with asthma and COPD, and Diabetes AvH per 100,000 habitants in 26 countries of the European Region, was performed. It considered 4 regression models with structural determinants, service delivery and HSF schemes. GP self/privately employed group associated with social health insurance scheme was significantly associated with higher total AvH (OR = 28.27 [CI 95% 2.34–77.54]), and for asthma and COPD AvH (OR = 21.88 [CI 95% 6.69–180.18]). Diabetes AvH were significantly associated with increasing GP outpatient coverage (model 1) and GP availability (model 2) under a GP self/privately employed group (respectively, OR = 17.01 [CI 95% 3.67–20.63] and OR = 17.80 [CI 95% 8.12–130.35]). The study evidenced that publicly employed GPs working in a tax-based HSF scheme ensure better health outcomes for the population. Although some limitations of equity and categorisation, the results show that the governance model might influence population health outcomes.</p>","PeriodicalId":47133,"journal":{"name":"American Journal of Economics and Sociology","volume":"83 1","pages":"127-141"},"PeriodicalIF":0.8,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47063495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}