Chasing the golden fleece : increasing healthcare quality, efficiency and patient satisfaction while reducing costs

There are a number of global concerns in healthcare today including ageing populations, high cost of developing new drugs, high-risk lifestyles, and how to transfer research into practice. However, the overarching goal of healthcare systems everywhere, regardless of the particular issues, is to improve care while at the same time reducing cost. This could be called the ‘Golden Fleece’ of healthcare. Just as in Greek mythology, Jason and his Argonauts embarked on a long and risky journey to find something of which they had only heard rumours, healthcare managers seek methods of providing better care more efficiently, yet many fail on the quest. This is a review article which examines the seven articles which make up one issue of the International Journal of Clinical Governance (IJHG), and exploring themes relating to lean management in health governance

A Transaction cost Perspective on the Influence of Standards on Product Development Examples from the Fruit and Vegetable Market

In this paper I argue that quality standards, products standards, and quality classes influence the priority that firms give to different product developments. These standards may be viewed as institutions in the sense of shared rules of behavior or codes. They have become shared because there are increasing returns to their use. These increasing returns apply both to their functions as means of reducing the costs of specifying and communicating product quality and to their functions as means of reducing buyers' costs of comparing the quality of different products - both of which are part of transaction costs. When reliable and extensively used standards exist, transaction costs are reduced. But these positive consequences to individual firms of adhering to the same standards create a sort of inertia in product development. This is because developments which are in line with existing standards will not introduce new transaction costs, while developments which break with the conformity of the standards will. In order for the latter kinds of product developments to be profitable, both development costs and transaction costs have to be overcome.Transaction costs, product development standards

Neckties in the Tropics: A Model of International Trade and Cultural Diversity

Some cultural goods, like clothes and films, are consumed socially and are thus characterized by the same consumption network externalities as languages. At the same time, producers of new cultural goods in any one country draw on the stock of ideas generated by previous cultural production in all countries. For such goods, costless trade and communication tend to lead to the dominance of one cultural style, increasing utility in the short run but reducing quality and generating cultural stagnation in the long run. Increasing trade costs while keeping communication costs low may reduce welfare by stimulating production of cultural goods that are "compatible" with the dominant style, thereby capturing consumption network externalities, but that add little to the stock of usable ideas. A reform of cultural policy suggested by our two-country analysis could be to remove import restrictions in the smaller country and replace them with subsidies to the fixed costs of production of new cultural goods in its traditional style.

Can Health Promotion Programs Effectively Reduce Health Care Costs, Increase Productivity and Retain Qualified Employees?

The changing nature of work organization includes modification in the type of work performed, increasing working hours, as well as increasing competition stemming from globalization. These factors combined with declining quality of life and health habits are among the main reasons that continue imposing a financial burden to many employers in the United States and they are reflected in increasing health care costs, employee absenteeism and costs of employee turnover. Many organizations have attempted to target the issue by providing health promotion programs directed at reducing health care costs to the employer while improving productivity. To what extent can these programs effectively assist the employer in achieving positive results in regards costs, productivity and employee retention

Neckties in the Tropics: a Model of International Trade and Cultural Diversity

Some cultural goods, like clothes and films, are consumed socially and are thus characterized by the same consumption network externalities as languages. At the same time, producers of new cultural goods in any one country draw on the stock of ideas generated by previous cultural production in all countries. For such goods, costless trade and communication tend to lead to the dominance of one cultural style, increasing utility in the short run but reducing quality and generating cultural stagnation in the long run. Increasing trade costs while keeping communication costs low may reduce welfare by stimulating production of cultural goods that are “compatible†with the dominant style, thereby capturing consumption network externalities, but that add little to the stock of usable ideas. Our two-country analysis suggests a reform of cultural policy whereby import restrictions in the smaller country are replaced by subsidies to the fixed costs of production of “authentic†new cultural goods, funded by contributions from the larger countryGains from trade; Cultural goods; Diversity; Network externalities

Neckties in the Tropics: A Model of International Trade and Cultural Diversity

Some cultural goods, like clothes and films, are consumed socially and are thus characterized by the same consumption network externalities as languages. At the same time, producers of new cultural goods in any one country draw on the stock of ideas generated by previous cultural production in all countries. For such goods, costless trade and communication tend to lead to the dominance of one cultural style, increasing utility in the short run but reducing quality and generating cultural stagnation in the long run. Increasing trade costs while keeping communication costs low may reduce welfare by stimulating production of cultural goods that are compatible with the dominant style, thereby capturing consumption network externalities, but that add little to the stock of usable ideas. Our two-country analysis suggests a reform of cultural policy whereby import restrictions in the smaller country are removed, and are replaced by subsidies to the fixed costs of production of new cultural goods in its traditional style.consumption network externalities, home market effect, globalization, cultural policy

Effects of pre-steaming on the drying quality of rubberwood

In this study, the kiln drying yield of 30 mm Rubberwood (Hevea brasiliensis) furniture stocks with pre-steaming treatment was evaluated. The results revealed that pre-steaming increased the permeability of the wood, hence increasing the drying rate while reducing drying defects. It was found that the pre-steaming treatment should be included in the drying of Rubberwood in order to reduce the overall drying costs as well as improving its quality

Soft-Defined Heterogeneous Vehicular Network: Architecture and Challenges

Heterogeneous Vehicular NETworks (HetVNETs) can meet various quality-of-service (QoS) requirements for intelligent transport system (ITS) services by integrating different access networks coherently. However, the current network architecture for HetVNET cannot efficiently deal with the increasing demands of rapidly changing network landscape. Thanks to the centralization and flexibility of the cloud radio access network (Cloud-RAN), soft-defined networking (SDN) can conveniently be applied to support the dynamic nature of future HetVNET functions and various applications while reducing the operating costs. In this paper, we first propose the multi-layer Cloud RAN architecture for implementing the new network, where the multi-domain resources can be exploited as needed for vehicle users. Then, the high-level design of soft-defined HetVNET is presented in detail. Finally, we briefly discuss key challenges and solutions for this new network, corroborating its feasibility in the emerging fifth-generation (5G) era

Expanding Health-Care Access in the United States: Gender and the Patchwork 'Universalism' of the Affordable Care Act

This paper focuses on the ways in which women in the United States are impacted by the 2010 passage of the Patient Protection and Affordable Care Act (usually referred to as ACA or 'Obamacare'). The ACA's three main goals of expanding access, increasing consumer protections and reducing costs while increasing quality of services will improve coverage, access to services and types of services that benefit women (and men). However, universal coverage remains illusive due to employer-based insurance coverage that allows firms to make decisions about coverage type. This patchwork universalism is the result of political decisions to extend rather than transform the current health-care system and as such reproduces many of the previously existing problems of uneven costs and coverage. The paper argues the ACA is consistent with other sets of US social welfare and labour market regimes that stratify access to social protections by income, race/ethnicity and gender as well as provide individual states with administrative and policy authority. The paper concludes that the passage of ACA will vastly improve health-care coverage in the United States, however, will continue to leave millions of people uninsured. This paper was produced for UN Women's flagship report Progress of the World's Women 2015-2016 and is released as part of the UN Women discussion paper series