Residence, income and cancer hospitalizations in British Columbia during a decade of policy change

BACKGROUND: Through the 1990s, governments across Canada shifted health care funding allocation and organizational foci toward a community-based population health model. Major concerns of reform based on this model include ensuring equitable access to health and health care, and enhancing preventive and community-based resources for care. Reforms may act differentially relative to specific conditions and services, including those geared to chronic versus acute conditions. The present study therefore focuses on health service utilization, specifically cancer hospitalizations, in British Columbia during a decade of health system reform. METHODS: Data were drawn from the British Columbia Linked Health Data resource; income measures were derived from Statistics Canada 1996 Census public use enumeration area income files. Records with a discharge (separation) date between 1 January 1991 and 31 December 1998 were selected. All hospitalizations with ICD-9 codes 140 through 208 (except skin cancer, code 173) as principal diagnosis were included. Specific cancers analyzed include lung; colorectal; female breast; and prostate. Hospitalizations were examined in total (all separations), and as divided into first and all other hospitalizations attributed to any given individual. Annual trends in age-sex adjusted rates were analyzed by joinpoint regression; longitudinal multivariate analyses assessing association of residence and income with hospitalizations utilized generalised estimating equations. Results are evaluated in relation to cancer incidence trends, health policy reform and access to care. RESULTS: Age-sex adjusted hospitalization rates for all separations for all cancers, and lung, breast and prostate cancers, decreased significantly over the study period; colorectal cancer separations did not change significantly. Rates for first and other hospitalizations remained stationary or gradually declined over the study period. Area of residence and income were not significantly associated with first hospitalizations; effects were less consistent for all and other hospitalizations. No interactions were observed for any category of separations. CONCLUSIONS: No discontinuities were observed with respect to total hospitalizations that could be associated temporally with health policy reform; observed changes were primarily gradual. These results do not indicate whether equity was present prior to health care reform. However, findings concur with previous reports indicating no change in access to health care across income or residence consequent on health care reform

Impact of stakeholder characteristics on voluntary dissemination of interim information and communication of its level of assurance

Equity of access to information for listed entities is a key principle in an efficient and effective market. Direct mailing is a mechanism for achieving this. This study examines equity of access by identifying the half-yearly financial information, if any, voluntarily mailed out by Australian listed entities and associated stakeholder characteristics. We find that certain stakeholder characteristics (presence of audit committee and shareholder dispersion) are associated with voluntary mail-out of half-yearly financial information, along with certain control variables (size of entity, industry and audit opinion). This study further identifies that there are very few instances of the higher level of assurance (audit) being chosen, and where half-year information is disseminated there are very few instances of the level of assurance on this information being communicated to shareholders. Copyright (c) The Authors Journal compilation (c) 2007 AFAANZ.

Board structures and the establishment of a risk management committee by Malaysian listed firms

Corporate governance, Malaysian companies, Risk management, Boards of directors, Internal control,