Franchisors' disclosure duty: market transparency and franchisee protection

The franchisee is usually the most vulnerable part of the franchise relationship, and should therefore receive greater protection from the legal framework. In this regard, the franchisor's pre-contractual disclosure duty has evolved in its legal status. Whereas its original purpose was to ensure transparency in the market, it now serves to protect the franchisee. In this paper, we compare the franchisor's obligations established by the legal framework in Spain with those set out in the Model Law drawn up by The International Institute for the Unification of Private Law.Lapiedra-Alcami, R.; Reig Fabado, I.; Rueda Armengot, C. (2014). Franchisors' disclosure duty: market transparency and franchisee protection. Service Industries Journal. 34(9-10):788-795. doi:10.1080/02642069.2014.905917S788795349-10Chaudey, M., & Fadairo, M. (2010). Contractual design and networks performance: empirical evidence from franchising. Applied Economics, 42(4), 529-533. doi:10.1080/00036840701704428Collins, H. (2008). Principles, Definitions and Model Rules of European Private Law: Draft Common Frame of Reference (DCFR) Interim Outline Edition, prepared by the Study Group on a European Civil Code and the Research group on EC Private Law (Acquis group) by Christian von Bar, Eric Clive, Hans Schulte-Nöcke (eds). Modern Law Review, 71(5), 840-844. doi:10.1111/j.1468-2230.2008.00718.xPeris-Ortiz, M., Peris Bonet, F. J., & Rueda-Armengot, C. (2011). Vertical integration in production and services: development in transaction cost economics. Service Business, 5(1), 87-97. doi:10.1007/s11628-011-0103-0Perryman, A. A., & Combs, J. G. (2011). Who should own it? An agency-based explanation for multi-outlet ownership and co-location in plural form franchising. Strategic Management Journal, 33(4), 368-386. doi:10.1002/smj.1947Rondan-Cataluña, F. J., Navarro-Garcia, A., Diez-De Castro, E. C., & Rodriguez-Rad, C. J. (2012). Reasons for the expansion in franchising: is it all said? The Service Industries Journal, 32(6), 861-882. doi:10.1080/02642069.2010.550041Shane, S. (2001). Organizational Incentives and Organizational Mortality. Organization Science, 12(2), 136-160. doi:10.1287/orsc.12.2.136.10108Vázquez, L. (2008). Complementarities between franchise contract duration and multi-unit propensity in franchise systems. The Service Industries Journal, 28(8), 1093-1105. doi:10.1080/0264206080218794

Does the pharmacy expenditure of patients always correspond with their morbidity burden? Exploring new approaches in the interpretation of pharmacy expenditure

<p>Abstract</p> <p>Background</p> <p>The computerisation of primary health care (PHC) records offers the opportunity to focus on pharmacy expenditure from the perspective of the morbidity of individuals. The objective of the present study was to analyse the behaviour of pharmacy expenditure within different morbidity groups. We paid special attention to the identification of individuals who had higher values of pharmacy expenditure than their morbidity would otherwise suggest (i.e. outliers).</p> <p>Methods</p> <p>Observational study consisting of 75,574 patients seen at PHC centres in Zaragoza, Spain, at least once in 2005. Demographic and disease variables were analysed (ACG^®8.1), together with a response variable that we termed 'total pharmacy expenditure per patient'. Outlier patients were identified based on boxplot methods, adjusted boxplot for asymmetric distributions, and by analysing standardised residuals of tobit regression models.</p> <p>Results</p> <p>The pharmacy expenditure of up to 7% of attendees in the studied PHC centres during one year exceeded expectations given their morbidity burden. This group of patients was responsible for up to 24% of the total annual pharmacy expenditure. There was a significantly higher number of outlier patients within the low-morbidity band which matched up with the higher variation coefficient observed in this group (3.2 vs. 2.0 and 1.3 in the moderate- and high-morbidity bands, respectively).</p> <p>Conclusions</p> <p>With appropriate validation, the methodologies of the present study could be incorporated in the routine monitoring of the prescribing profile of general practitioners. This could not only enable evaluation of their performance, but also target groups of outlier patients and foster analyses of the causes of unusually high pharmacy expenditures among them. This interpretation of pharmacy expenditure gives new clues for the efficiency in utilisation of healthcare resources, and could be complementary to management interventions focused on individuals with a high morbidity burden.</p

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p&lt;0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology