The effect of activity-based financing on hospital efficiency: A panel data analysis of DEA efficiency scores 1992-2000

Activity-based financing (ABF) was implemented in the Norwegian hospital sector from 1 July 1997. A fraction (30 to 50 per cent) of the block grant from the state to the county councils has been replaced by a matching grant depending upon the number and composition of hospital treatments. As a result of the reform, the majority of county councils have introduced activity-based contracts with their hospitals. This paper studies the effect of activity-based funding on hospital efficiency. We predict that hospital efficiency will increase because the benefit from cost-reducing efforts in terms of number of treated patients is increased under ABF compared with global budgets. The prediction is tested using a panel data set from the period 1992-2000. Efficiency indicators are estimated by means of data envelopment analysis (DEA) with multiple inputs and outputs. Using a variety of econometric methods, we find that the introduction of ABF has improved efficiency when measured as technical efficiency according to DEA analysis. Contrary to our prediction, the result is less uniform with respect to the effect on cost-efficiency. We suggest several reasons why this prediction fails. Keywords are poor information of costs, production-oriented drive, tight factor markets and soft budget constraints.Public hospitals; financing; efficiency; DEA-scores; panel data; Norway

Heterogenety in hospitals responses to a financial reform: A random coefficient analysis of the impact of activity-based financing on efficiency

The paper examines the heterogeneity with respect to the impact of a financial reform - Activity Based Financing (ABF) - on hospital efficiency in Norway. Measures of technical efficiency and of cost-efficiency are considered. The data set is from a contiguous ten-year panel of 47 hospitals covering both pre-ABF years and years after its imposition. Substantial heterogeneity in the responses, as measured by both estimated and predicted coefficients, is found. Rank correlations between the estimated/predicted coefficients of the ABF dummy and the pre-ABF/post-ABF efficiencies are examined. Overall, improvement seems to be more pronounced in technical efficiency than in cost-efficiency.Health econometrics; Panel data; Hospital efficiency; Activity-based financing; Random coefficients; Heterogeneity; Rank Correlation

The Effect of Activity-Based Financing on Hospital Efficiency: A Panel Data Analysis of DEA Efficiency Scores 1992-2000

Activity-based financing (ABF) was implemented in the Norwegian hospital sector from 1 July 1997. A fraction (30 to 50 per cent) of the block grant from the state to the county councils has been replaced by a matching grant depending upon the number and composition of hospital treatments. As a result of the reform, the majority of county councils have introduced activity-based contracts with their hospitals. This paper studies the effect of activity-based funding on hospital efficiency. We predict that hospital efficiency will increase because the benefit from cost-reducing efforts in terms of number of treated patients is increased under ABF compared with global budgets. The prediction is tested using a panel data set from the period 1992-2000. Efficiency indicators are estimated by means of data envelopment analysis (DEA) with multiple inputs and outputs. Using a variety of econometric methods, we find that the introduction of ABF has improved efficiency when measured as technical efficiency according to DEA analysis. Contrary to our prediction, the result is less uniform with respect to the effect on cost-efficiency. We suggest several reasons why this prediction fails. Keywords are poor information of costs, production-oriented drive, tight factor markets and soft budget constraints.Public Hospitals; Financing; Efficiency; DEA Scores; Panel Data; Norway

Unchanged thermopower enhancement at the semiconductor-metal transition in correlated FeSb2−x_{2-x}Tex_x

Substitution of Sb in FeSb$_2$ by less than 0.5% of Te induces a transition from a correlated semiconductor to an unconventional metal with large effective charge carrier mass $m^*$. Spanning the entire range of the semiconductor-metal crossover, we observed an almost constant enhancement of the measured thermopower compared to that estimated by the classical theory of electron diffusion. Using the latter for a quantitative description one has to employ an enhancement factor of 10-30. Our observations point to the importance of electron-electron correlations in the thermal transport of FeSb$_2$, and suggest a route to design thermoelectric materials for cryogenic applications.Comment: 3 pages, 3 figures, accepted for publication in Appl. Phys. Lett. (2011

Physical Inactivity: A Behavioral Disorder in the Physical Therapist’s Scope of Practice

In health, the gold standard is a state of complete physical, mental, and social well-being.This state is weakened by physical inactivity, which involves a higher risk of cardiovascular disease, hypertension, diabetes, cancer, depression, and obesity. Moreover, 6% to 10% of all deaths from non-communicable diseases worldwide can be attributed to physical inactivity. These adverse effects of physical activity provide evidence that physically active individuals are closer to the gold standard of health than inactive individuals. Therefore, physical activity – not inactivity – should be the standard reference behavior. In this framework, physical inactivity is a clinically significant disturbance in an individual\u27s behavior, which is the definition of a behavioral disorder. Therefore, physical inactivity should be treated as such

Uncertainty in soil physical data at river basin scale

International audienceFor hydrological modelling studies at the river basin scale, decision makers need guidance in assessing the implications of uncertain data used by modellers as an input to modelling tools. Simulated solute transport through the unsaturated zone is associated with uncertainty due to spatial variability of soil hydraulic properties and derived hydraulic model parameters. In general for modelling studies at the river basin scale spatially available data at various scales must be aggregated to an appropriate scale. Estimating soil properties at unsampled points by means of geostatistical techniques require reliable information on the spatial structure of soil data. In this paper this information is assessed by reviewing current developments in the field of soil physical data uncertainty and adopting a classification system. Then spatial variability and structure is inspected by reviewing experimental work on determining spatial length scales for soil physical (and soil chemical) data. Available literature on spatial length scales for soil physical- and chemical properties is reviewed and their use in facilitating change of spatial support discussed. Uncertainty associated to the derivation of hydraulic properties from soil physical properties in this context is also discussed

Report on an acoustic survey for mackerel in the North Sea, Skagerrak and Kattegat in July - August 1987

An acoustic survey in the North Sea, Skagerrak and Kattegat was carried out in July-August 1987 by vessels from Denmark and Norway. This paper gives the distribution and the abundance estimates for mackerel