169 research outputs found

    The strengths and failures of incentive mechanisms in notional defined contribution pension systems

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    Public pension systems based on the Notional Defined Contribution (NDC) principle were introduced during the ‘90s in Italy, Sweden and Poland, among other countries. They mimic private savings, in that individuals get back, as pensioners, what they contributed to social security during working life, plus returns. As such, NDC systems should realize actuarial equity and incentive neutrality. However, when one considers the presence of NDC pensions together with minimum and social assistance pensions, this is no longer true. Indeed, in all the three countries considered, the NDC system shows a regressive feature, which disincentivizes contributions, particularly from low earners, who would be better off entering, or staying in, the shadow economy. In order to reduce the extent of this phenomenon, we examine the effects of introducing, or increasing, the possibility of accumulation of social assistance and NDC pensions, which would also improve pension adequacy. A complete accumulation of the two would solve the incentive problem, but would be costly and would require a structural reform of the pension system financing mechanism, altering the current balance between social contributions and general fiscal revenues. We show the effects of a change in the cumulation rules for social assistance and NDC pensions in Italy using CAPP_DYN, a population-based dynamic microsimulation model, which allows assessment of the evolution of the pension system in the coming decades and the distributional implications of such reform.

    Pension reforms, educational choices and the long term dynamic of the employment in Italy

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    In this paper we use CAPP_DYN, a population based dynamic microsimulation model to simulate the Italian employed population during the period 2005-2050. We find that the more interesting changes will affect the composition rather than the level of the employed population. We investigate main factors that are at work (cohorts effects, educational choices and pension reforms). Finally we present some sensitivity analyses to tes

    Un modello di microsimulazione a popolazione dinamica per la stima degli effetti distributivi della riforma pensionistica

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    In questo lavoro utilizziamo un modello di microsimulazione a popolazione dinamica per stimare l’impatto sulla distribuzione dei redditi da pensione del progressivo passaggio alla regola contributiva nel periodo 2004-2050. Il modello, costruito con procedure di tipo probabilistico e su scenari demografici e macroeconomici esogeni, evidenzia come il giudizio sugli effetti distributivi delle riforme pensionistiche diventi più complesso quando a fianco dei tradizionali indicatori usati in questi anni (tasso interno di rendimento, net present value ratio, ricchezza pensionistica) se ne considerino altri più attenti alla distribuzione e alla dispersione dei redditi correnti. In particolare il modello evidenzia una forte caduta del rapporto tra pensione e salario medio, un consistente aumento del numero di pensioni da lavoro di importo molto basso, un deciso aumento della dispersione delle pensioni da lavoro ed il ruolo sempre più importante per il futuro dell’assegno sociale come strumento di contrasto delle disuguaglianze nella distribuzione dei redditi da pensione

    Inequalities in the distribution of the general practice workforce in England: A practice-level longitudinal analysis

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    Background: In England, demand for primary care services is increasing and GP shortages are widespread. Recently introduced primary care networks (PCNs) aim to expand the use of additional practice-based roles such as physician associates (PAs), pharmacists, paramedics, and others through financial incentives for recruitment of these roles. Inequalities in general practice, including additional roles, have not been examined in recent years, which is a meaningful gap in the literature. Previous research has found that workforce inequalities are associated with health outcome inequalities. Aim: To examine recent trends in general practice workforce inequalities. Design & setting: A longitudinal study using quarterly General Practice Workforce datasets from 2015–2020 in England. Method: The slope indices of inequality (SIIs) for GPs, nurses, total direct patient care (DPC) staff, PAs, pharmacists, and paramedics per 10 000 patients were calculated quarterly, and plotted over time, with and without adjustment for patient need. Results: Fewer GPs, total DPC staff, and paramedics per 10 000 patients were employed in more deprived areas. Conversely, more PAs and pharmacists per 10 000 patients were employed in more deprived areas. With the exception of total DPC staff, these observed inequalities widened over time. The unadjusted analysis showed more nurses per 10 000 patients employed in more deprived areas. These values were not significant after adjustment but approached a more equal or pro-poor distribution over time. Conclusion: Significant workforce inequalities exist and are even increasing for several key general practice roles, with workforce shortages disproportionately affecting more deprived areas. Policy solutions are urgently needed to ensure an equitably distributed workforce and reduce health inequities

    Analysing changes to the flow of public funding within local health and care systems: An adaptation of the System of Health Accounts framework to a local health system in England

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    Financial flows relating to health care are routinely analysed at national and international level. They have rarely been systematically analysed at local level, despite sub-national variation due to population needs and decisions enacted by local organisations. We illustrate an adaptation of the System of Health Accounts framework to map the flow of public health and care funding within local systems, with an application for Greater Manchester (GM), an area in England which agreed a health and social care devolution deal with the central government in 2016. We analyse how financial flows changed in GM during the four years post-devolution, and whether spending was aligned with local ambitions to move towards prevention of ill-health and integration of health and social care. We find that GM decreased spending on public health by 15%, and increased spending on general practice by 0.1% in real terms. The share of total local expenditure paid to NHS Trusts for general and acute services increased from 70.3% to 71.6%, while that for community services decreased from 11.7% to 10.3%. Results suggest that GM may have experienced challenges in redirecting resources towards their goals. Mapping financial flows at a local level is a useful exercise to examine whether spending is aligned with system goals and highlight areas for further investigation

    Nonequilibrium molecular dynamics simulations of nanoconfined fluids at solidliquid interfaces

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    We investigate the hydrodynamic properties of a Lennard-Jones fluid confined to a nanochannel using molecular dynamics simulations. For channels of different widths and hydrophilic-hydrophobic surface wetting properties, profiles of the fluid density, stress, and viscosity across the channel are obtained and analysed. In particular, we propose a linear relationship between the density and viscosity in confined and strongly inhomogeneous nanofluidic flows. The range of validity of this relationship is explored in the context of coarse grained models such as dynamic density functional-theory
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