Hospital productivity and the Norwegian ownership reform – A Nordic comparative study

In a period where decentralisation seemed to be the prominent trend, Norway in 2002 chose to re-centralise the hospital sector. The reform had three main aims; cost control, efficiency and reduced waiting times. This study investigates whether the hospital reform has improved hospital productivity using the other four major Nordic countries as controls. Hospital productivity measures are obtained using data envelopment analysis (DEA) on a comparable dataset of 728 Nordic hospitals in the period 1999 to 2004. First a common reference frontier is established for the four countries, enveloping the technologies of each of the countries and years. Bootstrapping techniques are applied to the obtained productivity estimates to assess uncertainty and correct for bias. Second, these are regressed on a set of explanatory variables in order to separate the effect of the hospital reform from the effects of other structural, financial and organizational variables. A fixed hospital effect model is used, as random effects and OLS specifications are rejected. Robustness is examined through alternate model specifications, including stochastic frontier analysis (SFA). The SFA approach in performed using the Battese & Coelli (1995) one stage procedure where the inefficiency term is estimated as a function of the set of explanatory variables used in the second stage in the DEA approach. Results indicate that the hospital reform in Norway seems to have improved the level of productivity in the magnitude of approximately 4 % or more. While there are small or contradictory estimates of the effects of case mix and activity based financing, the length of stay is clearly negatively associated with estimated productivity. Results are robust to choice of efficiency estimation technique and various definition of when the reform effect takes place.Efficiency; productivity; DEA; SFA; hospitals

Deglaciation of Fennoscandia

To provide a new reconstruction of the deglaciation of the Fennoscandian Ice Sheet, in the form of calendar-year time-slices, which are particularly useful for ice sheet modelling, we have compiled and synthesized published geomorphological data for eskers, ice-marginal formations, lineations, marginal meltwater channels, striae, ice-dammed lakes, and geochronological data from radiocarbon, varve, optically-stimulated luminescence, and cosmogenic nuclide dating. This 25 is summarized as a deglaciation map of the Fennoscandian Ice Sheet with isochrons marking every 1000 years between 22 and 13 cal kyr BP and every hundred years between 11.6 and final ice decay after 9.7 cal kyr BP. Deglaciation patterns vary across the Fennoscandian Ice Sheet domain, reflecting differences in climatic and geomorphic settings as well as ice sheet basal thermal conditions and terrestrial versus marine margins. For example, the ice sheet margin in the high-precipitation coastal setting of the western sector responded sensitively to climatic variations leaving a detailed record of prominent moraines and ice-marginal deposits in many fjords and coastal valleys. Retreat rates across the southern sector differed between slow retreat of the terrestrial margin in western and southern Sweden and rapid retreat of the calving ice margin in the Baltic Basin. Our reconstruction is consistent with much of the published research. However, the synthesis of a large amount of existing and new data support refined reconstructions in some areas. For example, we locate the LGM extent of the ice sheet in northwestern Russia further east than previously suggested and conclude that it occurred at a later time than the rest of the ice sheet, at around 17-15 cal kyr BP, and propose a slightly different chronology of moraine formation over southern Sweden based on improved correlations of moraine segments using new LiDAR data and tying the timing of moraine formation to Greenland ice core cold stages. Retreat rates vary by as much as an order of magnitude in different sectors of the ice sheet, with the lowest rates on the high-elevation and maritime Norwegian margin. Retreat rates compared to the climatic information provided by the Greenland ice core record show a general correspondence between retreat rate and climatic forcing, although a close match between retreat rate and climate is unlikely because of other controls, such as topography and marine versus terrestrial margins. Overall, the time slice reconstructions of Fennoscandian Ice Sheet deglaciation from 22 to 9.7 cal kyr BP provide an important dataset for understanding the contexts that underpin spatial and temporal patterns in retreat of the Fennoscandian Ice Sheet, and are an important resource for testing and refining ice sheet models

Hospital productivity and the Norwegian ownership reform : A Nordic comparative study

Verkkoversion ISSN 1795-820

Measuring cost efficiency in the Nordic Hospitals—a cross-sectional comparison of public hospitals in 2002

Hospitals, Organisational efficiency, DEA, DRG, International comparisons,

Effects of Substrate and Post-Deposition Annealing on Structural and Optical Properties of (ZnO)1-x(GaN)x Films

The structural and optical properties of magnetron sputtered thin films of (ZnO)1−x(GaN)x deposited on zinc oxide, sapphire, and silicon oxide are studied as a function of strain accumulation and post‐deposition anneals at 600–800 °C. For the experimental conditions studied, we found that different amounts of tensile strain accumulated in the samples practically does not affect the strong bandbowing effect, that is, optical bandgap, observed in the as‐deposited alloys. In its turn, post‐deposition annealing results in a reduction of the tensile strain and dislocation density in the films, as measured by both X‐ray diffraction and transmission electron microscopy, corroborating an increase in the crystal quality. In addition, the grain size is found to increase with annealing temperature, for example, mean values of 20 nm up to 50 nm were measured for the alloys with x = 0.15. Meanwhile, the full‐width at half maximum of the (0002) X‐ray diffraction reflection increases with annealing temperature, but with only a small increase in bandgap energies for the x = 0.15 sample. However, this observation was explained combining the experimental data and first‐principles calculations based on density functional theory, showing that the increase in the amount of Ga‐N bonds lowers the total energy of the system. As such, we conclude that the thermal treatments increase the Ga‐N ordering, resulting in several contributions or a widening of the diffraction peaks

Evidence of defect band mechanism responsible for band gap evolution in (ZnO)1−x(GaN)x alloys

It is known that (ZnO)1−x(GaN)x alloys demonstrate remarkable energy band bowing, making the material absorb in the visible range, in spite of the binary components being classical wide band gap semiconductors. However, the origin of this bowing is not settled; two major mechanisms are under debate: Influence of the orbital repulsion and/or formation of a defect band. In the present work, we applied a combination of the absorption and emission measurements on the samples exhibiting an outstanding nanoscale level of (ZnO)1−x(GaN)x homogeneity as monitored by the high resolution electron microscopy equipped with the energy dispersive x-ray analysis and the electron energy loss spectroscopy; moreover the experimental data were set in the context of the computational analysis of the alloys employing density functional theory and quasiparticle GW approximation. A prominent discrepancy in the band gap values as deduced from the absorption and emission experiments was observed systematically for the alloys with different compositions and interpreted as evidence for the absorption gap shrinking due to the defect band formation. Computational data support the argument, revealing only minor variations in the bulk of the conduction and valence band structures of the alloys, except for a characteristic “tail” in the vicinity of the valence band maximum. As such, we conclude that the energy gap bowing in (ZnO)1−x(GaN)x alloys is due to the defect band formation, presumably at the top of the valence band maximum

Deglaciation of Fennoscandia

To provide a new reconstruction of the deglaciation of the Fennoscandian Ice Sheet, in the form of calendar-year time-slices, which are particularly useful for ice sheet modelling, we have compiled and synthesized published geomorphological data for eskers, ice-marginal formations, lineations, marginal meltwater channels, striae, ice-dammed lakes, and geochronological data from radiocarbon, varve, optically-stimulated luminescence, and cosmogenic nuclide dating. This is summarized as a deglaciation map of the Fennoscandian Ice Sheet with isochrons marking every 1000 years between 22 and 13 cal kyr BP and every hundred years between 11.6 and final ice decay after 9.7 cal kyr BP. Deglaciation patterns vary across the Fennoscandian Ice Sheet domain, reflecting differences in climatic and geomorphic settings as well as ice sheet basal thermal conditions and terrestrial versus marine margins. For example, the ice sheet margin in the high-precipitation coastal setting of the western sector responded sensitively to climatic variations leaving a detailed record of prominent moraines and other ice-marginal deposits in many fjords and coastal valleys. Retreat rates across the southern sector differed between slow retreat of the terrestrial margin in western and southern Sweden and rapid retreat of the calving ice margin in the Baltic Basin. Our reconstruction is consistent with much of the published research. However, the synthesis of a large amount of existing and new data support refined reconstructions in some areas. For example, the LGM extent of the ice sheet in northwestern Russia was located far east and it occurred at a later time than the rest of the ice sheet, at around 17–15 cal kyr BP. We also propose a slightly different chronology of moraine formation over southern Sweden based on improved correlations of moraine segments using new LiDAR data and tying the timing of moraine formation to Greenland ice core cold stages. Retreat rates vary by as much as an order of magnitude in different sectors of the ice sheet, with the lowest rates on the high-elevation and maritime Norwegian margin. Retreat rates compared to the climatic information provided by the Greenland ice core record show a general correspondence between retreat rate and climatic forcing, although a close match between retreat rate and climate is unlikely because of other controls, such as topography and marine versus terrestrial margins. Overall, the time slice reconstructions of Fennoscandian Ice Sheet deglaciation from 22 to 9.7 cal kyr BP provide an important dataset for understanding the contexts that underpin spatial and temporal patterns in retreat of the Fennoscandian Ice Sheet, and are an important resource for testing and refining ice sheet models