Compensation and Incentives in Medical Networks with Gate-keeping and Case Management

New approaches in health care, such as e.g. Integrated Delivery Systems, affect the role and tasks of medical suppliers. More and more, medical suppliers are incorporated into the process of guiding patients to medical specialists and hospitals and thus managing the course of disease. In this context, the role of medical gate-keepers and case managers may provide opportunities for undesirable behavior (from the network's point of view). Therefore, compensation-induced incentives for gatekeepers and case managers are in the main focus of the paper. Different health care payment systems and the impact of financial and non-financial incentives on case managers and gate-keepers in medical networks are analyzed. Another focus is laid on medical suppliers that are not involved in managing diseases and guiding patients. Due to their smaller margin of actions and possibilities to take advantage of it, reimbursement should emphasize different aspects than for case managers

Compensation and Incentives in Medical Networks with Gate-keeping and Case Management

New approaches in health care, such as e.g. Integrated Delivery Systems, affect the role and tasks of medical suppliers. More and more, medical suppliers are incorporated into the process of guiding patients to medical specialists and hospitals and thus managing the course of disease. In this context, the role of medical gate-keepers and case managers may provide opportunities for undesirable behavior (from the network's point of view). Therefore, compensation-induced incentives for gatekeepers and case managers are in the main focus of the paper. Different health care payment systems and the impact of financial and non-financial incentives on case managers and gate-keepers in medical networks are analyzed. Another focus is laid on medical suppliers that are not involved in managing diseases and guiding patients. Due to their smaller margin of actions and possibilities to take advantage of it, reimbursement should emphasize different aspects than for case managers.networks; compensation; gate-keeping; case management

Potentials of Spectral Imaging for Stress Monitoring in Viticulture

Remote sensing technologies are widely used to monitor quantity and quality of plants in agriculture and forestry. While conventional panchromatic and RGB cameras can provide spatial information equivalent to human vision, high-resolution spectroscopy can reveal information about the chemical and structural composition of plants and provide detailed insight about plant health. With the development of commercial high-resolution multi- and hyperspectral cameras in the past decade, it is now possible to combine spectral and spatial information to obtain high-throughput and accurate predictions of plant condition. In this article, the underlying optical phenomena in plants will be reviewed and projected to potential imaging applications for plant stress monitoring with a focus on viticulture

The timing of prominence information during the resolution of German personal and demonstrative pronouns

German personal and demonstrative pronouns have distinct preferences in their interpretation; personal pronouns are more flexible in their interpretation but tend to resolve to a prominent antecedent, while demonstratives have a strong preference for a non-prominent antecedent. However, less is known about how prominence information is used during the process of resolution, particularly in the light of two- stage processing models which assume that reference will normally be to the most accessible candidate. We conducted three experiments investigating how prominence information is used during the resolution of gender-disambiguated personal and demonstrative pronouns in German. While the demonstrative pronoun required additional processing compared to the personal pronoun, prominence information did not affect resolution in shallow conditions. It did, however, affect resolution under deep processing conditions. We conclude that prominence information is not ruled out by the presence of stronger resolution cues such as gender. However, the deployment of prominence information in the evaluation of candidate antecedents is under strategic control

Agentivity drives real-time pronoun resolution : Evidence from German er and der

We report two experiments on the referential resolution of the German subject pronoun er and the demonstrative der (‘he’). Using the visual world eye-tracking paradigm, we examined the effects of grammatical role, thematic role and the information status of potential referents in the antecedent clause operationalized by word-order (canonical/non-canonical), in the context of active--accusative verbs (Exp. 1) and dative-experiencer verbs (Exp. 2). In information-structurally neutral contexts, er prefers the proto-agent and der the protopatient. This suggests that agentivity is a better predictor for pronoun resolution than subjecthood or sentence topic as previously proposed. It further supports the claim that agentivity is a core property of language processing and it more generally substantiates the proposal from cognitive sciences that agentivity represents core knowledge of the human attentional system. With non-canonical antecedent clauses, because they lack alignment of prominence features, interpretive preferences become less stable, indicating that multiple cues are involved in pronoun resolution. The data further suggest that the demonstrative pronoun elicits more reliable interpretive biases than the personal pronou

A direct comparison of metonymic and metaphoric relations in adjective–noun pairs

Theories on metaphor and metonymy make different claims about the nature of the underlying processes in the computation of these two types of language use, i.e., whether they differ or not. Experimental investigations of metonymy and metaphor have generally not compared these two phenomena in a straightforward manner among others due to structural variability. To overcome this shortcoming, we conducted a study in German that used adjective–noun combinations to contrast metaphor and metonymy directly in an ERP-study during reading for comprehension. By combining three different nouns with one adjective in predicative position we construed adjective–noun pairs with literal (the baby was lively), metonymic (the eyes were lively) or metaphoric (the speed was lively) relations. The data revealed a more pronounced N400 for the metaphoric relations in comparison to the literal controls. We argue that the enhanced cost for metaphors reflects the activation process of two unrelated domains via mapping or extended predication. The metonymic adjective–noun pairs only showed a small trend to differ from the other two conditions. This might indicate that metonymies require mapping processes or shifts only within a single domain or domain matrix. Moreover, in contrast to previous studies, we did not find a Late Positivity. We explain this result with regard to different discourse representational consequences arising during combinatorial processing

Contextually enriched argument linking.

Klein U. Contextually enriched argument linking. In: Finkbeiner R, Meibauer J, Schumacher P, eds. What is a Context?. Linguistik Aktuell/Linguistics Today, 196. Vol 196. Amsterdam : John Benjamins Pub. Co.; 2012: 199-228

Regression modelling in hospital epidemiology: a statistical note

Barnett and Graves [1], in their commentary on our report recently published in Critical Care [2], suggested that timediscrete methods should be used to address time-dependent risk factors and competing risks. In this letter we comment on two statements by those authors. First, Barnett and Graves claim that, ‘An alternative method to the competing risks model is a multistate model. ’ In fact, a multistate model is not an alternative to modelling competing risks, but a competing risks model is an example of a multistate model. This is explained in the tutorial by Putter and coworkers [3]. However, competing risks only model the time to first event and the event type (for example, time to nosocomial infection [NI]) or discharge/death, whatever comes first. To model subsequent events also, more complex multistate models are needed. Barnett and Graves give a

Majas Ahnfrauen? Über Bienen in der mittelalterlichen Literatur

Schumacher M. Majas Ahnfrauen? Über Bienen in der mittelalterlichen Literatur. In: Josting P, Schmideler S, eds. Bonsels' Tierleben. Insekten und Kriechtiere in Kinder- und Jugendmedien. Baltmannsweiler: Schneider Verlag Hohengehren; 2015: 293-308