The Physician-Patient Relationship Revisited - the Patient's View

The importance of the physician-patient relationship for the health care market is beyond controversy. Most theoretical work is done in a principal-agent framework, dealing with moral hazard problems. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient (double moral hazard). In contrast to most work looking only at the physician's perspectives, our paper concentrates on the patient's view. Estimation results using panel data support the hypotheses that physician consultation and health-relevant behavior are not stochastically independent. This means that health care demand is determined by the patient and not only by the physician. In the recursive bivariate probit model, the patient’s health-relevant behavior has a significant positive influence on the probability of a physician visit. This should be taken into account in the discussion that primary care physicians should function as gatekeepers.physician-patient relationship, health behavior, bivariate probit

Health Relevant Behavior and its Impact on the Physician-Patient Relationship

The importance of the physician-patient relationship for the health care market is beyond controversy. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient. In contrast to most work looking only at the physician's perspective, our paper concentrates on the patient's view. Estimation results support the hypotheses that physician consultation and health relevant behavior are not stochastically independent. In the recursive bivariate probit model, patient’s health relevant behavior has a significant influence on the probability of a physician visit. This means that health care demand and not only the contact decision is determined by both, patient and physician.physician-patient relationship, health behavior, bivariate probit panel

Thermoelectric properties of the misfit cobaltate Ca3_3Co4_4O9_9

The layered misfit cobaltate Ca$_3$Co$_4$O$_9$, also known as Ca$_2$CoO$_3$[CoO$_2$]$_{1.62}$, is a promising p-type thermoelectric oxide. Employing density functional theory, we study its electronic structure and determine, on the basis of Boltzmann theory within the constant-relaxation-time approximation, the thermoelectric transport coefficients. The dependence on strain and temperature is determined. In particular, we find that the $xx$-component of the thermopower is strongly enhanced, while the $yy$-component is strongly reduced, when applying 2% tensile strain. A similar anisotropy is also found in the power factor. The temperature dependence of the conductivity in the $a$-$b$ plane is found to be rather weak above 200 K, which clearly indicates that the experimentally observed transport properties are dominated by inhomogeneities arising during sample growth, i.e., are not intrinsic.Comment: 12 pages (preprint style), 5 figure

International Fragmentation of Production and the Labour Input into Germany’s Exports – An Input-Output-Analysis

The import penetration of exports has become a topic of public debate, particularly in the context of Germany’s position as one of the world’s leading exporters. The growth in the volume of intermediate products purchased from abroad for subsequent processing into export goods in Germany seems to be undermining the importance of exports as a driver of domestic production and employment. The gains that arise from an increase in exports seem to have been offset by the losses caused by the crowding out of local production by imports. Empirical evidence on the impact of this international integration of the goods market on the German labour market is ambiguous. Short-term negative effects on employment are claimed to be offset by the long-term benefit that the jobs lost in the short run will eventually be replaced by higher-skilled jobs with better perspectives. Against this background, the following hypothesis is tested empirically: Germany is poor in natural resources, but rich in skilled labour. In line with the Heckscher- Ohlin theory, Germany should therefore specialize in the production of export goods and services that are relatively intensive in these factors and should import those goods and services that are relatively intensive in unskilled labour. The empirical part of the paper deals with the extent of the German export penetration by imports. At first, it analyses by what ways imports are affecting the exports directly and indirectly and shows the consequences of import penetration of exports for the national output and employment. Secondly, consequences for employment are split in different skill types of labour. These issues are discussed with the standard open static inputoutput- model. The data base is a time series of official input-output tables. The employment effects for Germany divided by skill types of labour are investigated using skill matrices generated by the authors.international trade, labour and skills market interactions, input-output models

A discrete version of the Darboux transform for isothermic surfaces

We study Christoffel and Darboux transforms of discrete isothermic nets in 4-dimensional Euclidean space: definitions and basic properties are derived. Analogies with the smooth case are discussed and a definition for discrete Ribaucour congruences is given. Surfaces of constant mean curvature are special among all isothermic surfaces: they can be characterized by the fact that their parallel constant mean curvature surfaces are Christoffel and Darboux transforms at the same time. This characterization is used to define discrete nets of constant mean curvature. Basic properties of discrete nets of constant mean curvature are derived.Comment: 30 pages, LaTeX, a version with high quality figures is available at http://www-sfb288.math.tu-berlin.de/preprints.htm

Risk Adjustment Systems in Health Insurance Markets in the US, Germany, Netherlands and Switzerland

Gesetzliche Krankenversicherung, Versicherungstechnisches Risiko, Vereinigte Staaten, Deutschland, Niederlande, Schweiz, Public health insurance, Actuarial risk, United States, Germany, Netherlands, Switzerland

Health Relevant Behavior and its Impact on the Physician-Patient Relationship

The importance of the physician-patient relationship for the health care market is beyond controversy. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient. In contrast to most work looking only at the physician's perspective, our paper concentrates on the patient's view. Estimation results support the hypotheses that physician consultation and health relevant behavior are not stochastically independent. In the recursive bivariate probit model, patient's health relevant behavior has a significant influence on the probability of a physician visit. This means that health care demand and not only the contact decision is determined by both, patient and physician