scholarly journals Value-based provider payment: towards a theoretically preferred design

2018 ◽  
Vol 15 (1) ◽  
pp. 94-112 ◽  
Author(s):  
Daniëlle Cattel ◽  
Frank Eijkenaar ◽  
Frederik T. Schut
Keyword(s):  
Health Care ◽  
Pay For Performance ◽  
Empirical Studies ◽  
Risk Profile ◽  
Provider Group ◽  
Payment Incentives ◽  
Trade Offs ◽  
Provider Payment ◽  
Group 2 ◽  
The Relationship

AbstractWorldwide, policymakers and purchasers are exploring innovative provider payment strategies promoting value in health care, known as value-based payments (VBP). What is meant by ‘value’, however, is often unclear and the relationship between value and the payment design is not explicated. This paper aims at: (1) identifying value dimensions that are ideally stimulated by VBP and (2) constructing a framework of a theoretically preferred VBP design. Based on a synthesis of both theoretical and empirical studies on payment incentives, we conclude that VBP should consist of two components: a relatively large base payment that implicitly stimulates value and a relatively small payment that explicitly rewards measurable aspects of value (pay-for-performance). Being the largest component, the base payment design is essential, but often neglected when it comes to VBP reform. We explain that this base payment ideally (1) is paid to a multidisciplinary provider group (2) for a cohesive set of care activities for a predefined population, (3) is fixed, (4) is adjusted for the population’s risk profile and (5) includes risk-mitigating measures. Finally, some important trade-offs in the practical operationalisation of VBP are discussed.

Organized Crime, the State, and Paramilitarism

2020 ◽  
pp. 64-114
Author(s):  
Uğur Ümit Üngör
Keyword(s):  
Interpersonal Relationships ◽  
Organized Crime ◽  
Empirical Studies ◽  
The State ◽  
Private Interests ◽  
Trade Offs ◽  
Criminal Organizations ◽  
Criminal Groups ◽  
The Relationship ◽  
Law Making

How are paramilitarism and crime related to each other? Empirical studies of paramilitarism make abundantly clear that (organized) crime plays an important role in paramilitarism: the trade in illicit commodities and services and the fact that criminal gangs operate in secrecy are two phenomena that are closely related to paramilitary activity. The influences seem to run both ways: criminals benefit from paramilitarism, and paramilitarism often engenders crime. In many examples, entire organized crime structures have collided with states and paramilitary units. This chapter offers a deeper look at the relationships between paramilitarism and crime. It looks at how criminal organizations are coveted by states if the tasks at hand necessitate the need for trust that characterizes interpersonal relationships within criminal groups. The relationship is mutually beneficial, because it allows criminal groups to achieve a form of respectability, preserve their assets, and develop their activities by influencing law-making and extending their network. The chapter examines these shared interests and trade-offs, discusses organized crime in peace and wartime, and draws several paramilitary-criminal profiles of those who pursued not only wealth and private interests, but also political power.

scholarly journals Examining the trade-offs between human fertility and longevity over three centuries using crowdsourced genealogy data

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255528
Author(s):  
Chen-Hao Hsu ◽  
Oliver Posegga ◽  
Kai Fischbach ◽  
Henriette Engelhardt
Keyword(s):  
Empirical Studies ◽  
Individual Characteristics ◽  
Negative Effects ◽  
Trade Offs ◽  
Human Fertility ◽  
Geographical Regions ◽  
Negative Effect ◽  
The Relationship ◽  
Historical Periods

The evolution theory of ageing predicts that reproduction comes with long-term costs of survival. However, empirical studies in human species report mixed findings of the relationship between fertility and longevity, which varies by populations, time periods, and individual characteristics. One explanation underscores that changes in survival conditions over historical periods can moderate the negative effect of human fertility on longevity. This study investigates the fertility-longevity relationship in Europe during a period of rapid modernisation (seventeenth to twentieth centuries) and emphasises the dynamics across generations. Using a crowdsourced genealogy dataset from the FamiLinx project, our sample consists of 81,924 women and 103,642 men born between 1601 and 1910 across 16 European countries. Results from multilevel analyses show that higher fertility has a significantly negative effect on longevity. For both women and men, the negative effects are stronger among the older cohorts and have reduced over time. Moreover, we find similar trends in the dynamic associations between fertility and longevity across four geographical regions in Europe. Findings and limitations of this study call for further investigations into the historical dynamics of multiple mechanisms behind the human evolution of ageing.

scholarly journals Motivating health professionals through control mechanisms: A review of empirical evidence

2016 ◽  
Vol 5 (3) ◽  
pp. 67
Author(s):  
Pierluigi Smaldone ◽  
Milena Vainieri
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Pay For Performance ◽  
Health Care Systems ◽  
Empirical Studies ◽  
Employee Motivation ◽  
Management Control ◽  
Control Mechanisms ◽  
Care Workers ◽  
The Impact

This paper summarizes the findings of the literature on the levers used in the health care sector to motivate workers, with a particular focus on the impact of management control tools (such as Performance Measurement Systems (PMS) and Pay for Performance) on motivation. A review of the literature was carried out using the ISI Web of Knowledge, Pubmed and JSTOR search engines on the topic of motivation of health care workers, including, if possible, all the involved categories of employees. The research focused on empirical studies published in Europe, North America and Oceania from 1990 to 2015. Developing countries were intentionally excluded because of their specific needs and motivation perspectives that mainly focus on recruitment or retention strategies to ensure services provision. Studies on motivation generally focus on three main perspectives: (1) Employees’ satisfaction and emotions; (2) Retention; (3) Motivation or attitudes to carry out specific tasks or to behave appropriately. A few studies considered compensation strategies and monetary rewards as a driver of health care workers’ motivation. These studies did not report the crowding out effect of external locus of causality on motivation. On the contrary, most of the studies highlighted the importance of the relationship with patients and colleagues as a crucial factor affecting workers’ motivation, in particular referring to job satisfaction. Despite the large number of articles on the topic of employee motivation, there have been very few studies on the impact of the most popular managerial mechanisms introduced since the mid 1990s in health care systems.

Provider Payment and Incentives

2011 ◽  
pp. 623-648 ◽  
Author(s):  
Jon B. Christianson ◽  
Douglas Conrad
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Empirical Literature ◽  
Care Providers ◽  
Payment Incentives ◽  
Provider Payment ◽  
The Impact

The design of incentives and the evaluation of their impact are examined in the research literature at many different levels. This article provides a background and a conceptual framework relating to the effects of payment incentives on the behavior of health care providers. It then summarizes the empirical literature on the effect of financial incentives in health care. The article offers a conceptual model of the provider's choice of the quantity and quality of output as a means of organizing our thinking about the effects of specific provider payment incentives. This article addresses the effect of general provider payment incentives on the amount and type of care provided; the evidence that general payment incentives have indirectly affected quality of care; and the impact of payment incentive programs that attempt specifically to reward providers for improving quality of care, or for achieving specific benchmark levels of quality.

scholarly journals Health system design and performance: What can other countries learn from the Nordic experience?

2016 ◽  
Vol 4 (1) ◽  
pp. 84-91
Author(s):  
Peter C. Smith
Keyword(s):  
Health Care ◽  
Health System ◽  
System Design ◽  
Health Systems ◽  
Good Governance ◽  
Under Five ◽  
Payment Incentives ◽  
Provider Payment ◽  
And Performance ◽  
Developed World

Nordic health systems are amongst the strongest in the developed world. This paper discusses their strengths and lessons for other health systems under five headings: sources of finance, provider payment, organization, regulation, and persuasion. It attributes the good performance of Nordic systems to good governance of the institutions of health care, the behaviour and attitude of citizens, and high levels of cooperation in Nordic countries. The paper notes that there is only modest use of competition or payment incentives in the provider market. It suggests that improving information on the performance of providers and other institutions is an important priority for the future.Published: April 2016.

Oral health diseases among the older people: a general health perspective

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Health Professionals ◽  
General Health ◽  
Oral Health Care ◽  
Oral Diseases ◽  
Public Health Professionals ◽  
The Relationship

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.

Spotting a liar by looking for microexpressions: Challenges and Opportunities

2019 ◽  
Author(s):  
Xunbing Shen
Keyword(s):  
Empirical Evidence ◽  
Deception Detection ◽  
Empirical Studies ◽  
High Stake ◽  
Challenges And Opportunities ◽  
Cues To Deception ◽  
The Relationship

Microexpressions do exist, and they are regarded as valid cues to deception by many researchers, furthermore, there is a lot of empirical evidence which substantiates this claim. However, some researchers don’t think the microexpression can be a way to catch a liar. The author elucidates the theories predicting that looking for microexpressions can be a way to catch a liar, and notes that some data can support for the utilization of microexpressions as a good way to detect deception. In addition, the author thinks that the mixed results in the area of investigating microexpressions and deception detection may be moderated by the stake. More empirical studies which employ high-stake lies to explore the relationship between microexpressions and deception detection are needed.

Health and Medicine in the Islamic Tradition

1990 ◽  
Vol 7 (1) ◽  
pp. 89-90
Author(s):  
Dennis Michael Warren
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Human Health ◽  
Well Being ◽  
Islamic Tradition ◽  
Medical Tradition ◽  
Islamic Thought ◽  
History Of ◽  
Relationship Of ◽  
The Relationship

The late Dr. Fazlur Rahman, Harold H. Swift Distinguished Service Professor of Islamic Thought at the Oriental Institute of the University of Chicago, has written this book as number seven in the series on Health/Medicine and the Faith Traditions. This series has been sponsored as an interfaith program by The Park Ridge Center, an Institute for the study of health, faith, and ethics. Professor Rahman has stated that his study is "an attempt to portray the relationship of Islam as a system of faith and as a tradition to human health and health care: What value does Islam attach to human well-being-spiritual, mental, and physical-and what inspiration has it given Muslims to realize that value?" (xiii). Although he makes it quite clear that he has not attempted to write a history of medicine in Islam, readers will find considerable depth in his treatment of the historical development of medicine under the influence of Islamic traditions. The book begins with a general historical introduction to Islam, meant primarily for readers with limited background and understanding of Islam. Following the introduction are six chapters devoted to the concepts of wellness and illness in Islamic thought, the religious valuation of medicine in Islam, an overview of Prophetic Medicine, Islamic approaches to medical care and medical ethics, and the relationship of the concepts of birth, contraception, abortion, sexuality, and death to well-being in Islamic culture. The basis for Dr. Rahman's study rests on the explication of the concepts of well-being, illness, suffering, and destiny in the Islamic worldview. He describes Islam as a system of faith with strong traditions linking that faith with concepts of human health and systems for providing health care. He explains the value which Islam attaches to human spiritual, mental, and physical well-being. Aspects of spiritual medicine in the Islamic tradition are explained. The dietary Jaws and other orthodox restrictions are described as part of Prophetic Medicine. The religious valuation of medicine based on the Hadith is compared and contrasted with that found in the scientific medical tradition. The history of institutionalized medical care in the Islamic World is traced to awqaf, pious endowments used to support health services, hospices, mosques, and educational institutions. Dr. Rahman then describes the ...

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