scholarly journals The impact of delayed transfers of care on emergency departments: common sense arguments, evidence and confounding

2019 ◽  
Vol 37 (2) ◽  
pp. 95-101 ◽  
Author(s):  
Brad Keogh ◽  
Thomas Monks
Keyword(s):  
Open Data ◽  
Data Sets ◽  
Artificial Data ◽  
Acute Setting ◽  
Transfers Of Care ◽  
The Uk ◽  
Ed Crowding ◽  
The Impact ◽  
The Relationship ◽  
Over Time

ObjectivesThere have been claims that Delayed Transfers of Care (DTOCs) of inpatients to home or a less acute setting are related to Emergency Department (ED) crowding. In particular DTOCs were associated with breaches of the UK 4-hour waiting time target in a previously published analysis. However, the analysis has major limitations by not adjusting for the longitudinal trend of the data. The aim of this work is to investigate whether the proposition that DTOCs impact the 4-hour target requires further research.MethodEstimation of an association between two or more variables that are measured over time requires specialised statistical methods. In this study, we performed two separate analyses. First, we created two sets of artificial data with no correlation. We then added an upward trend over time and again assessed for correlation. Second, we reproduced the simple linear regression of the original study using NHS England open data of English trusts between 2010 and 2016, assessing correlation of numbers of DTOCs and ED breaches of the 4-hour target. We then reanalysed the same data using standard time series methods to remove the trend before estimating an association.ResultsAfter introducing upward trends into the uncorrelated artificial data the correlation between the two data sets increased (R2=0.00 to 0.51 respectively). We found strong evidence of longitudinal trends within the NHS data of ED breaches and DTOCs. After removal of the trends the R2 reduced from 0.50 to 0.01.ConclusionOur reanalysis found weak correlation between numbers of DTOCs and ED 4-hour target breaches. Our study does not indicate that there is no relationship between 4-hour target and DTOCs, it highlights that statistically robust evidence for this relationship does not currently exist. Further work is required to understand the relationship between breaches of the 4-hour target and numbers of DTOCs.

An End to Incrementalism? The Impact of Expenditure Restraint on Social Services Budgets 1979–1986

1989 ◽  
Vol 18 (2) ◽  
pp. 187-210 ◽  
Author(s):  
Aidan Kelly
Keyword(s):  
Social Services ◽  
Social Service ◽  
The Elderly ◽  
Activity Data ◽  
The Public ◽  
Total Budget ◽  
Service Departments ◽  
The Impact ◽  
The Relationship ◽  
Over Time

ABSTRACTThe theory of incrementalism is a long-standing and influential perspective on policy making and resource allocation in the public sector. Previous research on social services budgeting suggests that resources are allocated incrementally, although there has been some debate as to whether this would persist in an era of prolonged expenditure restraint. Incremental budgetary outcomes are operationalised as percentage changes in budgets pro-rata with percentage changes in the total budget, and as stable shares of total expenditure for each activity. Data for 99 English social service departments supports incrementalism in that budget shares change by only 1.8 per cent, but percentage allocations depart from pro-rata incrementalism by a mean of 74 per cent. The comparison of the two summary indices over time supports those who have argued that prolonged restraint would encourage non-incremental budgeting, but change in the agency's total budget does not consistently predict budgetary outcomes. The effect of restraint on incrementalism varies with the measure used and across the component activities of the measures, but there is enough evidence to suggest a significant decline in the level of incrementalism in social service departments. In particular, non-incremental budgeting is strongly associated with the growth of day centre expenditure on the mentally ill and the elderly before 1982–3, and after that with the pursuit of the ‘community care’ strategy within state provided services for the elderly and children. Incrementalism as a general theory of agency budgeting is limited in its ability to explain variations in the degree of incrementalism between agencies, between component budgets and over time. The conclusion suggests that further research should seek explanations for these variations in the varying balance of the competing forces which shape outcomes in welfare bureaucracies and in the relationship between these forces and the organisation's environment.

The dynamics of regional and global expansion

2015 ◽  
Vol 23 (4) ◽  
pp. 306-327 ◽  
Author(s):  
Christian Geisler Asmussen ◽  
Bo Bernhard Nielsen ◽  
Tom Osegowitsch ◽  
Andre Sammartino
Keyword(s):  
Design Methodology ◽  
Global Market ◽  
Market Penetration ◽  
Content Type ◽  
Global Expansion ◽  
Rates Of Change ◽  
Global Space ◽  
The Impact ◽  
The Relationship ◽  
Over Time

Purpose – The purpose of this paper is to model and test the dynamics of home-regional and global penetration by multi-national enterprises (MNEs). Design/methodology/approach – Drawing on international business (IB) theory, the authors model MNEs adjusting their home-regional and global market presence over time. The authors test the resulting hypotheses using sales data from a sample of 220 of the world’s largest MNEs over the period 1995-2005. The authors focus specifically on the relationship between levels of market penetration inside and outside the home region and rates of change in each domain. Findings – The authors demonstrate that MNEs do penetrate both home-regional and global markets, often simultaneously, and that penetration levels often oscillate within an MNE over time. The authors show firms’ rates of regional and global expansion to be affected by their existing regional and global penetration, as well as their interplay. Finally, the authors identify differences in the steady states at which firms stabilize their penetration levels in the home-regional and the global space. The findings broadly confirm the MNE as an interdependent portfolio with important regional demarcations. Originality/value – The authors identify complex interdependencies between home-regional and global penetration and growth, paving the way for further studies of the impact of regions on MNE expansion.

scholarly journals Malpractice Environment vs Direct Litigation: What Drives Nursing Home Exit?

2018 ◽  
Vol 55 ◽  
pp. 004695801878799
Author(s):  
R. Tamara Konetzka ◽  
Hari Sharma ◽  
Jeongyoung Park
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Fixed Effects ◽  
Online Survey ◽  
Market Competition ◽  
Consumer Welfare ◽  
Data Sets ◽  
For Profit ◽  
The Impact ◽  
The Relationship

An ongoing concern about medical malpractice litigation is that it may induce provider exit, potentially affecting consumer welfare. The nursing home sector is subject to substantial litigation activity but remains generally understudied in terms of the effects of litigation, due perhaps to a paucity of readily available data. In this article, we estimate the association between litigation and nursing home exit (closure or change in ownership), separating the impact of malpractice environment from direct litigation. We use 2 main data sources for this study: Westlaw’s Adverse Filings database (1997-2005) and Online Survey, Certification and Reporting data sets (1997-2005). We use probit models with state and year fixed effects to examine the relationship between litigation and the probability of nursing home closure or change in ownership with and without adjustment for malpractice environment. We examine the relationship on average and also stratify by profit status, chain membership, and market competition. We find that direct litigation against a nursing home has a nonsignificant effect on the probability of closure or change in ownership within the subsequent 2 years. In contrast, the broader malpractice environment has a significant effect on change in ownership, even for nursing homes that have not been sued, but not on closure. Effects are stronger among for-profit and chain facilities and those in more competitive markets. A high-risk malpractice environment is associated with change of ownership of nursing homes regardless of whether they have been directly sued, indicating that it is too blunt an instrument for weeding out low-quality nursing homes.

scholarly journals The perception of biopsychosocial impacts of COVID-19 during lockdown restrictions over time in the UK – a mixed methods study

2021 ◽  
Vol 4 (Special2) ◽  
pp. 402-414
Author(s):  
Samuel Grimwood ◽  
Kaz Stuart ◽  
Ruth Browning ◽  
Elaine Bidmead ◽  
Thea Winn-Reed
Keyword(s):  
Social Issues ◽  
Negative Impact ◽  
Mixed Methods Study ◽  
Biological Domain ◽  
Data Points ◽  
Integrated Recovery ◽  
Biopsychosocial Health ◽  
The Uk ◽  
The Impact ◽  
Over Time

Background: The COVID-19 pandemic has profoundly impacted the health of individuals physically, mentally, and socially. This study aims to gain a deeper understanding of this impact across the pandemic from a biopsychosocial stance. Methods: A survey created by the research team was employed between November 2020 and February 2021 across social media, relevant organizations, and networks. The survey incorporated 5-time points across the different stages of the pandemic, covering biological, psychological, and social. There were 5 items for each survey (Very Positive affect to Very Negative affect), and analysis was undertaken using SPSS version 16. Descriptive statistics and non-parametric Friedman and Wilcoxon Tests, as well as correlations between the three domains, were implemented. Results: This study included 164 participants (77.0% female and 35.0% male) across 24 out of 38 counties in the UK. The impact of COVID-19 on biological domain was significant across the five data points χ2(4) = 63.99, p < 0.001, psychological χ2(4) = 118.939, p <0.001 and socially χ2(4) = 186.43, p <0.001. Between the 5 data points, 4 out of 5 had a negative impact, however between the first stage of lockdown and the easing of restrictions, findings for biological (Z=-2.35, p <0.05), psychological (Z=-6.61, p < 0.001), and socially (Z = -8.61, p <0.001) were positive. Negative correlations between the three domains across the pandemic are apparent, but in later stages, the biological domain had a positive correlation r = 0.52, p < 0.001. Conclusion: The data shows a negative impact from the self-reported perception of wellbeing from a biopsychosocial stance over time, as well as perceiving the three domains to interact negatively. To address these biopsychosocial issues, the research implies a place-based integrated recovery effort is needed, addressing biological, psychological, and social issues simultaneously. Further research should investigate biopsychosocial health among a more generalizable population.

scholarly journals FOREST CERTIFICATION AS A TOOL TO ENSURE THE BALANCE OF FORESTRY LAND USE

2021 ◽  
Vol 71 (3) ◽  
Author(s):  
Stepan Dankevych
Keyword(s):  
Land Use ◽  
Regional Scale ◽  
Environmental Indicators ◽  
Statistical Characteristics ◽  
Forest Certification ◽  
Capital Investments ◽  
Forest Lands ◽  
The Impact ◽  
The Relationship ◽  
Over Time

The problem of ensuring the balanced use of forest lands determines the search for new economic and environmental tools that can influence this process. The need to improve the certification tool as part of the financial and economic mechanism for ensuring balanced forestry land use corresponds to the directions of state policy and European integration intentions of Ukraine, modern requirements of the ecological aspect of forestry land use. The work examines the practice in the field of forest certification in Ukraine from the point of view of balanced land use. Spatial-temporal analysis and assessment of the scale and dynamics of the spread of forest FSC certification in Ukraine has been carried out. The study was formed in three stages: (I) study of changes over time in the volume of forest certification on a national scale, (II) assessment of trends over time for indicators on a regional scale, (III) study of the relationship between individual indicators. The analysis of the impact of FSC-certification of forest management in Ukraine on the environmental indicators of forestry land use based on the results of the correlation between the statistical characteristics of certain economic and environmental indicators, such as the area of certified forests, capital investments, reforestation. Analysis of statistical data showed the relationship between environmental and economic performance over time and changes in specific characteristics on a regional scale. The study makes it possible, on the basis of an objectively existing causal relationship between phenomena and indicators, to identify the course of certain positive or negative processes in forestry land use. Forest certification can play a role in maintaining a balanced use of forest lands, preventing illegal logging, forest degradation and contributing to reforestation and capital investments. The study helps to identify certain key variables that limit the ability of forestry operators to ensure balanced use of forest lands and how forest certification can affect this. Foreign experience in stimulating forest certification has been investigated for the possibility of borrowing the experience of using management tools in order to motivate forest certification in Ukraine. It has been proven that certification is a significant environmental tool for ensuring a balanced level of land use and has the potential for further development.

scholarly journals Methods of Administrative and Legal Protection of Tax Relations: Theoretical and Legal Study

2019 ◽  
Vol 75 (4) ◽  
pp. 53-58
Author(s):  
K. S. Rohozinnikova
Keyword(s):  
Public Administration ◽  
Open Data ◽  
Legal Protection ◽  
Data Sets ◽  
Administrative Services ◽  
The Public ◽  
The Subject ◽  
State Coercion ◽  
The Relationship ◽  
Functional Purpose

The author of the article has provided the results of the analysis of the methods of administrative and legal protection taking into account the changes within the relations between public administration and taxpayers and the course chosen by the state for liberalization of tax relations. The place of the concept of the methods of administrative and legal protection in the term system of the science of administrative law and their dialectical relations with the methods of public administration and administrative activity has been established. The author has indicated generic and specific features of the methods of administrative and legal protection of tax relations, where the latter will depend on the peculiarities of the means and methods of influence used by the public administration for the purpose of exercising security functions. The system of methods of administrative and legal protection of tax relations has been offered to form from three elements: general methods of administrative activity (persuasion and coercion), service tools of influence (provision of administrative services, creation of electronic services and publication of open data sets) and organizational methods. The expediency of distinguishing service means of influence into a separate group of methods of administrative and legal protection has been proved. It is conditioned by their special functional purpose – creation of conditions for independent prevention of possible breach of protected relations by the taxpayer. The role and correlation of persuasion and coercion in the system of methods of administrative and legal protection of tax relations have been clarified. Despite the presented importance of the persuasion within the relationship between the controlling agencies and the taxpayers, it has been stated that state coercion remains the main mean of administrative and legal protection of tax relations. Particular attention has been paid on the need to reconsider the correlation of tax and administrative coercion within tax relations. It has been proved that the basis of their delimitation should be not the branch of legislation, where the authority to apply the appropriate measure is assigned, but the essential criterion and the subject matter of regulation (influence) – relations arising from incomplete calculation and late and incomplete payment of taxes and fees, or relationships related to the organization and enforcement of tax responsibilities and the proper exercise by the supervisory authorities of their powers. It has been emphasized that tax coercion, unlike administrative, performs both punitive and compensatory functions.

Market ranking and network structure: pathway to dominance

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yasaman Sarabi ◽  
Matthew Smith ◽  
Heather McGregor ◽  
Dimitris Christopoulos
Keyword(s):  
Firm Value ◽  
Critical Role ◽  
Firm Characteristics ◽  
Interlocking Directorates ◽  
Content Type ◽  
Network Autocorrelation ◽  
The Uk ◽  
Market Capitalisation ◽  
The Impact ◽  
The Relationship

PurposeThe relationship between interlocking directorates and firm performance has been increasingly debated, with a focus on whether firm's centrality in interlock networks is associated with performance. The purpose of this study is to examine not only how a firm's position in this network is associated with performance but also how the performance of network partners can impact a firm's performance. This study examines how firms effectively utilise the interlock network to achieve the goal of higher market capitalisation – termed market capitalisation rank (MCR).Design/methodology/approachThe premise of the study is the UK FTSE 350 firms from 2014 to 2018. The paper makes use of a temporal network autocorrelation model to examine how firm characteristics, the structural position in the interlock network and the performance of network partners affect MCR over time.FindingsThe analysis indicates that firms with ties (via the interlock network) to firms with high market capitalisation are more likely to enhance their own MCR, highlighting network partners have the opportunity to play a critical role in a firm's dominance strategy to optimise firm value.Originality/valueThe value of this research is that it does not only look at the impact of a firm's position in the network on performance, but the impact of the performance of network partners on a firm's market performance as well.

Beyond evidence-based policy and practice

2013 ◽  
Vol 16 (2) ◽  
pp. 20-36
Author(s):  
Mike Fisher
Keyword(s):  
North America ◽  
Practice Research ◽  
Evidence Based ◽  
Policy And Practice ◽  
Research And Practice ◽  
Social Work Research ◽  
Recent Developments ◽  
The Uk ◽  
The Impact ◽  
The Relationship

This paper concerns the impact of social work research, particularly on practice and practitioners. It explores the politics of research and how this affects practice, the way that university-based research understands practice, and some recent developments in establishing practice research as an integral and permanent part of the research landscape. While focusing on implications for the UK, it draws on developments in research across Europe, North America and Australasia to explore how we can improve the relationship between research and practice.

Introduction

2020 ◽  
pp. 1-18
Author(s):  
Elaine Chase ◽  
Jennifer Allsopp
Keyword(s):  
Young People ◽  
Social Care ◽  
Immigration Policies ◽  
Children And Young People ◽  
Unaccompanied Children ◽  
Youth Migration ◽  
The Uk ◽  
The Impact ◽  
Over Time

This introductory chapter provides an overview of youth migration. Youth migration needs to be understood in relation to its negative drivers of persecution, violence, and unsustainable lives in countries of origin, factors that motivated the flights of many young people. But at the same time, there is a need to recognize that such adversity also fuels individual and collective dreams and aspirations for better lives. Without acknowledging this, politicians will struggle to formulate meaningful and workable asylum and immigration policies. The chapter then briefly outlines the differing journeys that young people took in order to arrive in Europe. The chapter explains that the book focuses on how asylum, immigration, and social care procedures are operationalized once unaccompanied children and young people arrive in the UK and Italy, and the impact that these bureaucratic processes have on them over time.

2. The Political Organization of Parliament

2018 ◽  
Author(s):  
Philip Norton
Keyword(s):  
Political Parties ◽  
Political Organization ◽  
The Political ◽  
Internal Organization ◽  
The Uk ◽  
The Relationship ◽  
Over Time ◽  
Opposition Parties

This chapter discusses the political organization of the UK Parliament, at the heart of which are the political parties. It first considers the internal organization of Parliament, focusing on how political parties are structured. There are two principal parties facing one another in Parliament: the party in government and opposition parties. The opposition comprises frontbench Members (shadow ministers) and backbenchers. Smaller parties may also designate some Members as ‘frontbenchers’ (official spokespeople for the party). The frontbench of each party includes whips. The chapter provides an overview of these whips as well as parliamentary parties before considering legislative–executive relations. In particular, it examines how parties shape the relationship between Parliament and the executive, and how these have changed over time.

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