scholarly journals Competition between Public and Private Maternity Care Providers in France: Evidence on Market Segmentation

2020 ◽  
Vol 17 (21) ◽  
pp. 7846
Author(s):  
Daniel Herrera-Araujo ◽  
Lise Rochaix
Keyword(s):  
Hospital Competition ◽  
Care Providers ◽  
Data Set ◽  
Public And Private ◽  
User Choice ◽  
Hospital Markets ◽  
For Profit ◽  
Market Shares ◽  
French Case ◽  
Sources Of Variation

The purpose of this paper is to investigate the potential for segmentation in hospital markets, using the French case where private for-profit providers play an important role having nearly 25% of market shares, and where prices are regulated, leading to quality competition. Using a stylized economic model of hospital competition, we investigate the potential for displacement between vertically differentiated public and private providers, focusing on maternity units where user choice is central. Building over the model, we test the following three hypotheses. First, the number of public maternity units is likely to be much larger in less populated departments than in more populated ones. Second, as the number of public maternity units decreases, the profitability constraint should allow more private players into the market. Third, private units are closer substitutes to other private units than to public units. Building an exhaustive and nationwide data set on the activity of maternity services linked to detailed data at a hospital level, we use an event study framework, which exploits two sources of variation: (1) The variation over time in the number of maternity units and (2) the variation in users’ choices. We find support for our hypotheses, indicating that segmentation is at work in these markets with asymmetrical effects between public and private sectors that need to be accounted for when deciding on public market entry or exit.

scholarly journals Ownership Variation in Violated Regulations and National Care Standards: Evidence From Social Care Providers

2021 ◽  
pp. 089976402110014
Author(s):  
Anders M. Bach-Mortensen ◽  
Ani Movsisyan
Keyword(s):  
Social Care ◽  
Negative Binomial ◽  
Third Sector ◽  
Care Providers ◽  
Data Set ◽  
Logistic Regression Models ◽  
For Profit ◽  
Care Services ◽  
Significant Difference ◽  
Research Gap

Social care services are increasingly provisioned in quasi-markets in which for-profit, public, and third sector providers compete for contracts. Existing research has investigated the implications of this development by analyzing ownership variation in latent outcomes such as quality, but little is known about whether ownership predicts variation in more concrete outcomes, such as violation types. To address this research gap, we coded publicly available inspection reports of social care providers regulated by the Care Inspectorate in Scotland and created a novel data set enabling analysis of ownership variation in violations of (a) regulations, and (b) national care standards over an entire inspection year ( n = 4,178). Using negative binomial and logistic regression models, we find that for-profit providers are more likely to violate non-enforceable outcomes (national care standards) relative to other ownership types. We did not identify a statistically significant difference between for-profit and third sector providers with regard to enforceable outcomes (regulations).

The Role of the Business Sector in Global Health Politics

2018 ◽  
pp. 385-408
Author(s):  
Kelley Lee ◽  
Julia Smith
Keyword(s):  
Collective Action ◽  
Global Health ◽  
Business Sector ◽  
Policy Debate ◽  
Public And Private ◽  
Health Politics ◽  
For Profit ◽  
Goods And Services ◽  
Private Interests ◽  
Health Related

The influence of for-profit businesses in collective action across countries to protect and promote population health dates from the first International Sanitary Conferences of the nineteenth century. The restructuring of the world economy since the late twentieth century and the growth of large transnational corporations have led the business sector to become a key feature of global health politics. The business sector has subsequently moved from being a commercial producer of health-related goods and services, contractor, and charitable donor, to being a major shaper of, and even participant in, global health policymaking bodies. This chapter discusses three sites where this has occurred: collective action to regulate health-harming industries, activities to provide for public interest needs, and participation in decision-making within global health institutions. These changing forms of engagement by the business sector have elicited scholarly and policy debate regarding the appropriate relationship between public and private interests in global health.

The French Nitrogen Industry during the Interwar Period: The Ambiguous Relationship between the State and Manufacturers

2021 ◽  
Vol 62 (1) ◽  
pp. 191-212
Author(s):  
Michael Llopart
Keyword(s):  
Market Competition ◽  
The State ◽  
Nitrogen Fertilizers ◽  
Private Industry ◽  
Public And Private ◽  
The Public ◽  
The First World War ◽  
French Case ◽  
International Cartel ◽  
First World

Abstract At the end of the First World War, the French government seized the opportunity to acquire the chemical processes of the German firm BASF, including the Haber-Bosch process. This patent made it possible to synthesize nitrogen from the air and thus produce nitrogen fertilizers in large quantities. French industrialists, however, refused to acquire these patents, and to make up for this lack of private sector involvement, the French Parliament decided in 1924 to create a national plant (ONIA), which became the first state-owned plant to be exposed to market competition. The intention was for the ONIA to supply the army with nitric acid in times of war, and, in peacetime, to sell fertilizers at the lowest possible prices in order to curb the monopoly of the private industry cartel. The purpose of this article is therefore to study the establishment and organisation of the French market for nitrogen fertilisers during the inter-war period by raising a number of questions about the ambiguous and complex relations between the state and private industry in this strategic sector. Why was the state policy initiated with the ONIA not successful at first? From 1927-1928, once the ONIA was operational, why and how did the public and private players jointly organise the marketing of fertilisers even though their interests were partially divergent? From the economic crisis of the 1930s onwards, how did the regulation of this mixed market evolve and how were public/private tensions overcome? In the French case, why did French producers leave the international cartel very early on in favour of state protectionism? And finally, to what extent can it be said that this “managed economy” framework succeeded in satisfying all the players in the French nitrogen industry?

scholarly journals Household Wealth: Low-Yielding and Poorly Structured?

2021 ◽  
Vol 14 (3) ◽  
pp. 99
Author(s):  
Marc Peter Radke ◽  
Manuel Rupprecht
Keyword(s):  
Household Wealth ◽  
Financial Advisors ◽  
Investment Fund ◽  
Data Set ◽  
Public And Private ◽  
Consistent Manner ◽  
Widespread Belief ◽  
International Comparative ◽  
Real Returns ◽  
Mean Variance

In this paper, we present a newly generated data set on real returns of households’ aggregated asset holdings, which adds additional and more sophisticated information to existing relevant datasets in the literature. To do this, we draw on various datasets from public and private sources and then transform and combine them in a consistent manner that allows for international comparative and intertemporal analyses. Based on this, we address two current debates on the development of household wealth in the euro area that have been triggered by the low-interest environment. The first debate refers to the development of real yields on household wealth from 2000 to 2018, whereas the second debate deals with the mean-variance efficiency of household portfolios. Contrary to widespread belief, we find that yields on total wealth, which were largely dominated by non-financial assets’ yields, were mostly positive, although they exhibit a declining trend. Moreover, on average, overall real yields were significantly lower after 2008. Referring to portfolio efficiency, we find that current portfolios seem to be comparatively close to mean-variance efficiency. If households were to optimize their portfolios despite limited room for improvement, holdings of equity and investment fund shares should be reduced, contradicting common recommendations of financial advisors.

Financial Incentives and Competitive Pressure: The Case of the Hospital Industry

2021 ◽  
Author(s):  
Philippe Choné ◽  
Lionel Wilner
Keyword(s):  
Financial Incentives ◽  
Regulatory Reform ◽  
Hospital Industry ◽  
Competitive Pressure ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Industry Level ◽  
Market Shares

Abstract In the late 2000s, a regulatory reform dramatically strengthened the incentives of French nonprofit hospitals to attract patients. Exploiting exhaustive data for surgery treatments between 2005 and 2008, and modeling hospitals as supplying utility to patients, we show that increased competitive pressure on nonprofit hospitals caused them to perform more procedures, but did not inflate overall activity at the industry level. Although they have gained market shares over their for-profit counterparts, nonprofit hospitals have been significantly worse off after the reform. To adjust to stronger financial incentives, they incurred an additional effort (pecuniary and non-pecuniary costs) equivalent to about a quarter of their annual revenue.

scholarly journals Farm Gate Prices for Non-Varietal Wine in Argentina: A Multilevel Comparison of the Prices Paid by Cooperatives and Investor-Oriented Firms

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Agustina Malvido Perez Carletti ◽  
Markus Hanisch ◽  
Jens Rommel ◽  
Murray Fulton
Keyword(s):  
Multilevel Regression ◽  
Data Set ◽  
Unique Data ◽  
Market Shares ◽  
Price Effects ◽  
Theoretical Predictions ◽  
The One ◽  
The Cost ◽  
Price Differences ◽  
Multilevel Regression Model

AbstractIn this paper, we use a unique data set of the prices paid to farmers in Argentina for grapes to examine the prices paid by non-varietal wine processing cooperatives and investor-oriented firms (IOFs). Motivated by contrasting theoretical predictions of cooperative price effects generated by the yardstick of competition and property rights theories, we apply a multilevel regression model to identify price differences at the transaction level and the departmental level. On average, farmers selling to cooperatives receive a 3.4 % lower price than farmers selling to IOFs. However, we find cooperatives pay approximately 2.4 % more in departments where cooperatives have larger market shares. We suggest that the inability of cooperatives to pay a price equal to or greater than the one paid by IOFs can be explained by the market structure for non-varietal wine in Argentina. Specifically, there is evidence that cooperative members differ from other farmers in terms of size, assets and the cost of accessing the market. We conclude that the analysis of cooperative pricing cannot solely focus on the price differential between cooperatives and IOFs, but instead must consider other factors that are important to the members.

scholarly journals Awards

2008 ◽  
Vol 216 (4) ◽  
pp. 198-208 ◽  
Author(s):  
Bruno S. Frey ◽  
Susanne Neckermann
Keyword(s):  
Unique Combination ◽  
Data Set ◽  
For Profit ◽  
Unique Data ◽  
Private Organizations ◽  
Not For Profit ◽  
Nonmonetary Rewards ◽  
Scientific Attention ◽  
Vignette Experiment

Awards in the form of orders, decorations, prizes, and titles are ubiquitous in monarchies and republics, private organizations, not-for-profit, and profit-oriented firms. This paper argues that awards present a unique combination of different stimuli and that they are distinct and unlike other monetary and nonmonetary rewards. Despite their relevance in all areas of life, awards have not received much scientific attention. Employing a unique data set, we demonstrate that there are substantial differences in the frequency of awards across countries. Moreover, we present the results of a vignette experiment that quantifies and isolates the effects of different award characteristics such as the publicity associated with winning an award.

scholarly journals Integration of mental health care in private not-for-profit health centres in Guinea, West Africa: a systemic entry point towards the delivery of more patient-centred care?

2019 ◽  
Author(s):  
Abdoulaye Sow ◽  
Jeroen De Man ◽  
Myriam De Spiegelaere ◽  
Veerle Vanlerberghe ◽  
Bart Criel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Patient Participation ◽  
Care Providers ◽  
Patient Centred Care ◽  
For Profit ◽  
Not For Profit ◽  
Health Centres ◽  
Care Package

Abstract Abstract Background Patient-centred care is an essential component of quality of health care. We hypothesize that integration of a mental health care package into versatile first-line health care services can strengthen patient participation, an important dimension of patient-centred care. The objective of this study is to analyse whether consultations conducted by providers in facilities that integrated mental health care score higher in terms of patient participation. Methods This study was conducted in Guinea in 12 not-for-profit health centres, 4 of which had integrated a mental health care package (MH+) and 8 had not (MH-). The study involved 450 general curative consultations (175 in MH+ and 275 in MH- centres), conducted by 18 care providers (7 in MH+ and 11 in MH- centres). Patients were interviewed after the consultation on how they perceived their involvement in the consultation, using the Patient Participation Scale (PPS). The providers completed a self-administered questionnaire on their perception of patient’s involvement in the consultation. We compared scores of the PPS between MH+ and MH- facilities and between patients and providers. Results The mean PPS score was 24.21 and 22.54 in MH+ and MH- health centres, respectively. Participation scores depended on both care providers and the health centres they work in and ranged from 19.12 to 26.96 (p <0.001) for providers and from 20.49 to 26.96 (p <0.001) for the health centres. When adjusting for health providers and the duration of consultation, the patients consulting an MH+ centre were scoring higher on patient participation score than the ones of an MH- centre (adjusted odds ratio of 4.06 with a 95% CI of 1.17-14.10, p = 0.03). All care providers agreed they understood the patients' concerns, and patients shared this view. All patients agreed they wanted to be involved in the decision-making concerning their treatment; providers, however, were reluctant to do so. Conclusion Integrating a mental health care package into versatile first-line health services can promote more positive attitudes of care provider-patient interactions, even though this process by its own is not sufficient.

scholarly journals Measuring retirement savings adequacy: developing a multi-pillar approach in the Netherlands

2014 ◽  
Vol 15 (1) ◽  
pp. 55-89 ◽  
Author(s):  
MARIKE KNOEF ◽  
JIM BEEN ◽  
ROB ALESSIE ◽  
KOEN CAMINADA ◽  
KEES GOUDSWAARD ◽  
...  
Keyword(s):  
Pension System ◽  
Vulnerable Groups ◽  
Median Income ◽  
Retirement Savings ◽  
Housing Wealth ◽  
Replacement Rate ◽  
Data Set ◽  
Public And Private ◽  
Private Savings ◽  
The Uk

AbstractThe Dutch pension system is highly ranked on adequacy. These rankings, however, are based on fictitious replacement rates for median income earners. This paper investigates whether the Dutch pension adequacy is still high when we take into account the resources that people really accumulate, using a large administrative data set. A comprehensive approach is followed: not only public and private pension rights, but also private savings and housing wealth are taken into account. Summed over all age- and socioeconomic groups we find a median gross replacement rate of 83% and a net replacement rate of 101%. At retirement age, 31% of all households face a gross replacement rate that is lower than 70% of current income. Public and occupational pensions each account for more than 35% of total pension annuities. Private non-housing assets account for 14% and imputed rental income from net housing wealth accounts for about 10%. Some vulnerable groups, such as the self-employed, have below average replacement rates. Results are fairly similar to results found in the UK, indicating that we should be careful in evaluating the adequacy of pensions systems on the basis of fictitious replacement rates.

Digital Mediation, Soft Cabs, and Spatial Labour

2017 ◽  
Vol 3 (2) ◽  
pp. 59-76
Author(s):  
Donald N. Anderson
Keyword(s):  
Social Space ◽  
Large Degree ◽  
Care Providers ◽  
Public And Private ◽  
Digital Platforms ◽  
Race And Gender ◽  
Gig Economy ◽  
And Gender ◽  
Home Care Providers ◽  
The Impact

Abstract Critics of digitally mediated labour platforms (often called the “sharing” or “gig economy”) have focused on the character and extent of the control exerted by these platforms over both workers and customers, and in particular on the precarizing impact on the workers on whose labor the services depend. Less attention has been paid to the specifically spatial character of the forms of work targeted by mobile digital platforms. The production and maintenance of urban social space has always been dependent, to a large degree, on work that involves the crossing of spatial boundaries - particularly between public and private spaces, but also crossing spaces segregated by class, race, and gender. Delivery workers, cabdrivers, day labourers, home care providers, and similar boundary-crossers all perform spatial work: the work of moving between and connecting spaces physically, experientially, and through representation. Spatial work contributes to the production and reproduction of social space; it is also productive of three specific, though interrelated, products: physical movement from one place to another; the experience of this movement; and the articulation of these places, experiences, and movements with visions of society and of the social. Significantly, it is precisely such spatial work, and its products, which mobile digital platforms seek most urgently to transform. Drawing on several recent studies of “ridesharing” (or soft cab) labour platforms, I interrogate the impact of digital mediation on the actual practices involved in spatial work. I argue that the roll-out of digital labour platforms needs to be understood in terms of a struggle over the production of social space.

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