Association between hospital-insurer contract structure and hospital performance

2021 ◽  
Vol 27 (6) ◽  
pp. 242-248
Keyword(s):  
Hospital Performance ◽  
Contract Structure

Perspectives and Regulation of the Russian Market for Project-based Transactions under the Kyoto Protocol

2008 ◽  
pp. 108-125
Author(s):  
K. Zavodov
Keyword(s):  
Energy Efficiency ◽  
Market Mechanism ◽  
Point Of View ◽  
Market Regulation ◽  
Foreign Investments ◽  
Russian Market ◽  
Increase Energy Efficiency ◽  
New Form ◽  
Contract Structure ◽  
Carbon Fund

Project-based transactions (PBTs) are a market mechanism of attracting foreign investments in order to abate greenhouse gas emissions and increase energy efficiency of the country’s enterprises. The article provides a classification and analyzes advantages and drawbacks of PBTs from the point of view of a host country. The main trends and factors determining the dynamics of the PBT market are described. Given that Russia currently lags behind the leaders of the PBT market, an incorporation of a state carbon fund is put forward with an aim of channelling PBTs through it. This paper proposes a form of PBT market regulation by incorporating an option mechanism into the contract structure of a transaction. A comparison of the new form of regulation with the tools that are currently in use in Russia and other countries demonstrates its greater economic efficiency under uncertainty.

Ad Fraud Under the Vertical Contract Structure

2018 ◽  
Author(s):  
Yitian (Sky) Liang ◽  
Xinlei Chen ◽  
Yuxin Chen ◽  
Ping Xiao
Keyword(s):  
Vertical Contract ◽  
Contract Structure

scholarly journals Potential of community-based risk estimates for improving hospital performance measures and discharge planning

2021 ◽  
Vol 10 (2) ◽  
pp. e001230
Author(s):  
Michael Reid ◽  
George Kephart ◽  
Pantelis Andreou ◽  
Alysia Robinson
Keyword(s):  
Discharge Planning ◽  
Care Transitions ◽  
Hospital Setting ◽  
Hospital Performance ◽  
Case Mix ◽  
Readmission Rates ◽  
Mixed Effect ◽  
Adjusted Risk ◽  
Community Risk ◽  
Effect Regression

BackgroundRisk-adjusted rates of hospital readmission are a common indicator of hospital performance. There are concerns that current risk-adjustment methods do not account for the many factors outside the hospital setting that can affect readmission rates. Not accounting for these external factors could result in hospitals being unfairly penalized when they discharge patients to communities that are less able to support care transitions and disease management. While incorporating adjustments for the myriad of social and economic factors outside of the hospital setting could improve the accuracy of readmission rates as a performance measure, doing so has limited feasibility due to the number of potential variables and the paucity of data to measure them. This paper assesses a practical approach to addressing this problem: using mixed-effect regression models to estimate case-mix adjusted risk of readmission by community of patients’ residence (community risk of readmission) as a complementary performance indicator to hospital readmission rates.MethodsUsing hospital discharge data and mixed-effect regression models with a random intercept for community, we assess if case-mix adjusted community risk of readmission can be useful as a quality indicator for community-based care. Our outcome of interest was an unplanned repeat hospitalisation. Our primary exposure was community of residence.ResultsCommunity of residence is associated with case-mix adjusted risk of unplanned repeat hospitalisation. Community risk of readmission can be estimated and mapped as indicators of the ability of communities to support both care transitions and long-term disease management.ConclusionContextualising readmission rates through a community lens has the potential to help hospitals and policymakers improve discharge planning, reduce penalties to hospitals, and most importantly, provide higher quality care to the people that they serve.

scholarly journals Attributes of turnaround rural hospitals: Case study findings and research opportunities

2017 ◽  
Vol 6 (6) ◽  
pp. 8
Author(s):  
Asa B. Wilson
Keyword(s):  
Theory Of The Firm ◽  
Access Point ◽  
Hospital Performance ◽  
Rural Hospitals ◽  
Rural Hospital ◽  
Classical Economics ◽  
The Status ◽  
History Of ◽  
Closure Conversion ◽  
The Impact

Background: Rural and Critical Access Hospitals (CAHs) have a history of operating challenges and closure-conversion threats. The history is reviewed including the supportive public policy provisions and administrative tactics designed to maintain a community’s hospital as the hub and access point for health services. Limited research indicates that rural facilities are not strategic in their responses to challenges. A question emerges regarding the enduring nature of operating difficulties for these facilities, i.e., no understanding with explanatory value.Objective: The author, as the CEO in six rural hospitals designated as turnaround facilities, used inductive participant-observer involvement to identify operating attributes characteristic of these organizations. An objective description of each facility is provided. While implementing a turnaround intervention, fifteen behaviors or outcomes were found to be consistent across all six entities. This information is used to posit factors associated with or accounting for identified performance weaknesses.Conclusions: It is conceptualization that observed organizational behaviors can be explained as remnants of an agrarian ideology. Such a mindset is focused on preserving the status quo despite challenges that would require strategic positioning of the organization. In addition, emerging studies on community types indicates that follow-up research is needed that assesses the impact of community attributes on rural hospital performance. Also, this study shows that a theory of the rural hospital firm based on neo-classical economics has no explanatory value. Thus, a theory of the firm can be developed that includes behavioral economic principles.

A Massive Pulmonary Embolism Treatment Protocol: How Trauma Performance Improvement Affects Outcome Throughout the Hospital System

2010 ◽  
Vol 76 (2) ◽  
pp. 145-148
Author(s):  
Catherine Garrison Velopulos ◽  
Mark Zumberg ◽  
Priscilla Mcauliffe ◽  
Lawrence Lottenberg ◽  
A. Joseph Layon
Keyword(s):  
Pulmonary Embolism ◽  
Sudden Death ◽  
Performance Improvement ◽  
Pulmonary Embolus ◽  
Treatment Protocol ◽  
Right Heart Failure ◽  
Hospital Performance ◽  
Massive Pulmonary Embolism ◽  
Hospital System ◽  
Submassive Pulmonary Embolism

Trauma performance improvement is the hallmark of a mature trauma center. If loop closure is to be complete, preventable deaths must result in significant change in management and the establishment of protocol-driven improvements so such an instance does not recur. The trauma performance improvement committee reviewed a case of a massive pulmonary embolus and determined that this was a preventable death. The hospital performance improvement committee then initiated a root cause analysis, which led to creation of a treatment protocol for patients with massive or submassive pulmonary embolism. A focused review of the first 6 months of the implementation of the protocol was undertaken. Four patients over a 6-month period had massive or submassive pulmonary embolus. All four had sudden death or near sudden death and were appropriately resuscitated. All four sustained right heart failure. Two patients were treated by catheter-directed fibrinolysis, one with catheter-directed suction embolectomy, and one by surgical pulmonary embolectomy. All survived with full neurologic function. Trauma performance improvement is the model by which all hospital performance improvement should be done. Preventable deaths can result in change, which can have a future impact on survival in potentially lethal scenarios.

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