TRANSITION TOWARDS A CIRCULAR ECONOMY: THE ROLE OF UNIVERSITY ASSETS IN THE IMPLEMENTATION OF A NEW MODEL

Public awareness and relevant consumer behaviors are crucial in accelerating the transition to a circular economy (CE) model. This paper focused on exploring university activities for changing awareness and behaviors according to the principles of its new circular model to foster sustainable development. In this paper, a comprehensive literature review provides a holistic perspective on university CE-related activities in the implementation of the CE. The review revealed that the construction of a theoretical framework in universities with asset-based development is conducive to promoting the CE model through transformative learning. In light of recent academic insights into CE education, a theoretical framework for CE-related university activities was developed based on attributes of CE-related university assets, such as non-profit status, technology innovation, education, propagation, and efficient use of resources. We also introduce into scientific use the term CE-related university assets and provide a classification of these CE-related assets. The present findings contribute to a deeper understanding of universities’ CE-related resources and assets to improve public awareness and behaviors, as well as to train and inspire the leaders (including engineers, managers, designers, etc.) of tomorrow, required for further implementing the CE model.

Research on the Supply Chain Performance Evaluation Mechanism Based on Emergencies

Some emergencies have produced enormous changes in market demand in recent years as the economy has progressed. The supply chain’s capacity to adapt to this market demand has a substantial impact on the company’s future growth. As the frequency of emergencies rises, emergency management is becoming increasingly critical for enterprises. This article examines the responsiveness and profit status of the supply chain under the three conditions of total complete information symmetry, incomplete information symmetry, and information asymmetry based on the information sharing degree of supply chain firms. The research offers a novel approach to emergency management. It makes recommendations for how the company may share information to improve its emergency management capabilities. Finally, the feasibility of the model is verified and analyzed by a case.

Unmet Family Needs in Hospice and Research Priorities: Perspectives From a National Sample of Hospice Agencies

Although hospice cares for nearly 1.5 million patients and families annually, little is known about practitioners’ opinions of current gaps in care and research. To this end, we posed two open-ended questions to hospice representatives to identify practice-relevant research priorities. Data stem from two optional questions (Q1: N = 72; Q2: N = 73) appended to Cagle et al.’s (2020) national survey of 600 randomly selected hospices, stratified by state and profit status. Most participants provided the majority of care in-home (84.7%; 79.5%) and worked at a medium-sized hospice (50.0%; 49.3%). Responses to Q1 (“What is the biggest unmet need for hospice patients and families?”) and Q2 (“In your opinion, what is the most pressing topic that hospice researchers need to study?”) were analyzed for content and then synthesized. Analyst triangulation and peer debriefing improved trustworthiness. Emerging domains included: access to hospice, hospice services and workforce issues, and education. The access to hospice domain contained a subtheme regarding the need for earlier referrals. Participants noted that short lengths of stay undermine the clinical benefits to patients and families, and that hospice enrollment criteria may contribute to inadequate lengths of stay. The hospice services and workforce issues domain largely focused on burnout prevention. Participants acknowledged that provider self-care was linked to the quality of patient care. The education domain contained subthemes related to improving physician knowledge regarding prognostication and referral, and to patients and families regarding misconceptions about hospice care. Findings highlight critical needs for future hospice research and policy change.

Examining the Relationship Between Hospice Agency Characteristics and Complaint Deficiencies

The U.S. hospice industry has expanded over the last decade. Similar to nursing homes, research guided by the Donabedian framework has documented quality differences in hospice based on agency characteristics, including profit status and rural status. Yet, compared to nursing homes, quality oversight and transparency in hospice remain limited. When families report substandard care, a complaint survey is launched to investigate allegations. Using publicly available regulatory oversight data (e.g., CMS QCOR, Medicare PACPUF, CAHPS HIS, Hospice Compare), and guided by the Donabedian framework, this study describes hospice agency structure and process characteristics associated with care complaint deficiencies (outcome). Of the 4,415 hospice facilities examined, 453 (or 10.3%) have had complaint survey deficiency citations between January 2018 and December 2020. Chi-square and ANOVA tests were conducted to compare facility characteristics (e.g., ownership status, percentage of Medicare beneficiaries in rural zips), nursing and social work involvement, and CAHPS scores between hospices with and without complaint survey deficiencies. Results indicated that the average proportion of beneficiaries with a rural zip for Medicare correspondence was significantly lower in hospices with deficiencies (p<.001). Finding also suggested that weekly total nursing and social work minutes were significantly higher in hospices with deficiencies. Additionally, family ratings of hospice team communication, symptom management, and overall satisfaction were higher in facilities without complaint survey deficiencies. Future research and practice implications will be discussed.

Good Trouble Along the Winding Road: Disruption and Accomplishment

The establishment of a accreditation body for gerontology degree programs was seen as disruptive. Many key leaders were against creating such a body and wanted this to be delayed or to never happen. In 2012, the AGHE Accreditation Task Force was established with a Competency Work Group and an Organization Work Group..There have been 5 programs evaluated with a number of schools/university currently in process. The task force filed documents for creating a legal entity and obtaining non-profit status for the new Accreditation for Gerontology Education Council. The Task Force developed the dimensions for program evaluation based on the Competencies and shared information with AGHE members. The Task Force obtained start-up funding for the organization and identified the first programs for accreditation and has been providing outreach and guidance to new programs. There is continual refinement of the process.

Profit Status and Employee Turnover in Iowa Nursing Homes

Employee turnover is a huge concern for nursing homes that care for millions of older individuals whose physical and cognitive impairments make them vulnerable, especially in the middle of a pandemic like COVID-19. Existing research has shown that high turnover of employees can lead to poorer quality of care. Low pay is often cited as one of the key reasons for high turnover of employees in nursing homes. For-profit nursing homes may try to maximize profits by limiting wages paid to their employees. In this study, we examine whether profit-status of a facility is associated with high turnover of its employees. We obtain data on 415 nursing homes operating in Iowa between 2013-2017. We descriptively examine the turnover trends in nurse employees and all employees over time by profit status. We evaluate whether profit status is associated with high turnover using pooled linear regressions controlling for nursing home and resident characteristics. Descriptive results show that for-profit facilities had higher turnover of nurse employees (61.1% vs. 49.6%) and all employees (56.6% vs. 45.4%). Results from multivariate regressions show that, compared to non-profit facilities, for-profit facilities had 6.93 percentage points higher (p<0.01) turnover of all employees, and 7.76 percentage points higher (p<0.01) turnover of nurse employees after controlling for facility and resident characteristics. Given existing evidence on the adverse impact of high employee turnover on nursing home quality, we need policies aimed at lowering employee turnover, targeting for-profit nursing homes.

A Matter of Transition: Authenticity Judgments and Attracting Employees to Hybridized Organizations

Category-spanning organizations have been shown to face a number of penalties compared with organizations occupying a single category. The assumption seems to be, however, that organizations spanning the same categories will be evaluated similarly. Yet, this is not always the case. We know far less about why evaluations may differ within category-spanners, largely due to existing studies’ focus on comparing single-category to category-spanning organizations in equilibrium states at a fixed point in time. Instead, this paper investigates audience judgments of organizations as they transition from single to multiple categories. We rely on the empirical setting of social-commercial hybrids—an intriguing context in which to explore category-spanning across market and nonmarket domains associated with distinct values, norms, and expectations. In a series of two experimental studies, we investigate how hybridization affects audience judgments of organizational authenticity and the ability to attract potential employees. We find that across organizational fields associated with nonprofit (communal) and for-profit (market exchange) norms, hybridization—more than hybridity itself—triggers audience cynicism and leads to decreased judgments of authenticity. However, the penalties for hybridizing are only observed when organizations also move away from field-level profit-status norms. The findings contribute to the category-spanning and authenticity literatures by integrating social psychological and organizational theory perspectives to offer a dynamic view of spanning beyond for-profit, market contexts. They also offer empirical support for the theorized multidirectionality of mission drift in hybrid organizations, while suggesting that drifting need not always be detrimental.

Dialysis Facility Profit Status and Early Steps in Kidney Transplantation in the Southeastern United States

Background and objectivesDialysis facilities in the United States play a key role in access to kidney transplantation. Previous studies reported that patients treated at for-profit facilities are less likely to be waitlisted and receive a transplant, but their effect on early steps in the transplant process is unknown. The study’s objective was to determine the association between dialysis facility profit status and critical steps in the transplantation process in Georgia, North Carolina, and South Carolina.Design, setting, participants, & measurementsIn this retrospective cohort study, we linked referral and evaluation data from all nine transplant centers in the Southeast with United States Renal Data System surveillance data. The cohort study included 33,651 patients with kidney failure initiating dialysis from January 1, 2012 to August 31, 2016. Patients were censored for event (date of referral, evaluation, or waitlisting), death, or end of study (August 31, 2017 for referral and March 1, 2018 for evaluation and waitlisting). The primary exposure was dialysis facility profit status: for profit versus nonprofit. The primary outcome was referral for evaluation at a transplant center after dialysis initiation. Secondary outcomes were start of evaluation at a transplant center after referral and waitlisting.ResultsOf the 33,651 patients with incident kidney failure, most received dialysis treatment at a for-profit facility (85%). For-profit (versus nonprofit) facilities had a lower cumulative incidence difference for referral within 1 year of dialysis (−4.5%; 95% confidence interval, −6.0% to −3.2%). In adjusted analyses, for-profit versus nonprofit facilities had lower referral (hazard ratio, 0.84; 95% confidence interval, 0.80 to 0.88). Start of evaluation within 6 months of referral (−1.0%; 95% confidence interval, −3.1% to 1.3%) and waitlisting within 6 months of evaluation (1.0%; 95% confidence interval, −1.2 to 3.3) did not meaningfully differ between groups.ConclusionsFindings suggest lower access to referral among patients dialyzing in for-profit facilities in the Southeast United States, but no difference in starting the evaluation and waitlisting by facility profit status.

FEATURES OF ACCOUNTING OF MEDICINES IN HEALTHCARE INSTITUTIONS – COMMUNAL NON-COMMERCIAL ENTERPRISES

As a result of the ongoing health care reform in Ukraine, health care facilities are being transformed from budget institutions into municipal non-profit enterprises. The result is an all-encompassing change in the accounting system. At the same time, an important issue for them is compliance with the requirements for the non-profit status of the enterprise. This necessitates organization of careful detailed accounting. Medical devices and medicines are a necessary part of the medical services provided by healthcare facilities. From the point of view of accounting, most of these assets are stocks, which have their own specifics and features of accounting. The paper considers organization of accounting of medicines in health care facilities and communal non-profit enterprises. Different ways of receiving medicines in health care facilities provide a different procedure for accounting for their availability and use. This requires the appropriate organization of analytical accounting of medicines in the accounts. Important in the accounting of medical devices and medicines is a well-defined system of document flow between inventory and accounting, as well as the division of responsibilities between the materially responsible persons and the accounting officer responsible for accounting of medicines or inventories in general. The variety of sources of medicines and the directions of their use in health care facilities and communal non-profit enterprises requires the development of a generalized scheme of reflection in the accounting of their movement. All information reflected in the accounts must be summarized for the reporting of the enterprise. Accounting registers and auxiliary tables are used for this purpose. Because medicines account for the largest share of all health care stocks, special attention needs to be paid to generating information about their availability and movement. To obtain such information, it is advisable to use generalized data that will take into account the different sources of drugs to the company and the different areas of their use.

Mortality at For-Profit Versus Not-For-Profit Hemodialysis Centers: A Systematic Review and Meta-analysis

We conducted a systematic review and meta-analysis to assess differences in risk-adjusted mortality rates between for-profit (FP) and not-for-profit (NFP) hemodialysis facilities. We searched 10 databases for studies published between January 2001 to December 2019 that compared mortality at private hemodialysis facilities. We included observational studies directly comparing adjusted mortality rates between FP and NFP private hemodialysis providers in any language or country. We excluded evaluations of dialysis facilities that changed their profit status, studies with overlapping data, and studies that failed to adjust for patient age and some measure of clinical severity. Pairs of reviewers independently screened all titles and abstracts and the full text of potentially eligible studies, abstracted data, and assessed risk of bias, resolving disagreement by discussion. We included nine observational studies of hemodialysis facilities representing 1,163,144 patient-years. In pooled random-effects meta-analysis, the odds ratio of mortality in FP relative to NFP facilities was 1.07 (95% CI 1.04–1.11). Patients at FP hemodialysis facilities have 7 percent greater odds of death annually than patients with similar risk profiles at NFP facilities. Approximately 3,800 excess deaths might be averted annually if U.S. FP hemodialysis operators matched NFP mortality rates.