Variation in health care, whether it be in terms of the utilisation of resources, observed health outcomes, costs, quality or access to health care is a well recognised and ever present feature of the modern day health care system. Health care variations challenge basic assumptions about the nature of the health care economy and raise questions about efficiency, equity and where best to direct policy instruments in health care markets. Despite the vast literature documenting variation, and the many discussions around ways to reduce variations in health care markets, the field of dental care has received little interest, in comparison to that of general medical care. This thesis will address this gap and will analyse the variation observed in a specific dental care treatment (dental radiographs) within NHS Scotland, with particular emphasis on the contribution of both dentist and patient unobserved heterogeneity. The thesis takes its focus from two strands of the literature; the underlying theoretical aspect draws on the literature concerning the theory of incentives and physician agency, whilst the empirical component makes use of recent advances in micro-econometric methods, documented in the labour economics literature. Although the thesis is predominantly an empirical analysis, the estimation strategy combines ideas from both the theoretical and empirical literature. A matched patient provider dataset from NHS Scotland is used to conduct an analysis of the variation in dental radiographs, in the presence of, and controlling for unobserved dentist and patient heterogeneity. The results indicate that the remuneration structure alone has little or no impact on the treatment decision to provide a radiograph. When a dentist changes from being on a fixed salary contract to being paid on a fee-for-service basis, they are in fact less likely to provide a radiograph. This result changes in the presence of insurance (identified as being when patients are exempt from the patient charge) and indicates that when the self employed dentist can identify the patient as being exempt, they are more likely to provide a radiograph. This result provides some support for the theory that in the presence of insurance, financial incentives do influence the treatment decision. A final result of the study highlights the importance of accounting for unobserved patient and provider heterogeneity, a factor that has had little attention in the healthcare literature. The results suggest that patient variation, as opposed to the variation across dentists, is much more important in explaining total variation. This is a similar result to that found in both the labour and education literatures.

Introduction: Financial incentives increase smoking abstinence among pregnant and postpartum women. They have also been reported to reduce psychological symptoms using the Beck Depression Inventory (BDI) and Brief Symptom Inventory (BSI) in women at risk for perinatal depression. This prospective study aims to replicate and extend these findings using the BDI and Edinburgh Postpartum Depression Scale (EPDS). Methods: Participants were 169 pregnant cigarette smokers who were assigned to one of two treatment conditions: Best Practices only (n=88), which entails brief counseling and a referral to a pregnancy-specific quit-line, or Best Practices + Incentives (n=81). Participants were categorized as at increased risk (Dep+; n= 91) or lower risk (Dep-; n= 76) for depression based on history of depressive symptoms and baseline symptom scores. Treatment effects on smoking status and BDI/EPDS scores were examined across nine perinatal assessments using repeated measures analyses of covariance. Results: Financial incentives increased rates of biochemically-verified abstinence through 12-weeks postpartum independent of depression risk (ps ≤ .01) but did not differentially decrease BDI or EPDS scores (ps > .05). Scores decreased with both interventions for the Dep+ women (p = .001). Conclusions: These results replicate earlier evidence that financial incentives increase perinatal smoking abstinence in Dep+ women but not their efficacy in differentially reducing depressive symptoms at levels greater than Best Practices. The failure to replicate effects on depressive symptoms may be due to use of different control conditions in the current and prior study or increased screening and intervention for perinatal mental health during routine obstetrical care.

<p>Financial incentives have become important in health care all over the world. This thesis compares one council implementing a new payment system based on performance based reimbursement (PBR) with ten councils retaining an annual budget system. </p><p>The aim of this thesis was to study the effects of PBR on physicians’ attitudes and behaviours, that may affect the conditions for cost effective care. Aspects highlighted are efficiency, cost awareness, quality of care, professional autonomy and power, job satisfaction and leadership.</p><p>This thesis is based on data from seven studies, questionnaires, interviews and register based studies. One instrument, Incentive, Effectiveness, Environment (IEE) was developed within the framework of this thesis. It measures self-reported behavioural changes related to daily clinical work, judgements about work environment factors and the quality of care, and attitudes towards and existence of financial incentives.</p><p>Physicians in the council with PBR experienced a greater pressure to improve their efficiency and they did so. The average length of stay decreased more both in relative and absolute numbers. Much of the efficiency increase, however, seems to emanate from "running faster", not from working more rationally. Cost awareness increased in all councils studied although more so in the council with PBR. PBR was found to create a different financial incentive than an annual budget, stronger and more positive. Effects on quality of care were judged to be negative. Financial reductions were claimed to be the main reason for quality losses, but PBR was found to be more time consuming and therefore contributed to the negative outcome. Work environment factors, especially professional autonomy and power were judged to have deteriorated in all councils studied although more so in the council with PBR. Good leadership was shown to make a difference for quality of care as well as for professional autonomy and job satisfaction, regardless of context.</p><p>The results seem, at least partly, to depend on the new payment system, creating an increased efficiency pressure. Additional reasons discussed in this thesis are financial reductions, repeated organisational changes and a size effect.</p>

Financial incentives have become important in health care all over the world. This thesis compares one council implementing a new payment system based on performance based reimbursement (PBR) with ten councils retaining an annual budget system. The aim of this thesis was to study the effects of PBR on physicians’ attitudes and behaviours, that may affect the conditions for cost effective care. Aspects highlighted are efficiency, cost awareness, quality of care, professional autonomy and power, job satisfaction and leadership. This thesis is based on data from seven studies, questionnaires, interviews and register based studies. One instrument, Incentive, Effectiveness, Environment (IEE) was developed within the framework of this thesis. It measures self-reported behavioural changes related to daily clinical work, judgements about work environment factors and the quality of care, and attitudes towards and existence of financial incentives. Physicians in the council with PBR experienced a greater pressure to improve their efficiency and they did so. The average length of stay decreased more both in relative and absolute numbers. Much of the efficiency increase, however, seems to emanate from "running faster", not from working more rationally. Cost awareness increased in all councils studied although more so in the council with PBR. PBR was found to create a different financial incentive than an annual budget, stronger and more positive. Effects on quality of care were judged to be negative. Financial reductions were claimed to be the main reason for quality losses, but PBR was found to be more time consuming and therefore contributed to the negative outcome. Work environment factors, especially professional autonomy and power were judged to have deteriorated in all councils studied although more so in the council with PBR. Good leadership was shown to make a difference for quality of care as well as for professional autonomy and job satisfaction, regardless of context. The results seem, at least partly, to depend on the new payment system, creating an increased efficiency pressure. Additional reasons discussed in this thesis are financial reductions, repeated organisational changes and a size effect.

Organizational Ambidexterity är ett relativt nyuppkommit begrepp och få undersökningar har gjorts kring ämnet. De tidigare undersökningar som har bedrivits har främst fokuserat på hur ledarskap framkallar Organizational Ambidexterity. Tidigare undersökning har även forskat i hur dess komponenter, utforskande och bearbetande, kan samexistera i en organisation då de två komponenterna konkurrerar om samma resurser. För att vända blicken bort från ledarens roll i en organisation att inverka på Organizational Ambidexterity, har studien fokuserat på belöningssystemets inflytande på Organizational Ambidexterity med bankorganisationer som objekt.   Belöningssystem förekommer i både finansiell och icke-finansiell form. Finansiella belöningar kan tillkännages som en transaktion utav finansiell ersättning vid utfört arbete. Icke-finansiell belöning är ersättning vilket inte medför direkta kostnader för en organisation. Det kan ske i form av utbildning eller beröm från chefen.   Studien har genomförts på så vis att de empiriska material som frambringats ska förklara om och i så fall vilka belöningssystem som motiverar organisationen att arbete i både en utforskande och bearbetande kapacitet för att uppnå Organizational Ambidexterity. Detta för att uppnå konkurrensfördelar på marknaden.   Teorin stödjer sig på att finansiella belöningar leder till en mer bearbetande kapacitet och icke-finansiella belöningar framkallar en mer utforskande kapacitet. De empiriska material som samlats in stödjer inte detta resonemang till fullo då det visat sig att finansiella belöningar inte används i en större utsträckning och att det inte heller leder till en mer bearbetande kapacitet. Emellertid användes de icke-finansiella belöningarna i en större utsträckning och har till viss del påvisat att det inverkar över organisationens förmåga att arbeta i en utforskande kapacitet. / Organizational Ambidexterity is a relatively new concept and few studies have been done on the subject. Previous studies have focused on how leadership develops Organizational Ambidexterity. Previous investigations have also done research into how its components, exploration and exploitation, can co-exist in an organization where the two components compete for the same resources. To turn your gaze away from the leaders’ role in organizations and how they affect Organizational Ambidexterity, this study has focused on the reward systems influence on Organizational Ambidexterity with the banking organizations as an object.   Reward systems are present in both financial and non-financial terms. Financial rewards are transactions of financial compensation for work performed. Non-financial rewards are compensation which does not involve direct costs to an organization. It may take the form of training or appreciation from the boss.   This study was conducted in such a way that the empirical material that has emerged will explain if and how the reward systems motivate the organization to work in both an exploration and exploitation capacity to achieve Organizational Ambidexterity. This is done in order achieve competitive advantages in the market.   The theory relies on that financial rewards will lead to more exploitative capacity and non-financial rewards elicit more exploratory capability. The empirical material collected does not support this argument in full, since it was found that financial rewards are not used to a greater extent and that financial rewards does not lead to a more exploitative capacity. However, the use of non-financial rewards to a greater extent has partially demonstrated an impact on the organizations ability to work in an exploratory capacity.

Magistro baigiamajame darbe nagrinėjama ekonomikos magistrantūros studijų absolventų preferencijos ir finansinės paskatos, renkantis darbo vietą, naudingumo aspektu. Tyrimo empirinę bazę sudaro 200 iš 689 Mykolo Romerio universiteto, Vilniaus universiteto, Kauno Technologijos universiteto bei Šiaulių universiteto 2007/2008 m.m. ir 2008/2009 m.m. ekonomikos magistrantūros studijų absolventai. Tyrimo objektas - Mykolo Romerio universiteto, Vilniaus universiteto, Kauno Technologijos universiteto bei Šiaulių universiteto ekonomikos magistrantūros studijų absolventų preferencijos ir finansinės paskatos, renkantis darbo vietą. Tyrimo tikslas - ištirti ekonomikos magistrantūros studijų absolventų preferencijas ir pagrindines finansines paskatas, darbo vietos pasirinkimo atžvilgiu, naudingumo funkcijų pagrindu. Atsižvelgiant į tyrimo tikslą ir iškeltus uždavinius darbe atlikta vartotojų preferencijų ir paskatų įtakos ištyrimo lygio analizė; išanalizuoti naudingumo funkcijų tipai; praktinėje darbo dalyje įvertintos Mykolo Romerio universiteto, Vilniaus Universiteto, Kauno Technologijos universiteto bei Šiaulių universiteto ekonomikos magistrantūros studijų absolventų, renkantis darbo vietą, naudingumo funkcijos; to pasekoje nustatytos respondentų preferencijos bei pagrindinės finansinės paskatos, teikiančios jiems didžiausią naudingumą, renkantis darbo vietą. Pagrindiniai tyrimo metodai: mokslinės literatūros analizė ir sisteminimas, anketinė apklausa, naudingumo funkcijų taikymas... [toliau žr. visą tekstą] / The preferences and financial incentives based on utility aspect of graduates of master economics studies by choosing a work place is analyzed in the concluding paper of master degree. The empirical base of the research consisted of 200 from 689 graduates of Mykolas Romeris University, Vilnius University, Kaunas Technology University and Šiauliai University. The object of the research was the preferences and financial stimulants of graduates of master economic studies of Mykolas Romeris University, Vilnius University, Kaunas Technology University and Šiauliai University by choosing the work place. The main goal of the research was to investigate the preferences and financial stimulants of graduates of master economics studies by choosing them the work place by using the utility functions. The following findings are presented in the paper: the theoretical analyze of investigation level of preferences and incentives of customers; the analyze of the types of utility functions; weighted utility functions of the graduates of Mykolas Romeris University, Vilnius University, Kaunas Technology University and Šiauliai University by choosing the work place; the preferences and major financial incentives of the respondents, which give them the maximum utility by choosing a work place. The main research methods: analyze and filing of nonfiction, survey of questionnaire, statistic analyze. The descriptive statistics was used to calculate statistical findings.

Made available in DSpace on 2016-12-12T20:32:01Z (GMT). No. of bitstreams: 1 Final Mestrado Antonio Carlos.pdf: 527718 bytes, checksum: d6207c29bbf031d2f06e819094ac80a2 (MD5) Previous issue date: 2005-11-08 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present study aims to identify whether or not there is a correlation between using financial lines for export by small and medium companies, and its level of competitiveness. The Atletic Way company was analyzed for this study, a medium sized company located in the city of Joinville, state of Santa Catarina. The work began with the construction of the theoretical fundamentation, indispensable to give support to the research, being used the methodology proposed by Ferraz et al. (1997) that sees competitiveness as: the managerial factors, administration, innovation, production and human resources; also the structural factors, market configuration of the industry, regime of incentives; and the sistemics factors, as macroeconomics, political-institutional, infra-structure and international. There are very few research material found in this area, mainly when it aims businesses depending on finance policies to export, and also the difficulties that small and medium Brazilian companies face whenever they need a specific financing to export, which harms this sector in the international market. The study signals the low investment in this sector. / O presente trabalho tem por objetivo geral identificar se há correlação entre a utilização de linhas de financiamento para exportações pelas pequenas e médias empresas (PMEs) e o seu nível de competitividade, sendo utilizado como estudo de caso a empresa Athletic Way empresa industrial de médio porte, localizada no município de Joinville/SC. O trabalho se iniciou com a construção da fundamentação teórica, indispensável para dar sustentação à pesquisa, utilizando-se a metodologia proposta por Ferraz et al. (1997), que analisa a competitividade segundo seus fatores determinantes tais como: os fatores empresariais (gestão, inovação, produção e recursos humanos), os fatores estruturais (mercado, configuração da indústria, regime de incentivos) e os fatores sistêmicos (macroeconômicos, políticoinstitucionais, infra estruturais e internacionais). Tal estudo foi motivado pela pouca bibliografia existente na área, principalmente quando se leva em conta o financiamento para empresas vinculadas à exportação e reconhecida dificuldade das pequenas e médias empresas brasileiras em contrair linhas de financiamento específica à exportações, o que vem prejudicando sobremaneira uma maior inserção deste segmento no mercado internacional. O estudo sinaliza pelo baixo investimento nesse setor.

Background: Internet, as everybody knows, has a lot of advantages and possibilities. One of these possibilities for companies is changing their business to electronic commerce (e-commerce). Almost all companies might need this type of business to sustain in future and compete with others. Most of the traditional businesses decide to change their business to e-commerce to have more profits in the future. However, this kind of commercial (e-commerce) may have its own risks and difficulties. Therefore, financial drivers can help companies to start or change previous business to e-commerce better and more easily. Purpose: The aim of this study is to demonstrate the importance of financial drivers for business to business (B2B) companies when they are starting an e-commerce. Since financial drivers might motivate the companies to start with e-commerce. Design/Methodology/Approach: A qualitative method and two case studies in the plastic industry are used. There are six interviews with a company named Alpha and two with a company named Beta. The researcher chooses the semi-structured interview for this study. The data are collected from mentioned interviews and secondary data. Findings: The finding of this study is divided into two parts. A) The necessity of companies to start an e-commerce, B) The importance of the financial drivers for B2B companies. This study shows that the financial driver has a significant effect to start an e-commerce. The advantages of selling products through e-commerce are as follows: increasing sales and revenues, decreasing transaction costs, improving liquidity problems, introducing the company brand and reaching products in 24/7. Practical implications: The result of this study has several implications for B2B companies such as management motivation to start an e-commerce. This study introduces financial drivers as an important key to motivate management to start with e-commerce.

Veterans Affairs (VA) inconsistently distributes financial incentives, which might affect how VA employees perceived organizational justice, affecting employees’ job satisfaction and performance. The purpose of this qualitative transcendental phenomenological study was to explore the lived experiences of VA employees that informed their perceptions of their workplaces’ levels of organizational justice, their job satisfaction, and their performances due to inconsistent distribution of financial incentives by gathering data through interviews with 13 VA employees from the Southeastern United States. The research question concentrated on the lived experiences of VA employees with respect to the inconsistent distribution of financial incentives, and how these experiences shaped their perception of the level of organizational justice in their workplaces. The study was guided by the conceptual framework of social exchange theory, and data was analyzed per Moustakas 7-steps of data analysis. Four major themes emerged from the analysis of interview transcripts: financial incentives, fairness of financial incentives, organizational justice at the VA, and perceptions at VA. The study findings indicated that the allocation of financial incentives by the VA, based on performance appraisals—a product of supervisors, is skewed by supervisor’s relationship with employees, and negatively affects VA employees job satisfaction and commitment. The results of this study could contribute to positive social change by assisting managers and employees in rectifying the perception of the unfair distribution of financial incentives at the VA.

Under the shadow of the climate change dilemma and its consequence for the human’s future, the need for secured and stable energy sources is vital. Academia, political leaders, and influential business actors play a key role to introduce schemes to facilitate the adaptation of new technologies and energy systems improvement. Hydrogen as an energy carrier is one of the solutions to tackle environmental concerns in recent decades. However, hydrogen technology needs constant development to reduce its cost and to find production methods by which fossil fuels can be replaced by clean hydrogen. In this study, five different countries in terms of hydrogen technology introduction, their National Strategy on Hydrogen, influential variables on hydrogen application have been investigated. Along with a comparison between five countries, the differences in policies and political incentives and their effect on hydrogen applications have been studied. Policy incentives work differently according to the various cultural norms. In some countries such as Japan financial incentives work better but in some such as Sweden non-financial incentives work well. Along with policy introduction, collaboration between policy, industry, and academia contribute to the successful introduction, diffusion, and application of new technologies. Regarding hydrogen technology in Sweden, introduction of National Strategy on Hydrogen, a shift from hydrogen application in industry to transport section, and giving less priority to biogas and more to hydrogen fuel, applying suitable policy incentives can be helpful for Sweden to act faster and benefit more from hydrogen.