<p>Denna uppsats undersöker om tjänstesektorns storlek har någon effekt på ett lands ekonomiska tillväxt. Data för 92 länder under perioden 1975 till 2003 skattas i en dynamisk panelregression med tre alternativa metoder. Resultaten visar genomgående att effekten är negativ, dock med frånvaro av signifikans för vissa estimat. Detta resultat är i linje med den teoretiska bakgrunden som predicerar att produktivitetstillväxt är svårt att uppnå i tjänsteproduktion. Vidare säger teorin att den ekonomiska tillväxten blir lägre i länder med stor tjänstesektor eftersom långsiktig tillväxt per capita ytterst beror på produktivitetstillväxt. Ur de estimerade resultaten kan även utläsas att effekten är större när urvalet begränsas till att endast gälla OECD länderna jämfört med när samtliga 92 länder ingår.</p>

Denna uppsats undersöker om tjänstesektorns storlek har någon effekt på ett lands ekonomiska tillväxt. Data för 92 länder under perioden 1975 till 2003 skattas i en dynamisk panelregression med tre alternativa metoder. Resultaten visar genomgående att effekten är negativ, dock med frånvaro av signifikans för vissa estimat. Detta resultat är i linje med den teoretiska bakgrunden som predicerar att produktivitetstillväxt är svårt att uppnå i tjänsteproduktion. Vidare säger teorin att den ekonomiska tillväxten blir lägre i länder med stor tjänstesektor eftersom långsiktig tillväxt per capita ytterst beror på produktivitetstillväxt. Ur de estimerade resultaten kan även utläsas att effekten är större när urvalet begränsas till att endast gälla OECD länderna jämfört med när samtliga 92 länder ingår.

Background and problem discussion: The concept of Lean Production comes from Toyota's way of building cars with higher quality and efficiency. The concept is that you want to create continuous improvements by rationalizing your work and trying to reduce waste. The Lean concept was founded in production, but Lean has recently begun to be used in other industries and operations, including Lean Administration. Lean has become more common in public activity, and can be a way to work more efficiently and provide citizens with better service. Purpose: The purpose of our study was to create a greater understanding of the extent to which Lean Administration is applied in the 10 largest municipalities in Sweden, how this application looks and what similarities and differences exist between the municipalities' way of working with Lean. Methods: We have conducted a survey, where the ten largest municipalities have been asked about their Lean work. We have used a combined method where the survey was based on multiple choice questions and open questions, ie both quantitative and qualitative approaches. Conclusion: Our study shows that half of the municipalities in question are working with Lean to some extent. The study also shows that three of the municipalities who answered no to the question of working with Lean use the Lean approach without naming it as Lean work. The municipalities are satisfied about their Lean improvements. / Bakgrund och problemdiskussion: Begreppet Lean Production kommer från Toyotas sätt att bygga bilar med högre kvalitet och effektivitet. Konceptet går ut på att man vill skapa ständiga förbättringar genom att rationalisera sitt arbete och försöka minska slöserier. Konceptet Lean grundades inom produktionen men på senare tid har Lean börjat användas inom andra branscher och verksamheter, bland annat Lean Administration. Lean har blivit allt vanligare i offentlig verksamhet, och kan vara ett sätt att arbeta mer effektivt och ge medborgarna en bättre service. Syfte: Syftet med vår studie var att skapa en större förståelse för i vilken utsträckning Lean Administration tillämpas i de 10 största kommunerna i Sverige, hur denna tillämpning ser ut och vilka likheter och skillnader som finns mellan kommunernas sätt att arbeta med Lean. Metod: Vi har genomfört en enkätundersökning där de tio största kommunerna har fått berätta om sitt Lean-arbete. Vi har genomfört en kombinerad metod där undersökningen byggde på flervalsfrågor och öppna frågor, dvs både kvantitativ och kvalitativ ansats. Slutsats: Vår studie visar att hälften av de tillfrågade kommunerna arbetar med Lean i någon form. Studien visar också att tre av de kommuner som svarade nej på frågan om de arbetar med Lean använder sig av Lean-synsättet utan att benämna det som Lean-arbete. Kommunerna är nöjda med förbättringarna som Lean-arbetet lett till.

Denna studie syftar till att undersöka hur tjänsteproducerande företag kan utveckla processer för informationshantering mot interna kunder baserat på lean principer. Studien avser att fylla i det gapet som finns gällande forskningen om användandet av lean principer i hanteringen av information för tjänsteproducerande organisationer. Genom att tillämpa lean principer för informationshanteringsprocesser kan organisationer finna vilka slöserier som finns samt minimera dess uppkomst. I analysen av relevant teori samt den empiriska insamlingen framkommer det förbättringsmöjligheter för fallföretaget. Avgörande för SJ Stockholmståg är att följa konsekventa riktlinjer på alla avdelningar och att få en bättre förståelse för interna kunder för att på ett effektivt sätt möta deras olika behov. Utifrån den tematiska analysen kunde författarna utröna fyra fokusområden för vilket lean principer kan appliceras med syfte att förbättra informationshanteringen samt öka kvaliteten för mottagaren. Utformning av tydliga informationsprocesser där de interna kundernas behov är centrala, tankesättet om kunden i centrum är en av grundpelarna i lean principer. I linje med lean behöver organisationen öka sin förståelse för dess interna kunder, genomgående under intervjuerna framgick det en utvecklingspotential i detta område. Avdelningsöverskridande arbete kan hjälpa i detta och medföra en större känsla av sammanhang till SJ Stockholmståg för dess medarbetare. Sammanfattningsvis skulle en tillämpning av lean principer och främjande av en kultur uppbyggd på ständiga förbättringar. Genom att effektivisera informationshanteringen, eliminera slöserier och i slutändan förbättra konkurrenskraften och kundnöjdheten inom sin tjänsteproduktion. Rapportens förhoppning är att bidra till tjänsteproducerande organisationer där informationsdelning mellan avdelningar är en väsentlig del av verksamheten. / This study aims to investigate how service producing companies can develop processes for information management towards internal customers based on lean practices. The study also intends to fill the gap that exists regarding the research on the use of lean practices in the management of information for service producing organizations. By applying lean practices to information management processes, organizations can find what waste exists and minimize its occurrence. In the analysis of relevant theory and the empirical collection, improvement opportunities for the case company emerge. It is crucial for SJ Stockholmståg to follow consistent guidelines in all departments and to gain a better understanding of internal customers in order to effectively meet their various needs. Based on the thematic analysis, the authors were able to ascertain four focus areas for which lean practices can be applied with the aim of improving information management and increasing quality for the recipient. Designing clear information processes where the needs of the internal customers are central, the mindset of the customer at the center is one of the pillars of lean practice. In line with lean, the organization needs to increase its understanding of its internal customers, consistently during the interviews there was a development potential in this area. Cross-departmental work can help in this and bring a greater sense of context to SJ Stockholmståg for its employees. In conclusion, an application of lean practices and the promotion of a culture built on continuous improvement. By streamlining information management, minimizing waste and ultimately improving competitiveness and customer satisfaction within their service production. The report's aim is to contribute to service-producing organizations where information sharing between departments is an essential part of the business.

This dissertation consists of six essays in health economics.The first essay, “Economic evaluations in health care: Basic principles and special topics”, serves as an introduction to economic evaluations in health care, including estimations of costs, health effects, and the discount rate. Special topics of interest for the rest of the studies are also discussed, e.g. the role of modelling in cost-effectiveness analysis, and methods for dealing with incomplete observations in clinical trial data. The main theme of the second essay, “Consumption and production by age in Sweden: Basic facts and health economic implications”, is a fairly detailed compilation of consumption and production figures by age in Sweden. The purpose of this is to use the difference between consumption and production in each age group as a measure of the average costs of added years of life in the general population. In economic evaluations of health care interventions, only future costs for related ill­nesses have typically been included in the analysis. However, the health economist David Meltzer has argued that future costs for un­related illnesses and general consumption should also be in­cluded in eco­nomic evaluations. Otherwise, the analysis will not be consistent with expected utility maximiza­tion. The third essay is entitled “The possibility of predicting health care costs in the future from predicted changes in age structure and age specific mortality: The case of Sweden”. Changes in the age structure, especially the growing number of elderly people, have raised concerns about increasing costs for health and elderly care in the future. However, the number of elderly per se is not the main problem, since the growing number of elderly people is a result of better health and hence lower morta­lity. The main purpose of the study is to investigate if future health care costs can be predicted based on forecasts of future changes in age structure and mortality rates. It is shown here that at least in Sweden and in the U.S., there is a linear relationship between age-specific mortality and age-specific health care costs. When these relationships are applied retrospectively to old data, however, the predictions are underestimates of the actual costs. These results are in line with earlier studies, which show that the future age structure is not likely to have a great impact on the future health care costs. The fourth essay is called “Cost effectiveness of bisoprolol in the treatment of chronic congestive heart failure in Sweden: Analysis using data from the Cardiac Insufficiency Bisoprolol Study II” (with Niklas Zethraeus and Bengt Jönsson). Treatment of heart failure with beta blockers was introduced in Sweden already in the 1970s, but it was not until the 1990s that large-scale clinical trials established the efficacy of beta blockers in reducing heart failure mortality. The study consists of an economic evaluation of the beta blocker bisoprolol added to standard treatment of chronic heart failure, compared with placebo added to the same standard treatment. The study raises a number of methodological issues. At the forefront are the inclusion of costs of added years of life, and the question of how to model health effects that extend beyond the clinical trial on which the economic evaluation is based. The results indi­cate that treatment with bisoprolol is cost-effective. A drawback of the analysis in the fourth study was that the expected survival after the end of follow-up was modelled deterministically. This makes it impossible to assess the uncertainty of the cost-effectiveness estimate in a realistic way. The fifth essay is entitled “Assessing uncertainty in cost-effectiveness analysis by combining resampling of clinical trial data with stochastic modelling: The economic evaluation of bisoprolol for heart failure revisited”. Here, the drawback with the fourth study that was mentioned above is addressed by using resamp­ling of the clinical trial data in combination with stochastic modelling of the expected survival after the end of follow-up in the clinical trial. The methodology is inspired by the bootstrap method, which is a simulation technique whereby various statistics, like the mean and variance, can be estimated through repeated resampling from the original sample. The difference from the traditional boot­strap method is that resampling of observations from the clinical trial data is combined with stochastic modelling of the expected remaining lifetime of the patients who were alive at the end of the clinical trial. Cost-effectiveness acceptability curves for treatment of heart failure with bisoprolol were obtained as a result of the analysis. The sixth essay, “Survival analysis techniques for estimating the costs attributable to head and neck cancer in Sweden”, concerns the estimation of average treatment cost attri­butable to a disease when the data contain censored, i.e. incomplete, observations. For various reasons, censored observations are common in medical and epidemiological studies. As a result, the length of the survival time or the size of the costs for those who are alive at the end of follow-up are not exactly known. This is of course problematic if we want to estimate the average survival time or the average cost for all patients, both survivors and non-survivors included. In this study, the Kaplan-Meier sample-average estimator is used for overcoming the problem with censored observations. It is a method that has been proposed specifically for handling censored cost data. / Diss. Stockholm: Handelshögsk., 2002