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Actor or arena: contrasting translations of a law on interorganizational integration.

https://arctichealth.org/en/permalink/ahliterature117925
Source
J Health Organ Manag. 2012;26(6):778-93
Publication Type
Article
Date
2012
Author
Johanna Andersson
Mikael Löfström
Susanna Bihari Axelsson
Runo Axelsson
Author Affiliation
Nordic School of Public Health NHV, Gothenburg, Sweden. johanna.andersson@nhv.se
Source
J Health Organ Manag. 2012;26(6):778-93
Date
2012
Language
English
Publication Type
Article
Keywords
Budgets
Delivery of Health Care, Integrated - economics - legislation & jurisprudence - organization & administration
Financial Management - legislation & jurisprudence
Financing, Government
Humans
Interinstitutional Relations
Models, organizational
Rehabilitation, Vocational - economics
Social Work - economics - organization & administration
Sweden
Abstract
A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund and organize joint activities. The purpose of this study is to describe and analyze how the law has been interpreted and translated into local coordination associations and how local institutional logics have developed to guide the organization of these associations.
Data was collected through observations of meetings within two coordination associations and supplemented with documents. The material was analyzed by compilation and examination of data from field notes, whereupon the most important aspects were crystallized and framed with institutional organization theory.
Two different translations of the law were seen in the associations studied: the association as an independent actor, and as an arena for its member organizations. Two subsequent institutional logics have developed, influencing decisions on autonomy, objectives and rationality for initiating and organizing in the two associations and their activities. The institutional logics are circular, further enhancing the different translations creating different forms of integration.
Both forms of integration are legitimate, but the different translations have created integration with different degrees of autonomy in relation to the member organizations. Only a long-term analysis can show whether one form of integration is more functional than the other.
This article is based on an extensive material providing insights into a form of interorganizational integration which has been scarcely researched. The findings show how different translations can influence the integration of welfare services.
PubMed ID
23252326 View in PubMed
Less detail
Source
J Health Econ. 1999 Aug;18(4):393-407
Publication Type
Article
Date
Aug-1999
Author
A L Bretteville-Jensen
Author Affiliation
National Institute for Alcohol and Drug Research, Oslo, Norway. alb@sifa.no
Source
J Health Econ. 1999 Aug;18(4):393-407
Date
Aug-1999
Language
English
Publication Type
Article
Keywords
Budgets
Choice Behavior
Health Behavior
Humans
Income
Interviews as Topic
Mental Disorders - complications
Models, Econometric
Norway
Questionnaires
Research Design
Substance-Related Disorders - complications - economics - psychology
Time Factors
Abstract
In 1988, Becker and Murphy [Becker, G.S., Murphy, K.M., 1988. A theory of rational addiction. Journal of Political Economy, 96, 675-700.] launched a theory in which they proposed that the perspective of rational decision-making could be applied also to cases of addictive behaviour. This paper discusses the theory's assumptions of interpersonal variation and stability in time preferences on the basis of estimates derived from three groups of people with different consumption levels of illegal intoxicants. We find that active injectors of heroin and amphetamine have a higher discount rate than a group reporting that they have never used the substances. Of greater interest, though not in accordance with Becker and Murphy's assumption of stability, we also find that the discount rate among active and former users differs significantly. These findings raise the question of whether a high time-preference rate leads to addiction or whether the onset of an addiction itself alters people's inter-temporal equilibrium.
PubMed ID
10539613 View in PubMed
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Adequacy of food spending is related to housing expenditures among lower-income Canadian households.

https://arctichealth.org/en/permalink/ahliterature161594
Source
Public Health Nutr. 2007 Dec;10(12):1464-73
Publication Type
Article
Date
Dec-2007
Author
Sharon I Kirkpatrick
Valerie Tarasuk
Author Affiliation
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building Room 326, 150 College Street, Toronto, Ontario, Canada, M5S 3E2.
Source
Public Health Nutr. 2007 Dec;10(12):1464-73
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Budgets
Canada
Costs and Cost Analysis
Cross-Sectional Studies
Food - economics
Food Supply - economics - statistics & numerical data
Housing - economics
Humans
Income
Nutrition Surveys
Poverty
Abstract
A number of studies have pointed to the pressure that housing costs can exert on the resources available for food. The objectives of the present study were to characterise the relationship between the proportion of income absorbed by housing and the adequacy of household food expenditures across the Canadian population and within income quintiles; and to elucidate the impact of receipt of a housing subsidy on adequacy of food expenditures among low-income tenant households.
The 2001 Survey of Household Spending, conducted by Statistics Canada, was a national cross-sectional survey that collected detailed information on expenditures on goods and services. The adequacy of food spending was assessed in relation to the cost of a basic nutritious diet.
Canada.
The person with primary responsibility for financial maintenance from 15 535 households from all provinces and territories.
As the proportion of income allocated to housing increased, food spending adequacy declined significantly among households in the three lowest income quintiles. After accounting for household income and composition, receipt of a housing subsidy was associated with an improvement in adequacy of food spending among low-income tenant households, but still mean food spending fell below the cost of a basic nutritious diet even among subsidised households.
This study indicates that housing costs compromise the food access of some low-income households and speaks to the need to re-examine policies related to housing affordability and income adequacy.
PubMed ID
17764603 View in PubMed
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The affordability of a nutritious diet for households on welfare in Toronto.

https://arctichealth.org/en/permalink/ahliterature190784
Source
Can J Public Health. 2002 Jan-Feb;93(1):36-40
Publication Type
Article
Author
Nicholas Vozoris
Barbara Davis
Valerie Tarasuk
Author Affiliation
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2.
Source
Can J Public Health. 2002 Jan-Feb;93(1):36-40
Language
English
Publication Type
Article
Keywords
Budgets
Diet - economics
Family Characteristics
Financing, Personal
Humans
Income - statistics & numerical data
Nutritional Physiological Phenomena
Ontario
Poverty
Social Welfare - economics
Urban Population
Abstract
This study assesses the affordability of a nutritious diet for households in Toronto that are supported by welfare.
For three hypothetical households, welfare incomes were compared to the monthly costs for food, shelter, and other essential expenditures in Toronto.
If households lived in market rental accommodation, average monthly incomes were insufficient to cover expenses for the single-person household and two-parent family, and barely adequate for the single-parent family considered in this study. However, the single-parent family's actual income fell below expenses for six months of the year. For households with children, the relative inadequacy of welfare increased as children grew older. Living in rent-geared-to-income housing afforded substantial financial advantage, but the welfare income of single-person households was still insufficient to meet basic needs.
These findings indicate discrepancies between welfare incomes and costs of basic needs, which may explain the vulnerability of welfare recipients to food insecurity.
PubMed ID
11925698 View in PubMed
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[A functional model of a state district ophthalmologic clinic under the budget-deficit conditions].

https://arctichealth.org/en/permalink/ahliterature182998
Source
Vestn Oftalmol. 2003 Sep-Oct;119(5):40-3
Publication Type
Article
Author
V V Zharov
Source
Vestn Oftalmol. 2003 Sep-Oct;119(5):40-3
Language
Russian
Publication Type
Article
Keywords
Budgets
Eye Diseases - economics - surgery - therapy
Health Services - economics - standards
Humans
Russia
PubMed ID
14598495 View in PubMed
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Agency in health care with an endogenous budget constraint.

https://arctichealth.org/en/permalink/ahliterature217989
Source
J Health Econ. 1994 Jul;13(2):231-51
Publication Type
Article
Date
Jul-1994
Author
D. Clark
J A Olsen
Author Affiliation
Department of Economics, University of Tromsø, Norway.
Source
J Health Econ. 1994 Jul;13(2):231-51
Date
Jul-1994
Language
English
Publication Type
Article
Keywords
Budgets
Consumer Satisfaction - economics
Ethics, Medical
Health Maintenance Organizations - economics
Humans
Insurance, Health - economics
Models, Econometric
Norway
Patient Participation - economics
Physician's Role
Abstract
In this paper a doctor acts as a perfect agent for a group of patients in an environment where the health service is funded by a group of contributors. The contributor group donates resources to the health sector in accordance with its split preferences about the health care services which they would like for themselves and those which they would like for others. We show that the size of the health budget is endogenous and depends on the choices made by the doctor. The focus is on the division of the budget between health enhancing and non-health enhancing health care.
PubMed ID
10138027 View in PubMed
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AIDS could dominate Russian budget by 2020.

https://arctichealth.org/en/permalink/ahliterature188655
Source
Bull World Health Organ. 2002;80(8):686-7
Publication Type
Article
Date
2002

Allocating limited resources in a time of fiscal constraints: a priority setting case study from Dalhousie University Faculty of Medicine.

https://arctichealth.org/en/permalink/ahliterature113649
Source
Acad Med. 2013 Jul;88(7):939-45
Publication Type
Article
Date
Jul-2013
Author
Craig Mitton
Adrian Levy
Diane Gorsky
Christina MacNeil
Francois Dionne
Tom Marrie
Author Affiliation
Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada. craig.mitton@ubc.ca
Source
Acad Med. 2013 Jul;88(7):939-45
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Budgets - organization & administration
Decision Making
Faculty, Medical
Health Care Rationing - organization & administration
Humans
Models, organizational
Nova Scotia
Organizational Case Studies
Public Sector - economics
Resource Allocation - organization & administration
Schools, Medical - economics
Abstract
Facing a projected $1.4M deficit on a $35M operating budget for fiscal year 2011/2012, members of the Dalhousie University Faculty of Medicine developed and implemented an explicit, transparent, criteria-based priority setting process for resource reallocation. A task group that included representatives from across the Faculty of Medicine used a program budgeting and marginal analysis (PBMA) framework, which provided an alternative to the typical public-sector approaches to addressing a budget deficit of across-the-board spending cuts and political negotiation. Key steps to the PBMA process included training staff members and department heads on priority setting and resource reallocation, establishing process guidelines to meet immediate and longer-term fiscal needs, developing a reporting structure and forming key working groups, creating assessment criteria to guide resource reallocation decisions, assessing disinvestment proposals from all departments, and providing proposal implementation recommendations to the dean. All departments were required to submit proposals for consideration. The task group approved 27 service reduction proposals and 28 efficiency gains proposals, totaling approximately $2.7M in savings across two years. During this process, the task group faced a number of challenges, including a tight timeline for development and implementation (January to April 2011), a culture that historically supported decentralized planning, at times competing interests (e.g., research versus teaching objectives), and reductions in overall health care and postsecondary education government funding. Overall, faculty and staff preferred the PBMA approach to previous practices. Other institutions should use this example to set priorities in times of fiscal constraints.
PubMed ID
23702521 View in PubMed
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Alternative funding plans: is there a place in academic medicine?

https://arctichealth.org/en/permalink/ahliterature221368
Source
CMAJ. 1993 Apr 1;148(7):1141-6
Publication Type
Article
Date
Apr-1-1993
Author
R H Haslam
N E Walker
Author Affiliation
Department of Paediatrics, University of Toronto, Ont.
Source
CMAJ. 1993 Apr 1;148(7):1141-6
Date
Apr-1-1993
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - economics - organization & administration
Budgets
Child
Evaluation Studies as Topic
Faculty, Medical
Financing, Government - methods - trends
Hospital Departments - economics - organization & administration
Hospitals, Pediatric - economics
Humans
Medical Staff, Hospital - economics
Ontario
Organizational Innovation
Public Health Administration
Salaries and Fringe Benefits
Abstract
Because of shrinking resources and the resulting threat to its academic vitality the Department of Paediatrics, Hospital for Sick Children, University of Toronto, entered into an agreement on alternative funding with the Ontario Ministry of Health in 1990. The department developed a set of principles that guided the negotiations, which ultimately led to a budget that formed the basis of the agreement. The contract with the ministry provides a global budget to the department; this budget funds faculty members, administrative staff and the educational and research programs formerly supported by fee-for-service billing to the Ontario Health Insurance Plan. The alternative funding plan has provided financial stability to the department and affords an opportunity to develop innovative and cost-effective models of pediatric care.
Notes
Comment In: CMAJ. 1993 Sep 1;149(5):536-78364807
Comment In: CMAJ. 1993 Apr 1;148(7):1127-98457952
PubMed ID
8457954 View in PubMed
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An ethical dilemma for the clinician manager.

https://arctichealth.org/en/permalink/ahliterature229113
Source
Dimens Health Serv. 1990 May;67(4):15-7
Publication Type
Article
Date
May-1990
Author
W J Sibbald
A. Lynch
Author Affiliation
Richard Ivey Critical Care Trauma Centre, Victoria Hospital Corporation.
Source
Dimens Health Serv. 1990 May;67(4):15-7
Date
May-1990
Language
English
Publication Type
Article
Keywords
Adult
Aged
Budgets
Cost Control
Ethics
Ethics, Institutional
Female
Humans
Intensive Care Units - utilization
Male
Ontario
Patient Admission - economics
Patient Selection
Resource Allocation
PubMed ID
2373277 View in PubMed
Less detail

210 records – page 1 of 21.