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Jayawardhena, Chanaka, and Paul Foley. "Overcoming Constraints on Electronic Commerce - Internet Payment Systems." Journal of General Management 24, no. 2 (December 1998): 19–35. http://dx.doi.org/10.1177/030630709802400202.
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Salleh, Rozana Mohamed, Nur Emma Mustaffa, and Nafisah Abdul Rahiman. "The Adoption of Building Information Modelling and Intelligent Contract to Payment Process in Malaysian Conventional Contract." Journal of Computational and Theoretical Nanoscience 17, no. 2 (February 1, 2020): 1378–87. http://dx.doi.org/10.1166/jctn.2020.8814.
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Payment conflicts are never ending issue in Malaysian construction industry. This issue is a common scenario especially in public work project, which involves a conventional contract. The late payment and non-payment occur due to client inefficient payment administration caused by documentation and human factors. It commonly ended up causing delays in project completion. However, the revolution of Information Technology (IT) within construction industry has shown the development of various management systems, which transformed the way projects are administered. The introduction of Building Information Modelling (BIM) is one of the project management systems, which have been created to centralised knowledge sharing resource as an effective collaborative and integrated approach between inter-disciplines in construction industry. The development of digital technology of Intelligent Contracts brings great potential in BIM management to automate the contractual process and thus create possible solutions towards payment conflicts in the construction project. This paper discusses the process of payment in the conventional contractual procedure, which relate to the causes of delay in payment. It is believed that by integrating BIM and Intelligent Contract’s attributes may help to eliminate the unnecessary procedure, which prolong the payment processes. Therefore, this study is carried out to explore what are the effects of adopting BIM and Intelligent Contracts attributes in conventional payment process. This is a descriptive study and the methodology used is essentially on review of the literature in relation to payment processes in conventional contract, BIM management system and attributes of Intelligent Contract. The analysis revealed that the adoption of BIM and Intelligent Contracts attributes in payment conventional process could improve the efficiency; reduce the time by eliminating third party interference and manual signatory. In addition, the project performance is analysed intelligently as well as minimise the risks of losing information by keeping historical audit trails in automatic system repository.
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Nouri, Alireza, and Seyed Hamid Hosseini. "Payment minimisation auction with security constraints." IET Generation, Transmission & Distribution 11, no. 6 (April 20, 2017): 1370–80. http://dx.doi.org/10.1049/iet-gtd.2016.0537.
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Sivathanu, Brijesh. "Adoption of digital payment systems in the era of demonetization in India." Journal of Science and Technology Policy Management 10, no. 1 (March 4, 2019): 143–71. http://dx.doi.org/10.1108/jstpm-07-2017-0033.
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PurposeThis study aims to investigate the actual usage (AU) of digital payment systems by the consumers during the period of demonetization (from November 9, 2016 to December 30, 2016) in India.Design/methodology/approachThe conceptual frame work for this study is based on the unified theory of acceptance and use of technology (UTAUT 2) and innovation resistance theory. A total of 766 sample respondents were surveyed using a pre-tested questionnaire. The empirical validation of the framework and analysis was done using partial least squares (PLS)-structural equation modeling (SEM) technique.FindingsThe results suggest that the behavioral intention (BI) to use and innovation resistance (IR) affect the usage of digital payment systems. The relation between BI to use digital payment systems and the AU of digital payment systems is moderated by the stickiness to cash payments.Research limitations/implicationsThis cross-sectional study is limited by geographic constraints and highlights the AU of digital payment systems by using the UTAUT 2 and IR theory only during the demonetization period.Practical implicationsThis study offers valuable insights to the economists, policymakers and digital payment service providers regarding the usage of digital payment systems by consumers during demonetization.Originality/valueThis study assumes importance as it empirically examines the influence of BI and IR on the AU of digital payment systems during the demonetization period in India. This study empirically validates the moderating influence of stickiness to cash payments on the AU of digital payment systems.
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Tajani, Francesco, Pierluigi Morano, Francesca Salvo, and Manuela De Ruggiero. "An evaluation model for an effective risk assessment in the rent to buy property market." Property Management 38, no. 1 (November 27, 2019): 124–41. http://dx.doi.org/10.1108/pm-09-2019-0052.
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Purpose In this research a model for the rationalization of the assessment in a rent to buy contract has been proposed, in order to contextualize the economic amounts involved in the negotiation according to the specific market risk of the area where the property is located. The paper aims to discuss this issue. Design/methodology/approach The model borrows the logical principles of operational research, in order to take into account the convenience constraints of the parties involved (seller and buyer) and to determine the minimum amount of the additional annual rent to be charged as down payment on the final sale price, compensating the investment risk. The procedure proposed for the risk assessment combines the discrete modeling of real option analysis and the exponentially weighted moving average method, in order to weigh appropriately the data available for the specific area in the analysis. Findings Considering the limit conditions of variability of the property market value at the time provided for the notarial deed, the proposed model returns two values (minimum and maximum) for a fixed contract duration and for a specific market area for the annual additional rent, which define the reference range to ensure the compliance with the convenience constraints of the parties involved. Practical implications In order to test the reliability of the developed methodology, the model has been implemented to the 24 “microzones” defined by the Italian Revenue Agency for the city of Bari (Southern Italy). The results obtained were then georeferenced, in order to create thematic maps of convenience for the subjects interested in the rent to buy formula. The developed maps define a useful support to be consulted in the negotiation phase between the seller and the buyer, allowing both to verify the investment conveniences within the limits of their disposable incomes and their needs. Originality/value The tabulated values of the down-payment amounts and the related thematic maps constitute a valid support for both the parties in the initial negotiation phase of the contractual conditions: in fact, if comparable data for the assessment of the market value and the market rent at the time of the stipulation of the contract are ordinarily available, the increase in the rent, to be charged as the annual down payment on the final purchase price, is generally entrusted to the contractual capabilities of the subjects involved, since there is no market reference that can direct an appropriate assessment.
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GLUSHAKOVA, Ol'ga V. "The treasury system of Russia–2021: New development trends amid increasing budgetary constraints." Finance and Credit 27, no. 2 (February 26, 2021): 244–71. http://dx.doi.org/10.24891/fc.27.2.244.
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Subject. The article focuses on institutional transformations in bodies of the Federal Treasury in adopting the treasury payment mechanism and treasury service. Objectives. I analyze the performance of the public finance system in Russia during the COVID-19 crisis, and identify steps of the institutional environment emergence so as to adopt the treasury payment system and treasury service. I also evaluate whether it is possible to ensure the balance of the federal budget and regional budgets in Russia by placing temporarily available funds when introducing the treasury payment mechanism and implementing the technology of the single treasury account. Methods. The study is based on the systems and institutional approaches. I also resorted to general methods, such as the analysis, synthesis, comparison. Results. The revenue of the federal budget was found to drop considerably due to the lower business activity in Russia and worldwide and a decrease in the demand and prices for strategic power resources. The article outlines steps of the institutional environment emergence to adopt the treasury payment system and treasury service. Additional income from the placement of temporarily available federal and regional funds was found to be insufficient to ensure the balance of the above budgets. Conclusions and Relevance. Going beyond the structural conservatism of the national economy will lower the public finance sustainability risks amid rapidly changing development challenges, including the COVID-19 that outbroke worldwide in 2020. The findings can be used for practical purposes by the Federal Treasury and other parties to the treasury payment systems so as to improve its performance.
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Putri, Ailani Almira Hartono, Indrawati Yuhertiana, and Devy Sylvia Puspitasari. "Technology Constraints in Online Tax Payment: Case of Surabaya City." Journal of Economics, Business, and Government Challenges 2, no. 2 (October 31, 2019): 144–51. http://dx.doi.org/10.33005/ebgc.v2i2.83.
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This study aims to explore in depth the application of the online system of payment of land and building tax (PBB). The research location is in a government office, the Surabaya City Financial and Tax Management Board (BPKPD). This study uses a qualitative method. Interviews were conducted with the intended informants, namely the Surabaya City BPKPD as the tax authorities, and also the citizen as Taxpayers (WP). Miles Huberman's approach is used to analyze data. Stages of research include data collection, then reduced, presented and verified, so as to obtain valid conclusions. Informants are chosen based on the information needs needed by researchers. It can be concluded that the web display of online tax payment services is considered attractive and able to optimize public services. Online service brainware factor namely Human Resources (HR) plays an important role in realizing online services. The hardware factor in the online system is quite good using a good computer, but the internet connection is complained about being slow. Online tax payments that can be done through ATMs and m-banking at three banks in collaboration with the Surabaya City BPKPD are still complained of being convoluted by taxpayers. Fear of making payments online makes taxpayers still pay cash at the teller. The changing of service systems from offline to online requires time for the community to adapt.
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Palanisamy, Ramaraj, Jacques Verville, and Nazim Taskin. "The critical success factors (CSFs) for Enterprise Software contract negotiations." Journal of Enterprise Information Management 28, no. 1 (February 9, 2015): 34–59. http://dx.doi.org/10.1108/jeim-12-2013-0083.
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Purpose – As the wrong Enterprise Software (ES) acquisition can lead an organization with chronically exceeded budgets and settling for minimum returns, so can an unfavorable contractual agreement. Often the acquiring organizations become vulnerable to risks and mistakes as the software contracts are habitually written using legal terminologies and mainly to the advantage of the vendor. To avoid costly ES contracting mistakes, the purpose of this paper is to empirically identify the critical success factors (CSFs) of contracting in the context of ES acquisition. Design/methodology/approach – A questionnaire survey was conducted to gather the data for this study. Statistical analysis conducted for this study include descriptive statistics, factor analysis with reliability and validity tests and nonparametric test. Findings – The five key factors are: contractual assurance, forward compatibility and licensing; right to use, own and use of own, confidentiality and payment; software acceptance; license assignment; and vendor obligation for intellectual property. The research and managerial implications of these factors are given in discussion. Research limitations/implications – As with most empirical studies, the subjectivity of the opinion of respondents from only two industries presents some limitations to generalization. Another limitation is the respondent has been asked for the degree of criticality for each of the contracting issue given in the questionnaire. There could be critical issues other than the listed ones which are more specific to the organization. Practical implications – The results can be used by managers to improve their understanding on the critical contractual issues in ES acquisition negotiations. Originality/value – The significant value of this study identifies the CSFs for ES contract negotiations while acquiring the software.
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Sihaloho, Josef Evan, Atifah Ramadani, and Suci Rahmayanti. "Implementasi Sistem Pembayaran Quick Response Indonesia Standard Bagi Perkembangan UMKM di Medan." Jurnal Manajemen Bisnis 17, no. 2 (April 30, 2020): 287. http://dx.doi.org/10.38043/jmb.v17i2.2384.
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ABSTRACTThe use of server-based electronic money is one of the most popular non-cash payment systems in use today. The form of server-based electronic money is e-wallet / digital wallet. E-wallet can be used to transact by customers, if the merchant provides an application Same e-wallet to customers. This made Bank Indonesia, as the regulator of the payment system, issue a new payment channel namely; QRIS (QR Code Indonesia Standard). The use of QRIS is used to standardize all e-wallets applications that use the QR Code system to conduct payment transactions. This study examines how the application of QRIS to UMKM in Medan, and describes the roles, constraints, and income of UMKM s in the presence of QRIS. The research method used is interviews and literature studies with UMKM traders who have used QRIS as a payment tool in their characters. This research indicates that QRIS has benefits for UMKM traders.
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D.J. Garrick and N. Lopez-Villalobos. "Potential for economic benefits to the producer from altering the composition of milk." BSAP Occasional Publication 25 (2000): 93–108. http://dx.doi.org/10.1017/s1463981500040681.
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AbstractCost–price models were developed to describe milk collection, manufacture and marketing of standardised fluid milk, butter, cheese, casein, and milk powders. Market constraints were modelled by fixing fluid milk demand to 10% or 70% of milk production. Milks representative of New Zealand Holstein-Friesian (HF) and Jersey (J) breeds, and novel technologies were considered. The true value of each milk was assessed from its own processing performance on the basis of fat, protein, lactose and volume considerations. Average milk was worth £0.193/kg when a significant fluid market exists, reducing to £0.112/kg when most milk was manufactured into concentrated dairy products for sale on the world market. Milk from different breeds varied in true value. On a per kilogram basis, HF milk was less valuable than J milk.Single and multiple component payment systems were quantified for various subsets of milk components and used to obtain predicted values of a range of milks for comparison to their true values. Values of milks that differ in composition from average milk tend to have predicted values that deviate from their true value. The extent of such bias varies depending upon the payment system considered. For example, volume-based payment over-valued HF milk and penalised J milk. Other payment systems undervalued HF milk and over–valued J milk.Payment systems should be fair, discourage unfavourable changes in composition and provide opportunities for shifts towards the production of more valuable milk. The marketing mix and the choice of payment system have major impact on the potential for economic benefits to the producer from modifying the composition of milk. Payment systems need careful, thorough investigation in concert with market research and studies into breeding and other management opportunities for modifying milk composition.A value-based payment system can encourage producers to alter the composition of their milk in order to increase revenue.
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Benkler, Yochai. "WikiLeaks and the protect-ip Act: A New Public-Private Threat to the Internet Commons." Daedalus 140, no. 4 (October 2011): 154–64. http://dx.doi.org/10.1162/daed_a_00121.
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The WikiLeaks affair and proposed copyright bills introduced in the Senate are evidence of a new, extralegal path of attack aimed at preventing access and disrupting the payment systems and advertising of targeted sites. In this model, the attacker may be a government agency seeking to circumvent constitutional constraints on its power or a private company trying to enforce its interests beyond those afforded by procedural or substantive safeguards in the law. The vector of attack runs through the targeted site's critical service providers, disrupting technical services, such as Domain Name System service, cloud storage, or search capabilities; and business-related services, such as payment systems or advertising. The characteristics that make this type of attack new are that it targets an entire site, rather than aiming for removal or exclusion of specific offending materials; operates through denial of business and financial systems, in addition to targeting technical systems; and systematically harnesses extralegal pressure to achieve results beyond what law would provide or even permit.
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Sachedina, Hassan, and Fred Nelson. "Protected areas and community incentives in savannah ecosystems: a case study of Tanzania’s Maasai Steppe." Oryx 44, no. 3 (July 2010): 390–98. http://dx.doi.org/10.1017/s0030605310000499.
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AbstractTwo issues of central importance to conservation are developing an improved understanding of the relative roles of state protected areas and local institutions and developing effective strategies for creating community-based incentives for conservation. We provide a case study of northern Tanzania’s Maasai Steppe to explore these issues in the context of a savannah ecosystem where wildlife is mobile and depends extensively on community lands for seasonal habitats. We compare the impacts and outcomes of four approaches to developing local incentives for wildlife conservation on community lands: protected area benefit-sharing, trophy hunting donations, village–private tourism concession contracts, and a direct payment scheme for habitat conservation. Tourism and direct payment concession areas have resulted in large areas of community land being protected for wildlife by villages as a result of the conditional and contractual nature of these ventures. By contrast, other approaches that provide economic benefits to communities but are not conditional on defined conservation actions at the local level demonstrate little impact on wildlife conservation on community lands. In spatially extensive ecosystems where protected areas cover limited areas and wildlife relies heavily on community and private lands, strategies based on maximizing the direct income of communities from wildlife are fundamental to the sustainability of such systems.
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CHEN, CHENG-WU, MORRIS H. L. WANG, and JENG-WEN LIN. "MANAGING TARGET THE CASH BALANCE IN CONSTRUCTION FIRMS USING A FUZZY REGRESSION APPROACH." International Journal of Uncertainty, Fuzziness and Knowledge-Based Systems 17, no. 05 (October 2009): 667–84. http://dx.doi.org/10.1142/s0218488509006200.
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Construction firms that work on a contractual basis are generally more concerned with short-term rather than long-term financial strategies. The main focus in short-term financial strategies is on working capital management (WCM). Cash management is a major factor for achieving good liquidity and profitability. In this study we take into consideration the cash component of working capital management based on the target cash balance. We develop a practical model that should allow Taiwan construction firms to utilize the currently available cash and assets at any point in time in the most rational way. To help understand the issues involved, we first introduce a model developed by Miller and Orr. The relationship between project duration and progress towards completion is most effectively represented in practical construction management by the S-curve. Thus, in this study we plot the fuzzy S-curve regression based on the Takagi-Sugeno (T-S) fuzzy model. The practicality of the model is demonstrated using project cash flow and progress payment records from a sample project. The data are obtained from the Taipei City Government's Department of Rapid Transit Systems. Some tentative conclusions concerning the model are also given.
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Lailiyah, Nikmatul, and Lesta Karolina Br Sebayang. "Effectiveness of E-Billing System in Tax Payments for Taxpayers." Economics Development Analysis Journal 8, no. 4 (January 4, 2020): 267–80. http://dx.doi.org/10.15294/edaj.v8i4.35266.
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The application of e-Billing system in facilitating tax payment services for taxpayers is still complained about in its use. This study aims to determine the effectiveness of the e-Billing system in tax payments as well as the use constraints for taxpayers in the Tax Office Batang. The type of this research is quantitative research with percentage descriptive analysis technique. Sources of data obtained from the distribution of questionnaires and interviews with taxpayers who have used the e-Billing system independently with accidental sampling techniques. The results showed that the effectiveness of the e-Billing system in the payment of taxes for taxpayers in Tax Office Batang with taxpayer research subjects who have used the e-Billing system independently is still less effective. This is because taxpayers still find the quality of the system that is still often disturbed and the quality of information that is felt to have not been spared errors, as well as the lack of effective success of targets with low levels of use independently. Constraints on the use of e-Billing systems for taxpayers include internal obstacles from technological capabilities, awareness of taxpayers, taxpayer accuracy, and external constraints from server down, facility limitations, instability of internet taxpayers' connections. The advice given is the need for attention to the quality of thesystem e-Billing by the Directorate General of Tax as the organizer of the system given the system that is often down, such as applying a tax payment limit date based on the type of tax to minimize solid use by taxpayers. The need for socialization both materially and practically, providing knowledge about the types of taxes and types of deposits, as well as giving directions to taxpayers to act more carefully in filling out electronic deposit papers on the e-Billing system to minimize errors and repetition of making codes Billing
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Fleischman, Tomaž, and Paolo Dini. "Mathematical Foundations for Balancing the Payment System in the Trade Credit Market." Journal of Risk and Financial Management 14, no. 9 (September 21, 2021): 452. http://dx.doi.org/10.3390/jrfm14090452.
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The increasingly complex economic and financial environment in which we live makes the management of liquidity in payment systems and the economy in general a persistent challenge. New technologies make it possible to address this challenge through alternative solutions that complement and strengthen existing payment systems. For example, interbank balancing and clearing methods (such as real-time gross settlement) can also be applied to private payments, complementary currencies, and trade credit clearing to provide better liquidity and risk management. The paper defines the concept of a balanced payment system mathematically and demonstrates the effects of balancing on a few small examples. It then derives the construction of a balanced payment subsystem that can be settled in full and therefore that can be removed in toto to achieve debt reduction and payment gridlock resolution. Using well-known results from graph theory, the main output of the paper is the proof—for the general formulation of a payment system with an arbitrary number of liquidity sources—that the amount of liquidity saved is maximum, along with a detailed discussion of the practical steps that a lending institution can take to provide different levels of service subject to the constraints of available liquidity and its own cap on total overdraft exposure. From an applied mathematics point of view, the original contribution of the paper is two-fold: (1) the introduction of a liquidity node with a store of value function in obligation-clearing; and (2) the demonstration that the case with one or more liquidity sources can be solved with the same mathematical machinery that is used for obligation-clearing without liquidity. The clearing and balancing methods presented are based on the experience of a specific application (Tetris Core Technologies), whose wider adoption in the trade credit market could contribute to the financial stability of the whole economy and a better management of liquidity and risk overall.
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Tamblay, Sebastián, Antonio Gschwender, Marina Dragicevic, and Juan Carlos Muñoz. "Risks Involved in Transit Provision of Bus Contracts." Transportation Research Record: Journal of the Transportation Research Board 2649, no. 1 (January 2017): 89–96. http://dx.doi.org/10.3141/2649-10.
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To design and evaluate contractual arrangements for transit service delivery, it is crucial to understand the risks assumed by the actors involved. This understanding in turn clarifies the incentive structures of the contracts and their expected effects as well as explains the performance and development of public transport systems. This study examined urban bus contracts and presented a framework that grouped the risks inherent in any transit system, extended the usual dimensions of the analysis, and allowed for the examination of more complex contracts. This methodology was applied to current contracts of Transantiago, in Chile, which had been in effect since mid-2012, and showed that various contractual mechanisms transferred risks to the transit authorities. These mechanisms were shown to reduce operators’ revenue risk from 70% to around 25%, to weaken incentives, and to move the system further away from the 2012 reform objectives. This situation contributed to the persistence of a serious problem of buses skipping stops and fare evasion. In addition, a large proportion of users were captive to a single operator; this setup generated incentive issues in service planning. The analysis advised against the inclusion of demand risk reduction clauses because they might guarantee part of the operators’ income. Instead, stronger incentives could be generated by reducing the importance of the passengers transported in the payment formula while increasing that of service indicators. Complementarily, new solutions to the system’s remaining problems are suggested for further research, such as direct penalties for skipping stops or payments directly linked to fare evasion rates.
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SCHLEYER, CHRISTIAN, and TOBIAS PLIENINGER. "Obstacles and options for the design and implementation of payment schemes for ecosystem services provided through farm trees in Saxony, Germany." Environmental Conservation 38, no. 4 (August 15, 2011): 454–63. http://dx.doi.org/10.1017/s0376892911000361.
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SUMMARYAgricultural crops and pasturelands cover 24–38% of the global land area, and thus the ecological services that agricultural systems provide are of utmost societal importance. An important determinant of ecosystem services provision from European farmland is the amount and spatial arrangement of trees, shrubs and woodlands that are integrated into the respective land-use systems. This paper uses an institutional economics framework for the analysis of payment schemes for ecosystem services (PES schemes) that enhance the establishment, conservation and management of farm trees and woodlands, elaborating on the reasons for the often very reluctant participation of farmers in these schemes. PES schemes in Saxony (Germany) were selected as a typical example. Obstacles identified included high production costs and opportunity costs for land use, contractual uncertainties, land-tenure implications and heterogeneous societal preferences for ecosystem services of farm trees. Further, since scheme adoption has been relatively low compared with the total area covered by the respective farm tree types in Saxony, the PES schemes alone could not explain the substantial increase in number and size of some farm-tree types, in particular hedgerows. Regionalized premiums, result-oriented remuneration and cooperative approaches are options to improve participation in PES schemes for farm trees. The example of PES schemes for farm trees highlights one of the major challenges for the protection and preservation of cultural landscapes: they are man-made and thus need to be preserved, managed and maintained continuously.
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Szczepański, Marek. "Modern Methods and Instruments for Managing Longevity Risk in Pension Plans." Olsztyn Economic Journal 8, no. 4 (December 31, 2013): 331–45. http://dx.doi.org/10.31648/oej.3243.
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Extending the average life span in every next generation is a positive phenomenon - the result of the progress of civilization in the area of working conditions, the level of medical care, etc. However, this process also entails certain risks. Such a threat which can be accurately predicted and calculated and thus also recognized in terms of risk (which can be managed by people) is the longevity risk, or in other words the risk of a longer than expected life expectancy. It applies both to individuals as well as whole generations (demographic cohorts). The longevity risk threatens public pension systems as well as complementary and supplementary systems (individual and company run) as long as they guarantee payment of benefits for life. The cognitive aim of this article is to present the theoretical and practical case studies of selected methods and longevity risk management instruments as well as an attempt to evaluate their effectiveness. The author attempts to address a question whether the use of certain instruments to manage longevity risk would not trigger yet another type of risk - the so-called counterparty risk. It poses threat to each party of a contract that the counterparty will not live up to its contractual obligations.
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Guzikova, Liudmila A., and Igor A. Nechitaylo. "Dysfunctionality of two-part transfer pricing in investment centers' performance assessment." Management 25, no. 2 (December 21, 2020): 291–304. http://dx.doi.org/10.30924/mjcmi.25.2.16.
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The paper discusses the question of the ability of the two-part transfer pricing system to stimulate investment centers to reject projects with positive NPV and to accept projects with negative NPV when there is no external market for intermediate products. The study revealed under which circumstances investment centers can take such dysfunctional decisions and it investigated if these systems can be modified to eliminate negative effects of such circumstances. In order to solve these problems, methods of financial analysis, real options theory and theory of constraints were used and several hypothetical business situations were modelled to exemplify possible dysfunctional behavior of investment centers when strategic decisions are taken in a decentralized manner. The paper considers the reasons for taking such decisions, such as using average rates of resource costs in calculating the transfer payment, presence of the real options in related projects complex and breaking the five focusing steps of the theory of constraints.
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Di Peri, Rosita. "Speaking Secular, Acting Sectarian. Lebanese Women’s Rights beyond the Constitution." Oriente Moderno 98, no. 2 (September 7, 2018): 247–64. http://dx.doi.org/10.1163/22138617-12340195.
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Abstract The aim of this paper is to show that, despite the constitutional provisions that sanction the equality of all Lebanese, women’s rights in Lebanon are subject to different (social, religious and political) constraints. In a system characterised by a complex and often perverse interweaving of state norms, religious tribunal norms, society structure and politics, women’s rights have received little to no attention or protection. This is the result, we argue, of the institutionalisation of the communities in the 1900s that has created, over the years, a system of power that has increasingly aimed to exclude state sovereignty from specific areas. The creation of autonomous spaces of power exempt from constitutional dictates and state laws has given religious leaders enormous decision-making (and contractual) power that has contributed to creating systems parallel to the state to manage individuals’ lives. This has had major consequences, especially for women.
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Geshniani, Yaser Vahedi, Reza Kamranrad, and Iman Emami. "A multi-objective scheduling payment pattern for project cash flow by considering resource constraints (a case study in power transfer system)." International Journal of Industrial and Systems Engineering 35, no. 3 (2020): 299. http://dx.doi.org/10.1504/ijise.2020.10029998.
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Geshniani, Yaser Vahedi, Reza Kamranrad, and Iman Emami. "A multi-objective scheduling payment pattern for project cash flow by considering resource constraints (a case study in power transfer system)." International Journal of Industrial and Systems Engineering 35, no. 3 (2020): 299. http://dx.doi.org/10.1504/ijise.2020.107773.
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Phan, Tan Minh, Phu Trieu Ha, Thanh Long Duong, and Thang Trung Nguyen. "Improved particle swarm optimization algorithms for economic load dispatch considering electric market." International Journal of Electrical and Computer Engineering (IJECE) 10, no. 4 (August 1, 2020): 3918. http://dx.doi.org/10.11591/ijece.v10i4.pp3918-3926.
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Economic load dispatch problem under the competitive electric market (ELDCEM) is becoming a hot problem that receives a big interest from researchers. A lot of measures are proposed to deal with the problem. In this paper, three versions of PSO method such as conventional particle swarm optimization (PSO), PSO with inertia weight (IWPSO) and PSO with constriction factor (CFPSO) are applied for handling ELDCEM problem. The core duty of the PSO methods is to determine the most optimal power output of generators to obtain total profit as much as possible for generation companies without violation of constraints. These methods are tested on three and ten-unit systems considering payment model for power delivered and different constraints. Results obtained from the PSO methods are compared with each other to evaluate the effectiveness and robustness. As results, IWPSO method is superior to other methods. Besides, comparing the PSO methods with other reported methods also gives a conclusion that IWPSO method is a very strong tool for solving ELDCEM problem because it can obtain the highest profit, fast converge speed and simulation time.
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Yin, Zhengyu, Albert Xin Jiang, Milind Tambe, Christopher Kiekintveld, Kevin Leyton-Brown, Tuomas Sandholm, and John P. Sullivan. "TRUSTS: Scheduling Randomized Patrols for Fare Inspection in Transit Systems Using Game Theory." AI Magazine 33, no. 4 (December 21, 2012): 59. http://dx.doi.org/10.1609/aimag.v33i4.2432.
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In proof-of-payment transit systems, passengers are legally required to purchase tickets before entering but are not physically forced to do so. Instead, patrol units move about the transit system, inspecting the tickets of passengers, who face fines if caught fare evading. The deterrence of fare evasion depends on the unpredictability and effectiveness of the patrols. In this paper, we present TRUSTS, an application for scheduling randomized patrols for fare inspection in transit systems. TRUSTS models the problem of computing patrol strategies as a leader-follower Stackelberg game where the objective is to deter fare evasion and hence maximize revenue. This problem differs from previously studied Stackelberg settings in that the leader strategies must satisfy massive temporal and spatial constraints; moreover, unlike in these counterterrorism-motivated Stackelberg applications, a large fraction of the ridership might realistically consider fare evasion, and so the number of followers is potentially huge. A third key novelty in our work is deliberate simplification of leader strategies to make patrols easier to be executed. We present an efficient algorithm for computing such patrol strategies and present experimental results using real-world ridership data from the Los Angeles Metro Rail system. The Los Angeles County Sheriff’s department is currently carrying out trials of TRUSTS.
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Basar III, Roy Jucip Tabañag, Honey Rose Borden, Manuel Lorenzo Busano III, Xelani Kaye Gonzales, Vanessa Grace Guerrero, Tiffany Adelaine Tan, Leahlizbeth Sia, Kafferine D. Yamagishi, and Lanndon Ocampo. "Using the Interpretative Structural Modeling Approach for Understanding the Relationships of Drivers of Online Shopping." International Journal of Sociotechnology and Knowledge Development 13, no. 2 (April 2021): 90–104. http://dx.doi.org/10.4018/ijskd.2021040106.
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The internet has paved the way for a revolution in the shopping industry via online platforms. As online shopping transactions become popular, it is increasingly important to understand the drivers that influence the consumers in availing such platforms. Furthermore, the differences between developed and developing economies are evident from socioeconomic, regulatory, and e-commerce disparities. Understanding such domain from a developing economies perspective is not well explored in the current literature. Thus, this study aims to identify the relationships among drivers of consumers in pursuing online shopping in a developing economy (i.e., the Philippines) using interpretative structural modeling. The study identified six drivers: “convenience/ease of use,” “competitive price,” “product availability,” “value of time,” “access to more information,” and “several payment options.” Results show that all drivers, except for “competitive price,” are closely interlinked to each other, such that initiatives must be simultaneously developed to address these drivers under resource constraints.
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Duong, Thanh Long, Ly Huu Pham, Thuan Thanh Nguyen, and Thang Trung Nguyen. "Application of a new constraint handling method for economic dispatch considering electric market." Bulletin of Electrical Engineering and Informatics 9, no. 4 (August 1, 2020): 1542–49. http://dx.doi.org/10.11591/eei.v9i4.2351.
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In this paper, optimal load dispatch problem under competitive electric market (OLDCEM) is solved by the combination of cuckoo search algorithm (CSA) and a new constraint handling approach, called modified cuckoo search algorithm (MCSA). In addition, we also employ the constraint handling method for salp swarm algorithm (SSA) and particle swarm optimization algorithm (PSO) to form modified SSA (MSSA) and modified PSO (MPSO). The three methods have been tested on 3-unit system and 10-unit system under the consideration of payment model for power reserve allocated, and constraints of system and generators. Result comparisons among MCSA and CSA indicate that the proposed constraint handling method is very useful for metaheuristic algorithms when solving OLDCEM problem. As compared to MSSA, MPSO as well as other previous methods, MCSA is more effective by finding higher total benefit for the two systems with faster manner and lower oscillations. Consequently, MCSA method is a very effective technique for OLDCEM problem in power systems.
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Li, Meng, Guowei Hua, and Haijun Huang. "A Multi-Modal Route Choice Model with Ridesharing and Public Transit." Sustainability 10, no. 11 (November 19, 2018): 4275. http://dx.doi.org/10.3390/su10114275.
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With the extensive use of smart-phone applications and online payment systems, more travelers choose to participate in ridesharing activities. In this paper, a multi-modal route choice model is proposed by incorporating ridesharing and public transit in a single-origin-destination (OD)-pair network. Due to the presence of ridesharing, travelers not only choose routes (including main road and side road), but also decide travel modes (including solo driver, ridesharing driver, ridesharing passenger, and transit passenger) to minimize travelers’ generalized travel cost (not their actual travel cost due to the existence of car capacity constraints). The proposed model is expressed as an equivalent complementarity problem. Finally, the impacts of key factors on ridesharing behavior in numerical examples are discussed. The equilibrium results show that passengers’ rewards and toll charge of solo drivers on main road significantly affect the travelers’ route and mode choice behavior, and an increase of passengers’ rewards (toll) motivates (forces) more travelers to take environmentally friendly travel modes.
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Kreier, Rachel. "Moral Hazard: It’s the Supply Side, Stupid!" World Affairs 182, no. 2 (May 13, 2019): 205–23. http://dx.doi.org/10.1177/0043820019841436.
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In health care markets, moral hazard is conventionally viewed as a demand-side phenomenon in which insurance causes patients to use more care because it reduces the price they have to pay for care. However, demand-side moral hazard cannot explain why U.S. per capita health care costs are much higher than those of countries with universal coverage and lower out-of-pocket charges. Instead, blame rests with a phenomenon that may be called supply-side moral hazard, which occurs when third-party payment removes the constraints the demand curve would otherwise exert over the prices providers charge, and the quantity of expensive services they can sell. Public institutions are better positioned than private entities to address supply-side moral hazard. This helps explain why the other wealthy democracies—both those with single-payer systems, like Canada, and those with multipayer systems and all-payer procedures for setting provider rates, like Germany and Switzerland—spend much less per capita than the United States. Although managed care achieved some success in controlling U.S. provider prices in the 1990s, in the longer term, it motivated increasing market concentration among providers, which vitiated cost control. Furthermore, managed care exacerbates inequity and complexity, problems that public price regulation avoids.
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Gedgaew, Chalee, Suchint Simaraks, and A. Terry Rambo. "Factors influencing long term tomato seed production under contract farming." Forest and Society 2, no. 2 (November 26, 2018): 150. http://dx.doi.org/10.24259/fs.v2i2.4340.
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Hybrid tomato seed production under contract farming in Northeast Thailand has been declining after three decades of initial introduction. However, some growers in some villages remain as long-term growers. This study was designed to identify factors influencing their long-term production decision making process. A purposive sampling technique was used to select the study sites and key informants for in-depth semi-structured interviews. Group interviews were conducted to validate the data. The contract hybrid tomato seed production system is a centralized model. It is based on a two-way contractual relationships between the company and the individual grower. The companies specify production systems and produce quality standards at a fixed time and price. They support a complete package of inputs credit, loans and extension services to the growers. Costs of all inputs and loans are deducted from the seed payment. These costs are usually forgiven when the crop fails through no fault of the growers. The growers cannot produce hybrid tomato seeds without a contract due to the proprietary germplasm. The quality of the product and marketing are also controlled by the companies. The companies must depend on the farmers’ knowledge however, for the management and technical skills. Therefore, the companies must allow considerable flexibility and leniency in enforcing the terms of the contracts. As a result, knowledgeable and skillful growers are vital factors in sustaining long term hybrid tomato seed production. Furthermore, grower’s personal characteristics stand out as an important factor for long term production. This is why the companies are lenient and flexible with the growers to sustain their mutual benefit.
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Li, Shan, Kay-Yut Chen, and Ying Rong. "The Behavioral Promise and Pitfalls in Compensating Store Managers." Management Science 66, no. 10 (October 2020): 4899–919. http://dx.doi.org/10.1287/mnsc.2019.3458.
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Compensation systems have rapidly been shifting away from a fixed wage contractual payment basis. Many companies today are creating incentive compensation contracts to reward hard-working employees for jobs done well. Profit sharing (“sharing compensation contract”) and target with bonus (“target compensation contract”) are two common performance-based compensation contracts prevalent in business. We theoretically and behaviorally study the sharing and target compensation contracts in an operational context where a firm sets the parameters of the compensation contracts and a store manager, after observing the compensation contract offered to him, chooses his effort level (unobservable by the firm) and makes ordering decisions for the store. Our experimental data suggest systematic deviations from the theoretical benchmark and reveal behavioral promise and pitfalls under the two compensation contracts. In particular, the store manager is more willing to exert high effort under the target contract all else being equal. However, the store manager is also more likely to punish the firm for perceived “unfair” offers by submitting an extremely low order quantity. We find that bounded rationality plays an important role in driving a higher effort rate under the target contract than the sharing contract. We introduce a new formulation of the fairness concerns, which is referred to as by-state fairness, where individuals, rather than considering whether the expected profits received are fair, consider the fairness in the potential realized outcomes. This new formulation explains why managers are more likely to order very little to punish the firm under the target contract. In addition, we conduct validation experiments to verify our behavioral explanation. This paper was accepted by Jayashankar Swaminathan, operations management.
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Bista, Sanat Kumar, Surya Nepal, Cécile Paris, and Nathalie Colineau. "Gamification for Online Communities: A Case Study for Delivering Government Services." International Journal of Cooperative Information Systems 23, no. 02 (June 2014): 1441002. http://dx.doi.org/10.1142/s0218843014410020.
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Gamification, the idea of inserting game dynamics into portals or social networks, has recently evolved as an approach to encourage active participation in online communities. For an online community to start and proceed on to a sustainable operation, it is important that members are encouraged to contribute positively and frequently. We decided to introduce gamification in an online community that we designed and developed with the Australian Government's Department of Human Services to support welfare recipients transitioning from one payment to another. We first defined a formal model of gamification and a gamification design process. In instantiating our model to the online community, we realised that our context applied a number of constraints on the gamification elements that could be introduced. In this paper, we outline the design and implementation of a gamification model for online communities and its instantiation into our context, with its specific requirements. While we cannot comment on the success of gamification to drive user engagement in our context (for lack of the possibility of a controlled experiment), we found our implementation of badges-based gamification a helpful way to provide a useful abstraction on the life of the community, providing feedback enabling us to monitor and analyze the community. We thus show how feedback provided by such gamification data has a potential to be useful to community providers to better understand the community needs and addressing them appropriately to maintain a level of engagement in the community.
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Рондовић, Биљана, Саша Вујошевић, and Зденка Драгашевић. "Препоруке за бржи развој електронског банкарства у делу електронских плаћања у Црној Гори // Recommendations for the faster development of e-banking in the area of electronic payments in Montenegro." ACTA ECONOMICA 11, no. 18 (February 6, 2013): 271. http://dx.doi.org/10.7251/ace1318271r.
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Резиме: Анализа тренутног стања електронског банкарства, анализа фактора који детерминишу тај развој, те праћење тенденција на овом пољу треба да буде тема од националног значаја за Црну Гору. Из тог разлога, циљ овог рада је да прикаже тренутну, незавидну ситуацију на пољу електронског банкарства, са фокусом на степен употребе инструмената електронских плаћања, потом да анализира ограничења за ширу употребу електронског новца на овим просторима, и на крају да афирмише употребу електронских средстава плаћања у Црној Гори.Рад је настао као резултат, са једне стране, све веће потребе за популаризацијом новчаних токова заснованих на дигитализацији, јер финансијски системи у Црној Гори постају сложенији и захтевнији, а са друге стране као резултат потребе да се уоче и отклоне веће несавршености везане за правила, стандарде и уобичајене токове класичних плаћања који су све мање ефикасни.Summary: Analysis of the current situation regarding the development of e-banking, the analysis of factors that determine the development and monitoring of trends in this field, should be a topic of national importance in Montenegro. For this reason, the aim of this paper is to show the current, very unenviable situation in the field of electronic banking services, focusing on the level of use of electronic payment instruments, as well as to analyze the constraints for the wider use of electronic money in this area, and finally, to make recommendations for the promotion of increased use of electronic means of payment in Montenegro.The paper is created as the result of the growing need for popularization of cash flows based on digitization, on the one hand, because financial systems in Montenegro are becoming more complex and demanding. On the other hand, it’s a result of the need to detect and remove major imperfections related to the rules, standards and the usual classical payments that are less effective.
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Robinson, A. "Rationale for cost-effective laboratory medicine." Clinical Microbiology Reviews 7, no. 2 (April 1994): 185–99. http://dx.doi.org/10.1128/cmr.7.2.185.
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There is virtually universal consensus that the health care system in the United States is too expensive and that costs need to be limited. Similar to health care costs in general, clinical laboratory expenditures have increased rapidly as a result of increased utilization and inflationary trends within the national economy. Economic constraints require that a compromise be reached between individual welfare and limited societal resources. Public pressure and changing health care needs have precipitated both subtle and radical laboratory changes to more effectively use allocated resources. Responsibility for excessive laboratory use can be assigned primarily to the following four groups: practicing physicians, physicians in training, patients, and the clinical laboratory. The strategies to contain escalating health care costs have ranged from individualized physician education programs to government intervention. Laboratories have responded to the fiscal restraints imposed by prospective payment systems by attempting to reduce operational costs without adversely impacting quality. Although cost containment directed at misutilization and overutilization of existing services has conserved resources, to date, an effective cost control mechanism has yet to be identified and successfully implemented on a grand enough scale to significantly impact health care expenditures in the United States.
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Zhumatayeva, G., M. Nurgalieva, Zh Bayburayeva, B. Musabyaev, Zh Zhanbirov, and I. Taran. "FEATURES OF DETERMINING THE COST OF TRANSPORT SERVICES." REPORTS 2, no. 330 (April 15, 2020): 73–80. http://dx.doi.org/10.32014/2020.2518-1483.34.
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The strong competition in the logistics market enforces the service provider companies to enhance the capabilities of their management accounting systems. It is of high importance to know the real costs of transport services as well as the cost efficiency of activities contributing to the production of services. This information is needed for assessing the profitability and operation efficiency and for determining the price of services. Traditional costing methods, however, are not always able to provide the information necessary for decision support in the required quality. They may even distort service cost calculations as detailed cost driver analyses are not applied within conventional costing regimes. Thus it is worth introducing alternative cost calculation methods which improve the accuracy and reliability of service cost data [1]. To properly manage costs in transport logistics, it is necessary to optimize all stages of the transport and logistics process-from choosing the type of transport and building the supply chain to planning routes and monitoring the execution of tasks. The article deals with determining the optimal cost of auto cargo transportation, taking into account internal and external factors of influence. The results of the research in the article show that a transport company should have different payment options for paying for a completed flight with specific brands of cars, i.e. the cost of one m3, t, km, depending on the type of orders and the distance of transportation. The materials consider the methodology of determining the contractual price of transport services in the Republic of Kazakhstan. In the market conditions, the main objective is the correctness and accuracy of the assessment of the actual costs of the implementation of the transport service and, as a result, the correct pricing of this service.
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Plianbangchang, Samlee. "Universal Health Coverage (UHC)." Journal of Health Research 32, no. 4 (July 9, 2018): 322–24. http://dx.doi.org/10.1108/jhr-05-2018-029.
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Purpose The WHO Health for All goal of the year 2000 was unreachable due to a number of irreconcilable factors. However, governments agree that a resolution must be found to effectively cope with increasing health care costs. Furthermore, national health insurance schemes must be properly refined to suit local situations. Workable health policies and strategies for caring and treating sick people through reduced or cost effective methods must be developed as part of a Universal Health Coverage scheme. A review of progress made toward achieving the WHO goal of health for all. The purpose of this paper is to explore the government’s role and responsibilities to educate and support society to achieve optimum health. Design/methodology/approach This is a commentary piece. Findings Participation and involvement of all people of all walks of life in the development and management of their nation’s health care programs is an important requisite of good health for all. This should include financial participation and co-payment into the national health insurance scheme. Furthermore, national health care systems should involve or include the traditional/local and alternative systems of medicine in the most appropriate manner. Health care has to encompass the total range of comprehensive health interventions, inclusive of at least preventive, curative and rehabilitative care. Originality/value This paper provides a review of the current health system constraints and assesses the effectiveness of available options by way of ensuring that a country-specific UHC system may be successfully implemented.
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Kapsalis, Vasilis C., Grigorios L. Kyriakopoulos, and Konstantinos G. Aravossis. "Investigation of Ecosystem Services and Circular Economy Interactions under an Inter-organizational Framework." Energies 12, no. 9 (May 8, 2019): 1734. http://dx.doi.org/10.3390/en12091734.
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Nowadays, the conceptualization of circular economy is an attractive managerial tool among governments and businesses throughout the word, while ecosystem services are a contentious issue due to the particular needs of humans’ well-being. At this review the interactions between the principles of ecosystem services and the circular economy were investigated in the light of inter-organizational systems. This evaluation was based on more and more complex processes, while the integration of the growing circular economy concept within the shrinking parent ecosystem unveiled challenges and constraints for products’ end of life and quality. It was argued that: (a) The existence of social and people-related barriers can be considered under three groups, namely, the “sustainable provision and modeling schemes”, “socio-cultural appreciation and payment schemes”, and “regulatory and maintenance schemes”, (b) The impacts of circular economy—ecosystem services toward an inter-organizational functional stream model associated with distinguished proactive and post treatment risk values (c) The functionality and the accountability of the technosphere are the two critical components to support the restorative and the regenerative perspectives of the biosphere. The aforementioned findings unveiled new emerging paths to be further investigated, offering a deeper appraisal of circular economy under the inter-organizational perception.
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Rautenbach, Christa. "Editorial." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 17, no. 6 (November 14, 2014): 0. http://dx.doi.org/10.17159/1727-3781/2014/v17i6a618.
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EditorialThis voluminous issue consists of 13 articles and 8 notes dealing with various legal topics in South Africa and abroad. The articles commences with Ig Rautenbach’s discussion of the ever-elusive concept of proportionality in the light of the text of the South African Constitution. Mmaphuti Tuba analyses the different approaches adopted for the regulation of payment systems in a variety of legislative instruments by the European Union. Phoebe Boltondeals with the thorny issue of public tenders and the extent to which bidders must comply with tender specifications and conditions. Leentjie de Jong examines present-day family arbitration and the problems experienced with it. Daleen Millard and Birgit Kuschke evaluate the insurer’s pre-contractual duties in the light of the transparency principle in insurance law. Karin Calitz deals with the question if a church can be held liable for the sexual assault of children by a priest, when the victims claim as adults, many years after the events took place. The entitlement of a non-member spouse to the member’s pension forms the focus point of Clement Marumoagae’scontribution. Mitzi Wiese reflects on the correctness of the classification of liens into enrichment and contractual liens. Frans Viljoen and Nicholas Orago analyses the importance and implications of the individual communications procedure under the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (OP-ICESCR) and details some of the reasons why it would be beneficial for South Africa to accede thereto. The interplay between international law and labour law in South Africa in the context of diplomatic immunity is investigated byEzette Gericke. Cornelius Kilian and Elizabeth Snyman-Van Deventer consider section 75 in the Companies Act of 1973 (or its equivalent, section 36(2) in the Companies Act of 2008) and the topic of statutory approval for an artificial decrease or increase in the number of issued shares. Annelie Laas and Trynie Boezaart give a critical analysis of the legal measures available to curb bullying in schools. Further afield, Mtendeweka Mhango discusses the development and current status of the political question doctrine in Ghana.The first note by Roger Evans and Lienne Steyn deliberate on the seemingly contradictory outcomes of three high court judgments regarding the question of ownership of property which vests in the master of the high court by virtue of the Insolvency Act 24 of 1936. Philip Stevens also discusses recent judgments pronouncing on the entering of the particulars of child sex offenders into the register for sex offenders as enunciated in Chapter 6 of the Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007. Sieg Eiselen illustrates how the Department of Trade and Industry’s proposed amendment to the definition of “electronic signature” would undermine the key principles of functional equivalence, media neutrality and party autonomy. Luanda Hawthorne deliberates on the element of exploitation in bargaining relationships between contractual parties, as highlighted in Uniting Reformed Church, De Doorns v President of the Republic of South Africa 2013 5 SA 205 (WCC). Anneliese Roos and Magda Slabbert discuss the case of Isparta v Richter 2013 6 SA 4529 (GP), which dealt with defamation in the social media on the Facebook platform. Rowena Bernard considers the case of Department of Correctional Services v Police and Prison Civil Rights Union (POPCRU) 2011 32 ILJ 2629 (LAC), where the employer's application of rules relating to the dress code of employees impacted on the religious beliefs and practices of five of the staff members. Nico Buitendag and Karin van Marle reflect on Afriforum v Malema 2011 6 SA 240 (EqC), which drew considerable attention in the media and in the public discourse. In the last contribution, James Linscott analyses F v Minister of Safety and Security 2012 1 SA 536 (CC), which dealt with the “standard” test for vicarious liability.EditorChrista Rautenbach
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Sáenz-Segura, F., R. A. Schipper, D. Miranda, and J. M. Chaves. "Modelling price scenarios for sustainable collective action and farm production: pepper in El Roble settlement, Costa Rica." Journal on Chain and Network Science 15, no. 1 (January 2015): 39–59. http://dx.doi.org/10.3920/jcns2015.x001.
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Pepper (Piper nigrum L.) is considered a non-traditional cash crop for enhancing local development in Costa Rica and a suitable activity for small farmers. Trade of pepper has been done by using contractual agreements between producers and processors, which provides at least three functions: insurance, incentives and information. Contracts also require a high level of commitment from contracting parties to keep the equity, efficiency, and sustainability of the trade relationship. The shift of trade conditions from a competitive to a monopsony market encouraged a group of farmers to start an association that aims to bulk and process pepper from members. Breaching contracts by members of the association endanger this effort of sustainable entrepreneurship. This usually happens when temporary market conditions yield higher procurement prices by other competitors. This situation is also worsened by the lack of proper information on production and processing costs between the contracting parties, and then, the disagreement on the procurement price fixation and payment conditions. By using a mixed integer linear optimization model, we aim to identify the ‘best’ price of fresh pepper traded between both parties. We make use of primary information from 12 different farms on production costs and from the association on processing costs. The model incorporates minimum required net margins for all contracting parties, while modelling the net margins of each party, the amount of traded fresh pepper and preferred contract possibilities, given different fresh pepper price scenarios. At lower prices, some of the farmers that supply pepper, do this to just break-even. At higher prices, more is supplied by more farmers. Under monopsony conditions and individual contracts between parties, it is in the interest of the buyer to offer higher fresh pepper prices in order to buy and process more pepper, up to the point that the marginal costs of buying more pepper are equal to the marginal benefits of that extra pepper. This is because the processor has fixed costs, next to variable costs. Higher volumes reduce the average total costs of processing per kg of pepper, and thereby increase profit. When group contracts are possible, thus under bilateral monopoly conditions – farmers acting as ‘one’ seller and the processor as the only buyer – more fresh pepper is supplied at higher prices than under monopsony conditions as more farmers would have higher surpluses. At the same time the processor would have a higher profit than using individual contracts.
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Fikriawan, Suad. "CROWDFUNDING DALAM PERSPEKTIF HUKUM ISLAM (Analisis Skema Akad Sewa Pada Website Kitabisa.com)." El-Barka: Journal of Islamic Economics and Business 1, no. 2 (March 21, 2019): 181. http://dx.doi.org/10.21154/elbarka.v1i2.1449.
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Abstract:This study aims to answer the problem of the contractual practice of leasing the Kitabisa.com website and how to analyze Islamic business law on its implementation. Research data was collected through documentation and interviews. The research approach used is a qualitative approach with descriptive analysis method, where data is analyzed using ijarah theory. The results of the study concluded that: first, leasing a website at Kitabisa is a leasing contract between campaign owners (tenants) and Kitabisa (who rents out). Kitabisa.com does not explain the nominal amount of rent that must be paid by the campaign owner and also without time constraints. Payment of service fees is taken from donations collected by 5% and is charged to donors. If the campaign during the promotion does not result in a donation, service fees will not be charged; second, payment of service fees in online donations in Kitabisa is permissible in Islamic law, because it is included in the ijarah contract category. Payment of donation service fees does not violate the rules of Islamic law because there is no element of gharar. Transactions carried out are in accordance with the rules of Islamic law where both parties do not feel disadvantaged, so as to prevent the occurrence of disputes. The Kitabisa party should improve the agreement contract and provide clear information about donation services to users. Campaign owners and donors should pay attention to the principles in Islamic law so as not to fall into things that are prohibited. الملخص: تهدف هذه الدراسة إلى الإجابة عن مشكلة ممارسة تأجير المواقع الإلكترونية في kitabisa.comوكيفية تحليل قانون الأعمال الإسلامية في تنفيذه. نهج البحث المستخدم هو نهج نوعي مع طريقة التحليل الوصفي. وخلصت نتائج الدراسة إلى أن: أولاً ، استئجار موقع على الإنترنت فيkitabisa.com هو عقد إيجار بين مالكي الحملة (المستأجرين) و kitabisa.comالذين يستأجرون). لا يشرح موقع kitabisa.comالقيمة لاسمية لرسوم الإيجار التي يجب أن يدفعها مالك الحملة ودون قيود زمنية ، حيث يتم دفع رسوم الخدمة من التبرعات التي تم جمعها بنسبة 5٪ من قبل نظام kitabisa.comقبل الدخول إلى الحملة. يتم تحميل رسوم الخدمة على الجهات المانحة وليس لأصحاب الحملة. إذا لم تكن الحملة أثناء الترويج تبرعات ، فلن يتم تحصيل رسوم الخدمة ؛ ثانياً ، يجوز دفع رسوم الخدمة في التبرعات عبر الإنترنت فيkitabisa.comفي الشريعة الإسلامية ، لأنه يتم تضمين دفع خدمات التبرعات في فئة عقد الإجارة. يعتبر دفع رسوم خدمة التبرع مخالفاً لقواعد الشريعة الإسلامية من حيث الحيازة ، لأن تكلفة خدمات التبرع قد تم إعفاؤها من الغرر. كما أن المعاملات التي تتم وفقا لقواعد الشريعة الإسلامية ، وفي هذه الحالة ، لا يشعر الطرفان أيضا بالأذى ، لمنع وقوع الأعمال العدائية والنزاعات. بناء على ذلك يوصى بما يلي: أولاً ، ينبغي على الطرفkitabisa.comتحسين اتفاقية الاتفاق وتقديم معلومات واضحة عن خدمات التبرع لمستخدمي تسهيلات التبرع عبر الإنترنت حتى لا تفهم المعلومات بشكل جيد ؛ ثانياً ، يجب على مالكي الحملة والمانحين دائماً أن ينتبهوا للمبادئ التي تم تدريسها من قبل الشريعة الإسلامية بحيث لا تقع ضمن المسائل المحظورة. Abstrak: Penelitian ini bertujuan untuk menjawab problem praktik akad sewa website Kitabisa.com dan bagaimana analisis hukum bisnis Islam terhadap implementasinya. Data penelitian dihimpun melalui dokumentasi dan wawancara. Pendekatan penelitian yang digunakan adalah pendekatan kualitatif dengan metode analisis deskriptif, dimana data dianalisis dengan menggunakan teori ija>rah. Hasil penelitian menyimpulkan bahwa: pertama, sewa website di Kitabisa merupakan akad sewa-menyewa antara pemilik kampanye (pihak penyewa) dan Kitabisa (yang menyewakan). Kitabisa tidak menjelaskan jumlah nominal biaya sewa yang harus dibayarkan oleh pemilik kampanye dan tanpa dibatasi waktu. Pembayaran biaya jasa diambil dari uang donasi yang terkumpul sebesar 5% dan dibebankan kepada donatur. Apabila campaign selama promosi tidak menghasilkan donasi, maka tidak akan dibebankan biaya jasa; kedua, pembayaran biaya jasa dalam donasi online di Kitabisa diperbolehkan dalam hukum Islam, karena termasuk dalam kategori akad ija>rah. Pembayaran biaya jasa donasi tidak menyalahi aturan hukum Islam karena tidak ada unsur gharar. Transaksi yang dilakukan telah sesuai dengan aturan hukum Islam dimana kedua belah pihak tidak merasa dirugikan, sehingga dapat mencegah terjadinya perselisihan. Pihak Kitabisa hendaknya memperbaiki akad perjanjian dan memberikan informasi yang jelas mengenai jasa donasi kepada pengguna. Pihak pemilik kampanye dan donatur hendaknya memperhatikan prinsip-prinsip dalam syariat Islam agar tidak terjerumus kepada hal-hal yang dilarang.
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Shepherd, Joanna. "Combating the Prescription Painkiller Epidemic: A National Prescription Drug Reporting Program." American Journal of Law & Medicine 40, no. 1 (March 2014): 85–112. http://dx.doi.org/10.1177/009885881404000103.
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Prescription painkiller abuse is the fastest growing drug problem in the United States. In the past year, approximately one out of twenty Americans reported misuse or abuse of prescription painkillers. Several factors contribute to the prescription painkiller epidemic. Drug abusers use various methods—such as doctor shopping, paying with cash, and filling prescriptions in different states—to avoid detection and obtain prescription painkillers for illegitimate uses. A few rogue physicians and pharmacists, lured by substantial profits, enable drug abusers by illegally prescribing or supplying controlled substances. Even ethical physicians rarely have adequate training to recognize and address prescription drug abuse, and as a result, prescribe painkillers to patients who are not using them for legitimate medical purposes. Similarly, although the majority of pharmacies have taken steps to combat drug abuse and reduce prescription painkiller dispensing, under current reporting systems, pharmacists lack visibility into several important indicators of drug abuse. As a result, even the most vigilant pharmacists find it extremely difficult to identify and detect drug abuse with certainty.While state governments have established prescription drug monitoring programs (PDMPs) to crack down on prescription drug abuse, these programs have proven to be inadequate. The programs currently suffer from inadequate data collection, ineffective utilization of data, insufficient interstate data sharing, and constraints on sharing data with law enforcement and state agencies. By contrast, third-party prescription payment systems run by pharmacy benefit managers (PBMs) or health insurers have been effective in detecting prescription drug abuse. This paper suggests that a national prescription drug reporting program building on existing PBM networks could be significantly more effective than existing state PDMPs in detecting prescription drug abuse.
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Jansen, Florian, Idoia Biurrun, Jürgen Dengler, and Wolfgang Willner. "Vegetation classification goes open access." Vegetation Classification and Survey 1 (May 4, 2020): 1–6. http://dx.doi.org/10.3897/vcs/2020/53445.
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With this inaugural editorial, we introduce Vegetation Classification and Survey (VCS), the new gold open access (OA) journal of the International Association for Vegetation Science (IAVS). VCS is devoted to vegetation classification at any spatial and organisational scale and irrespective of the methodological approach. It welcomes equally case studies and broad-scale syntheses as well as conceptual and methodological papers. Two Permanent Collections deal with ecoinformatics (including the standardised Database Reports published in collaboration with GIVD, the Global Index of Vegetation-Plot Databases) and phytosociological nomenclature (edited in collaboration with the respective IAVS Working Group). We discuss the advantages of OA as well as challenges and drawbacks caused by the way it is currently implemented, namely “pay for flaws” and publication impediments for scientists without access to funding. Being a society-owned journal, editorial decisions in VCS are free from economic considerations, while at the same time IAVS offers significant reductions to article processing charges (APCs) for authors with financial constraints. However, it is recognised that sustainable OA publishing will require that payment systems are changed from author-paid APCs to contracts between the science funding agencies and publishers or learned societies, to cover the production costs of journals that meet both quality and impact criteria. Abbreviations: APC = article processing charge, GIVD = Global Index of Vegetation-Plot Databases, IAVS = International Association for Vegetation Science, JVS = Journal of Vegetation Science, OA = open access, VCS = Vegetation Classification and Survey.
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Wandira, Bertin Ayu, Ketut Suarayasa, and Kadek Viyan Kristiawan. "Management of Post-Disaster Medicine Logistics at the Pharmacy Installation of Regional Public Hospital Undata of Central Sulawesi Province." Journal La Medihealtico 1, no. 2 (July 20, 2020): 21–25. http://dx.doi.org/10.37899/journallamedihealtico.v1i2.116.
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The purpose of this research is to fine out how the management of post-disaster medicine logistics at the Pharmacy Installation of Regional Public Hospital Undata the research. Method used was qualitative with in-depth interview data cullcolection techniques. Research informants were 6 informants who were determined by purposive sampling technique. The results show that the planning of pharmaceutical supplies at Regional Public Hospital Undata used consumtion methods epidemiology. The obstacles to logistical planning for type medicine, a disease tread is changing. Medicine logistics budget in pharmaceutical installations comes from the state budget and BLUD. Procurement of pharmaceutical supplies using the method of direct purchases and E-purchasing, obstacles in the procurement of medicine logistic are still arrears of payment of medicine to distributors. Slow distribution of medicine from distributors and the emtiness of medicine stocks acceptance of pharmaceutical supplies is carried out by the pharmaceutical installation warehouse staff and reception team, there are still obstacles in receiving the time for quality inspection and quantity of logistical goods wich quite long. Medicine logistics storage is carried out with the FIFO and FEFO systems with alphabetical storage arrangements, constraints in logistics storage, narrow IFRS repositories. Medicine logistics control was done by taking inventory to find out the quality and quantity of medicine as well as the medicine expired date, the obstacles in controlling medicine logistics time to take stock of hospitalization takes a long time.
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Souliotis, Kyriakos, Christina Golna, Vasiliki Mantzana, Sotirios Papaspyropoulos, Anastasios Koutsovasilis, and Alexios Sotiropoulos. "Clinical audit as a tool to optimize contracted private healthcare provision: Testing the waters in resource-deprived Greece." SAGE Open Medicine 7 (January 2019): 205031211983873. http://dx.doi.org/10.1177/2050312119838736.
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Background and Aims: Clinical audit is applied to optimize clinical practice and quality of healthcare services while controlling for money spent, critically in resource-deprived settings. This case study reports on the outcomes of a retrospective clinical audit on private hospitalizations, for which reimbursement had been pending by the Health Care Organization for Public Servants (OPAD) in Greece. This case study is the first effort by a social insurance organization in Greece to employ external clinical audit before settling contracted private healthcare charges. Methods: One thousand two hundred hospitalization records were reviewed retrospectively and a fully anonymized clinical audit summary report created for each one of them by a team of clinical audit experts, proposing evidence-based cuts in pending charges where medical services were deemed clinically unnecessary. These audit reports were then collated and analysed to test trends in overcharges among hospitalized insureds per reason for hospitalization. Results: The clinical audit report concluded that 17.4% of a total reimbursement claim of €12,387,702.18 should not be reimbursed, as it corresponded to unnecessary or not fully justifiable according to evidence-based, best practice, medical service provision. The majority of proposed cuts were related to charges for medical devices, which are borne directly by social insurance with no patient or private insurance co-payment. Conclusion: Clinical audit of hospital practice may be a key tool to optimize care provision, address supplier-induced demand and effectively manage costs for national health insurance, especially in circumstances of budgetary constraints, such as in austerity-stricken settings or developing national healthcare systems.
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Ustyugov, Nikita V., and Oleg M. Protalinsky. "Managing the Enterprise Power Consumption Process." Vestnik MEI 3, no. 3 (2021): 96–102. http://dx.doi.org/10.24160/1993-6982-2021-3-96-102.
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Decisions made adopted in an enterprise power system in managing the electric energy consumption are analyzed. The urgency of the subject matter is stemming from the global-wide growth in the demand for electric energy and a systemic increase in the cost of energy resources. The study was carried out at an operating enterprise considered as an organizational and technical system. The subject area boundaries and the types of power engineering structures are determined at the enterprise. The system was decomposed into subsystems with identifying the applied organizational and technical managing/control actions. The power consumption management problem is formulated taking into account the minimization of financial costs, and its solution is found for one element. An algorithm for determining the optimal measure to be taken in the system is proposed, which offers a solution taking into account the specified criterion (financial expenditures for consumed electricity) and constraints (prototype functionality and energy payment budget). The algorithm checks the control actions in the course of system operation, which is the system lifecycle longest part. The structure of the decision making support system for managing the power consumption of an element is developed. The structure determines the sequence of measures to be taken in applying control actions with subsequently verifying the decisions made. Experimental studies were carried out on a system element, which that have demonstrated the practical applicability and financial savings, thereby testifying the possibility of further application of the study results in the power systems of enterprises belonging to all levels.
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Kuznetsov, A. V. "The Regional Role of the Eurasian Development Bank in the Post-Coronavirus World." World of new economy 14, no. 4 (February 1, 2021): 22–32. http://dx.doi.org/10.26794/2220-6469-2020-14-4-22-32.
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Until now, the processes of global regionalisation have not been adequately reflected in the formation of systemic approaches to the management of financial relations within the Eurasian Economic Union. It leads to the search for new financial policy mechanisms necessary to stimulate the economies of the EAEU countries in the context of emerging economic and geopolitical constraints, as well as the creation of the necessary prerequisites for industrial cooperation in the context of anti-Russian sanctions and de-globalisation trends intensified by the COVID-19 pandemic. Currently, the vulnerability of the economies of the EAEU member states is due to their extreme dependence on external extra-regional demand, international capital and technology markets, as well as international settlement and payment systems based on the US dollar. The study is based on a dialectical approach. In conducting the research, we used general scientific methods of analysis, synthesis, generalisation, as well as methods of systemic, historical-logical and comparative analysis. The contradictory nature of the development of the world economy at the present stage was revealed. The role of the EDB in creating conditions for sustainable development of the EAEU member states has been substantiated. Changes in the structure of the EDB’s investment portfolio were analysed. The advantages and disadvantages of the EDB’s current activities in the context of the implementation of the Bank’s Strategy for 2018–2020 were summarised. Comparative characteristics of financing of EDB member countries through multilateral development banks were presented. The impact of the COVID-19 coronavirus pandemic on the current and future activities of the EDB was shown.
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Karelina, E. A. "Opportunities for building effective digital platforms and ecosystems in developing countries." E-Management 3, no. 1 (May 20, 2020): 59–67. http://dx.doi.org/10.26425/2658-3445-2020-1-59-67.
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The factors and opportunities for development of digital ecosystems in developing countries have been analysed. The purpose of the study is to summarize the practice of digitalization of emerging markets and to develop an approach to research of the potential for digital entrepreneurship development in these countries. It has been shown, that there are still many economic constraints that prevent developing countries from integrating effectively into the digital economy. It has been proven, that the effect of digital transformation vectors assists redefining the economic policy of developing countries. Such policy should become trans- and multidisciplinary, more iterative and flexible. In particular, investment promotion methods, rules of origin and other geographical specifications, labor and social policies of the states should be interpreted in a new way. Finally, economic policy should take into account, that many markets are being reoriented to platforms (which, for example, may involve a review of public service delivery policies to take advantage of platforms). It has been substantiated, that the development of digital entrepreneurship in developing countries was largely due to the quality of digital ecosystems, which can be presented as innovation centers, but it is hampered by the uneven development of digital start-ups between countries. It has been concluded, that even with opportunities to build digital platforms and ecosystems in developing countries, their companies can`t scale widely to overseas markets, and catching-up platforms have almost no potential to reach global platforms in the long term. The main factors, limiting the comparative size of platforms and the potential of global platforms in developing countries are weak local economic and business environment, low reliability of payment systems, low technological potential, problems with efficient logistics.
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Gutiérrez Santiago, Pilar. "Mecanismos "alternativos" frente al desahucio hipotecario de la vivienda habitual." Revista Jurídica de la Universidad de León, no. 2 (June 1, 2016): 3. http://dx.doi.org/10.18002/rjule.v0i2.3730.
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<p>La irresponsable y descontrolada vorágine crediticia de los años de bonanza, unida a la crisis económica desatada en 2007-2008, ha desembocado en una avalancha de ejecuciones hipotecarias y en el desahucio de su vivienda habitual de miles de deudores incapaces de hacer frente a sus préstamos. Nuestro legislador, poco preocupado a su debido tiempo de articular mecanismos de <em>prevención</em> del sobreendeudamiento del consumidor de crédito (test de solvencia, información contractual y precontractual, transparencia bancaria), ha tratado luego −cuando el llamado “sinhogarismo” se había ya convertido en una auténtica lacra social− de <em>parchear</em> la situación con medidas <em>ex post</em> (suspensión de lanzamientos, quitas, dación en pago,...) que, en determinados casos, pueden enturbiar algunos postulados básicos del Derecho <em>privado</em>; todo ello sin perjuicio de que, activado el aparato del Estado Social, se hayan también puesto en marcha medidas paliativas de cariz <em>público</em> (prestaciones económicas de urgencia social, bolsas de alquiler social y hasta medidas expropiatorias −declaradas inconstitucionales− del uso temporal de viviendas desocupadas, propiedad de las entidades bancarias).</p><p> </p><p>Con estas premisas, y ante la indiscutible y rabiosa “actualidad” de los sistemas alternativos de resolución de litigios en materia de consumo −moda auspiciada desde la propia Unión Europea−, en este trabajo se deja constancia del limitadísimo, por no decir nulo, papel del <em>arbitraje de consumo</em> en el campo de los desahucios hipotecarios y del relativo grado de éxito de la <em>mediación hipotecaria</em>. A tal fin, se examina cada una de ambas vías extrajudiciales en su proyección particular a los deudores hipotecarios atrapados por la coyuntura económica y en riesgo de perder su vivienda; estudio, cuyo enfoque técnico-jurídico es acompañado de una óptica socio-económica de los costes y riesgos que juegan como incentivos o, por el contrario, y con mayor intensidad, como trabas fácticas a la viabilidad y eficiencia en la práctica de tales mecanismos alternativos. Junto a la normativa estatal en la materia, se atenderá también al Código de Consumo catalán que, llevando el fomento de esos sistemas hasta sus últimos extremos, ha instaurado una (dudosamente constitucional) <em>presunción de sumisión al arbitraje</em> de las entidades que otorgan créditos hipotecarios sobre la vivienda habitual y ha impuesto una<em> mediación obligatoria</em> −de discutible conveniencia− como trámite preceptivo previo al procedimiento judicial de ejecución hipotecaria.</p><p>Irresponsible and uncontrolled credit overfall in years of prosperity, followed by the economic crisis of 2007-2008, it has produced an avalanche of foreclosures and eviction from his habitual housing of thousands of debtors unable to pay their loans. Our legislator did not regulate timely mechanisms for the <em>prevention</em> of over-indebtedness consumer credit (solvency tests, pre-contractual and contractual information, bank transparency), and he has tried after −when the so-called “homelessness” has become a serious social problem− relieve the situation with <em>ex post</em> measures (suspension of eviction, debt reduction, payment with housing,...) which, in certain cases, may jeopardize some basic principles of <em>private</em> law; but also, based on the system of social state, have launched mitigation measures in this <em>public</em> order (economic benefits of social urgency, social rents and even expropriatory measures −declared unconstitutional− temporary use of housing unoccupied, property of banks).</p><p> </p><p>From these premises, and at the obvious “fashion” of alternative dispute resolution systems in the field of consumer -fashion sponsored from the European Union-, this paper explains the very little, or none, paper <em>consumer arbitration</em> in the field of mortgage foreclosures and the relative success of the <em>mortgage mediation</em>. For that, I examined each of the two-judicial procedures in their particular application to mortgage debtors at risk of becoming homeless; study, whose technical and legal approach is accompanied by a socio-economic point of costs and risks playing as incentives or, on the contrary, and with greater intensity, as factual obstacles to the viability and efficiency in practical of such alternative mechanisms. In addition to state regulations, also study the Consumer Code of Cataluña that, with excessive promotion of these systems, he has established a (questionably constitutional) <em>presumption of submission to arbitration </em>of institutions providing mortgage credit housing and imposed a <em>mandatory mediation</em> −whose desirability is debatable− as a prerequisite for the judicial mortgage foreclosure process.</p>
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SHVETS, Alexander. "MODERN ASPECTS OF LABOR MARKET REGULATION: THEORETICAL AND METHODOLOGICAL CONTEXT." Ukrainian Journal of Applied Economics 4, no. 3 (August 30, 2019): 350–58. http://dx.doi.org/10.36887/2415-8453-2019-3-38.
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Introduction. The current trends in the development of socio-economic systems in a globalization dimension lead to an update of the labor market regulation system. In today's conditions in Ukraine, the expectations of the population to improve well-being and quality of life are linked to the exercise of the right to decent work. Reforming labor market regulation processes should ensure both the current internal needs of Ukrainian society and the realization of its European integration priorities. The purpose of the research is to develop modern principles of methodological basis of labor market regulation. Results. Current conditions of Ukrainian economy as a social and economic system have been defined as a crisis. The content of labor market regulation is considered. It is determined that the mechanism of the labor market regulation is a set of normative, legislative or collective agreements, which are guided by partners in the implementation of employment policy. The mechanism of labor market regulation covers the list of economic, social, psychological factors that determine the functioning of the labor market. The mechanism of labor market regulation in the conditions of socio-economic crisis should cover the purpose, agents, objects, subject of investigation, functional support of the goal realization, principles, methods (means), instruments of influence. The purpose of regulating the labor market is related to its state regulation. It is established that objects of state regulation of the labor market are the processes and conditions of functioning and reproduction of the labor force, employment of the population and its individual groups, to which the organizational, coordination and stimulating activity of the relevant subjects of state power structures, the system of labor organization (conditions, regulation, payment, etc.). The objective is clearly defined proportions of government regulation, self-regulation and contractual regulation, substantiation of the limit level of state intervention in issues of employment and social protection of the unemployed. The subjects are represented by the authorities, individuals and legal entities, trade unions, associations and all other participants in labor relations. The object of the mechanism is the social-labor relations between the employee and the employer, as well as the processes and conditions of the labor market. Between subjects and objects should be social dialogue. The subject is seen as problems and contradictions of functioning of the labor market at all levels. Groups of regulatory methods include administrative, informational, economic and organizational-managerial. The functions of the mechanism are represented by planning, motivation, organization and control. The list of general, special principles and principles of the systematic approach of the state regulatory policy in the labor market is given. Keywords: labor market, economic activity of the population, employment of the population, employment level, regulation of the labor market, mechanism of regulation, labor resources.
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Brocklehurst, Paul, Stephen Birch, Ruth McDonald, Harry Hill, Lucy O’Malley, Richard Macey, and Martin Tickle. "Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study." Health Services and Delivery Research 4, no. 22 (July 2016): 1–118. http://dx.doi.org/10.3310/hsdr04220.
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BackgroundMaximising health gain for a given level and mix of resources is an ethical imperative for health-service planners. Approximately half of all patients who attend a regular NHS dental check-up do not require any further treatment, whereas many in the population do not regularly attend. Thus, the most expensive resource (the dentist) is seeing healthy patients at a time when many of those with disease do not access care. Role substitution in NHS dentistry, where other members of the dental team undertake the clinical tasks previously provided by dentists, has the potential to increase efficiency and the capacity to care and lower costs. However, no studies have empirically investigated the efficiency of NHS dental provision that makes use of role substitution.Research questionsThis programme of research sought to address three research questions: (1) what is the efficiency of NHS dental teams that make use of role substitution?; (2) what are the barriers to, and facilitators of, role substitution in NHS dental practices?; and (3) how do incentives in the remuneration systems influence the organisation of these inputs and production of outputs in the NHS?DesignData envelopment analysis was used to develop a productive efficiency frontier for participating NHS practices, which were then compared on a relative basis, after controlling for patient and practice characteristics. External validity was tested using stochastic frontier modelling, while semistructured interviews explored the views of participating dental teams and their patients to role substitution.SettingNHS ‘high-street’ general dental practices.Participants121 practices across the north of England.InterventionsNo active interventions were undertaken.Main outcome measuresRelative efficiency of participating NHS practices, alongside a detailed narrative of their views about role substitution dentistry. Social acceptability for patients.ResultsThe utilisation of non-dentist roles in NHS practices was relatively low, the most common role type being the dental hygienist. Increasing the number of non-dentist team members reduced efficiency. However, it was not possible to determine the relative efficiency of individual team members, as the NHS contracts only with dentists. Financial incentives in the NHS dental contract and the views of practice principals (i.e. senior staff members) were equally important. Bespoke payment and referral systems were required to make role substitution economically viable. Many non-dentist team members were not being used to their full scope of practice and constraints on their ability to prescribe reduced efficiency further. Many non-dentist team members experienced a precarious existence, commonly being employed at multiple practices. Patients had a low level of awareness of the different non-dentist roles in a dental team. Many exhibited an inherent trust in the professional ‘system’, but prior experience of role substitution was important for social acceptability.ConclusionsBetter alignment between the financial incentives within the NHS dental contract and the use of role substitution is required, although professional acceptability remains critical.Study limitationsOutput data collected did not reflect the quality of care provided by the dental team and the input data were self-reported.Future workFurther work is required to improve the evidence base for the use of role substitution in NHS dentistry, exploring the effects and costs of provision.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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King, Michael W. "Health Care Efficiencies." American Journal of Law & Medicine 43, no. 4 (November 2017): 426–67. http://dx.doi.org/10.1177/0098858817753407.
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Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease,1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain.2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation.Fundamentally, what is the best way to reduce U.S. health care spending, while improving the patient experience of care in terms of quality and satisfaction, and driving better patient health outcomes? Mergers, partnerships, and consolidation in the health care industry, new care delivery models like Accountable Care Organizations and integrated care systems, bundled payments, information technology, innovation through new drugs and new medical devices, or some combination of the foregoing? More importantly, recent ambitious reform efforts fall short of a cohesive approach, leaving fundamental internal inconsistencies across divergent arms of the federal government, raising the issue of whether the U.S. health care system can drive sufficient efficiencies within the current health care and antitrust regulatory environments.While debate rages on Capitol Hill over “repeal and replace,” only limited attention has been directed toward reforming the current “fee-for-service” model pursuant to which providers are paid for volume of care rather than quality or outcomes. Indeed, both the Patient Protection and Affordable Care Act (“ACA”)3 and proposals for its replacement focus primarily on the reach and cost of providing coverage for health care, rather than specifics for the delivery of health care.4 With the U.S. expenditures on health care producing inferior results, experts see consolidation and alternatives to fee-for-service as fundamental to reducing costs.5 Integrating care coordination and delivery and increasing scale to drive efficiencies allows organizations to benefit from shared savings and relationships with payors and vendors.6 Deloitte forecasts that, by 2024, the current health system landscape—which includes roughly 80 national health systems, 275 regional systems, 130 academic medical centers, and 1,300 small community systems—will morph into just over 900 multi-hospital systems.7Even though health care market and payment reforms encourage organizations to consolidate and integrate, innovators must proceed with extreme caution. Health care organizations attempting to drive efficiencies and bring down costs through mergers may run afoul of numerous federal and state laws and regulations.8 Calls for updates or leniency in these laws are growing, including the possible recognition of an “Obamacare defense” to antitrust restrictions9 and speculation that laws restricting physicians from having financial relationships will be repealed, ostensibly to allow sharing of the rewards reaped from coordinated care.10 In the meantime, however, absent specific waivers or exemptions, all the usual rules and regulations apply, including antitrust constraints,11 physician self-referral12 and anti-kickback laws and regulations,13 state fraud and abuse restrictions,14 and more. In short, a maelstrom of conflicting political prescriptions, health care regulations, and antitrust restrictions undermine the ability of innovators to achieve efficiencies through joint ventures, transactions, innovative models, and other structures.This article first considers the conflicting positions taken by the United States government with respect to achieving efficiencies in health care under the ACA and alternative delivery models, on the one hand, and health care regulatory enforcement and antitrust enforcement, on the other. At almost a fifth of the U.S. economy,15 health care arguably has grown ungovernable, exceeding the ability of any one law or branch of government to create or implement coherent reform. Indeed, the article posits that although the ACA reformed and expanded access to health care, it failed to transform the way health care is delivered beyond limited “demonstration projects”, leaving fee-for-service intact. Nonetheless, even with limited rather than revolutionary goals, the ACA still lacks sufficient authority across disparate branches of government to achieve its stated goals. The article then examines the conflicting positions of the various United States regulatory schemes and enforcement agencies governing health care, and whether they can be reconciled with the stated goal of the government, often referred to as the “Triple Aim”:16 improving quality of care, improving population health, and lowering health care costs. It examines fundamental, systemic challenges to achieving the “Triple Aim”: longstanding health care regulatory laws that impede adoption of innovative delivery systems beyond their current “demonstration project” status, and antitrust enforcement that promotes waste and duplication in densely populated areas, while preventing necessary consolidation to more efficiently reach rural areas. The article concludes with recommendations for promoting efficiency through modest reconciliation of the conflicting goals and regulations in health care.