In The Netherlands, the remuneration system for GPs changed in 2006. Before the change, GPs received a capitation fee for publicly insured patients and fee for service (FFS) for privately insured ...patients. In 2006, a combined system was introduced for all patients, with elements of capitation as well as FFS. This created a unique opportunity to investigate the effects of the change in the remuneration system on contact type and consultation length. Our hypothesis was that for former publicly insured patients the change would lead to an increase in the proportion of home visits, a decrease in the proportion of telephone consultations and an increase in consultation length relative to formerly privately insured patients. Data were used from electronic medical records from 36 to 58 Dutch GP practices and from 532,800 to 743,961 patient contacts between 2002 and 2008 for contact type data. For consultation length, 1,994 videotaped consultations were used from 85 GP practices in 2002 and 499 consultations from 16 GP practices in 2008. Multilevel multinomial regression analysis was used to analyse consultation type. Multilevel logistic and linear regression analyses were used to examine consultation length. Our study shows that contact type and consultation length were hardly affected by the change in remuneration system, though the proportion of home visits slightly decreased for privately insured patients compared with publicly insured patients. Declaration behaviour regarding telephone consultations did change; GP practices more consistently declared telephone consultations after 2006.
Según lo previsto en la normativa interna, cada año en el cabildo catedral de Toledo se repartía entre los canónigos y racioneros el superávit o excedente de tesorería del refitor, la oficina que ...gestionaba el acervo de rentas más importante de la Corporación. Esta misma costumbre existía en otros cabildos hispánicos y en las universidades. En este último caso era frecuente que se repartiera el superávit entre el arca de la fundación y los catedráticos.
El reparto del superávit entre los prebendados de los cabildos catedrales resulta un tema de investigación novedoso. Su interés está justificado inicialmente por la curiosidad que puede suscitar este comportamiento económico tan cercano a los modernos sistemas de retribución utilizados en la empresa y que ponen de manifiesto la preocupación de la corporación por preservar los intereses económicos de sus miembros. A este respecto, podemos decir que la producción bibliográfica es escasa. Únicamente existen ciertas referencias en trabajos de contenidos distintos, que tratan de cuestiones relativas a la norma interna, constituciones o estatutos de estas corporaciones.
El trabajo que aquí presentamos analiza el origen del superávit del refitor de la Catedral de Toledo, la forma de reparto y su objeto, así como su evolución durante el siglo XVI. De su análisis concluiremos que el incremento de los ingresos de este departamento no fue empleado en aumentar los gastos, como era costumbre, sino en consolidar el excedente de tesorería para su reparto entre los prebendados, al objeto de potenciar la asistencia al coro, siguiendo la doctrina de concilio de Trento. Así, dicho complemento retributivo premiaba la productividad en el servicio cultual del personal ya existente, evitando comprometer a largo plazo recursos en la dotación de nuevas plazas.
One-piece flow is one of the effective tools of lean production. Many garment enterprises expect to implement it in their own enterprises, but a lot of difficulties exist in the implementation ...process. In this paper, it takes an example of a well-known processing enterprise and to study the one-piece flow implementation process of a pair of jeans pipeline. By nearly a year of tracking and research, the paper systematically summarizes the pre-production preparation and production maintenance in the implementation of the One-piece flow. It demonstrates in detail on how to achieve the improvement of the hardware, software and personnel in order to reach the requirement of one-piece flow. Then, it systematically discusses the wage system of one-piece flow and will provide a theoretical and practical basis for the implementation of a single-piece flow production.
The concepts "standard of living" and "quality of life" play an essential role in society. They are indicators of assessing the socio-economic situation in a country. In the paper the model the ...dynamics of living standards which makes it possible to substantiate management decisions on the formation of a remuneration system at enterprises, taking into account the financial security of employees is developed. The use of the model showed that the financial indicators of the salary system effectiveness at enterprises do not reflect its adequate impact on the living standard of employees. Namely, the positive tendencies of an increase in average salary and an increase in the salary bill do not fully ensure an increase in the level indicator reflecting the volume of consumption of basic food products. This is due to the fact that the level of the real salary index is insufficient to fully meet the needs of employees.
La «petite corruption» est un élément important de la relation entre personnels de santé et patients dans les contextes propices aux actes de corruption. Ce phénomène bien étudié en Europe centrale ...et orientale sous le nom de «paiements informels» (PIs), est peu documenté en Afrique. Pour contribuer à combler cette lacune, cette thèse propose une série d'analyses sur certains aspects clés de ce problème dans le contexte africain. Dans le chapitre 1, nous montrons que les PIs sont concentrés sur les plus pauvres. Ils sont plus susceptibles d’avoir fait face à l'absence de médicaments, à l'absentéisme des médecins et à des longs temps d'attente dans leur hôpital public local, ce qui accroît la probabilité d'encourir des frais non officiels. Une analyse plus approfondie de l'influence des facteurs d'offre dans le chapitre 2 confirme que les longs temps d'attente, la gestion du personnel de santé (par exemple, le recours à la délégation de tâches) et la perception des personnels vis-à-vis de leur revenu jouent un rôle crucial. Le chapitre 3 met en évidence l’existence d’effets de pairs dans la survenue des PIs lors de la consultation, l’effet étant plus important chez les plus pauvres. Enfin, avec un modèle théorique dans le chapitre 4, nous montrons qu’à l'équilibre, les PIs sont plus élevés en salariat pur qu’avec une rémunération basée sur la production. Aussi, une augmentation du paiement unitaire dans ce dernier système fait baisser les PIs, alors qu'une augmentation du salaire a un effet contraire. Un système mixte (salaire + rémunération à la production) semble être approprié pour assurer la participation des médecins et les inciter à réduire la recherche de rente.
« Petty corruption » is an important feature of the relationship between health workers and patients in settings that allow corrupt acts to happen. It has been well studied in Central and Eastern Europe under the term « informal payments » (IPs), but little has been done in Africa. To contribute in filling this gap in the literature, this thesis proposes a series of analyses to better understand some key aspects of this issue in the African context. In chapter 1, we show that the occurrence of IPs is concentrated on the poorest individuals. They are more likely to report having faced the lack of medicines, absenteeism of doctors and long waiting times in their local hospital, and these factors significantly increase the probability of incurring unofficial fees. In chapter 2, a deeper analysis of the influence of supply factors confirms that long waiting times, the management of the health workforce (e.g. using task shifting) and health workers’ perception vis-à-vis their earnings play a crucial role. In chapter 3, we highlight the existence of peer effects in the occurrence of IPs during consultation for HIV care, with a higher effect for the poorest patients. Finally, with a theoretical model in chapter 4, we show that at the equilibrium, the level of IPs is higher when the physician is paid by salary compared to output-based remuneration. Also, an increase of the unit payment in the later system leads to a reduction of IPs, while an increase of salary has the contrary effect. A blended remuneration (mix of salary and output-based remuneration) appears to be appropriate to both ensure the participation of physicians and introduce incentives to reduce rent-seeking.
Abstracts: The level of wages is an important indicator for the population life quality and for the socio-economic development of the country. Problems related to considered remuneration have been ...studied throughout the whole existence of economic science and are still relevant today, in particular for Russia, where there is a generally insufficient level of wages. Insufficient pay for production workers does not improve the quality of human capital and hinders the intellectualization of industry. In this paper we consider the possibility of evaluating the effectiveness of the wage system, its conformity with the production level of the industry of enterprise functioning. It is important to correlate the level of payment and the efficiency of use of human capital. It is considered that in order to improve the employee's life quality it is necessary that the wage system not only meets their needs, but also corresponds to the industry level. That is why the authors suggest the approach, on the basis of which it is possible to assess the efficiency of the wage system with the help of rating tools. The research is based on mathematical and sociological methods. It allows you to rank enterprises in the rating and identify their weaknesses. The scope of research in the field of application of human resources technologies, human capital and labor relations makes it possible to develop an evaluation algorithm that allows to assess the adequacy of wages, as well as to develop steps to increase employee satisfaction at the expense of non-economic sources, while preventing the reduction of the final efficiency of the enterprise. Separately, it is worth noting the possibility of comparing the effectiveness of human and intellectual capital as a whole with the rating obtained. Qualitative analysis of the national economy sectors will allow further development of recommendations on changes in the wage system at enterprises and will give an idea of regional distribution of enterprises by the level of salary efficiency.
A declining birth rate and an aging population has become an issue in the Japanese medical industry. Because of this situation, a revision of the medical remuneration system was performed in April, ...2006. It had a severe impact on rehabilitation. We tried to establish a system of treatment at patients' own expense in our hospital, an institution authorized under Article 42 of the medical law. Our new rehabilitation system was called a post-rehabilitation course (post-rehab course). We have prepared five post-rehab courses. They consist of a maintenance adjustment course, a function improvement course, a basic course, a general course and a special course. Users pay a fee to register on a post-rehab course. A user must take our counseling. If registration and counseling are complete, we perform rehabilitation. For 1.5 months until September 30, 45 and 117 persons registerd for rehabilitation and were treated. The burden of expense is big for a person on a low income. In medical facilities, it is important to create rehabilitation systems that are not influenced by a change in the insurance regime.
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