Since 2020, China has piloted an innovative payment method known as the Diagnosis-Intervention Packet (DIP). This study aimed to assess the impact of the DIP on inpatient volume and bed allocation ...and their regional distribution. This study investigated whether the DIP affects the efficiency of regional health resource utilization and contributes to disparities in health equity among regions.BACKGROUNDSince 2020, China has piloted an innovative payment method known as the Diagnosis-Intervention Packet (DIP). This study aimed to assess the impact of the DIP on inpatient volume and bed allocation and their regional distribution. This study investigated whether the DIP affects the efficiency of regional health resource utilization and contributes to disparities in health equity among regions.We collected data from a central province in China from 2019 to 2022. The treatment group included 508 hospitals in the pilot area (Region A, where the DIP was implemented in 2021), whereas the control group consisted of 3,728 hospitals from non-pilot areas within the same province. We employed the difference-in-differences method to analyze inpatient volume and bed resources. Additionally, we conducted a stratified analysis to examine whether the effects of DIP implementation varied across urban and rural areas or hospitals of different levels.METHODSWe collected data from a central province in China from 2019 to 2022. The treatment group included 508 hospitals in the pilot area (Region A, where the DIP was implemented in 2021), whereas the control group consisted of 3,728 hospitals from non-pilot areas within the same province. We employed the difference-in-differences method to analyze inpatient volume and bed resources. Additionally, we conducted a stratified analysis to examine whether the effects of DIP implementation varied across urban and rural areas or hospitals of different levels.Compared with the non-pilot regions, Region A experienced a statistically significant reduction in inpatient volume of 14.3% (95% CI 0.061-0.224) and a notable decrease of 9.1% in actual available bed days (95% CI 0.041-0.141) after DIP implementation. The study revealed no evidence of patient consultations shifting from inpatient to outpatient services due to the reduction in hospital admissions in Region A after DIP implementation. Stratified analysis revealed that inpatient volume decreased by 12.4% (95% CI 0.006-0.243) in the urban areas and 14.7% in the rural areas of Region A (95% CI 0.051-0.243). At the hospital level, primary hospitals experienced the greatest impact, with a 19.0% (95% CI 0.093-0.287) decline in inpatient volume. Furthermore, primary and tertiary hospitals experienced significant reductions of 11.0% (95% CI 0.052-0.169) and 8.2% (95% CI 0.002-0.161), respectively, in actual available bed days.RESULTSCompared with the non-pilot regions, Region A experienced a statistically significant reduction in inpatient volume of 14.3% (95% CI 0.061-0.224) and a notable decrease of 9.1% in actual available bed days (95% CI 0.041-0.141) after DIP implementation. The study revealed no evidence of patient consultations shifting from inpatient to outpatient services due to the reduction in hospital admissions in Region A after DIP implementation. Stratified analysis revealed that inpatient volume decreased by 12.4% (95% CI 0.006-0.243) in the urban areas and 14.7% in the rural areas of Region A (95% CI 0.051-0.243). At the hospital level, primary hospitals experienced the greatest impact, with a 19.0% (95% CI 0.093-0.287) decline in inpatient volume. Furthermore, primary and tertiary hospitals experienced significant reductions of 11.0% (95% CI 0.052-0.169) and 8.2% (95% CI 0.002-0.161), respectively, in actual available bed days.Despite efforts to curb excessive medical service expansion in the region following DIP implementation, large hospitals continue to attract a large number of patients from primary hospitals. This weakening of primary hospitals and the subsequent influx of patients to urban areas may further limit rural patients' access to medical services. The implementation of the DIP may raise concerns about its impact on health care equality and accessibility, particularly for underserved rural populations.CONCLUSIONSDespite efforts to curb excessive medical service expansion in the region following DIP implementation, large hospitals continue to attract a large number of patients from primary hospitals. This weakening of primary hospitals and the subsequent influx of patients to urban areas may further limit rural patients' access to medical services. The implementation of the DIP may raise concerns about its impact on health care equality and accessibility, particularly for underserved rural populations.
Tipping behavior is a vital way for waiting staff to enhance their wages, and for managers to monitor guest satisfaction. Despite its importance, there is not yet an established consensus on reasons ...why people tip. Our lack of understanding about tipping behavior is exacerbated by a strong reliance on studies conducted in countries that have a system of voluntary tipping (e.g., the United States). The study aims therefore at expanding our understanding of tipping behavior beyond voluntary tipping countries and more specifically explaining tipping behavior under service-inclusive pricing. Data obtained from 1458 guests in five European countries show that income and payment method are the strongest predictors of customers' decision to tip, whereas bill size is the most robust predictor of tip amount. Results advance knowledge by suggesting that social norm theory plays a major role to understand tipping behavior in service-inclusive pricing.
PurposeThe primary aim of this study is to resolve a longstanding debate concerning the impact of takeover premiums on post-acquisition performance. Specifically, we aim to examine how acquirers' ...marketing capabilities and payment methods moderate the relationship between takeover premiums and post-acquisition performance.Design/methodology/approachThis study employs linear regression to examine the relationship between acquirers' marketing capabilities, payment methods, takeover premiums and post-acquisition performance in the Chinese manufacturing industry. Data for the analysis were collected from both mergers and acquisition (M&A) announcements and the China Stock Market & Accounting Research Database (CSMAR), covering 1,169 acquisitions from 2012 to 2021.FindingsThe results indicate that acquirers' marketing capabilities moderate the impact of takeover premiums on post-acquisition performance. When acquirers possess strong marketing capabilities, takeover premiums increase post-acquisition performance. Conversely, when acquirers lack strong marketing capabilities, takeover premiums are not significantly related to post-acquisition performance. Additionally, it is noteworthy that takeover premiums show a positive correlation with post-acquisition performance, irrespective of the payment methods employed by acquirers for target firms.Originality/valueGiven that takeover premiums are essential for acquiring resources from target firms, it is crucial to maximize the value of these acquired resources. Our findings suggest that acquirers with weaker marketing capabilities before the deal should consider a more conservative approach to pricing target firms.
► Bus congestion depends on frequency, demand and the fare payment technique. ► Bus congestion decreases optimal frequency while fare and bus capacity increase. ► An off-board fare payment system is ...the most cost effective in most cases. ► Optimal infrastructure investment and running speed grow with logarithm of demand.
Microeconomic optimisation of scheduled public transport operations has traditionally focused on finding optimal values for the frequency of service, capacity of vehicles, number of lines and distance between stops. In addition, however, there exist other elements in the system that present a trade-off between the interests of users and operators that have not received attention in the literature, such as the optimal selection of a fare payment system and a designed running speed (i.e., the cruising speed that buses maintain in between two consecutive stops). Alternative fare payment methods (e.g., on-board and off-board, payment by cash, magnetic strip or smart card) have different boarding times and capital costs, with the more efficient systems such as a contactless smart card imposing higher amounts of capital investment. Based on empirical data from several Bus Rapid Transit systems around the world, we also find that there is a positive relationship between infrastructure cost per kilometre and commercial speed (including stops), achieved by the buses, which we further postulate as a linear relationship between infrastructure investment and running speed. Given this context, we develop a microeconomic model for the operation of a bus corridor that minimises total cost (users and operator) and has five decision variables: frequency, capacity of vehicles, station spacing, fare payment system and running speed, thus extending the traditional framework. Congestion, induced by bus frequency, plays an important role in the design of the system, as queues develop behind high demand bus stops when the frequency is high. We show that (i) an off-board fare payment system is the most cost effective in the majority of circumstances; (ii) bus congestion results in decreased frequency while fare and bus capacity increase, and (iii) the optimal running speed grows with the logarithm of demand.
•Acquirers with strong union power tend to pay target firms by cash.•The effect is stronger when the interests of managers and shareholders are aligned.•Acquirers with strong union power experience ...positive announcement return, lower labor strikes, higher wage concessions, and no decline in operating performance.
Acquirers facing strong union power tend to acquire target firms with cash rather than equity or a mix of cash and equity. A one standard deviation increase in the union power faced by the acquirer increases the odds of choosing cash payment by a factor ranging from 1.26 to 1.57. The effect is stronger when: the acquiring firm is located in states without the right-to-work laws; the interests of managers are more aligned with shareholders in acquiring firms; and acquiring firms’ asset specificity is high. When union power is strong, acquirers making cash payment are associated with a significantly positive announcement return. In addition, they are less likely to experience labor strikes or declines in operating performance, and more likely to obtain wage concessions in collective bargaining in the post-acquisition period than acquirers using other methods of payment. These findings suggest that cash payment allows acquirers to reduce excess liquidity and strengthen their bargaining power with unions.
The transformation from the retrospective to the prospective payment system is significant to improve the quality of public healthcare (QPH). This article used the quasi-natural experiment of the ...global budget payment reform of government (GBPRG) in Chengdu, adopted the difference in difference (DID) method to estimate the effect of the GBPRG on the QPH, and concluded that GBPRG has a significant positive impact on the healthcare outcome and has a significant effect on improving the QPH. Policy implications drawn from the results show that the government should continue to explore compound healthcare insurance payment method (HIPM), improve the governance capabilities of the government, reduce transaction costs, improve healthcare insurance reimbursement policies, adjust the proportion of healthcare insurance reimbursements, continuously optimize the allocation of healthcare resources, establish an incentive mechanism to improve the QPH, and realize the pareto optimal choice of healthcare resource allocation.
How consumers pay influences how they feel about a transaction. In particular, paying by card has been argued to have an effect on the perception of cost, making it less salient and painful. We ...propose and show that payment method also influences how consumers feel about the acquired good. Specifically, we focus on effects of the payment method on psychological ownership, i.e., the perception of an object as "mine." We propose that cash payment results in stronger psychological ownership because it influences the extent of perceived investment in an object. We provide evidence for the proposed effect from field and laboratory settings. Results of a longitudinal exit survey and an experiment show that cash payers report higher levels of immediate psychological ownership than card payers. However, this effect seems to depend on the meanings associated with a payment method. Asian students (who associate credit card payment with investment and debt) do not exhibit this effect. Moreover, the initial boost in psychological ownership seems to be comparably short-lived. While those paying in cash experience no further increase in psychological ownership over time, those paying by card do.
Introduction: The number of dental services provided is related to the type of services needed by a population and treatment decision making by dentists. This descriptive study aimed to compare the ...dental service mix in two different payment systems. Methods: The dental records of a long-established dental clinic were reviewed. Treatment performed, during October 2018 and October 2019, by 36 dentists, 12 dentists worked in both payment method periods, 12 of them worked only in salary, and 12 of them worked in fee for service (FFS) period. Results: Preventive dental services and practices without treatment (visits, diagnostic radiography, and referrals) decreased, and practices included aggressive treatments (randomized controlled trial, extraction, and crown) and highly aggressive procedure (surgery) increased from salary to FFS period. The total activities of dentists were higher in FFS. Conclusion: According to our results, in a salary system, the dentist was more likely to refer and perform preventive treatments, whereas in the FFS payment system, the dentists choose more aggressive treatments. Payment method may change dental service mix.
Abstract
Business capital and revenue are not only the decisive of the health of SMEs but also they must be balanced. In general, customers find their benefit from the flexible payment methods while ...on the other hand the SMEs should get their benefit too. So that, it needs to be studied whether it is necessary for SMEs to get their profit in accordance to this situation. One of the methods that suitable to be applied is by applying customer groupings based on revenue and payment namely the K-means clustering method since it can raise several groups that have not been known before. This information is useful for SMEs to be utilized based on their needs. Data in this study were gathered from customer attributes, number of transactions, and payment methods. The number of centroids was 3. The grouping results were stopped at the 5
th
iteration. The finding showed that the ratio value of the 4
th
iteration and the 5
th
iteration having the same ratio value, 0.07393. From the results of the iterations can be found; first, based on the customers’ number, the groups can be classified into three C1(18%), C2 (45%), C3 (36%). Second, based on the average number of transactions, post-paid payments was in the first rank (12.7 / week). From the results, it can be analyzed that this situation is burdensome for SMEs because the more the number of transactions, the more investment must be prepared for accounts receivable.
It is believed that the payment method to dentists may affect their treatment decisions. Although payment systems may enhance job satisfaction, reduce the costs, and make better treatment decisions, ...there is little information about how to achieve these objectives. The aim of the present study was to survey the payment methods and the related factors in dental clinics of Tehran.
Using the latest list published by the Iranian Ministry of Health, we visited all dental clinics located in Tehran, and used a checklist to collect the data of the type of management, geographical location of the clinic in Tehran, payment method and its amount, history of payment method changes in the last decade, relationship between the amount of payment and the position of technical supervisor dentist, any difference in the amount of payment to male and female dentists and to young and experienced dentists. Then, the relationship between the amount of payment and the above-mentioned variables was investigated.
The governmental sector tends to use fixed salary methods and the private sector usually uses the fee-for-service (FFS) method. Geographical location, type of management, date of establishment, and having the position of technical supervisor dentist had a significant relationship with the amount of payment. The dentist's gender and years of experience did not have any relationship with the amount of payment.
According to the results of the present study, the method and amount of payment to dentists were related to the date of clinic establishment, having the position of technical supervisor dentist, and geographical location of the clinic. These factors could be considered as the main elements in balancing costs in clinics and improving job satisfaction among dentists.
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