Surgical site infections (SSIs) may increase health care costs, but few studies have conducted an analysis from the perspective of hospital administrators.
To determine the change in hospital profit ...due to SSIs.
Retrospective study of data from January 1, 2007, to December 31, 2010.
The study was performed at 4 of The Johns Hopkins Health System acute care hospitals in Maryland: Johns Hopkins Bayview (560 beds); Howard County General Hospital (238 beds); The Johns Hopkins Hospital (946 beds); and Suburban Hospital (229 beds).
Eligible patients for the study included those patients admitted to the 4 hospitals between January 1, 2007, and December 31, 2010, with complete data and the correct International Classification of Diseases, Ninth Revision code, as determined by the infection preventionist. Infection preventionists performed complete medical record review using National Healthcare Safety Network definitions to identify SSIs. Patients were stratified using the All Patient Refined Diagnosis Related Groups to estimate the change in hospital profit due to SSIs.
Surgical site infections.
The outcomes of the study were the difference in daily total charges, length of stay (LOS), 30-day readmission rate, and profit for patients with an SSI when compared with patients without an SSI. The hypothesis, formulated prior to data collection, that patients with an SSI have higher daily total costs, a longer LOS, and higher 30-day readmission rates than patients without an SSI, was tested using a nonpaired Mann-Whitney U test, an analysis of covariance, and a Pearson χ2 test. Hospital charges were used as a proxy for hospital cost. RESULTS The daily total charges, mean LOS, and 30-day readmission rate for patients with an SSI compared with patients without an SSI were $7493 vs $7924 (P = .99); 10.56 days vs 5.64 days (P < .001); and 51.94 vs 8.19 readmissions per 100 procedures (P < .001). The change in profit due SSIs was $2 268 589.
The data suggest that hospitals have a financial incentive to reduce SSIs, but hospitals should expect to see an increase in both cost and revenue when SSIs are reduced.
Before a strategy can be developed, the problem it is supposed to address needs to be formulated. We establish the microfoundations of strategic problem formulation by developing a theory that ...predicts a core set of impediments to formulation that arise when complex, ill-structured problems are addressed by heterogeneous teams. These impediments fundamentally constrain and narrow problem formulation, thereby limiting solution search and potential value creation. We establish these impediments as a set of design goals, which, if remedied by an appropriately constructed mechanism, can expand problem formulation to be more comprehensive. Finally, we consider how organizations can improve problem formulation by creating a structured process that satisfies the theoretically derived design goals and detail a specific example of this mechanism (collaborative structured inquiry).
Conceiving of stock options as providing CEOs with cues for the possibility of both greater prospective wealth and losses to current wealth, we revisit predictions of the behavioral effects of ...equity-based pay using the behavioral agency model (BAM). We refine the BAM's original formulation and provide an explanation for previous conflicting empirical results by theorizing that the anticipation of prospective wealth attenuates the negative effect of accumulated current equity wealth upon CEO strategic risk taking. In doing so, we offer an advancement of the dialectic between: (1) classical agency scholars, arguing that equity-based pay leads to more risk taking, and (2) behavioral scholars, arguing that equity wealth creates risk bearing, leading to less risk taking. We also suggest that the influences of prospective wealth and current wealth on strategic risk taking depend on the extent to which agents can manage the risk inherent in their compensation package and agent vulnerability to losses. Formal hypotheses to test these expectations are made by focusing on equity-based compensation. Our findings offer strong support for these theoretical expectations.
In today's rapidly changing economic landscape, financial resilience has become increasingly important especially for public sector organizations. This study investigates the impact of e-government ...adoption and social support on individuals' financial resilience in Indonesia, with a focus on the mediating role of financial management skills. A quantitative research methodology was employed, and 348 complete and suitable questionnaires from individuals in the financial department in local government in Indonesia were analyzed using SmartPLS 4.0 software. The results indicate a significant relationship between e-government adoption and financial management skills, suggesting that digitizing government services contributes to improved financial resilience. Additionally, social support was found to have a positive impact on financial management skills, supporting the notion that social networks provide resources and support for financial well-being. Financial management skills were also found to be significantly associated with financial resilience, indicating that individuals with strong financial management skills are better equipped to adapt to changing circumstances. While the mediating effect of financial management skills between e-government adoption and financial resilience was not significant, it was significant in the relationship between social support and financial resilience. These findings provide insights into the factors that enhance financial resilience in an increasingly digitized society and inform strategies to promote financial well-being in Indonesia.
This study aims to determine, from the perspective of investors, the factors that predict Islamic unit trust (IUT) investment intentions. Additionally, this paper examines the moderating effect of ...fintech self-efficacy (FSE) on the relationship between attitude and investment intention. A total of 392 data were collected from IUT investors in Malaysia and analyzed using partial least squares structural equation modeling. The findings reveal that subjective norms have the highest impact on investment intention, followed by attitude and FSE, while religiosity is not significantly associated with investment intention in Islamic unit trust funds. Attitude significantly mediates religiosity-intention and Islamic financial literacy-intention relationships. FSE significantly moderates the attitude-intention relationship. The results shed light on the key factors that increase investing behavior and have direct managerial implications with regard to marketing strategies and target markets. These findings suggest that IUT service providers should take the lead in attracting customers through effective and targeted marketing initiatives, particularly by enhancing customers' FSE and capabilities. This study provides empirical evidence on the interrelationships between Islamic financial literacy, religiosity, and FSE in examining investors' behavior using the Theory of Planned Behavior framework. The study explores the moderating role of FSE on the relationship between attitude and investment intention.
High-powered incentives may induce higher managerial effort, but they also expose managers to idiosyncratic risk. If managers are risk averse, they might underinvest when firm-specific uncertainty ...increases, leading to suboptimal investment decisions from the perspective of well-diversified shareholders. We empirically document that, when idiosyncratic risk rises, firm investment falls, and more so when managers own a larger fraction of the firm. This negative effect of managerial risk aversion on investment is mitigated if executives are compensated with options rather than with shares or if institutional investors form a large part of the shareholder base.
Previous studies report that cash holdings are more valuable for financially constrained firms than for unconstrained firms. We examine (i) why this is so and (ii) why some constrained firms appear ...to hold too little cash. Our results indicate that greater cash holdings are associated with higher levels of investment for constrained firms with high hedging needs and that the association between investment and value is stronger for constrained firms than for unconstrained firms. These findings imply that higher cash holdings allow constrained firms to undertake value-increasing projects that might otherwise be bypassed. We further find that some constrained firms exhibit low cash holdings because of persistently low cash flows. Overall, our findings support the view that greater cash holdings of constrained firms are a value-increasing response to costly external financing.
In this work we seek to enhance the frameworks practitioners in asset management and wealth management may adopt to asses how different screening rules may influence the diversification benefits of ...portfolios. The problem arises naturally in the area of Environmental, Social, and Governance (ESG) based investing practices as practitioners often need to select subsets of the total available assets based on some ESG screening rule. Once a screening rule is identified, one constructs a dynamic portfolio which is usually compared with another dynamic portfolio to check if it satisfies or outperforms the risk and return profile set by the company. Our study proposes a novel method that tackles the problem of comparing diversification benefits of portfolios constructed under different screening rules. Each screening rule produces a sequence of graphs, where the nodes are assets and edges are partial correlations. To compare the diversification benefits of screening rules, we propose to compare the obtained graph sequences. The method proposed is based on a machine learning hypothesis testing framework called the kernel two-sample test whose objective is to determine whether the graphs come from the same distribution. If they come from the same distribution, then the risk and return profiles should be the same. The fact that the sample data points are graphs means that one needs to use graph testing frameworks. The problem is natural for kernel two-sample testing as one can use so-called graph kernels to work with samples of graphs. The null hypothesis of the two-sample graph kernel test is that the graph sequences were generated from the same distribution, while the alternative is that the distributions are different. A failure to reject the null hypothesis would indicate that ESG screening does not affect diversification while rejection would indicate that ESG screening does have an effect. The article describes the graph kernel two-sample testing framework, and further provides a brief overview of different graph kernels. We then demonstrate the power of the graph two-sample testing framework under different realistic scenarios. Finally, the proposed methodology is applied to data within the SnP500 to demonstrate the workflow one can use in asset management to test for structural differences in diversification of portfolios under different ESG screening rules.
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