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Article
Publication date: 7 August 2018

David Kealy, Alicia Spidel, Sharan Sandhu, Dan Kim and Andrew Izbicki

While epidemiological studies have linked economic hardship and financial difficulties with psychological distress and suicide, investigation of financial concerns among…

Abstract

Purpose

While epidemiological studies have linked economic hardship and financial difficulties with psychological distress and suicide, investigation of financial concerns among users of public mental health services has been limited. Moreover, empirical data regarding a relationship between financial difficulties and mental health symptoms are lacking. The purpose of this paper is to examine the prevalence of financial difficulties among patients attending community mental health clinics, and to examine the relationship between such difficulties and psychological distress and suicidality.

Design/methodology/approach

Participants attending three community mental health clinics in British Columbia, Canada provided demographic information, including annual income, and completed brief measures of personal financial management, psychological distress and suicidal behavior.

Findings

Although more than half of participants reported good-to-excellent ability to pay their bills on time, nearly half indicated poor long-range saving and financial planning. Lower annual income was directly related to suicidality. Financial management difficulties were associated with psychological distress, and were significantly related to suicidality after controlling for the effects of income and psychological distress.

Originality/value

The findings highlight the need for attention to distress and suicidality as potential sequelae of financial management difficulties, and carry implications for further research, clinical intervention and social policy. The findings confirm the need to address financial needs and money management abilities among users of public mental health services.

Details

Journal of Public Mental Health, vol. 17 no. 3
Type: Research Article
ISSN: 1746-5729

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Book part
Publication date: 2 August 2021

Marquita Kilgore-Nolan

The overall objective of this research was to elucidate the ecosystem of women’s health social enterprises (WHSEs) based in the United States. The Aim I was to conduct a…

Abstract

The overall objective of this research was to elucidate the ecosystem of women’s health social enterprises (WHSEs) based in the United States. The Aim I was to conduct a secondary data analysis of a random national sample of non-profit WHSEs based in the United States regarding their characteristics and areas of intervention. Aim II was to conduct a qualitative assessment of a sample of WHSEs based in the United States regarding their perspectives on the ecosystem of WHSEs. Aim I utilized the GuideStar database and assessed enterprise size, geographic location, financial distress, health intervention area, and health activity category using descriptive statistics, statistical tests, and multivariable regression analysis via SPSS. Aim II utilized in-depth interviewing and grounded theory analysis via MAXQDA 2018 to identify novel themes and core categories while using an established framework for mapping social enterprise ecosystems as a scaffold.

Aim I findings suggest that WHSE activity is more predominant in the south region of the United States but not geographically concentrated around cities previously identified as social enterprise hubs. WHSEs take a comprehensive approach to women’s health, often simultaneously focusing on multiple areas of health interventions. Although most WHSEs demonstrate a risk for financial distress, very few exhibited severe risk. Risk for financial distress was not significantly associated with any of the measured enterprise characteristics. Aim II generated four core categories of findings that describe the ecosystem of WHSE: (1) comprehensive, community-based, and culturally adaptive care; (2) interdependent innovation in systems, finances, and communication; (3) interdisciplinary, cross-enterprise collaboration; and (4) women’s health as the foundation for family and population health. These findings are consistent with the three-failures theory for non-profit organizations, particularly that WHSEs address government failure by focusing on the unmet women’s health needs of the underserved populations (in contrast to the supply of services supported by the median voter) and address the market failure of over exclusion through strategies such as cross-subsidization and price discrimination. While WHSEs operate with levels of financial risk and are subject to the voluntary sector failure of philanthropic insufficiency, the data also show that they act to remediate other threats of voluntary failure.

Aim I findings highlight the importance of understanding financial performance of WHSEs. Also, lack of significant associations between our assessed enterprise characteristics and their financial risk suggests need for additional research to identify factors that influence financial performance of WHSE. Aim II findings show that WHSEs are currently engaged in complex care coordination and comprehensive biopsychosocial care for women and their families, suggesting that these enterprises may serve as a model for improving women’s health and health care. The community-oriented and interdisciplinary nature of WHSE as highlighted by our study may also serve as a unique approach for research and education purposes. Additional research on the ecosystem of WHSE is needed in order to better inform generalizability of our findings and to elucidate how WHSE interventions may be integrated into policies and practices to improve women’s health.

Details

Entrepreneurship for Social Change
Type: Book
ISBN: 978-1-80071-211-9

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Article
Publication date: 1 March 2017

John Topinka

The purpose of this research is to examine fiscal health of a specific local enterprise operation: seaports. Seaports provide unique local services while spending and…

Abstract

The purpose of this research is to examine fiscal health of a specific local enterprise operation: seaports. Seaports provide unique local services while spending and borrowing billions of dollars. Decision makers should be aware of the fiscal health of these enterprises in part to assess the potential risks to the fiscal health of the government at large or public authority. Using eight stock and flow fiscal indicators appropriate for enterprise activities, this research examines eight seaports to compare fiscal health by geographic location and governing structure as well as the connection between long-term and short-term fiscal measures. Descriptive measures suggest that western and public authority ports exhibit better fiscal health than southern and departmental ports with some evidence showing a modest link between long-term and short-term fiscal health.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 29 no. 1
Type: Research Article
ISSN: 1096-3367

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Article
Publication date: 27 May 2021

Elok Heniwati, Nella Yantiana and Gita Desyana

This paper aims to investigate whether Syariah banks are more financially stable than non-Syariah banks and check the differential impact of explanatory variables in…

Abstract

Purpose

This paper aims to investigate whether Syariah banks are more financially stable than non-Syariah banks and check the differential impact of explanatory variables in financial health and efficiency in the context of Indonesia.

Design/methodology/approach

By using unbalanced panel data from Bankfocus over the period 2011–2018, regression analysis is performed with two response variables representing financial health, ZSCORE for return on average assets, liquid asset to deposit and short-term funding ratio. A number of control variables are used as tools to confirm the hypotheses. To check the robustness of the findings, a model with different specifications has been used.

Findings

The results indicate that while Syariah banks present higher insolvency risk (less health) for long-term activity, the opposite is true for short-term activity. Other findings show that Syariah and non-Syariah banks contribute differently to the national system of financial stability owing to varying influential factors on the bank’s health.

Originality/value

This paper presents a comparative analysis between the financial stability of Syariah banks and that of non-Syariah banks in Indonesia by building an empirical framework that allows the author to examine the differential effects of each underlying feature on financial stability in Syariah and non-Syariah banks.

Details

Journal of Islamic Accounting and Business Research, vol. 12 no. 4
Type: Research Article
ISSN: 1759-0817

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Book part
Publication date: 11 June 2009

Pablo Gottret, Vaibhav Gupta, Susan Sparkes, Ajay Tandon, Valerie Moran and Peter Berman

Objective – This chapter assesses the extent to which previous economic and financial crises had a negative impact on health outcomes and health financing. In addition, we…

Abstract

Objective – This chapter assesses the extent to which previous economic and financial crises had a negative impact on health outcomes and health financing. In addition, we review evidence related to the effectiveness of different policy measures undertaken in past crises to protect access to health services, especially for the poor and vulnerable. The current global crisis is unique both in terms of its scale and origins. Unlike most previous instances, the current crisis has its origins in developed countries, initially the United States, before it spread to middle- and lower-income countries. The current crisis is now affecting almost all countries at all levels of income. This chapter addresses several key questions aimed at helping inform possible policy responses to the current crisis from the perspective of the health sector: What is the nature of the current crisis and in what ways does it differ from previous experiences? What are some of the key lessons from previous crises? How have governments responded previously to protect health from such macroeconomic shocks? How can we improve the likelihood of positive action today?

Methodology/approach – The chapter reviews the literature on the impact of financial crises on health outcomes and health expenditures and on the effectiveness of past policy efforts to protect human development during periods of economic downturn. It also presents analysis of household surveys and health expenditure data to track health seeking behavior and out-of-pocket expenditures by households during times of financial crisis.

Findings – Evidence from previous crises indicates that health-related impacts during economic downturns can occur through various channels. The impact in households experiencing reductions in employment and income could be manifest in terms of poorer nutritional outcomes and lower levels of utilization of health care when needed. Households may become impoverished, reduce needed health services, and experience reductions in consumption as a result of health shocks occurring during a time when their economic vulnerability has increased. Women, children, the poor, and informal sector workers are likely to be most at risk of experiencing negative health-related consequences in a crisis. Real government spending per capita on health care could decline due to reduced revenues, currency devaluations, and potential reductions in external aid flows. Low-income countries with weak fiscal positions are likely to be the most vulnerable.

Implications for policy – Past crises can inform policy-making aimed at protecting health outcomes and reducing financial risk from health shocks. Evidence from previous crises indicates that broad-brush strategies that maintained overall levels of government health spending tended not to be successful, failing to protect access to quality health services especially for the poor. It is particularly vital to ensure access to essential health commodities, which in many low-income countries are imported, in the face of weakening exchange rates. Focused efforts to sustain the supply of lower-level basic services, combined with targeted demand-side approaches like conditional cash transfers may be more effective than broader sectoral approaches. Low-income countries may need specific short-term measures to ensure that health outcomes do not suffer.

Details

Innovations in Health System Finance in Developing and Transitional Economies
Type: Book
ISBN: 978-1-84855-664-5

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Book part
Publication date: 26 October 2020

Sebastian Bauhoff, Katherine Grace Carman and Amelie Wuppermann

Under the Patient Protection and Affordable Care Act (ACA), many low-income consumers have become eligible for government support to buy health insurance. Whether these…

Abstract

Under the Patient Protection and Affordable Care Act (ACA), many low-income consumers have become eligible for government support to buy health insurance. Whether these consumers are able to take advantage of the support and to make sound decisions about purchasing health insurance likely depends on their knowledge and skills in navigating complex financial products. This ability is frequently referred to as “financial literacy.” We examined the level and distribution of consumers' financial literacy across income groups, using 2012 data collected in the RAND American Life Panel, an internet panel representative of the US population. Low financial literacy was particularly prevalent among individuals with incomes between 100% and 400% of the federal poverty level, many of whom will be eligible for health insurance subsidies. In this group, people who are young, less educated, female, and have less income were more likely to have low financial literacy. Our findings suggest the need for targeted policies to support vulnerable consumers in making good choices for themselves, possibly above and beyond the support measures already part of the ACA.

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Book part
Publication date: 23 February 2015

Gang Nathan Dong

Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether…

Abstract

Purpose

Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor.

Methodology

We collected the financial information of health care providers in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects.

Findings

The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability.

Originality/value

The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial book-tax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

Details

International Best Practices in Health Care Management
Type: Book
ISBN: 978-1-78441-278-4

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Article
Publication date: 19 February 2018

Jukka Pellinen, Toni Mättö, Kari Sippola and Antti Rautiainen

The purpose of this paper is to investigate how the complexity of the network governance setting affects accountability practices. The authors pay particular attention to…

Abstract

Purpose

The purpose of this paper is to investigate how the complexity of the network governance setting affects accountability practices. The authors pay particular attention to the organizational characteristics that may enable a common understanding of multiple accountability relationships, or lead to problems in reconciling competing forms of accountability, thereby appearing as blame game-type behavior.

Design/methodology/approach

The authors conducted a case study with 31 semi-structured interviews in a Finnish health care organization (FHC) that offers basic public health care services. The organization represents a co-operative arrangement with the main city and three smaller municipalities. The FHC has faced difficulties in balancing budget constraints with the provision of statutory care to citizens. This case is analyzed with the help of theories relating to accountability, the blame game, and dialogue.

Findings

The authors found that in the FHC operating under austerity constraints, attempts to reconcile financial, professional, and democratic accountability were made but, instead of dialogue and consensus, the different stakeholder groups resorted to defensive tactics in order to protect their resources, position, or sense of professional obligation. The authors suggest that in a context of network governance, accompanied by an increasing emphasis on financial accountability, organizational practices are susceptible to conflicting accountabilities and behavior characterized in this paper as a blame game.

Originality/value

The study contributes to the empirical studies on accountability in the new public governance context by analyzing the complex accountability relations between stakeholder groups with different agendas. The authors suggest organizational characteristics that may exacerbate conflicts between different stakeholder groups and prevent constructive dialogue. Furthermore, the study analyzes the composition of democratic accountability within the studied organization.

Details

Accounting, Auditing & Accountability Journal, vol. 31 no. 2
Type: Research Article
ISSN: 0951-3574

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Article
Publication date: 2 September 2019

Beatriz Cuadrado-Ballesteros, Serena Santis, Francesca Citro and Marco Bisogno

The purpose of this paper is to investigate the possible influence of financial health of local governments (LGs) on the re-election of politicians.

Abstract

Purpose

The purpose of this paper is to investigate the possible influence of financial health of local governments (LGs) on the re-election of politicians.

Design/methodology/approach

The study investigates a sample of 129 Italian LGs with more than 50,000 inhabitants for the period 2008–2014, resulting in 903 observations. A regression model has been implemented, where the dependent variable refers to the probability of re-election, and different dimensions of financial health are the independent variables.

Findings

Budgetary and service-level solvency influence positively the probability of re-election of the major, while the ability of the government to generate liquidity to pay its short-term debts is not statistically relevant. Moreover, the sustainability dimension of budgetary solvency is more relevant than the flexibility and vulnerability dimensions.

Practical implications

To be re-elected, local politicians are advised to pay attention to and preserve the social welfare of citizens with the available resources.

Originality/value

This study adds fresh insight to the literature on financial health, emphasising the relevance of public financial management in the re-election of local politicians.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 31 no. 3
Type: Research Article
ISSN: 1096-3367

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Article
Publication date: 5 April 2013

Mary L.M. Gilhooly, Deborah Cairns, Miranda Davies, Priscilla Harries, Kenneth J. Gilhooly and Elizabeth Notley

The purpose of this paper is to explore the detection and prevention of elder financial abuse through the lens of a “professional bystander intervention model”. The…

Abstract

Purpose

The purpose of this paper is to explore the detection and prevention of elder financial abuse through the lens of a “professional bystander intervention model”. The authors were interested in the decision cues that raise suspicions of financial abuse, how such abuse comes to the attention of professionals who do not have a statutory responsibility for safeguarding older adults, and the barriers to intervention.

Design/methodology/approach

In‐depth interviews were conducted using the critical incident technique. Thematic analysis was carried out on transcribed interviews. In total, 20 banking and 20 health professionals were recruited. Participants were asked to discuss real cases which they had dealt with personally.

Findings

The cases described indicated that a variety of cues were used in coming to a decision that financial abuse was very likely taking place. Common to these cases was a discrepancy between what is normal and expected and what is abnormal or unexpected. There was a marked difference in the type of abuse noticed by banking and health professionals, drawing attention to the ways in which context influences the likelihood that financial abuse will be detected. The study revealed that even if professionals suspect abuse, there are barriers which prevent them acting.

Originality/value

The originality of this study lies in its use of the bystander intervention model to study the decision‐making processes of professionals who are not explicitly charged with adult safeguarding. The study was also unique because real cases were under consideration. Hence, what the professionals actually do, rather than what they might do, was under investigation.

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