Search results

The purpose of this paper is to demonstrate how probabilistic simulation can be used to assist prospective general partners (GP) and limited partners (LP) of a venture capital limited partnership fund to evaluate alternative investment strategies for the proposed fund. The model presented in the paper is based upon observed characteristics of the venture capital market reported in the finance, economics, and management science literature. The body of the paper is organized as follows. In Section II we review the structural characteristics of the model. In Section III we present the results, in terms of ending wealth, obtained from simulating the fund's operations over its life under selected alternative investment strategies. In Section IV we show evaluations of the fund's simulated results under expected return, mean/variance and four moment approaches. In Section V, we present conclusions and implications of the results for financial management.

The paper charts ten years of movement in Wiltshire towards greater integration for health and social care, and highlights two important messages for others at different stages of the process. The first is that while an early strategic vision can create the right conditions, there can be no short cuts to effective integration. The second is that independent evaluation is necessary to produce the evidence to sustain initiatives and promote organisational and professional learning ‐ which are key ingredients of the change process.

Introduces the relationship marketing paradigm as a means of analysing the purchaser‐provider relationship within the NHS internal market. This focus is justified in the context of the limitations of orthodox economic analysis. The research evidence is based upon a national survey of all NHS trust hospitals in England. The survey consisted of key questions relating to the process of relationship building strategies employed by NHS hospital trusts. In particular, emphasis was given to non‐price competitive behaviour, i.e. the extent to which health care contracts were augmented or customised by providers. An empirical analysis is presented, identifying those factors driving such non‐price competitive behaviour, based upon a LOGIT model. The results suggest the hypotheses tested are consistent with the evidence from our survey. Finally, the model is used to make some tentative predictions regarding the future of the purchaser‐provider relationship within the reformed NHS.

In April 2015, Shannon Enberg, Managing Director of Real Assets at the United Kingdom Telecom and Technology Pension Scheme (UKTTPS), received a startling memo from the fund's board of directors. In a nutshell, the board sought to reduce the fund's multimillion-pound annual expenditure on management fees by asking all managing directors to drastically cut the number of private managers being used to manage UKTTPS assets. Enberg was told to cut the number of her external managers in half, but given the illiquidity of her private equity investments in commercial property, she would be allowed to make the decision to rehire each manager (or not) as each of her investments matured. UKTTPS had two investments in closed-end property funds that had just liquidated their final holdings at the end of 2014. Both managers had new funds being raised that could recycle the investment proceeds, but now that she was being forced to cut back, Enberg wondered whether either was really worth rehiring.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

As a model of integrated care (IC), deliberate team-based care (DTBC) can help address workforce shortages facing rural communities by improving the health and wellbeing of healthcare providers. This study focuses on a GP practice implementing DTBC in rural Australia. The aim of this research was to understand the perspectives of the healthcare workers involved and to ascertain factors impacting on the day to day running of the model, patient care and clinician work-life. The authors conducted a qualitative study on the experiences of the DTBC workers.

Team members were invited to participate in semi-structured interviews (n = 9). Interviews were analysed using an iterative thematic analysis, summarised, collated and explored for emergent themes.

Key themes included: creating change from old ways of doing things, development and implementation processes outlining how the model evolved and how it ran from day to day, model outcomes for patients and clinicians, as well as practical considerations like funding, technology and time.

Building DTBC from the ground up has produced a high functioning team who demonstrate trust and equality, share information freely and all have a voice which is heard and respected. By acting as a champion and a leader, the GP has created a psychologically safe environment allowing the team to share knowledge, collaborate in problem solving and provide effective patient care which is holistic and community grounded. This work environment holds promise for creating improved work-life for rural clinicians and potential for workforce retention.

Purpose – The aim of this paper is to examine the effects of government reforms to improve the accountability of primary healthcare providers in Scotland. As a result of the reforms, funding arrangements for GP practices changed and new financing mechanisms were introduced; this paper seeks to investigate the impact of these changes. Design/methodology/approach – The investigation is undertaken using a case study method involving a medical practice in Dundee. Interviews were conducted with staff at the practice and one researcher spent a week on site studying documentation and observing procedures. Findings – The main findings from the case study suggest that as a result of the government reforms, new funding allocation procedures for the practice better resemble a system of financial control rather than demonstrating financial accountability. GPs were more willing to engage in discussions regarding new procedures being introduced to demonstrate clinical accountability; they did not anticipate that practice accreditation or professional revalidation would alter their established practices in any way. Research limitations/implications – The main limitation of this research is that it only relates to one case study in Dundee. In addition, further government reforms in this area mean that follow up case studies are needed to see how subsequent changes have addressed the issues raised in the current research; indeed, some longitudinal studies might investigate how cumulative reforms have impacted upon GPs. Orginality/value – Nevertheless, despite these limitations, this paper does build on previous work in this area and provides a platform on which subsequent work can build.

This case study describes a community-based urgent care clinic in a general practitioner (GP) super clinic in South East Queensland.

This retrospective chart audit describes patient demographic characteristics, types of presentations and management for Sundays in 2015.

The majority of patients (97%) did not require admission to hospital or office investigations (95%) and presented with one condition (94%). Of the presentations, 66.5% were represented by 30 conditions. Most patients received a prescription (57%), some were referred to the pathology laboratory (15%) and some were referred to radiology (12%). A majority (54%) of patients presented in the first three hours. Approximately half (51%) of patients presenting were aged under 25. More females (53%) presented than males. A majority (53%) lived in the same postcode as the clinic. The three most common office tests ordered were urinalysis, electrocardiogram (ECG) and urine pregnancy test. Some patients (19%) needed procedures, and only 3% were referred to hospital.

The study offers analysis of the client group that can be served by an urgent care clinic in a GP super clinic on a Sunday. The study provides an option for emergency department avoidance.

Despite calls for more research into community-based urgent care clinics, little is known in Australia about what constitutes an urgent care clinic. The study proposes a classification system for walk-in presentations to an urgent care clinic, which is comparable to emergency department presentations.

This paper aims to be nested in the empirical literature examining the impact of gender quotas for elected posts to local government councils (panchayats) in India. Gender quotas apply at the level of both head (sarpanch, randomly assigned) and member (uniformly across councils). Received studies exploit the randomly allocated quota across panchayats at the level of sarpanch, and find a statistically significant impact of the gender of the sarpanch on public expenditure choices. This paper is motivated by the fact that those results imply sarpanch domination in the collective decisions of the council, and seeks to develop a model to show that such dominance is possible in the short run, but not inevitable. It then aims to test for sarpanch dominance using primary data from a field survey of panchayats in four states.

The model is tested on field survey data from a sample of 776 panchayats. The probit specifications test for factors explanatory of the choice of expenditure on waterworks as a binary variable, on the grounds that this is a smoother measure in multi‐year expenditure commitments. However, there are supplementary specifications testing for the quantum of expenditure on water, both as a share of the total, as well as in absolutes.

For the region surveyed, a higher probability of expenditure on waterworks is found in the presence of key variables that explain the incidence of water‐borne diseases like cholera and diarrhea, as ascertained from a separate set of specifications. The gender of the head is statistically insignificant. Thus, in the region studies, gender of the head is trumped by economic fundamentals in expenditure choices, but this leaves open the possibility that the (uniform) gender quotas at membership level may have been what aligned choices with fundamentals.

The key message of this paper is that the citizen candidate framework does not point to unique outcomes where public choice emerges from multi‐member councils. Following from this, any finding on the impact of a gender quota at the level of head will necessarily be context‐specific, and cannot become the basis for generalized expectations.