Search results

Purpose – Health information technology (HIT) holds promise for improving the quality of health care and reducing health care system inefficiencies. Numerous studies have examined HIT availability, specifically electronic health records (EHRs), and utilization among physicians in individual countries. However, no one has examined EHR use among physicians who train in one country and move to practice in another country. In the United States, physicians who complete medical school outside the country but practice within the United States are commonly referred to as International Medical Graduates (IMGs). IMGs have a growing presence in the United States, yet little is known about the availability and use of HIT among these physicians. The purpose of this study is to explore the availability and use of HIT among IMGs practicing in United States.

Design/methodology/approach – The Health Tracking Physician Survey (2008) was used to examine the relationship between availability and use of HIT and IMG status controlling for several physician and practice characteristics. Our analysis included responses from 4,720 physicians, 20.7% of whom were IMGs.

Findings – Using logistic regression, controlling for physician gender, specialty, years in practice, practice type, ownership status and geographical location, we found IMGs were significantly less likely to have a comprehensive EHR in their practices (OR=0.84; p=0.005). In addition, findings indicate that IMGs are more likely to have and use several so-called first generation HIT capabilities, such as reminders for clinicians about preventive services (OR=1.31; p=0.001) and other needed patient follow-up (OR=1.26; p=0.007).

Originality/value – This study draws attention to the need for further research regarding barriers to HIT adoption and use among IMGs.

Shane and Venkataraman (2000) suggest “the field [of entrepreneurship] involves the study of sources of opportunities; the processes of discovery, evaluation, and exploitation of opportunities; and the set of individuals who discover, evaluate, and exploit them” (p. 218). However, the study of the judgment required for opportunity evaluation has been greatly overshadowed by interest in opportunity recognition and to a lesser extent opportunity exploitation. This is surprising considering the number of economic theories of the entrepreneur that recognize sound judgment as a principal quality of entrepreneurship (Cantillon, 1755; Kirzner, 1973; Knight, 1921; Mises, 1949; Say, 1840; Schumpeter, 1934; Shackle, 1955). In fact, the first recognized theory of the entrepreneur defined the entrepreneur as someone who exercises business judgment in the face of uncertainty (Cantillon, 1755/1931, pp. 47–49). Similarly, Knight (1921, p. 271) suggests that the essence of entrepreneurship is judgment, born of uncertainty, and argues that it is this judgment that delineates the function of entrepreneur from that of manager. He goes on to point out that the function of manager does not in itself imply entrepreneurship but that a manager becomes an entrepreneur when he exercises judgment involving liability to error (Knight, 1921, p. 97). However, the judgment referred to by these theorists is not just any form of judgment, it is judgment exercised in the decision of whether to take action.

Prior analyses of racial bias in the New York City’s Stop-and-Frisk program implicitly assumed that potential bias of police officers did not vary by crime type and that their decision of which type of crime to report as the basis for the stop did not exhibit any bias. In this paper, we first extend the hit rates model to consider crime type heterogeneity in racial bias and police officer decisions of reported crime type. Second, we reevaluate the program while accounting for heterogeneity in bias along crime types and for the sample selection which may arise from conditioning on crime type. We present evidence that differences in biases across crime types are substantial and specification tests support incorporating corrections for selective crime reporting. However, the main findings on racial bias do not differ sharply once accounting for this choice-based selection.

Each of the four objectives can be applied within the military training environment. Military training often requires that soldiers achieve specific levels of performance or proficiency in each phase of training. For example, training courses impose entrance and graduation criteria, and awards are given for excellence in military performance. Frequently, training devices, training media, and training evaluators or observers also directly support the need to diagnose performance strengths and weaknesses. Training measures may be used as indices of performance, and to indicate the need for additional or remedial training.

This chapter argues that there are a number of different versions of decoupling hypotheses and that rapid swings in their popularity are due largely to herding in popular mental models and shifts in short-run correlations. It is important to not put too much emphasis on such changes of correlations since these can vary substantially depending on the patterns of shocks. There are substantial differences in the effects of contagion during the current crisis on growth rates of both advanced and emerging economies, including Brazil, Russia, India, and China (the BRICs). Our estimates suggest that while countries like China and India have been able to maintain high growth rates, their short falls from trends have not been greatly smaller than for the United States itself. Thus, their decoupling has not been as great as many popular analyses have suggested.

In this chapter, we examine the impact of pay-for-performance incentives on learning-by-doing. We exploit personnel data on fruit pickers paid under two distinct compensation contracts: a standard piece rate plan and one with an extra one-time bonus tied to output. Under the latter, we observe bunching of performance just above the bonus threshold, suggesting workers distort their behavior in response to the discrete bonus. Such bunching behavior increases as workers gain experience. At the same time, the bonus contract induces considerable learning-by-doing for workers throughout the productivity distribution who presumably hope to one day hit the target, and these improvements significantly outweigh the losses to the firm from the bunching. In contrast, under the standard piece rate contract, we find minimal evidence of bunching and only small performance improvements at the bottom of the productivity distribution. Our results suggest that contract design can help foster learning on the job, underscoring the importance of dynamic considerations in principle-agent models.

The interbank market in China experienced remarkable squeezes in liquidity in 2013. In particular, the overnight Shanghai Interbank Offered Rate reached a historical high in June. Banks were unprepared, facing the occurrence of various liquidity demands simultaneously. Effects of the liquidity squeeze spread across markets, and concerns were expressed about the health of the banking sector in the world’s second largest economy. Yet the central bank of China maintained an unswerving view that the tightness of liquidity was only structural, and could be overcome by the commercial banks themselves. While it may be too early to judge whether the central bank was correct, or whether there is systematic liquidity risk in the banking sector, markets received a clear signal from the People’s Bank of China. The central bank stopped acting as a ‘perpetual put option’ for commercial banks and refused to take responsibility to satisfy liquidity needs in the interbank market. Its intention is clear; that is, to adjust monetary policy and support economic reform in China. The new Chinese government seems determined to steer a new course away from the previous growth episode. Its resolution has been published and actions have been taken. Among them, the central bank’s changes to monetary policy have received responses from the markets, and the People’s Bank of China is now in the vanguard of a battle to squeeze liquidity. It is difficult to predict what further actions the government will take. However, it should be aware that the driving force of economic reform in China comes from structural change and productivity improvement. Without follow-up policies, complication in the financial system could undermine the central bank’s effort and international capital flows may quickly substitute the opening position of the central bank in the interbank market. More wisdom is required if China is to win the battle for deleveraging and structural reform.