Search results

Our objective was to evaluate the cost-utility of a health and social care integration programme for frail older adults in Buenos Aires, Argentina.

Based on a study of the programme’s effectiveness, a Markov model was conducted to assess its cost-utility. The active intervention was the health and social care integration programme, and the control was the best standard of care so far. The setting was the patients' home of residence. A third-party payer perspective and a lifelong time horizon were adopted. All transition probabilities, quality-adjusted life years (QALYs) and costs were estimated from the effectiveness study. A discount rate of 3.5% was applied to costs and benefits. Costs are expressed in international dollars (Int$), calculated according to the International Monetary Fund’s purchasing power parity rate. Different sensitivity analyses were performed. The model was built in Excel 365. Construct validity, verification during model construction and internal consistency of the results were assessed.

The programme had an average cost of Int$18,768.22/QALY, and the control Int$42,609.68/QALY. In the incremental analysis, the programme saved Int$26,436.10 and gained 0.81 QALYs over the control. In the sensitivity analyses, in 99.96% of cases, the programme was less costly and more effective.

The cost savings can facilitate the scalability.

The health and social care integration programme for frail older adults was more effective and less costly than the best standard of care to date. This study contributes to the scarce evidence on the efficiency of integrated care strategies for frail older persons.

This article problematizes the concept of freedom rooted in liberalism, examining the detention of historian Ilan Pappe by the Federal Bureau of Investigation (FBI) at Detroit Airport in the United States as an emblematic case study.

The research adopts a methodological triangulation approach, based on an analysis that combines data about the event and theories about the concept of freedom, problematizing authors who focused on the relationship between the individual and society in a liberal context, where individualism serves as the basis for specific conceptions of social relations.

Through the use of authors such as John Stuart Mill and John Locke, as well as the contributions of authors like Norbert Elias, it is argued that true freedom is relational, rooted in social interdependencies and the social construction of an individuality that is not individualistic but intrinsically linked to collective aspects.

Pappe’s case illustrates the tensions between individual freedom and collective interests, highlighting the need to reassess freedom of expression in complex political and social contexts.

This article proposes a more inclusive and interconnected view of human freedom, where individual and collective interests are negotiated within a dynamic web of social relations.

This chapter assesses the extent to which historical levels of inequality affect the creation and survival of businesses over time. To this end, we use the Global Entrepreneurship Monitor survey across 66 countries over 2005–2011. We complement this survey with data on income inequality dating back to early 1800s and current institutional environment, such as the number of procedures to start a new business, countries’ degree of financial inclusion, corruption and political stability. We find that, although inequality increases the number of firms created out of need, inequality reduces entrepreneurial activity as in net terms businesses are less likely to be created and survive over time. These findings are robust in using different measures of inequality across different points in time and regions, even if excluding Latin America, the most unequal region in the world. Our evidence then supports theories that argue early conditions, crucially inequality, influence development path.

Roma form the largest ethnic group in Europe. Currently, between 10 and 12 million Roma live in Europe, 6 million of which live in the European Union.

In this chapter, the authors analyze the socioeconomic and health problems faced by the Roma population, their causes and the barriers to Roma access to adequate medical care.

Roma population is generally younger than the general population, but with a lower life expectancy, due to poor living conditions and the increased prevalence of chronic and acute diseases. There are numerous barriers to accessing medical services by the Roma patients, such as language, low education, lack of information, discrimination in medical institutions, lack of medical insurance or identity documents and the relationship with medical staff.

Health mediators represent the link between communities and medical staff, with the role of reducing the negative consequences of the language barrier, sociocultural differences and tensions between ethnic groups.

The authors also present the results of a study conducted in Romania that aimed to analyze the role of health mediators as intercultural facilitators who contribute to increasing the quality of medical care provided to Roma patients and their ability to respond culturally appropriate to the health needs of the Roma patients.

The authors conclude that the medical staff has an ethical obligation to provide culturally sensitive medical care, since the ethnic origin, the level of education, the language proficiency and the cultural values of the patients are essential for a functional doctor–patient relationship. The activity of the health mediators is an important element in the health policies aimed at increasing the cultural competence of the medical staff and improving the medical care provided to the Roma population.

Historically, Lean Six Sigma (LSS) implementation has demonstrated a great deal of enhancement to process efficiency, profitability and customer satisfaction. The emerging market pressure for developing better quality, cheaper and greener products invokes a change of view in LSS economical effectiveness. The purpose of this study is to identify under which condition the final output of LSS projects with traditional strategic benefits are more environmentally friendly.

To investigate the choice of different types of LSS projects, the environmental impact under different conditions and the comparison of those conditions, the author developed an analytical mathematical model and analysed four different propositions.

The final price and production volume were recommended as mediating factors to leverage an LSS project to achieve a greener, customised and finance-oriented outputs.

This research contributes to existing LSS research and knowledge development via promoting the different perspectives of LSS and environmental sustainability integration.

This study further enables managers to identify the cut-off point in relation to the production volume and finished prices to leverage the expected financial outputs and environmental impact of the LSS project. This would potentially promote a green LSS project in both implementation and output, alongside its traditional values.

This study uses a modelling approach to identify the conditions under which the actual methodology of the LSS project could be green via less energy consumption with consideration of expected LSS values and outcomes.

This paper examines the mediating process of enhancing employees' psychological ownership among family hotel employees.

A total of 1,005 employees from 197 budget-to-three-star family hotels took part in the study by completing an either self-reported or interviewer questionnaire. The respondents were selected using a convenient sampling technique. A partial least square structural equation was used to analyse the data.

Work engagement and organisational performance were shown to significantly predict psychological ownership, except for counterproductive work behaviour. Both counterproductive work behaviour and organisational performance were found to predict psychological ownership. Finally, the relationship between (1) counterproductive work behaviour and psychological ownership and (2) organisational performance and psychological ownership is mediated by work engagement.

Replication of this model in different countries and other work settings is highly recommended for cross validating the reported findings in this study. The study emphasises the need for family hotel owners to create a conducive work environment devoid of conditions that promote counterproductive work behaviour among employees and encourage them to engage in higher productivity.

This study appears to be one of the first to have investigated a model linking counterproductive work behaviour, performance to psychological ownership through work engagement in the family hotel context.

The first purpose of this paper is the implementation of Lean Six Sigma (LSS) in a manufacturing company operating in South East Europe in order to understand the importance of critical success factors (CSFs) in LSS adoption and to find out the benefits that the company gained. The second purpose is to propose a standardized toolset based on DMAIC phases, for the application of LSS in small scale projects, in order to facilitate LSS adoption by more manufacturing companies.

This case study is based on the interlacement of the Yin's method about case studies and the DMAIC method for the improved deployment of LSS.

The analysis of this case study shows that the company attained to benefit financially, operationally and organizationally from the implementation of LSS. The already existing mentality of CI inside the company helped the project procedure and the application of changes and improvements fulfilling LSS adoption CSFs.

The paper constructs a toolset and studies the role of CSFs in order to achieve the desirable benefits in a manufacturing environment, constituting a guide for future LSS initiatives.

As stated by literature reviews, even though there are several papers concerning LSS implementation in the manufacturing sector, there is a need for more case studies papers, such as this one, in order to enrich the literature. In this paper, it is also the first time that a specific toolset for small scale projects is proposed based on to DMAIC which can be implemented in further LSS projects.