scholarly journals Hospital Productivity Shows Resilience After Data Breaches (Preprint)

2020 ◽  
Author(s):  
Jinhyung Lee ◽  
Sung Choi
Keyword(s):  
Patient Care ◽  
Fixed Effects ◽  
Care Delivery ◽  
Health Planning ◽  
Value Added ◽  
Hospital Data ◽  
Difference In Differences ◽  
Data Breach ◽  
Data Breaches ◽  
Hospital Productivity

BACKGROUND Data breaches are an inevitable risk to hospitals operating with information technology. The financial costs associated with data breaches are also growing. The costs associated with a data breach may divert resources away from patient care, therefore negatively affect hospital productivity. OBJECTIVE After a data breach, the resulting regulatory enforcement and remediation is a shock to a hospital’s patient care delivery. Exploiting this shock, the association between hospital data breaches and productivity was estimated using a generalized difference-in-differences model with multiple pre and post periods. METHODS The study analyzed the California Office of Statewide Health Planning and Development hospital financial data from 2012 to 2016. The study sample was an unbalanced panel of hospitals with 2,610 unique hospital-year observations, including general acute care hospitals. California hospital data was merged with breach data published by the Department of Health and Human Services. The dependent variable was hospital productivity measured as value-added. The difference-in-differences model was estimated using a fixed-effects regression. RESULTS Hospital productivity did not significantly differ from the baseline for three years after a breach. Data breaches were not significantly associated with a reduction in hospital productivity. Before a breach, the productivity of breached hospitals maintained a parallel trend with control hospitals. CONCLUSIONS Hospital productivity was resilient against the shocks from a data breach. Nonetheless, data breaches continue to threaten hospitals, therefore healthcare workers should be trained for cybersecurity to mitigate disruptions.

scholarly journals Hospital Productivity After Data Breaches: Difference-in-Differences Analysis

10.2196/26157 ◽  
2021 ◽  
Vol 23 (7) ◽  
pp. e26157
Author(s):  
Jinhyung Lee ◽  
Sung J Choi
Keyword(s):  
Patient Care ◽  
Fixed Effects ◽  
Care Delivery ◽  
Health Planning ◽  
Value Added ◽  
Hospital Data ◽  
Difference In Differences ◽  
Data Breach ◽  
Data Breaches ◽  
Hospital Productivity

Background Data breaches are an inevitable risk to hospitals operating with information technology. The financial costs associated with data breaches are also growing. The costs associated with a data breach may divert resources away from patient care, thus negatively affecting hospital productivity. Objective After a data breach, the resulting regulatory enforcement and remediation are a shock to a hospital’s patient care delivery. Exploiting this shock, this study aimed to investigate the association between hospital data breaches and productivity by using a generalized difference-in-differences model with multiple prebreach and postbreach periods. Methods The study analyzed the hospital financial data of the California Office of Statewide Health Planning and Development from 2012 to 2016. The study sample was an unbalanced panel of hospitals with 2610 unique hospital-year observations, including general acute care hospitals. California hospital data were merged with breach data published by the US Department of Health and Human Services. The dependent variable was hospital productivity measured as value added. The difference-in-differences model was estimated using fixed effects regression. Results Hospital productivity did not significantly differ from the baseline for 3 years after a breach. Data breaches were not significantly associated with a reduction in hospital productivity. Before a breach, the productivity of hospitals that experienced a data breach maintained a parallel trend with control hospitals. Conclusions Hospital productivity was resilient against the shocks from a data breach. Nonetheless, data breaches continue to threaten hospitals; therefore, health care workers should be trained in cybersecurity to mitigate disruptions.

scholarly journals Who Really Benefits from Consumption Tax Cuts? Evidence from a Large VAT Reform in France

2019 ◽  
Vol 11 (1) ◽  
pp. 38-63 ◽  
Author(s):  
Youssef Benzarti ◽  
Dorian Carloni
Keyword(s):  
Value Added ◽  
Consumption Tax ◽  
Difference In Differences ◽  
Firm Level ◽  
Employment Effects ◽  
Level Data ◽  
Price Effects ◽  
Firm Level Data ◽  
Material Goods ◽  
Firm Owners

This paper evaluates the incidence of a large cut in value-added taxes (VATs) for French sit-down restaurants in 2009. In contrast to previous studies, which only focus on the price effects of VAT reforms, we estimate the effects of the VAT cut on four groups: workers, firm owners, consumers, and suppliers of material goods. Using a difference-in-differences strategy on firm-level data, we find that: firm owners pocketed more than 55 percent of the VAT cut; consumers, sellers of material goods, and employees shared the remaining windfall with consumers benefiting the least; and the employment effects were limited. (JEL H22, H25, L83)

scholarly journals Veterans Health Administration’s Whole Health System of Care: Supporting the Health, Well-Being, and Resiliency of Employees

2021 ◽  
Vol 10 ◽  
pp. 216495612110226
Author(s):  
Kavitha P Reddy ◽  
Tamara M Schult ◽  
Alison M Whitehead ◽  
Barbara G Bokhour
Keyword(s):  
Health System ◽  
Care Delivery ◽  
Health Planning ◽  
Well Being ◽  
Employee Health ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered ◽  
Foundational Work ◽  
Health And Well Being

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.

scholarly journals Linking the Unitary Paradigm to Policy through a Synthesis of Caring Science and Integrative Nursing

2017 ◽  
Vol 30 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Mary S. Koithan ◽  
Mary Jo Kreitzer ◽  
Jean Watson
Keyword(s):  
Patient Care ◽  
Healthcare System ◽  
Care Delivery ◽  
Healthcare Policy ◽  
Patient Centered ◽  
Nursing Knowledge ◽  
Call To Action ◽  
Caring Science ◽  
Patient Care Delivery

The principles of integrative nursing and caring science align with the unitary paradigm in a way that can inform and shape nursing knowledge, patient care delivery across populations and settings, and new healthcare policy. The proposed policies may transform the healthcare system in a way that supports nursing praxis and honors the discipline’s unitary paradigm. This call to action provides a distinct and hopeful vision of a healthcare system that is accessible, equitable, safe, patient-centered, and affordable. In these challenging times, it is the unitary paradigm and nursing wisdom that offer a clear path forward.

scholarly journals Determinants of Firm Performance: Evidence from Romanian Listed Companies

2016 ◽  
Vol 9 (1) ◽  
pp. 53-69 ◽  
Author(s):  
Sebastian Lazăr
Keyword(s):  
Firm Performance ◽  
Fixed Effects ◽  
Value Added ◽  
Listed Companies ◽  
Sales Growth ◽  
Fixed Effects Model ◽  
Resource Based View ◽  
Firm Profitability ◽  
Negative Effect ◽  
Positive Effect

AbstractThe paper investigates firm-specific determinants of firm profitability for Romanian listed companies over the 2000-2011 period within the framework of resource based view of the firm. The results show that tangibles, leverage, size and labour intensity have negative effect on firm performance, while sales growth and value added have a positive effect. The results prove robust when introducing two-way fixed effects model and industry year effects model (in order to simultaneously account for specific industry characteristics and time effects).

scholarly journals Adaptation of the AACN Synergy Model for Patient Care to Critical Care Transport

2014 ◽  
Vol 34 (1) ◽  
pp. 16-28 ◽  
Author(s):  
Scott Swickard ◽  
Wendy Swickard ◽  
Andrew Reimer ◽  
Deborah Lindell ◽  
Chris Winkelman
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Level Of Care ◽  
Patient Centered ◽  
Levels Of Care ◽  
Interhospital Transfer ◽  
Mode Of Transport ◽  
Interfacility Transport

Today’s health care delivery system relies heavily on interhospital transfer of patients who require higher levels of care. Although numerous tools and algorithms have been used for the prehospital determination of mode of transport, no tool for the transfer of patients between hospitals has been widely accepted. Typically, the interfacility transport decision is left to the discretion of the referring provider, who may or may not be aware of the level of care provided or the means of transport available. A need exists to determine the appropriate level of care required to meet the needs of patients during transport. The American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care is a patient-centered model that focuses on optimizing patient care by matching the characteristics of the patient with the competencies of the nurse. This model shows significant promise in providing the theoretical backing to guide the decision on the level of care necessary to complete interfacility transfers safely and effectively. This article describes a new tool inspired by the AACN Synergy Model for Patient Care to determine the appropriate level of care required for interfacility transport.

Why is Corporate Virtue in the Eye of The Beholder? The Case of ESG Ratings

2021 ◽  
Author(s):  
Dane M. Christensen ◽  
George Serafeim ◽  
Anywhere Sikochi
Keyword(s):  
Fixed Effects ◽  
Return Volatility ◽  
External Financing ◽  
Difference In Differences ◽  
Rating Agencies ◽  
Lower Likelihood ◽  
Price Movements ◽  
Outcome Metrics

Despite the rising use of environmental, social, and governance (ESG) ratings, there is substantial disagreement across rating agencies regarding what rating to give to individual firms. As what drives this disagreement is unclear, we examine whether a firm's ESG disclosure helps explain some of this disagreement. We predict and find that greater ESG disclosure actually leads to greater ESG rating disagreement. These findings hold using firm fixed effects, and using a difference-in-differences design with mandatory ESG disclosure shocks. We also find that raters disagree more about ESG outcome metrics than input metrics (policies), and that disclosure appears to amplify disagreement more for outcomes. Lastly, we examine consequences of ESG disagreement and find that greater ESG disagreement is associated with higher return volatility, larger absolute price movements, and a lower likelihood of issuing external financing. Overall, our findings highlight that ESG disclosure generally exacerbates ESG rating disagreement rather than resolving it.

scholarly journals P027: Nursing duties and accreditation standards and their impacts: the nursing perspective

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S86-S87
Author(s):  
P.K. Jaggi ◽  
R. Tomlinson ◽  
K. McLelland ◽  
W. Ma ◽  
C. Manson-McLeod ◽  
...  
Keyword(s):  
Patient Care ◽  
Registered Nurses ◽  
Online Survey ◽  
Care Delivery ◽  
Care Quality ◽  
Medication History ◽  
Quality Initiatives ◽  
Response Options ◽  
Accreditation Standards ◽  
Strongly Agree

Introduction: With ongoing medical advances and an increase in elderly and complex patients presenting to the Emergency Department (ED), there is a requirement for nurses to continue to gain new knowledge and skills to provide optimal patient care. Quality initiatives are frequently introduced with the goal of improving patient safety and the effectiveness of care delivery; some being provincial, while others are new requirements from Accreditation Canada. We sought the perspectives of emergency nurses regarding the importance of key ED processes and standards, and their impact on patient care and nurse efficiency. Methods: All Registered Nurses and Licensed Practical Nurses throughout the Edmonton Zone EDs were invited to complete an online survey consisting of 23 statements on nursing attitudes (10 on nursing duties) and beliefs (11 on the importance of Accreditation standards and their impacts; two that involved selecting the 5 most important nursing activities). The survey was constructed through an iterative approach. Response options included a 7-point Likert scale (‘very strongly disagree’ to ‘very strongly agree’). Median scores and interquartile ranges were determined for each survey statement. Results: A total of 433/1241 (34.9%) surveys were submitted. Respondents were predominantly Registered Nurses (91.4%), female (88.9%), and worked 0-5 years overall in the ED (43.7%). Overall, respondents were favourable (‘agree’ or ‘strongly agree’) towards the Accreditation Canada standards and other quality initiatives. They were, however, ‘neutral’ towards universal domestic violence screening, and whether there is a difference between Best Possible Medication History (BPMH) and med reconciliation. The top five nursing activities in terms of perceived importance were: vital sign documentation, recording of allergies, listening to patients’ concerns, hand hygiene, and obtaining a complete nursing history. Best Possible Medication History and the screening risk tools followed these. Conclusion: Despite their heavy workload, nurses strongly agreed on the importance of med reconciliation, falls risk, and skin care, but felt that improved documentation forms could support efficiency. Nursing perspective is valuable in informing future attempts to standardize, streamline, and simplify documentation, including the design and implementation of a provincial clinical information system.

scholarly journals Macro level analysis of factors contributing to value added: technological changes in European countries

2018 ◽  
Vol 16 (4) ◽  
pp. 417-428
Author(s):  
Larysa Antoniuk ◽  
Nataliia Cherkas
Keyword(s):  
Fixed Effects ◽  
Value Added ◽  
European Countries ◽  
Macro Level ◽  
Eastern European ◽  
Technological Changes ◽  
Random Effects Models ◽  
Currency Depreciation ◽  
Developed Economies ◽  
Eastern European Countries

In conditions of globalization and rapidly growing production fragmentation, generation of value added becomes an ultimate goal and a measure of economic performance. The study provides an analysis of factors contributing to value added at macro level in different European countries. The analysis includes a panel framework covering 27 European countries over the period 2006–2015. In order to investigate the differences across regions, three subsamples are considered, namely, developed economies, PIIGS (Portugal, Italy, Ireland, Greece and Spain) and Central-Eastern European Countries (CEEC). Pooled OLS, fixed effects and random effects models are used. The results indicate that increase of value added corresponds to budget discipline, quality of human capital improvement, strong currency and transparent institutions. It could be expected that currency depreciation improves performance of the value added of exported final goods. However, the results show the opposite evidence: currency depreciation causes the value added decrease in all groups. Thus, for transitional countries, it is im¬portant not only to join global production chains, but also to acquire a significant share in generation of value added in these chains based on technological changes.

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