Medicare's prospective payment system for hospitals: new evidence on transitions among health care settings

Previous studies of Medicare’s prospective payment system for hospitals (PPS), introduced in 1983, evaluated only its first few years, using data collected during the hospital stay to control for patients’ health. We examine transitions among health care settings over a full decade following implementation of PPS, using survival models and a national longitudinal survey with independent information on health. We find that the rate of discharge from hospitals to nursing homes continued to rise as PPS matured, hospital readmissions from the community dropped after the early years, and risk of nursing home admission from the community soon after hospital discharge tripled. Evaluations of new payment systems for one type of provider need to be comprehensive in order to capture the full effects on other providers

New Evidence on Medicare?s Prospective Payment System: A Survival Analysis based on the NHANES I Epidemiologic Followup Study

Medicare?s prospective payment system (PPS), introduced in 1983, pays hospitals a fixed price for each stay rather than reimbursing costs. Previous studies evaluated its first few years using endogenous measures to control for heterogeneity in patients? health. We examine PPS over a full decade using competing risks Cox survival models and a national longitudinal survey with independent information on patients? health. New findings include: risk of death in hospital increased; risk of discharge to a nursing home continued to increase as PPS matured; and risk of nursing home admission from the community following hospital discharge rose. HMOs may have contributed to these outcomes

THE ROLE OF ARTISTIC DESCRIPTION IN THE EXPRESSION OF CONTENT

The artistic description, with its quality, gives the text a new poetic character and provides an interpretation of the content in the aesthetic structure. The description not only increased the artistic and aesthetic quality of literary works, but also enriched them in terms of language and style. Like many writers who took advantage of the descriptive potential of the Azerbaijani language, which is characteristic of the early twentieth century, Seyid Hussein also created successful poetic figures. Based on his creative style, he formed a unique style of description, and in this regard, managed to create authentic works at the level of figurative literary and artistic language. In Seyid Hussein's stories, the description is multifaceted and has become an expression form of different attitudes, feelings and thoughts. Using description methods, the writer not only narrates the subject, does not draw the external and internal qualities of the images, does not give a poetic picture of place and time. He delivers to the reader the psychological moods of characters, their effects on their situations and actions, feelings and thoughts to the reader in a poetic language. Artistic description played the role of illuminating the dark worlds of the characters in the stories.The artistic description, with its quality, gives the text a new poetic character and provides an interpretation of the content in the aesthetic structure. The description not only increased the artistic and aesthetic quality of literary works, but also enriched them in terms of language and style. Like many writers who took advantage of the descriptive potential of the Azerbaijani language, which is characteristic of the early twentieth century, Seyid Hussein also created successful poetic figures. Based on his creative style, he formed a unique style of description, and in this regard, managed to create authentic works at the level of figurative literary and artistic language. In Seyid Hussein's stories, the description is multifaceted and has become an expression form of different attitudes, feelings and thoughts. Using description methods, the writer not only narrates the subject, does not draw the external and internal qualities of the images, does not give a poetic picture of place and time. He delivers to the reader the psychological moods of characters, their effects on their situations and actions, feelings and thoughts to the reader in a poetic language. Artistic description played the role of illuminating the dark worlds of the characters in the stories

Žmogaus teisių apribojimo kultūros paveldui išsaugoti teisinis vertinimas

This article researches the following questions: defining the protectable subject matter as cultural heritage in the International Law, the obligation to protect the cultural heritage and evaluation of the cultural heritage as a Human Rights issue. Additionally, assessment of the Human Rights-based limitations on the preservation of the cultural heritage and legal grounds for the right to destroy and its limits have been discussed. It is defined that, the obligation to protect the cultural heritage is a duty established by the International Law on the states, rather than on the non-state actors. The general approach for the assessment of the Human Rights limitations on cultural heritage protection is expected to be based on the principles of balance of interests and the limited transformation or conditionality.Straipsnyje nagrinėjami šie klausimai: saugotino objekto kaip kultūros paveldo apibrėžimas tarptautinėje teisėje, pareiga saugoti kultūros paveldą ir kultūros paveldo vertinimas kaip žmogaus teisių problema. Be to, aptartas žmogaus teisėmis pagrįstų kultūros paveldo išsaugojimo apribojimų ir teisės sunaikinti teisinių pagrindų bei jos ribų įvertinimas. Apibrėžiama, kad pareiga saugoti kultūros paveldą yra tarptautinės teisės nustatyta pareiga valstybėms, o ne nevalstybinėms organizacijoms. Tikimasi, kad bendras požiūris vertinant žmogaus teisių apribojimus kultūros paveldo apsaugos srityje bus grindžiamas interesų pusiausvyros ir ribotos transformacijos ar sąlygiškumo principais

Implementation of Human Resource Management System in Preschool Educational Organizations

This article presents the introduction of the human resource management system in preschool educational organizations, a comparative analysis of management styles, leadership styles, and a description of the knowledge and skills required of a modern leader

Successful Organizational Business Communication and its Impact on Business Performance: An Intra- and Inter-Organizational Perspective

Intra-firm communication is critical for building synergy amongst the internal business units of a firm, enabling employees from various functional departments and ranks to incorporate their decision-making, understanding of organizational objectives, and common norms and culture to achieve increased organizational effectiveness. This study builds on and assesses a framework of the causes and consequences of effective communication in business interactions between customer and supplier firms, as well as the path for efficient communication within a firm. The proposed study’s structural equation modeling (SEM) analysis based on 352 responses collected from firm representatives in different job positions, ranging from marketing to logistics operations, revealed that in terms of intra-organizational communication, organization characteristics and shared values, top management support and style of leadership, and information technology were all significantly related to communication effectiveness. Furthermore, the frequency and variety of interactions enhanced communication outcomes, thus improving company performance. The results revealed that cultural factors were significantly related to communication effectiveness, as well as shared beliefs and goals. The organizational factors of leadership style, top management support, and information technology were significant determinants of effective communication. Among the contextual factors, interaction frequency and diversity were found to be significant. The study also tested the relationship between supplier and supplier firm performance in the context of communication effectiveness and found that they were closely related when trust and commitment were built between business partners

Development of Intellectual Abilities of Preschool Children

The problem of the full development of the intellectual abilities of preschool children remains relevant in our time, since one of the criteria for preschool preparation of children is intellectual development. Working in the senior group of compensatory assignment, I was convinced that one of the most important areas in the work of the educator is the development of the cognitive processes of children, as a means of a successful transition to schooling

Revisiting Moldova's transnistria dispute amid severing EU-Russia ties

This chapter is designed to accomplish two goals. First, it offers a brief overview of Moldova's Transnistria predicament with a specific focus on the internationalization of the dispute under the circumstances of heightened competition over post-Soviet Eastern Europe. Second, the chapter explores the current stalemate in the resolution of the territorial dispute by concentrating on the increasingly incompatible interests of the major geopolitical actors. In this sense, the EU and Russia's incompatible visions of European security order and divergent integrationist approaches toward the shared neighborhood are described as an external context that influences the situation around Transnistria. The fact that the issue of a mutually negotiated regional security order still lingers unresolved and indeed has led to a dramatic East-West confrontation with the western countries severing all ties with Russia further increases the uncertainty. Such a situation inflicts detrimental consequences for the in-between countries such as Moldova becoming components of the geopolitical tug-of-war between major powers

Inclusion of indigenous peoples in Olympic legacy-shaping processes

Scholars emphasise the need to understand how contested concepts, like social inclusion and legacy, are interpreted within specific contexts. However, there are a lack of critical studies on social legacies of sports mega-events. This study aims to analyse how social inclusion of marginalised groups is constructed in the legacy-shaping process of and bidding for the Olympic Games. Three cases were chosen in which the inclusion of Indigenous Peoples was stated as one of the goals of the bidding and organising committees: Sydney 2000, Vancouver 2010 and Tromsø 2014, 2018 bids. Translation theory and critical discourse analysis were used to understand how inclusion and legacy efforts are taken into action. The cases spread across space, time and bidding stage did not provide unique approaches to the formulations of legacies and inclusion. Despite the highlighted celebration of culture and diversity of communities in the documents, we interpret the inclusion discourse as a symbolic appreciation of Indigenous Peoples with attempts to address and solve the challenges connected to social exclusion. However, these attempts are characterised by postcolonial and assimilation thinking. A broader commitment is needed to create lasting social change through long-term initiatives created with and led by Indigenous Peoples.publishedVersio

Regional Cooperation Initiatives in the South Caucasus after the Second Karabakh War

The South Caucasus is presented as a “broken” region especially in the western literature due to several reasons. On one hand, the external actors has had incompatible interests over the territory because of its significant geopolitical and geostrategic location and rich energy resources. On the other hand, the South Caucasus has been scene to numerous long-standing disputes and destructive military confrontations. At the result, the security and peace of the region were jeopardized. Even if different regional partnership initiatives were proposed by the leaders of regional states since the dissolution of the Soviet Union, none of them have been implemented. The outbreak of the Second Karabakh War between Azerbaijan and Armenia did not only change the status quo between these two countries, it transformed the geopolitical realities of the South Caucasus and was a “wake-up” call for the countries to understand the necessity of peace and stability for the region. One of the first initiatives put forward to this end is the so-called 3+3 regional cooperation platform which includes the three South Caucasian republics plus Turkey, Russia, and Iran. The initiative was proposed by Turkish President Recep Tayyip Erdogan following the war. This master thesis discusses the impacts of 44 days war on the possibility of realization of the 3+3 cooperation format. It evaluates the benefits the interested parties could derive from this partnership and its role for developing conditions conducive for peace, security and prosperity in the South Caucasus. The research methodology is based on the case study method which helps the author to investigate the six-country regional cooperation from different analytical perspectives. The findings shows that even if there are opportunities for the integration of the region more than ever, there are still challenges for stability and the security of this territory which hinders the materialization of six-party cooperation. In order to end the hostilities between Azerbaijan and Armenia, the ceasefire agreement was signed in November 2020. However, it is not enough, and a peace agreement is needed to refrain parties from any military attack and support the reconciliation process. Other requirements for the peaceful and prosperous future of the South Caucasus are the harmonization of the interest of the external parties and the creation of security framework