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Social Insurance, Organization and Hospital Care

Rehn, Eric LU (2009) In Lund Economic Studies 152.
Abstract (Swedish)
Popular Abstract in Swedish

Svensk sammanfattning av avhandlingen: “Social Insurance, Organization and Hospital Care”.

Denna avhandling handlar om incitament och organisation. Det inledande kapitlet sammanfattar avhandlingen samt diskuterar relaterad litteratur. Kapitel 2 är ett bidrag till den teoretiska litteraturen kring socialförsäkringar, kapitel 3 behandlar den optimala organisationen av trilateralhandel (definieras nedan) och kapitel 4 diskuterar ett nytt sätt att teoretiskt analysera organisationen av offentliga sjukhus.

Kapitel 2: Med Parsons (1996) sjukersättningsmodell (disability insurance) som utgångspunkt så analyseras vad som händer när man ökar antalet ”arbetsförmågenivåer” i ekonomin (i... (More)
Popular Abstract in Swedish

Svensk sammanfattning av avhandlingen: “Social Insurance, Organization and Hospital Care”.

Denna avhandling handlar om incitament och organisation. Det inledande kapitlet sammanfattar avhandlingen samt diskuterar relaterad litteratur. Kapitel 2 är ett bidrag till den teoretiska litteraturen kring socialförsäkringar, kapitel 3 behandlar den optimala organisationen av trilateralhandel (definieras nedan) och kapitel 4 diskuterar ett nytt sätt att teoretiskt analysera organisationen av offentliga sjukhus.

Kapitel 2: Med Parsons (1996) sjukersättningsmodell (disability insurance) som utgångspunkt så analyseras vad som händer när man ökar antalet ”arbetsförmågenivåer” i ekonomin (i Parsons är individerna antingen arbetsoförmögna eller arbetsförmögna). Först introduceras en tredje nivå: partiell arbetsförmåga. Därefter betraktas arbetsförmåga som en kontinuerlig variabel, d.v.s. alla tänkbara nivåer av arbetsförmåga finns representerade i ekonomin. I stort följer resultaten, i kapitel 2, resultaten i Parsons (1996); individer bör ges incitament att arbeta i linje med sin arbetsförmåga, detta möjliggör en generösare behandling av målgruppen för sjukersättningen (de som inte kan arbeta).

Kapitel 3: Tänk er en situation där en biltillverkare behöver insatsvaror från två olika underleverantörer – den ena producerar kretskort och den andra producerar färddatorer. Underleverantören som producerar färddatorer behöver kretskort för denna produktion och köper dessa från den andra underleverantören. Denna typ av handel kallas trilateralhandel i kapital 3. Hur ska denna trilaterala handel organiseras? För att analysera detta anpassas modellen i Hart (1995) till trilateralhandel. Det visar sig att det ofta är optimal med partiell integration d.v.s. att en av underleverantörerna integreras med företaget som producerar slutprodukten, men inte den andra. Underleverantörerna ska således, i många fall, behandlas olika och hur de ska behandlas beror i slutändan på deras humankapital och relationen mellan företagens fysiska tillgångar.

Kapitel 4: Utgångspunkten är att sjukhusvård är produkten av samarbete mellan behandlande avdelningar (t.ex. medicin eller kirurgi), stödjande avdelningar (t.ex. laboratorier och bilddiagnostik) och till viss del hotelltjänster (t.ex. städning och matlagning). Här appliceras samma typ av modell som i kapitel 3 på offentliga sjukhus, detta för att analysera integration och desintegration (privatisering) av delar av offentliga sjukhus. Det visar sig att integration generellt är att fördra så länge sjukhushuvudmannens human kapital är essentiellt för sjukhusvården t.ex. om sjukhushuvudmannen är en behandlande sjukhusavdelning. Under vissa förutsättningar bör dock hotelltjänster privatiseras. Förutom detta diskuteras hur väl modellen passar för en analys av offentliga sjukhus. (Less)
Abstract
This thesis consists of four chapters where chapter 1 introduces the topics in the following chapters and discusses some related literature.

Chapter 2 moves beyond the disability insurance with two types, able and disabled, in Parsons (1996). This is done in two ways: by introducing a third type, the partially disabled, and by allowing for a continuum of types. It is assumed throughout that the individuals have state-dependent utility of consumption. The results are in essence consistent with Parsons: individuals should be given incentives to work in line with their ability and this leaves room for being more generous towards the targeted group(s). The continuous model, however, opens up for using a broader range of incentives... (More)
This thesis consists of four chapters where chapter 1 introduces the topics in the following chapters and discusses some related literature.

Chapter 2 moves beyond the disability insurance with two types, able and disabled, in Parsons (1996). This is done in two ways: by introducing a third type, the partially disabled, and by allowing for a continuum of types. It is assumed throughout that the individuals have state-dependent utility of consumption. The results are in essence consistent with Parsons: individuals should be given incentives to work in line with their ability and this leaves room for being more generous towards the targeted group(s). The continuous model, however, opens up for using a broader range of incentives than in the discrete models.

Chapter 3 uses the basics from the property rights approach to organization (Grossman-Hart-Moore model) to develop a model for trilateral trade transactions. In this transaction a downstream producer produces the final good using inputs from two upstream suppliers. Moreover one of the upstream suppliers needs an input from the other for its production. The optimal way to organize this transaction depends on the characteristics of assets, human capital and investments. The general finding is that it is more demanding to find a unique Pareto optimal organization in the trilateral model than in the bilateral version of the model. In addition, it is found that the starting point for the analysis affects the results, suggesting that choosing suitable starting points is important for applications of the model.

Chapter 4 presents a novel way to analyze the organization of hospitals, with special focus on public hospitals. The novelty is that the property rights approach to organization (PRA) is used to analyze the problem. It is proposed that PRA is suitable for the analysis of all hospitals and especially so for public hospitals. The analysis explores issues concerning privatization and integration of public hospital services. The findings are generally supportive of integration as long as the public principal's human capital is essential for the production of hospital care. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Dr. Siciliani, Luigi, Department of Economics, York University
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Disability insurance, Trilateral Trade, Continuous disability, Partial Disability, Property Rights Approach to Organization, Imperfect Tagging, Partial Integration, Public Hospitals, Joint Production, Privatization, Integration
in
Lund Economic Studies
volume
152
pages
208 pages
defense location
EC3:210, Holger Crafoords Ekonomicentrum
defense date
2009-05-09 11:15
ISSN
0460-0029
language
English
LU publication?
yes
id
5ba10ff2-6360-47da-8d9e-5b46a735191c (old id 1364008)
date added to LUP
2009-04-06 12:46:48
date last changed
2016-09-19 08:45:00
@phdthesis{5ba10ff2-6360-47da-8d9e-5b46a735191c,
  abstract     = {This thesis consists of four chapters where chapter 1 introduces the topics in the following chapters and discusses some related literature.<br/><br>
 Chapter 2 moves beyond the disability insurance with two types, able and disabled, in Parsons (1996). This is done in two ways: by introducing a third type, the partially disabled, and by allowing for a continuum of types. It is assumed throughout that the individuals have state-dependent utility of consumption. The results are in essence consistent with Parsons: individuals should be given incentives to work in line with their ability and this leaves room for being more generous towards the targeted group(s). The continuous model, however, opens up for using a broader range of incentives than in the discrete models.<br/><br>
 Chapter 3 uses the basics from the property rights approach to organization (Grossman-Hart-Moore model) to develop a model for trilateral trade transactions. In this transaction a downstream producer produces the final good using inputs from two upstream suppliers. Moreover one of the upstream suppliers needs an input from the other for its production. The optimal way to organize this transaction depends on the characteristics of assets, human capital and investments. The general finding is that it is more demanding to find a unique Pareto optimal organization in the trilateral model than in the bilateral version of the model. In addition, it is found that the starting point for the analysis affects the results, suggesting that choosing suitable starting points is important for applications of the model.<br/><br>
 Chapter 4 presents a novel way to analyze the organization of hospitals, with special focus on public hospitals. The novelty is that the property rights approach to organization (PRA) is used to analyze the problem. It is proposed that PRA is suitable for the analysis of all hospitals and especially so for public hospitals. The analysis explores issues concerning privatization and integration of public hospital services. The findings are generally supportive of integration as long as the public principal's human capital is essential for the production of hospital care.},
  author       = {Rehn, Eric},
  issn         = {0460-0029},
  keyword      = {Disability insurance,Trilateral Trade,Continuous disability,Partial Disability,Property Rights Approach to Organization,Imperfect Tagging,Partial Integration,Public Hospitals,Joint Production,Privatization,Integration},
  language     = {eng},
  pages        = {208},
  school       = {Lund University},
  series       = {Lund Economic Studies},
  title        = {Social Insurance, Organization and Hospital Care},
  volume       = {152},
  year         = {2009},
}