Adopting new medical technologies in Russian hospitals: what causes inefficiency? (qualitative study)
The adoption of new medical technologies often generates losses in efficiency associated with the excess or insufficient acquisition of new equipment, an inappropriate choice (in terms of economic and clinical parameters) of medical equipment, and its poor use. Russia is a good example for exploring the problem of the ineffective adoption of new medical technologies due to the massive public investment in new equipment for medical institutions in 2006–2013. This study examines the procurement of new technologies in Russian hospitals to find the main causes of inefficiency. The research strategy was based on in-depth semistructured interviews with representatives of prominent actors (regional health care authorities, hospital executives, senior physicians). The main result is that inefficiencies arise from the contradiction between hospitals’ and authorities’ motivation for acquiring new technologies: hospitals tend to adopt technologies which bring benefits to their department heads and physicians and minimize maintenance and servicing costs, while the authorities’ main concern is the initial cost of the technology.
The first volume involves the Russian Federation as a common denominator with either Norway (oldest multilateral region in the Arctic) or the United States (sharing with Russia the longest maritime boundary in the world) to interpret changes with connected biophysical and socio-economic systems that underscore decisions across a “continuum of urgencies” from security to sustainability time scales. The second and third volumes will emerge from presentations during the annual Arctic Frontiers Conferences in Tromsø, Norway, starting in January 2020. Volume 2 will consider circumstances associated with areas beyond sovereign jurisdictions from Arctic and non-Arctic perspectives, recognizing the international community has unambiguous rights and responsibilities in the Arctic High Seas under the law of the sea. Volume 3 is intended to synthesize insights on a pan-Arctic scale, analogous to the world ocean across all sea zones, involving decisions to achieve ongoing progress with sustainability, coupling governance mechanisms and built infrastructure. Throughout this book series, which we expect to expand beyond the Arctic, science diplomacy will be applied as an international, interdisciplinary, and inclusive (holistic) process, facilitating informed decisionmaking to balance national interests and common interests for the benefit of all on Earth across generations. With holistic integration, this book series will reveal skills, methods, and theory of informed decisionmaking that will continue to evolve, contributing to balance, resilience, and stability that underlie progress with sustainability across our home planet.
Modern capitalism favors values that undermine our face-to-face bonds with friends and family members. Focusing on the post-communist world, and comparing it to more 'developed' societies, this book reveals the mixed effects of capitalist culture on interpersonal relationships. While most observers blame the egoism and asocial behavior found in new free-market societies on their communist pasts, this work shows how relationships are also threatened by the profit orientations and personal ambition unleashed by economic development. Successful people in societies as diverse as China, Russia, and Eastern Germany adjust to the market economy at a social cost, relaxing their morals in order to obtain success and succumbing to increased material temptations to exploit relationships for their own financial and professional gain. The capitalist personality is internally troubled as a result of this "sellout," but these qualms subside as it devalues intimate qualitative bonds with others. This book also shows that post-communists are similarly individualized as people living in Western societies. Capitalism may indeed favor values of independence, creativity, and self-expressiveness, but it also rewards self-centeredness, consumerism, and the stripping down of morality. As is the case in the West, capitalist culture fosters an internally conflicted and self-centered personality in post-communist societies.
This abstract offers a method for ranking alternatives in a decison making problem. It determines importance of the criteria with help of factor analysis. Though the alternatives are evaluated by each of the criteria by a group of experts, the weights for the criteria are to be found with the help of factor analysis.
The algorithm of the method is as follows:
1. Under the constraint that the problem handles several evaluation criteria, several items to compare (alternatives) and several experts to give their evaluation.
2. Find the principal components that replace the input criteria implicitly.
3. To find the final mark for each of the alternatives the marks given by experts are multiplied with the regression coefficients, found in the step 2.
4. The final marks are represented in axes „crieria“ and „mark“ so that each alternative is described with a curve (trajectory). These curves represent the map of graded alternatives. Depending on the problem to be solved (min or max,) a record for each main criteria is to be found.
5. With help of special deviation measure procedures (Minkowski, Chebyshev e.t.s) a matrix of deviations from ideal solution is to be built.
6. The alternatives are to be rated in accordance to the deviation from the ideal trajectory.
To prove the effectiveness of the method it was applied to a problem for 5 alternatives, 3 experts and 38 evaluation criteria. The problem was also solved with the help of most popular method of Weighted Sum Model (WSM) and TOPSIS method. The problem was also being solved by finding the geometric mean for each alternative. The results for approaches were compared and the method, offered in this abstrat, proved itself as a feasible one.
The Working Paper examines the peculiarities of the Russian model of corporate governance and control in the banking sector. The study relies upon theoretical as well as applied research of corporate governance in Russian commercial banks featuring different forms of ownership. We focus on real interests of all stakeholders, namely bank and stock market regulators, bank owners, investors, top managers and other insiders. The Anglo-American concept of corporate governance, based on agency theory and implying outside investors’ control over banks through stock market, is found to bear limited relevance. We suggest some ways of overcoming the gap between formal institutions of governance and the real life.
The main focus of this paper is the relation between the realisation of the right of the child to express his/her views and democracy in Russia. With this in view, I will study the interconnection between the right to express the views and the right to participate. Further, I will give an overview of the specifics of democracy in Russia, how they influence political participation, and what could be done to prevent the further infantilisation of citizens in Russia. Finally, I will explore traditional perceptions with regard to children’s participation in Russia and the legal framework and practice of the implementation of the child’s right to social and political participation.
We review the transition of the Russian banking sector focusing on the interplay between ownership change and institutional change. We find that the state's withdrawal from commercial banking has been inconsistent and limited in scope. To this day, core banks have yet to be privatized and the state has made a comeback as owner of the dominant market participants. We also look at the new institutions imported into Russia to regulate banking and finance, including rule of law, competition, deposit insurance, confidentiality, bankruptcy, and corporate governance. The unfortunate combination of this new institutional overlay and traditional local norms of behavior have brought Russia to an impasse - the banking sector's ownership structure hinders further advancement of market institutions. Indeed, we may now be witnessing is a retreat from the original market-based goals of transition.
UK corporate tax reform, corporate tax in Russia and tax relief system were considered and described in the article. Also it was made an attempt to apply UK experience of innovative activity encouragement through corporate tax regulation to Russian economy.
In this paper the public-private wage gap is estimated by means both of the OLS and the quantile regression, which will provide a more complex picture of the distribution of the public-private sector wage gap. The author finds the existence of significant public-private wage gap (about 30%) considering both observable and unobservable characteristics of workers and jobs. Using the decomposition based on quantile regression helps to answer the question about the nature of the wage differences. The author comes to the conclusion that the main reason for the gap is the institutional mechanisms of public sector wages in Russia. The analysis is based on the data from Russian Longitudinal Monitoring Survey (RLMS-HSE) 2000-2010.
In his article Vladimir Kantor explores the destiny of Russia intelligentsia within the context of cultural crisis that took place at the turn of XIX and XX centuries, analyzing the Vekhovs, a group of leading intellectuals who ran a collection of essays, titled "Vekhi", studying their relationship towards that Russian cultural phenomenon. To author, the intelligentsia is considered as a critical factor in the development of Russian history. Within a context of the struggle around the "Vekhi", by referring to famous philosophical and literature books, published in 1909, the author focuses on relationships between intelligentsia and ordinary people, their attractive and repulsive interaction, which represents the key theme of the Russian destiny. Any historical movement occurs through tragedy; heroes who move the history have to sacrifice themselves to provide that movement. Confirmation to that idea would be rejection and exclusion of the Russian intelligentsia from the country's mentality throughout a number of generations which ultimately led to its tragic being.
The paper examines the structure, governance, and balance sheets of state-controlled banks in Russia, which accounted for over 55 percent of the total assets in the country's banking system in early 2012. The author offers a credible estimate of the size of the country's state banking sector by including banks that are indirectly owned by public organizations. Contrary to some predictions based on the theoretical literature on economic transition, he explains the relatively high profitability and efficiency of Russian state-controlled banks by pointing to their competitive position in such functions as acquisition and disposal of assets on behalf of the government. Also suggested in the paper is a different way of looking at market concentration in Russia (by consolidating the market shares of core state-controlled banks), which produces a picture of a more concentrated market than officially reported. Lastly, one of the author's interesting conclusions is that China provides a better benchmark than the formerly centrally planned economies of Central and Eastern Europe by which to assess the viability of state ownership of banks in Russia and to evaluate the country's banking sector.
The paper examines the principles for the supervision of financial conglomerates proposed by BCBS in the consultative document published in December 2011. Moreover, the article proposes a number of suggestions worked out by the authors within the HSE research team.
We address the external effects on public sector efficiency measures acquired using Data Envelopment Analysis. We use the health care system in Russian regions in 2011 to evaluate modern approaches to accounting for external effects. We propose a promising method of correcting DEA efficiency measures. Despite the multiple advantages DEA offers, the usage of this approach carries with it a number of methodological difficulties. Accounting for multiple factors of efficiency calls for more complex methods, among which the most promising are DMU clustering and calculating local production possibility frontiers. Using regression models for estimate correction requires further study due to possible systematic errors during estimation. A mixture of data correction and DMU clustering together with multi-stage DEA seems most promising at the moment. Analyzing several stages of transforming society’s resources into social welfare will allow for picking out the weak points in a state agency’s work.