RESUMEN
The inefficiency observed in investment within state-owned enterprises presents a significant practical challenge that can affect the sustainable development of China's economy. To address this issue, this study comprehensively explores the intricate mechanisms underlying the governance implications of mixed ownership on the investment efficiency of listed companies. Drawing on unbalanced panel data encompassing Shanghai and Shenzhen Stock Exchange A-share listed companies in China spanning the period from 2008 to 2022, this study employs a fixed-effects model to unveil the nuanced ways in which mixed ownership influences investment efficiency through the lens of agency costs. This study transcends the boundaries of traditional agency conflicts between managers and shareholders. It delves deeper, illuminating the diverse effects of agency conflicts between significant controlling shareholders and minority shareholders. The results revealed a noteworthy positive correlation between mixed ownership and investment efficiency, and verified the intermediary role of agency costs between mixed ownership and investment efficiency, which is an important result of our research. Heterogeneity analysis indicates that the relationship between the two can be affected by external events, such as during the COVID-19 pandemic, investment efficiency is not the most concerned issue for enterprises. The findings have practical implications for practitioners and policymakers, as they offer avenues for optimizing investment strategies and fostering efficient and effective corporate governance practices.
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COVID-19 , Inversiones en Salud , Propiedad , China , Inversiones en Salud/economía , Propiedad/economía , Humanos , COVID-19/economía , COVID-19/epidemiología , SARS-CoV-2 , Pandemias/economíaAsunto(s)
Hospitales Psiquiátricos , Servicios de Salud Mental , Propiedad , Sector Privado , Humanos , Hospitales Psiquiátricos/economía , Hospitales Psiquiátricos/organización & administración , Servicios de Salud Mental/economía , Servicios de Salud Mental/organización & administración , Propiedad/economía , Propiedad/organización & administración , Sector Privado/economía , Estados Unidos , Fuerza Laboral en Salud , Comercio , Calidad de la Atención de Salud , Accesibilidad a los Servicios de SaludRESUMEN
BACKGROUND: Emerging and re-emerging infectious diseases (EIDs), such as Ebola virus disease and highly pathogenic influenza, are serious threats to human health and wellbeing worldwide. The financial sector has an important, yet often ignored, influence as owners and investors in industries that are associated with anthropogenic land-use changes in ecosystems linked to increased EIDs risks. We aimed to analyse financial influence associated with EIDs risks that are affected by anthropogenic land-use changes. We also aimed to provide empirical assessments of such influence to help guide engagements by governments, private organisations, and non-governmental organisations with the financial sector to advance a planetary health agenda. METHODS: For this integrative analysis, we identified regions in the world where there was evidence of a connection between EIDs and anthropogenic land-use changes between Nov 9, 1999, and Oct 25, 2021, through a targeted literature review of academic literature and grey literature to identify evidence of drivers of anthropogenic land-use change and their association with commodity production in these regions. We only included publications in English that showed a connection between deforestation and the production of one or more commodities. Publications merely describing spatial or temporal land-use change dynamics (eg, a reduction of forest or an increase of palm-oil plantations) were excluded. As we were assessing financial influence on corporate activities through ownership specifically, we focused our analysis on publicly listed companies. Equity data and data about ownership structure were extracted from Orbis, a company information database. We assessed financial influence by identifying financial entities with the largest equity ownership, descriptively mapping transboundary connections between investors and publicly listed companies. FINDINGS: 227 public and private companies operating in five economic sectors (ie, production of palm oil, pulp and wood products, cocoa, soybeans, and beef) between Dec 15, 2020, and March 8, 2021, were identified. Of these 227, 99 (44%) were publicly listed companies, with 2310 unique shareholders. These publicly listed companies operated in six geographical regions, resulting in nine case-study regions. 54 (55%) companies with complete geographical information were included in the countries network. Four financial entities (ie, Dimensional, Vanguard, BlackRock, and Norway's sovereign wealth fund) each had ownership in 39 companies or more in three of the case-study regions (ie, north America, east Asia, and Europe). Four large US-based asset managers (ie, Vanguard, BlackRock, T Rowe Price, and State Street) were the largest owners of publicly listed companies in terms of total equity size, with ownership amounts for these four entities ranging from US$8 billion to $21 billion. The specific patterns of cross-national ownership depended on the region of interest; for example, financial influence on EIDs risks that was associated with commodity production in southeast and east Asia came from not only global asset managers but also Malaysian, Chinese, Japanese, and Korean financial entities. India, Brazil, the USA, Mexico, and Argentina were the countries towards which investments were most directed. INTERPRETATION: Although commodity supply chains and financial markets are highly globalised, a small number of investors and countries could be viewed as disproportionally influential in sectors that increase EIDs risks. Such financial influence could be used to develop and implement effective policies to reduce ecological degradation and mitigate EIDs risks and their effects on population health. FUNDING: Formas and Networks of Financial Rupture-how cascading changes in the climate and ecosystems could impact on the financial sector.
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Enfermedades Transmisibles Emergentes , Industrias , Políticas , Zoonosis , Humanos , Ecosistema , Industrias/economía , Inversiones en Salud , Propiedad/economía , Zoonosis/economía , Zoonosis/epidemiología , Internacionalidad , Enfermedades Transmisibles Emergentes/economía , Enfermedades Transmisibles Emergentes/epidemiología , Sector Privado/economía , Sector Público/economía , Organizaciones/economíaAsunto(s)
Atención a la Salud , Costos de la Atención en Salud , Instituciones de Salud , Propiedad , Sector Privado , Calidad de la Atención de Salud , Atención a la Salud/economía , Atención a la Salud/organización & administración , Atención a la Salud/normas , Instituciones de Salud/economía , Instituciones de Salud/normas , Propiedad/economía , Propiedad/organización & administración , Propiedad/normas , Sector Privado/economía , Sector Privado/organización & administración , Sector Privado/normas , Calidad de la Atención de Salud/economía , Calidad de la Atención de Salud/organización & administración , Calidad de la Atención de Salud/normasRESUMEN
The strategic choice of state-owned enterprises (SOEs) is crucial to the sustainable development of China's economy. This paper explores the impact of mixed-ownership reform on the strategic choice of SOEs from the shareholder power and the board power. We find that the greater the diversity of mixed shareholders, the depth of mixed equity, the control of mixed equity, and the excess control of mixed equity, the higher the degree of mixed-ownership reform, and the more likely it is to promote SOEs to choose the prospector strategy. The mechanism test states that the impact of mixed-ownership reform on enterprise strategy is achieved through the balance effect between non-state-owned shareholders and state-owned controlling shareholders with the same power, and the synergy effect between different powers of non-state shareholders. Further research indicates that the mixed-ownership reform has a stronger driving effect on the prospector strategy in SOEs under strict external supervision, competitive industries, and local areas. This study clarifies the governance logic of non-state-owned shareholders on the strategic positioning of SOEs by dual control rights, and it provides empirical evidence for the formulation of enterprises' market-oriented strategic objectives.
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Industrias , Propiedad , Desarrollo Sostenible , China , Industrias/economía , Industrias/organización & administración , Propiedad/economía , Propiedad/organización & administración , Desarrollo Sostenible/economíaRESUMEN
Importance: Care of adults at profit vs nonprofit dialysis facilities has been associated with lower access to transplant. Whether profit status is associated with transplant access for pediatric patients with end-stage kidney disease is unknown. Objective: To determine whether profit status of dialysis facilities is associated with placement on the kidney transplant waiting list or receipt of kidney transplant among pediatric patients receiving maintenance dialysis. Design, Setting, and Participants: This retrospective cohort study reviewed the US Renal Data System records of 13â¯333 patients younger than 18 years who started dialysis from 2000 through 2018 in US dialysis facilities (followed up through June 30, 2019). Exposures: Time-updated profit status of dialysis facilities. Main Outcomes and Measures: Cox models, adjusted for clinical and demographic factors, were used to examine time to wait-listing and receipt of kidney transplant by profit status of dialysis facilities. Results: A total of 13â¯333 pediatric patients who started receiving maintenance dialysis were included in the analysis (median age, 12 years [IQR, 3-15 years]; 6054 females [45%]; 3321 non-Hispanic Black patients [25%]; 3695 Hispanic patients [28%]). During a median follow-up of 0.87 years (IQR, 0.39-1.85 years), the incidence of wait-listing was lower at profit facilities than at nonprofit facilities, 36.2 vs 49.8 per 100 person-years, respectively (absolute risk difference, -13.6 (95% CI, -15.4 to -11.8 per 100 person-years; adjusted hazard ratio [HR] for wait-listing at profit vs nonprofit facilities, 0.79; 95% CI, 0.75-0.83). During a median follow-up of 1.52 years (IQR, 0.75-2.87 years), the incidence of kidney transplant (living or deceased donor) was also lower at profit facilities than at nonprofit facilities, 21.5 vs 31.3 per 100 person-years, respectively; absolute risk difference, -9.8 (95% CI, -10.9 to -8.6 per 100 person-years) adjusted HR for kidney transplant at profit vs nonprofit facilities, 0.71 (95% CI, 0.67-0.74). Conclusions and Relevance: Among a cohort of pediatric patients receiving dialysis in the US from 2000 through 2018, profit facility status was associated with longer time to wait-listing and longer time to kidney transplant.
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Instituciones de Atención Ambulatoria , Accesibilidad a los Servicios de Salud , Fallo Renal Crónico , Trasplante de Riñón , Diálisis Renal , Listas de Espera , Adolescente , Instituciones de Atención Ambulatoria/economía , Instituciones de Atención Ambulatoria/organización & administración , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Niño , Preescolar , Femenino , Administración de Instituciones de Salud/economía , Administración de Instituciones de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Fallo Renal Crónico/economía , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/terapia , Trasplante de Riñón/economía , Trasplante de Riñón/estadística & datos numéricos , Masculino , Organizaciones sin Fines de Lucro/economía , Organizaciones sin Fines de Lucro/organización & administración , Organizaciones sin Fines de Lucro/estadística & datos numéricos , Propiedad/economía , Propiedad/estadística & datos numéricos , Diálisis Renal/economía , Diálisis Renal/estadística & datos numéricos , Estudios Retrospectivos , Factores de TiempoRESUMEN
In the paper the costs of Polish county hospitals in 2015-2018 are studied using behavioral cost function. The set of variables combines hospitals' characteristics which may determine their level of costs, such as the form of ownership, bed turnover rate, number of patient-days and share of beds in emergency department with environment characteristics which may influence both outsourcing costs and patients' health. In 2017 the system of basic hospital service provision (hospital network) was introduced in Poland. Dummy variables included in the model represent the category of hospital in the system. The results show that the costs may be described using fixed effect panel model. Positive impact of percentage of emergency department patients transferred to other departments and of wages is found. Higher ratio of residents and interns to doctors is found to decrease costs. Dummy variable for the period after the introduction of hospital network assumed a negative sign with costs, but the parameter remained insignificant.
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Análisis Costo-Beneficio , Servicio de Urgencia en Hospital/economía , Necesidades y Demandas de Servicios de Salud , Costos de Hospital/organización & administración , Hospitales de Condado/economía , Propiedad/economía , Salarios y Beneficios/economía , Humanos , PoloniaRESUMEN
BACKGROUND: For-profit (FP) trauma centers (TCs) charge more for trauma care than not-for-profit (NFP) centers. We sought to determine charges, length of stay (LOS), and complications associations with TC ownership status (FP, NFP, and government) for three diagnoses among patients with overall low injury severity. METHODS: Adult patients treated at TCs with an International Classification of Diseases-based injury severity score (ICISS) survival probability ≥ 0.85 were identified. Only those who with a principal diagnosis of femur, tibial or rib fractures were included. RESULTS: Total charges were significantly higher at FP centers than NFP and lower at government centers (89.6% and -12.8%, respectively). FP TCs had a 12.5% longer LOS and government TCs had a 20.4% longer LOS than NFP TCs. CONCLUSION: Patients presenting to FP TCs with mild/moderate femur, tibial, or rib fractures experienced higher charges and increased LOS compared with government or NFP centers. There was no difference in overall complication rates.
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Fijación de Fractura/economía , Fracturas Óseas/cirugía , Propiedad/economía , Complicaciones Posoperatorias/epidemiología , Centros Traumatológicos/estadística & datos numéricos , Adolescente , Adulto , Femenino , Fijación de Fractura/efectos adversos , Fijación de Fractura/estadística & datos numéricos , Fracturas Óseas/diagnóstico , Fracturas Óseas/economía , Programas de Gobierno/economía , Programas de Gobierno/estadística & datos numéricos , Precios de Hospital/estadística & datos numéricos , Hospitales Privados/economía , Hospitales Privados/estadística & datos numéricos , Hospitales Públicos/economía , Hospitales Públicos/estadística & datos numéricos , Humanos , Puntaje de Gravedad del Traumatismo , Tiempo de Internación/economía , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/economía , Complicaciones Posoperatorias/etiología , Centros Traumatológicos/economía , Centros Traumatológicos/organización & administración , Adulto JovenAsunto(s)
Vacuna nCoV-2019 mRNA-1273 , Disentimientos y Disputas , Industria Farmacéutica , Inventores/legislación & jurisprudencia , National Institutes of Health (U.S.) , Patentes como Asunto/legislación & jurisprudencia , Investigadores/legislación & jurisprudencia , Vacuna nCoV-2019 mRNA-1273/economía , Vacuna nCoV-2019 mRNA-1273/genética , Vacuna nCoV-2019 mRNA-1273/provisión & distribución , Industria Farmacéutica/economía , Industria Farmacéutica/legislación & jurisprudencia , Humanos , Inventores/economía , National Institutes of Health (U.S.)/economía , National Institutes of Health (U.S.)/legislación & jurisprudencia , Propiedad/economía , Propiedad/legislación & jurisprudencia , Asociación entre el Sector Público-Privado/economía , Asociación entre el Sector Público-Privado/legislación & jurisprudencia , Investigadores/economía , SARS-CoV-2/genética , Estados UnidosRESUMEN
OBJECTIVE: To assess the impact of a novel communication and consultation skills model (WISE COACH [WC]) on dog owner perceptions of veterinarians and projected spending on veterinary care. SAMPLE: 1,200 US dog owners who had visited a veterinarian within the prior 18 months. PROCEDURES: Video recordings of 2 staged client consultations were made, with the veterinarian following the WC recommendations in one video and not following them in the other (control). Participants were randomly assigned to view one of the videos and completed an online survey to assess their perceptions and projected spending. Qualitative responses were coded to identify themes. RESULTS: The veterinarian was rated significantly higher in the WC video than in the control video for the characteristics first impression, skilled and knowledgeable, cares about me, cares about my pet, and communicates clearly, and was rated significantly lower for the characteristic rushed or abrupt. Participants who viewed the WC video were significantly more likely to follow the veterinarian's recommendations, return to see the veterinarian, and recommend the veterinarian. They were also approximately 1.4 times as likely to approve the full recommended treatment plan, and their projected total spending was approximately 15% higher than projected spending for participants who viewed the control video. CLINICAL RELEVANCE: Results showed improved client perceptions, client retention, quality of patient care, and financial metrics when the veterinarian followed the WC recommendations. Further study is needed to determine whether this model may also improve veterinarian well-being by improving client relationships and decreasing resistance to recommendations.
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Bienestar del Animal , Veterinarios , Bienestar del Animal/economía , Animales , Comunicación , Análisis Costo-Beneficio , Costos y Análisis de Costo , Perros , Humanos , Propiedad/economía , Derivación y Consulta , Encuestas y Cuestionarios , Veterinarios/economía , Veterinarios/psicologíaRESUMEN
BACKGROUND: Ambulatory surgery growth has increased in the last few decades as ambulatory surgery centers have been shown to succeed in cost efficiencies through their smaller size and breadth, specialization of care, and ability to quickly participate in perioperative process improvement and education. METHODS: A 5-year retrospective fiscal review was performed for all Northwell Health-physician ambulatory surgery center joint ventures. The outcome measures studied included model of ownership, specialty types, and gross revenue. Additional facility characteristics were studied, including growth trajectory, facility size, and cost to build a de novo facility. RESULTS: Eleven free-standing ambulatory surgery centers were identified at Northwell Health during the 5-year study period. The total gross revenue for all Northwell clinical joint ventures for 2019 alone was $102,854,000. Northwell Health is a majority stakeholder in eight of their joint venture ambulatory surgery centers, with an average Northwell ownership of 53 percent and an average number of physician owners per facility of 11. The number of hospital-physician joint-venture ambulatory surgery centers grew from two to 11 facilities during the study period (450 percent). Surgical volume followed a similar trajectory, increasing 295 percent over the same time period. CONCLUSIONS: The ambulatory surgery center setting provides a vast number of possibilities for key stakeholders, including patients themselves, to benefit from financial and clinical efficiencies. Ambulatory surgery centers have been popular, as they meet patient expectations for convenience of elective surgery, reduce payer and clinical pressures to minimize length of stay in hospitals, and achieve similar or higher quality care with less intense resources.
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Convenios Médico-Hospital/economía , Propiedad/economía , Calidad de la Atención de Salud/economía , Centros Quirúrgicos/organización & administración , Procedimientos Quirúrgicos Ambulatorios/economía , Humanos , Estudios Retrospectivos , Centros Quirúrgicos/economía , Estados UnidosRESUMEN
The impacts of autonomous vehicles (AV) are widely anticipated to be socially, economically, and ethically significant. A reliable assessment of the harms and benefits of their large-scale deployment requires a multi-disciplinary approach. To that end, we employed Multi-Criteria Decision Analysis to make such an assessment. We obtained opinions from 19 disciplinary experts to assess the significance of 13 potential harms and eight potential benefits that might arise under four deployments schemes. Specifically, we considered: (1) the status quo, i.e., no AVs are deployed; (2) unfettered assimilation, i.e., no regulatory control would be exercised and commercial entities would "push" the development and deployment; (3) regulated introduction, i.e., regulatory control would be applied and either private individuals or commercial fleet operators could own the AVs; and (4) fleets only, i.e., regulatory control would be applied and only commercial fleet operators could own the AVs. Our results suggest that two of these scenarios, (3) and (4), namely regulated privately-owned introduction or fleet ownership or autonomous vehicles would be less likely to cause harm than either the status quo or the unfettered options.
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Automatización/ética , Vehículos Autónomos/ética , Modelos Estadísticos , Propiedad/economía , Accidentes de Tránsito/prevención & control , Actitud , Automatización/legislación & jurisprudencia , Conducción de Automóvil/psicología , Vehículos Autónomos/legislación & jurisprudencia , Técnicas de Apoyo para la Decisión , Humanos , Principios Morales , Encuestas y CuestionariosRESUMEN
We analyze the connectivity of equity investments to the firms in the global ownership network that are reported as non-compliant with Environment, Social, and Government (ESG) benchmarks. We find that a large number of shareholders have ownership linkages to non-ESG firms, most commonly with three or four degrees of separation. Analyzing the betweenness centrality for shareholders connecting the ultimate owners and non-ESG firms, we find that the investment management companies play important roles in channeling the investment money into non-ESG firms, where largest American asset managers commonly have one to two degrees of separation on their ownership linkages to those problematic firms. Since asset managers collect capital from investors by running the equity funds, we analyze the ownership stakes and the associated voting rights attributable to the equity funds investors. We estimate the distribution of the power of corporate control over non-ESG firms among specific asset managers (such as BlackRock and Fidelity) and among different types of the equity funds (such as mutual funds and exchanged-traded funds), and explores how investing in the equity funds rather than ownership investing may have shifted the distribution of the power to control those non-ESG firms.
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Algoritmos , Administración Financiera/economía , Inversiones en Salud/economía , Inversiones en Salud/organización & administración , Organizaciones/economía , Propiedad/economía , Responsabilidad Social , Humanos , Estados UnidosRESUMEN
Guiding institutional investors to actively participate in corporate governance is a hot issue to improve the internal governance of China's listed companies. This study seeks to provide a comprehensive understanding of the mechanism that underlies the governance effects of the heterogeneity of institutional investors on the cost of capital, and the influence of ownership structure on the relationship between them. Using an unbalanced panel data on A-share listed companies of Shanghai and Shenzhen in China's capital market during the 2014-2019 period, this study reveals how institutional investors with longer holding period and higher shareholding ratio are negatively associated with the cost of capital in China's capital market. Furthermore, this study successfully confirms the moderating effect of ownership structure in the relationship between institutional investors and the cost of capital. China's state-owned enterprises are more likely to introduce improvements at the corporate governance level, and ownership concentration weakens the negative influence of institutional investors on the cost of capital. The research contributes to a deeper understanding of the impacts of institutional investor's heterogeneity and ownership structure on the cost of capital in China. In the process, the study yields useful implications for the theory and practice of corporate governance.
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Inversiones en Salud/organización & administración , Propiedad/economía , China , Gobierno , Propiedad/organización & administraciónRESUMEN
OBJECTIVES: This study examines the relationship of debt stress and reverse mortgage borrowing and compares it to stress from standard mortgages and consumer debt. Debt stress is measured as a self-reported response to the amount of debt. METHODS: Using a unique national data set of 1,026 homeowners who chose whether to obtain a reverse mortgage in 2010, we estimate the relationship of 2014 levels of debt stress with various types of debt, assets, and income. Using an ordered probit model, we address the endogeneity of our measures of mortgage and consumer debt using an instrumental variables regression model. RESULTS: We found that consumer debt causes more stress per dollar of debt compared to mortgage debt. Reverse mortgages cause a relatively low level of stress per dollar of debt compared with standard mortgage debt. The average treatment effect of originating a reverse mortgage indicates statistically significantly higher probability of reporting no and not very much debt stress. DISCUSSION: Reverse mortgage debt causes a complex stress response. Stress per dollar of debt is lower for reverse than standard mortgages 4 years after origination. However, reverse mortgages' loan balance grows over time causing total stress to increase, while stress from a standard mortgage decreases as it is repaid. If an older adult uses reverse mortgage funds to repay consumer debt then total stress is reduced.
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Financiación Personal/economía , Vivienda/economía , Propiedad/economía , Satisfacción Personal , Anciano , Comportamiento del Consumidor , Femenino , Humanos , Renta/estadística & datos numéricos , Masculino , Estados UnidosAsunto(s)
Cárceles Locales , Servicios de Salud Mental/organización & administración , Organizaciones sin Fines de Lucro , Propiedad/clasificación , Propiedad/organización & administración , Prisioneros/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Servicios de Salud Mental/economía , Propiedad/economía , Estados UnidosRESUMEN
As passive investment through index funds and Exchange Traded Funds (ETFs) has become pervasive, the structure of corporate control in the global capital market is more complex than before. We propose a new model and calculation algorithm to measure a shareholder's power to control corporations in the global economy. Our method takes into account how fragmented voting rights attached to dispersed ownership may be consolidated to generate corporate control. Analyzing the ownership holdings in 49 million companies worldwide by 69 million shareholders in 2016, we find that the landscape of global corporate control appears differently if we adequately evaluate indirect influence via dispersed ownership. In particular, a larger portion of corporate control appears to be concentrated in the hands of sovereign governments than has been recognized before. Yet, such governmental capacities are "hidden" if we use the conventional method. Moreover, financial institutions appear to not be as powerful as emphasized before. These results point to important financial and political risks both for scholars and policymakers.
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Organizaciones/economía , Propiedad/economía , Algoritmos , Análisis Numérico Asistido por ComputadorRESUMEN
PURPOSE: Do pets provide benefits or risks for low-income individuals in regards to food security? METHOD: Surveys of food security were administered to 392 low-income adults utilizing food pantries. Data collection included a self-administered questionnaire about demographics, food security, health and well-being, and for those with pets, animal attachment, commitment and animal information. Qualitative interviews were conducted with fifteen pet-owning individuals who completed the questionnaire and agreed to be contacted and interviewed over the phone about food security and their pets. RESULTS: Bivariate analyzes suggested that those with pets were more food secure and logistic regression found pet ownership associated with greater food security. The interviews suggest that pets assisted in creating a routine, and motivation for obtaining food. DISCUSSION: It is critical that social workers realize the importance of pets in the lives of humans and include them in psychosocial assessments and as motivators for health interventions.
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Seguridad Alimentaria/economía , Propiedad/economía , Aceptación de la Atención de Salud/estadística & datos numéricos , Mascotas/economía , Mascotas/psicología , Pobreza/economía , Pobreza/psicología , Adulto , Anciano , Anciano de 80 o más Años , Animales , Femenino , Seguridad Alimentaria/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Propiedad/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
Recently, dermatology group practice ownership structures have changed, as private equity (PE) consolidates independent dermatology practices to create larger groups. Currently, little is known about how dermatology residents perceive practice ownership structures, including those that are owned by PE. One hundred thirty-seven residents from 32 dermatology residency programs responded to a 21-question anonymous survey. Approximately 65% of residents in this study were not open to working for PE-backed practices, and their negative perceptions of how PE influences quality of care, long-term salary, and physician autonomy were associated with their unwillingness to work at a PE-backed practice. Most residents in this study valued education about practice ownership structures, and approximately 43% of respondents did not feel adequately informed about practice options during residency. Future studies should evaluate how PE ownership of group practices influences practice parameters, including quality of patient care, physician autonomy, and long-term salary.
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Dermatología/economía , Estados Financieros/economía , Práctica de Grupo/economía , Internado y Residencia , Propiedad/economía , Pautas de la Práctica en Medicina/economía , Práctica Privada/economía , Humanos , Calidad de la Atención de Salud , Salarios y Beneficios/economía , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
The corporatization of dermatopathology has long preceded that of dermatology and has been driven by federal legislation and economic influences. Although the Clinical Laboratory Improvement Amendments and the Stark Law limited physician-owned laboratories, loopholes via the Safe Harbor Exemptions outlined in the Anti-Kickback Statute allowed corporate laboratories to flourish through relationships built by health information technology donations. The rise of corporatization has had widespread effects on the fields of dermatopathology and dermatology, resulting in reduced numbers of dermatology-trained dermatopathologists and decreased caseloads in academic institutions, potentially compromising dermatology residency education. Although there have been efforts to counteract these effects, more global changes will be required to alter the direction of this subspecialty.