COVID-19 and Public Health Spending; Effects on the Economic Sustainability of the Spanish Private Healthcare System.

This research analyzes the influence of COVID-19 and public health spending policies on the economic sustainability of Spanish private hospitals. Moreover, it explores the relationship between public health spending policies and the spread of COVID-19 in Spain. Private health care is an understudied sector, yet it is fundamental to the health of citizens. Moreover, the economic causes linked to the spread of the pandemic have not yet been clearly established. Therefore, this work covers a gap in the literature. Private hospital profitability was analyzed by applying ordinary least squares and panel data regressions on financial and macroeconomic data for the period 2017-2020. The spread of COVID-19 was examined by means of cluster and component analysis. The results show that the COVID-19 pandemic negatively affected the economic sustainability of Spanish private hospitals, which was also influenced by public health spending. In turn, the spread of the pandemic was mainly related to population density, but was also influenced by public health spending and the gross domestic product of the region. Therefore, policymakers must consider that it is essential to make adequate investments in the healthcare system to cope with pandemics such as COVID-19. In addition, managers can see how corporate social responsibility is a valuable strategy for maintaining hospital profitability.

Women in monitoring positions and market risk. Are the stocks of companies with gender diverse boards less volatile?

Gender equality is included in the United Nations Sustainable Development Goals and in the Global Jobs Pact of the International Labour Organization. Many countries, especially in Europe, are incorporating legal quotas into their legislation to oblige companies to increase the presence of women in the highest positions of responsibility. This measure has been controversial and widely debated, and so it is of great interest to analyze the economic effects that the incorporation of women brings. The aim of this paper is to analyze the relationship between the percentage of women on the board of directors and systematic market risk, measured using the beta of stocks in the S&P 500 and Euro Stoxx 300 indexes from 2015 to 2019. Applying OLS regressions with instrumental variables, fixed effects panel data, and a GMM estimation, the results show a negative and significant relationship for the U.S. market. However, this relationship was not confirmed for the European market.

The Effect of Public Healthcare Expenditure on the Reduction in Mortality Rates Caused by Unhealthy Habits among the Population.

The health systems of developed countries aim to reduce the mortality rates of their populations. To this end, they must fight against the unhealthy habits of citizens, such as smoking, excessive alcohol consumption, and sedentarism, since these result in a large number of deaths each year. Our research aims to analyze whether an increase in health resources influences the number of deaths caused by the unhealthy habits of the population. To achieve this objective, a sample containing key indicators of the Spanish health system was analyzed using the partial least squares structural equation modeling (PLS-SEM) method. The results show how increasing public health spending and, thus, the resources allocated to healthcare can curb the adverse effects of the population's unhealthy habits. These results have important implications for theory and practice, demonstrating the need for adequate investment in the healthcare system to reduce mortality among the population.

Regional well-being inequalities arising from healthcare expenditure public policies in Spain.

Well-being inequalities arising from different healthcare expenditure public policies is currently a hot topic at a national scale, but especially so at a sub-national level because the inequalities in question are among citizens of the same country. Spain is an optimal study area to carry out research on this topic because it is considered to have one of the best health systems in the world, it is one of the top-ranking countries in terms of life expectancy rates (the indicators we use for well-being), and it has a decentralized public health system with significantly different regional healthcare expenditure public policies. Given that the factors involved in the complex direct, indirect, and second-order relationships between well-being and health spending are latent in nature, and that there are more hypotheses than certainties regarding these relationships, we propose a partial least squares structural equation modeling specification to test the research hypotheses and to estimate the corresponding impacts. These constructs are proxied by a set of 26 indicators, for which annual values at a regional scale were used for the period 2005-2018. From the estimation of this model, it can be concluded that mortality, expenditure and resources are the factors that have the greatest impact on well-being. In addition, a cluster analysis of the indicators for the constructs included in this research reveals the existence of three clearly differentiated groups of autonomous communities: the northern part of the country plus Extremadura (characterized by the lowest well-being and the highest mortality rates), Madrid (with the best results in well-being and mortality, the lowest public health expenditure per inhabitant and percentage of pharmaceutical spending, and the highest percentage in specialty care services and medical staff spending), and the rest of the country (south-eastern regions, with similar well-being values to those of the first group but with less health expenditure). Finally, a principal component analysis reveals that "healthiness" and "basic spending" are the optimal factors for mapping well-being and health spending in Spain.

Analysis of Patient Satisfaction through the Effect of Healthcare Spending on Waiting Times for Consultations and Operations.

In recent years, public authorities have invested large amounts of public money in trying to reduce waiting times for consultations and operations with the aim of improving the quality of the healthcare system. Our research aims to analyze the effect of these investments on patient satisfaction through the mediating relationship of waiting times for consultations and operations, as well as from a gender perspective. By studying a series of key indicators of the Spanish healthcare system and applying partial least squares structural equation modelling (PLS-SEM), the findings show that the model explains 12.10% of the variance in consultant waiting times, 51.90% in operation waiting times, and 27.00% in patient satisfaction. We found that increased public spending leads to increased patient satisfaction by reducing waiting times. However, no gender-based differences were found. The results provide exciting implications for theory and practice, indicating how policymakers can orient their strategies towards improving patient satisfaction.

Health Investment Management and Healthcare Quality in the Public System: A Gender Perspective.

The aim of this empirical research was to provide useful information for health system managers on the costs and investments involved in improving the quality of the National Health Service (NHS) based on patient assessments and from a gender perspective, i.e., without assuming that the perceived experience is identical for men and women. A cross-sectional study of 31 variables was applied using partial least squares structural equation modeling (PLS-SEM) as a research tool. The data were obtained from the Spanish Ministry of Health, Consumption, and Social Welfare for the entire Spanish territory between 2005 and 2018. The influence of expenditure, resource allocation, and mortality was hypothesized with regard to patient satisfaction according to disconfirmation theory. Patient satisfaction reflects clinical effectiveness, and therefore is a measure of health system quality. The results show that women are more sensitive to public investment in health than men, i.e., an increase in the level of spending and resources increases satisfaction more in women. In both sexes, the level of expenditure has a direct influence on patient satisfaction, and therefore on the quality of the healthcare system. It is important to increase spending on primary care, especially on specialized medical care and diagnostic equipment. However, reducing the use of drugs in favor of alternative treatments or therapies is considered to be positive. Likewise, spending has an impact on available resources, and these, in turn, have a positive influence on the level of use and a negative impact on mortality. Resources, especially healthcare staff, nuclear magnetic resonance equipment, and the number of posts in day hospitals, increase patients' positive perception of the NHS.

Sustainable and conventional banking in Europe.

At the end of the 20th century a new banking model, the so-called ethical banking, emerged becoming the maximum exponent of a socially responsible investment. The financial crisis in 2008 led to a distrust of the conventional financial system and consequently investors began to look with interest this new banking, which only invests in ethical activities and products, with social and environmental criteria, total transparency and a democratic management. The aim of this article is to analyze the economic structure of ethical banking, compared to that of conventional banking, by paying attention to its liquidity, coverage and solvency. Specifically, We compare the financial statements of Triodos Bank, the main European ethical bank belonging to the Global Alliance for Banking on Values, with two of the main conventional banks of each of the five countries in Europe in which it operates. To do this, we apply a financial and economic analysis to the period from 2015 to 2018, the means difference test and analysis of variance on an array of financial ratios and, finally, probit regressions. The results reveal that ethical banking is growing more than conventional banking and it presents greater liquidity and solvency, although, in general terms, its profitability is not higher. In conclusion, both savers and investors have guarantees that their savings are invested not only in a responsible but also in a confident way in ethical banking.

Loan transactions associated to continuous distributions of capital.

The objective of this paper is to design a loan repayment plan adapted to the financed company with the aim to avoid a possible situation of illiquidity. More specifically, in this paper the sequence of payments which amortizes a loan is determined according to the distribution of the future income expected by the borrower. To do this, we will start from the concept of a continuous distribution of capital or, equivalently, a continuous annuity. The continuous distribution of capital will be derived from a continuous distribution of probability, to then obtain a discrete annuity which fits the future income of the debtor. On the other hand, it is noteworthy the analysis of the particular case of financial transactions with interest periods of different amplitude, which can facilitate the adjustment of the sequence of instalments to the timing of the real income of the borrower in loan transactions.