do doctors practice defensive medicine defensive medicine is a potentially serious social problem if fear of liability drives health care providers to administer treatments that do not have worthwhile medical benefits then the current liability system may generate inefficiencies much larger than the costs of compensating malpractice claimants to obtain direct empirical evidence on this question we analyze the effects of malpractice liability reforms using data on all elderly medicare beneficiaries treated for serious heart disease in 1984 1987 and 1990 we find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications we conclude that liability reforms can reduce defensive medical practices

collective learning tacit knowledge and regional innovative capacity lawson c and lorenz e 1999 collective learning tacit knowledge and regional innovative capacity reg studies 33 305 317 the paper reviews key ideas in the firm capabilities literature and shows how they can be usefully extended to develop a conception of collective learning among regionally clustered enterprises the paper also explores the relationship between codifiable and tacit knowledge in the innovation process and investigates the claim that tacit knowledge because it is difficult to transfer in the absence of labour mobility may constitute a basis for sustained regional competitive advantage the closing section uses case study material based on minneapolis and cambridge to illustrate the importance for innovation of a regional capability for combining and integrating diverse knowledge and of the sources of such capabilities as pre conditions for successful high technology regions lawson c et lorenz e 1999 l apprentissage collectif la connaissance implicite et la capacite regio

concentration diversification and earnings instability some evidence on developing countries exports of manufactures and primary products policies aimed at diversification of the commodity composition of exports continue to be advocated as a means of reducing instability in ldcs export earnings the usual assumptions are that earnings from manufactures are more stable than earnings from primary products and that diversification will reduce the covariances between earnings from different pairs of products it is suggested here that for several reasons these assumptions may not be valid evidence is then presented which indicates that across a sample of countries diversification has taken place but has not been accompanied by relatively greater stability in manufactures and favourable changes in covariances

booming sector economic activity in paraguay 1973 86 a case of dutch disease the primary purpose of this study is to investigate the applicability of the dutch disease model as a means of explaining the changing sectoral composition of output for paraguay in the period 1973 86 the consequences of booming sector activity for 1 the distribution of income as it affects wages and 2 the in stability of export earnings for paraguay are examined the dutch disease model predicts that the consequences of booming activity will include a contraction of non booming sector activity as well as a real appreciation of the exchange rate these outcomes are tested in several single and multiple equation estimable models for the case of paraguay

sources of stagnation in sub saharan africa abstract this paper investigates the sources of economic stagnation in sub saharan africa during the 1970s several policy variables are considered as well as a set of environmental variables which include climate violence export prices and other exogenous factors the paper uses statistical analysis in an attempt to identify the relative importance of the policy variables and the environmental variables taken as groups it also seeks to identify particular policy variables which seem to have been most significant in determining growth outcomes the technique employed for investigation is reduced form econometric estimation in a preliminary analysis the impact of the international trade environment on average economic performance in africa during the period since independence is investigated the results suggest an extremely close relationship between movements in export prices and average performance throughout the 20 year period a second econometric exercise investigates the joint impacts of environmental and policy variables on growth in a cross section of african states since 1970 the spirit of the approach is exploratory and a relatively large number of variables are constructed and tested through multivariate analysis a primary finding is that the environmental variables seem to have had more impact on growth as a group than the policy variables this finding must be qualified however by the continuing lack of some important policy variables agricultural price data have not yet become available in sufficient quantity for cross section analysis nor have several important human resource variables and indices of the use of resources in the public domain among the policy variables which have been used for the analysis those identified with retrenchment during periods of declining commodity prices seem most significant primary among these are the real effective exchange rate and some measures of effectiveness in foreign exchange reallocation during periods when imports must contract severely in the final section of the paper the cross section results are used for a counterfactual analysis of the growth experiences of individual african states measures of growth opportunity cost are constructed which suggest the degree to which errors in management and uncontrollable circumstances have held states below their potential growth paths the results suggest that some success stories may owe much to good luck while some failures may well be due less to bad management than to adverse circumstances

a survey of agricultural household models recent findings and policy implications semicommercial farms that produce multiple crops make up a large part of the agricultural sector in developing economies these farms or agricultural households combine two fundamental units of microeconomic analysis the household and the firm traditional economic theory has dealt with these units seperately but in developing economies in which peasant farms dominate their interdependence is of crucial importance researchers have developed models of agricultural households that combine producer and consumer behavior in a theoretically consistent fashion recent empirical applications of these models have extended them and expanded the range of policy issues which can be investigated using this general framework this article reports the results of empirical applications of this model in india indonesia japan the republic of korea malaysia nigeria senegal sierra leone taiwan and thailand it provides a comparative analysis of the policy implications of the approach for such matters as the welfare of farm households the size of marketed surplus the demand for nonagricultural goods and services and for hired labor and the availability of budget revenues and foreign exchange

technological capabilities and industrialization abstract this paper reviews the implications for industrial strategy of recent research on technological capabilities at the firm and national levels after exploring the nature and determinants of microlevel technological development a simple framework for explaining the growth of national capabilities is set out based on the interplay of incentives capabilities and institutions each may suffer market failure and so require corrective intervention the experience of some industrializing countries is described to assess the validity of this framework it is concluded that interventions carefully and selectively applied are necessary for industrial success

models of export instability and empirical tests for less developed countries abstract alternative models are developed in which export earnings instability is generated by domestic supply domestic demand or foreign demand fluctuations their relative merits over the 1957 1972 period are examined through multiple regression analysis for a sample of 50 ldcs with breakdown into sub samples based on the type of commodity exported and the nature of foreign markets the results suggest that export instability originates mainly from foreign sources especially variations of market shares in foreign markets and commodity groups however domestic supply and demand fluctuations are the dominant factors for countries highly dependent on food exports geographic concentration is an important factor for countries dependent on food exports and developed country markets

sources procedures and microeconomic effects of innovation fabio arcangeli paul david frank engelman christopher freeman massimo moggi richard nelson luigi orsenigo nathan rosenberg michele salvati g n von tunzelman two anonymous referees and the participants at the meeting of the committee on distribution growth and technical progress of the italian national research council cnr rome november 16 1985 have helped with various redraftings a particularly grateful acknowledgment is for the insightful and patient help of moses abramovitz this work has been undertaken at the science policy research unit spru university of sussex as part of the research program of the designated research centre sponsored by the economic and social research council esrc earlier support to the research that led to this paper by the italian national research council cnr is also gratefully acknowledged the statistical research has been undertaken with the assistance of stephano brioschi ilaria fornari and giovannu prennushi

the u s patent system in transition policy innovation and the innovation process abstract this paper surveys the major changes in patent policy and practice that have occured in the last two decades in the u s and reviews the existing analyses by the economists that attempt to measure the impacts these changes have had on the processes of technological change it also reviews the broader theoretical and empirical literature that bears on the expected effects of changes in patent policy despite the significance of the policy changes and the wide availability of detailed data relating to patenting robust conclusions regarding the empirical consequences for technological innovation of changes in patent policy are few possible reasons for these limited results are discussed and possible avenues for future research are suggested

the emergence of technology systems knowledge production and distribution in the case of the emilian plastics district the emergence of technology systems is the result of interdependen t dynamics of generation and diffusion of complementary bits of localised technological knowledge technological communication is the crucial element assessing the collective conditions under which technological knowledge is accumulated and diffused the case study of the emerging emilian technological system in the plastics sector shows that the synchronic and diachronic localised interactions among industrial dynamics institutional r d efforts and technological interrelatedness are the determinants of the systematic production accumulation and distribution of localised technological knowledge in turn explaining the origin and development of the technology system itself

geographic concentration and china s agricultural export instability this paper investigates the impacts of geographic concentration on china s agricultural export instability with a multiple region variance decomposition approach the decomposition results suggest that china s agricultural export concentration into the japanese market greatly lowers agricultural export instability while concentration into the hong kong south korea asean the us and russian federation markets increases export instability china s exports to the eu also lower its agricultural export instability further decomposition results indicate that the impacts of geographic concentration on different agricultural product export instabilities are different

commodity concentration and export earnings instability a shift from cross section to time series analysis conventionally commodity concentration has been regarded as a major factor contributing to the short term instability in earnings experienced by developing countries the repeated and unexpected lack of correspondence between the conventional view and results of empirical studies has generated attempts to identify the limitations of the customary analytical framework this paper attempts to derive a more satisfactory alternative framework application of this alternative approach to export data for a sample of developing countries produces results which in contrast to the evidence of previous studies indicate the widespread existence of a statistically significant positive relationship between concentration and export instability

export instability and economic growth in sub saharan africa empirical research on the relationship between export instability and economic growth in less developed countries ldcs has yielded mixed results while some researchers find a negative relationship between export instability and economic growth others find a positive relationship a third group of researchers finds no significant relationship between export instability and economic growth in ldcs 1 those who find a negative relationship between export instability and economic growth in ldcs stress the negative effect export instability has on the supply of output through the generation of uncertainty in long term planning as well as due to shortages of inputs at critical times during the production process those who find a positive relationship between export instability and economic growth argue that ldcs respond to export instability by reducing consumption this process if repeated over a period of time increases savings and hence the rate of investment those who find no significant relationship between export instability and economic growth argue that ldcs are able to anticipate the fluctuations in export earnings and plan for such fluctuations hence instability in export earnings has no appreciable effect on economic growth c moran investigates the relationships between domestic savings rate and economic growth rate on the one hand and export instability on the other in a sample of ldcs 2 he finds that export instability has no significant long run impact on either domestic savings rate or economic growth rate however over relatively short periods of time export instability has a negative and significant effect on both savings and economic growth rate the negative effect occurs when the negative effects of price and of quantity fluctuations reinforce each other on the other hand when the negative effect of price fluctuations is counterbalanced by the effects of quantity fluctuations export instabil

new firm formation and regional development the italian case garofoli g 1994 new firm formation and regional development the italian case reg studies 28 381 393 the italian case appears to have had a very high firm birth rate mainly in manufacturing in comparison with the experience of other economically advanced countries regional differentiation in new firm formation has been very high in italy in the analysed period 1987 1991 the paper deals with the hypotheses to be tested for the interpretation of the regional differentiation in firm birth and analyses the problem of the choice of socio economic variables which must be examined the results of the regression analysis prove that production structure and mainly local productive specialization firms size social structure and professional employment structure are the most important explanatory variables for new firm formation and for its regional differentiation the level of local demand does not seem to be a significant factor and increases in unemployment appear to reduce firm births all t

booming sector and de industrialisation in a small open economy this paper presents a theoretical analysis of the dutch disease the phenomenon whereby a boom in one traded goods sector squeezes porfitability in other traded goods sectors both by directly bi

science parks and regional innovation performance in fiscal austerity era less is more european financial crisis has raised questions about the sustainability and the contribution of innovation anchors especially in southern european countries such as greece this paper utilizes the concept of regional innovation systems riss and introduces a methodological approach that allows for evaluating an science and technology park s stp contribution into the corresponding ris performance taking into consideration 1 the ris idiosyncrasies 2 the dominant role of government expenditures on r d and 3 the underlying complexity of knowledge production and management under alternative sets of restrictions imposed by fiscal consolidation on the preferences of authorities which design and implement science technology and innovation sti policies our framework relies on the estimation of a multi input multi output latent knowledge production function approach and the corresponding efficiency indices data requirements are sourced from the regional innovation scoreboard for the four greek regions and from a small scale case study with respect to the examined regional stp covering the period from 2000 to 2012 the main empirical findings highlight that the contribution of the examined stp in the corresponding ris performance diminishes alongside with the decrease in gerd investment levels with respect to all the efficiency indices these findings are attributed to the structural characteristics of both the ris and the stp under investigation and capture their dependence on managing public financial resources for sti activities

commodity decomposition of export import instability new zealand abstract this study examines instability of a country s income terms of trade in preference to its export receipts and uses a two step decomposition first the normalised variance of the income terms of trade is explained in terms of the variance of its two components the commodity terms of trade and the export quantity index then the variance of these indices is explained in terms of the variance of the individual commodity components the model is applied to the new zealand economy during 1962 1963 to 1978 1979 interaction terms account for a large part of the total variance indicating that the structure of the domestic economy is an important determinant of trade instability

determinants of export instability in the primary commodity trade of ldc s abstract based on a sample of 61 ldc primary commodity markets an attempt is made to explain inter market variations in price quantity and earnings instability a model similar to that used to explain aggregate export earning instability is tested empirical results point to internal fluctuations as a major determinant of export market instability

the diffusion of regional innovation capabilities evidence from italian patent data quatraro f diffusion of regional innovation capabilities evidence from italian patent data regional studies this paper investigates the diffusion of regional innovation capabilities within the manufacturing sector the competence based theory of the region allows for combining the schumpeterian view upon innovation and business cycles and the growth poles theory innovation capabilities spread within the region after the expansion of the propulsive sector due to learning dynamics adopting a methodology for the analysis of diffusion processes the paper presents empirical evidence on italian regions the results show that in late industrialized regions the diffusion of innovation capabilities is faster than in the early industrialized ones the role of research and development and complementary changes in the economic structure is also investigated quatraro f la diffusion des capacites d innovation regionale des preuves provenant des donnees italiennes sur les brevets regional studies cet article

terms of trade fluctuations and stabilization of producer prices by compensatory taxation abstract a small general equilibrium model is presented which highlights the role of the real exchange rate in the south in determining the terms of trade between the south and the north the dynamics of the model may generate terms of trade instability for some values of the parameters of the system compensatory taxation of export earnings by a stabilization fund in the south is shown to increase the likelihood of instability

towards a competence theory of the region this paper argues the case for extending the competence theory of the firm or more generally the competence perspective to analysis of the region the relevance of the perspective follows from the characterisation of productive systems such as firms and regions as ensembles of competences that emerge from but are not reducible to social interaction attention is drawn to an identifiable although unacknowledged convergence of ideas in the recent regional literature arguing that these ideas are best re conceptualised in terms of regional competences the cluster of hightechnology firms in the cambridge region of the uk is briefly referred to in order to illustrate the main ideas of the paper

does regulation of physicians reduce health care spending the medical community argues that physician fear of legal liability increases health care spending theoretically though the effect could be positive or negative and empirical evidence has supported both cases previous studies however have ignored the fact that physicians face risk from industry oversight groups like state level medical licensing boards in addition to civil litigation risk this article addresses this omission by incorporating previously unused data on punishments by oversight groups against physicians known as adverse actions along with malpractice payments data to study state level health care spending my analysis suggests that contrary to conventional wisdom spending does not rise in response to increased risk an increase in adverse actions of 16 the year to year average is associated with statistically significant annual decreases in state spending on hospital care of approximately 22 million and on prescription drugs of nearly 10 million malpractice payments are estimated to have smaller statistically insignificant effects

first do no harm tort reform and birth outcomes in the 1980s and 1990s many states adopted tort reforms it has been argued that these reforms have reduced the practice of defensive medicine arising from excess tort liability we find that this does not appear to be true for a large and important class of cases childbirth in the united states using data from national vital statistics natality files on millions of individual births from 1989 to 2001 we ask whether specific tort reforms affect the types of procedures that are performed and the health outcomes of mothers and their infants we find that reform of the joint and several liability rule or the deep pockets rule reduces complications of labor and procedure use whereas caps on noneconomic damages increase them we show that these results are consistent with a model of tort reform that explicitly allows for variations in patient condition

innovation networking and proximity lessons from small high technology firms in the uk the article explores how the innovative performance of small high tech firms relates to their external networking activities and whether geographical proximity in their network relations matters data from a small sample of electronics firms and software developers in south east england are used to construct indicators of innovativeness which are correlated with variables capturing intensity of external interactions and proximity benefits the regional science base is found to have played a key role in nurturing new high tech ventures but science parks had not contributed to this interaction with parties with complementary capabilities such as suppliers and service providers is also associated with high innovative performance however the findings do not support the current policy fashion of encouraging regional networks revolving around firms in similar business activities and close customer relations