Financial risk in health purchasing: risk pools
Part one of this series explored the financial risk associated with the size of a practice-based commissioning (PBC) group. A process for determining the point of minimum possible financial risk was illustrated by excluding high cost admissions from the core PBC budget (Jones, 2008). By implication, such exclusions will be gathered into a risk pool held on behalf of the PBC group.
Volatile inpatient costs: implications to CCG financial stability
The introduction of GP commissioning almost assumes that there is a weak link between financial risk and size and that risk is independent of location-specific environmental factors, i.e. costs are entirely predicted by a capitation formula based on population demographic and socio-economic variables. This is the first of three articles seeking to investigate the volatility associated with different aspects of health care costs, namely, occupied beds as a proxy for inpatient costs, cancer care as an example of initial diagnosis triggering a cascade of costs and death as a proxy for end of life care costs. The observed volatility across these three domains can be compared to give an estimate of the real world volatility in the total costs of a commissioning budget. This study extends the previous analysis of year-to-year volatility at national level down to local level using English PCT populations mainly aligned to local authority boundaries. The difficulty of formulating equitable risk sharing instruments in the presence of significant environment- or location-specific volatility is discussed along with the implications to population- or person-based funding formula.
Routine quantitative phase analysis of niobium-bearing lateritic ores
Routine quantitative analyses by Rietveld full-pattern fitting have been carried out on more than one thousand niobium ore samples originating from four pyrochlore deposits: Lueshe and Bingo (D.R. Congo), Mabounie (Gabon), and Sokli (Finland). The ore samples were characterized by a highly variable mineral content, the presence of mineral phases with a wide range of compositions and a high amorphous content. An analytical procedure was established which addressed several problems: creation of an appropriate crystallographic parameter database, specimen preparation, check for preferred orientation and measurement of the amorphous content by the internal standard method.