As the public in the U.S. has grown increasingly concerned over the gaps in the health care system's attention to quality, and as the health care industry itself struggles for stability in a volatile environment, a historic opportunity presents itself. This book reviews a variety of quality monitoring approaches, identifies critical issues pertaining to assessment, measurement, implementation, and evaluation of quality initiatives, and suggests scientific approaches to put in place a core set of performance measures that reliably identify the value-added clinical and managerial behaviors in health care - for both quality and cost efficiency. The key to quality improvement has to focus on physicians and other health professionals. This book is designed to identify issues pertaining to health care quality and to formulate appropriate approaches for improving quality. It can be used by risk managers and hospital executives to guide their development, implementation, and evaluation of quality improvement programs.

Policy Uncertainty and Risk presents a contribution to risk analysis and risk management in public policy and management at large. Special emphasis is put on the utilization of scientific knowledge by decision-makers in instances where knowledge in both spheres of science and administration is highly uncertain and contested. The book therefore contributes a model of science-practitioner interaction in a policy area of strong current relevance. The perspective is a realist constructivist one, which means that risk and policy are taken to be socially predicated insofar as we can choose and change the way we define and interact with its practices. It is realist insofar as we continually use such constructions to re-define and re-structure the world we live in. Although essentially theory-driven and conceptually oriented, the authors develop their argument for a new interpretation of policy-relevant science through a number of pressing case studies. These studies include the recent BSE/CJD crises in the UK, the introduction of Marine Protected Areas in Sweden, and the current practices surrounding risk management in corporate bodies. Drawing on empirical cases and theoretical explication, the book provides a number of suggestions as to how risk analysis and risk management may be more properly conceived of both from a practitioner as well as from an academic point of view.

The issue of asymmetric information and public decision-making has been widely explored by economists. Most of the traditional analysis of public sector activities has been reviewed to take account of the different incentive problems arising from an asymmetric distribution of relevant information among the actors of the public decision-making process. A normative approach has been developed, mainly employing the principal agent paradigm to design incentive schemes which tackle adverse selection and moral hazard problems within public organizations. Still, this analysis is under way in many fields of public economics. However, a debate is ongoing on the theoretical limitations of this approach and on its relevance for the actual public sector activities. Public Decision-Making Processes and Asymmetry of Information encompasses different contributions to these issues, on both theoretical and practical areas.The innermost problem in the current discussion arises from the fact that this normative analysis is firmly rooted in the complete contracting framework, with the consequence that, despite the analytical complexities of most models, their results rely on very simplified assumptions. Most complexities of the organization of public sector, and more generally, of writing contracts, are therefore swept away. Once the need for an incomplete contracting approach is recognized, the question becomes how to relax some of the assumptions characterizing the complete contracting framework, without getting ad hoc results. The Introduction to this book, written by Jean Jacques Laffont, sets the general grid to interpret the position of its papers in this debate. The four papers in Part 1 of the book are devoted to developing the analysis of some of the theoretical issues mentioned in the Introduction. Part 2 is devoted to discussing the applications of the theory to different public sector activities.

Over the past thirty years, urban economic theory has been one of the most active areas of urban and regional economic research. Just as static general equilibrium theory is at the core of modern microeconomics, so is the topic of this book - the static allocation of resources within a city and between cities - at the core of urban economic theory. An Essay on Urban Economic Theory well reflects the state of the field. Part I provides an elegant, coherent, and rigorous presentation of several variants of the monocentric (city) model - as the centerpiece of urban economic theory - treating equilibrium, optimum, and comparative statistics. Part II explores less familiar and even some uncharted territory. The monocentric model looks at a single city in isolation, taking as given a central business district surrounded by residences. Part II, in contrast, makes the intra-urban location of residential and non-residential activity the outcome of the fundamental tradeoff between the propensity to interact and the aversion to crowding; the resulting pattern of agglomeration may be polycentric. Part II also develops models of an urbanized economy with trade between specialized cities and examines how the market-determined size distribution of cities differs from the optimum. This book launches a new series, Advances in Urban and Regional Economics. The series aims to provide an outlet for longer scholarly works dealing with topics in urban and regional economics.

Economic Restructuring and the Growing Uncertainty of the Middle Class focuses on a relatively new research area which is becoming increasingly more important: the growing uncertainty of the middle class. Until recently, members of the middle class were not only assured of a good social and economic position but also of the continuation of this position. Nowadays, economic and organisational changes are threatening this once secure position. The boundaries between the middle classes and the working class are becoming less and less visible. `Making a career', which was in the past central for middle class people, is becoming ever more difficult. Moreover, organisational restructuring is threatening their employment. It seems that insecurity is becoming a central element in the lives of members of the middle class. In this book experts from several European countries discuss the question of to what extent the position of the middle class is really changing. They also discuss the mechanisms that are propelling these changes, and the effects these changes have on the attitudes of middle-class people. As the experts are from several parts of Europe (Great Britain, Germany, The Netherlands, Greece, Spain and Russia), the reader can compare the situation of the middle classes in these various countries. This book contains valuable information for anyone interested in this important topic: not only for those involved in the studies of economic and organisational change and social stratification and those interested in the similarities and differences between European countries, but (amongst others) for policy-makers, managers, and trade union representatives who will be dealing with problems induced by the changes that are discussed in the book.

Rolf R. Strauch and Jiirgen von Hagen Center for European Integration Studies (ZEI), University of Bonn; ZEI, University of Bonn, Indiana University, and CEPR The large and persistent deficits, rising levels of debt and growing levels of public spending observed in many DECO economies during the past 25 years have stimulated much theoretical and empirical research on the political economy of public finance. Although a number of issues have been studied extensively, certain areas are still at an exploratory stage and need further theorizing and thorough empirical research. During the last two decades, the theoretical debate on budgeting has been dominated by the controversy between partisan and institutionalist approaches. Within the more political-science oriented, institutionalist literature, a controversy exists between the distributive and the informational perspectives, each setting forth a distinctive organizational rationale of parliaments with different fiscal implications. The papers in this volume cover these different perspectives, extend previous models, and test their empirical validity. The papers were originally written for a conference on "Institutions, Politics, and Fiscal Policy" organized by the Center for European Integration Studies at the University of Bonn, Germany, in July 1998. The book is organized in three parts each focusing on a distinctive aspect. The first part is dedicated to the partisan perspective. The second part focuses on budget institutions. The third part consists of three case studies of institutional reform of the budget process. This book is directed to academics and practitioners alike.

Economic Development is but one facet of Human Development. This forces us to ask - how do humans develop? Man is a social animal and the growth of our humanity requires various social institutions, such as bureaucracy. The paradox of capitalism is that it is a system ostensibly based on self-interest yet wholly dependent on non-market values for its success. These non-market values are shaped by two much-neglected factors, religion and ethnicity. Economic Development is an applied field; whatever it claims as a conclusion should be an applicable conclusion. This requires attention to all those non-economic factors which translate economic decisions into practice - such as the forces of nationalism versus the pressures of such global powers as US foreign policy and the advice of the IMF/IBRD. Since policy is our goal, theory whose intellectual basis is inaccessible to policy makers or which fails to have application should be minimized. Mathematical models are best avoided and, if they are to be used, the burden of proof must be placed upon their proponents. As insights about the market are limited neither by time nor space, poor countries can learn from rich ones, and vice versa. It is most fruitful to focus on examples of success, such as the East Asian economies. They are the clearest illustration of the fact that rapid economic development is possible even to those who have suffered through imperialism, and possess few natural resources, but have their work and their determination intact. `One good example is enough.'

Any normative theory of democracy involves notions of equity, which are supposed to guide collective decisions. On the other hand, a descriptive theory of any decision-making body must take into account the distribution of power in that body. The development of collective decision theory along two different paths reflects these two foci of interest in the theory of democracy. One direction can be subsumed under the theory of social choice, the other under the theory of games. In the theory of social choice, the participants are characterized only by their preferences among a set of alternatives (candidates, courses of action, etc. ). They do not choose among these alternatives. They only submit their preferences to some central authority ("the Society"), which then chooses among the alternatives in accordance with some fixed rule of aggregating the preferences. On the other hand, the point of departure in the theory of games is a set of actors, each of whom can choose between alternative courses of action (strategies). The totality of choices results in an outcome, which gener ally has different utilities for the different actors. In this book, both approaches are presented in selected papers, from which the reader can get an excellent overview of the state of the art. Both branches of formal decision theory, the theory of social choice and the theory of games, were developed in mathematical language, but very little technical mathematical knowledge is required to follow the arguments."

The Papers collected in this volume are those presented at the tenth Collo- quium arranged by the Societe Universitaire Europeenne de Recherches Fi- nancieres (SUERF), which took place in Vienna in April 1982. The Society is supported by a large number of central banks, commercial banks, and other financial and business institutions, as well as by academics and others interested in monetary and financial problems. Since its estab- lishment in 1963 it has developed as a forum for the exchange of informa- tion, research results and ideas, valued by academics and practitioners in these fields, induding central bank officials and civil servants responsible for formulating and applying monetary and financial policies. A major activity of SUERF is to organise and conduct Colloquia on sub- jects of topical interest to members. The titles, places and dates of previous Colloquia for which volumes of the collected Papers were published are noted on page 421. Volumes were not issued for Colloquia held at Tar- ragona, Spain in October 1970 under the title "Monetary Policy and New Developments in Banking" and at Strasbourg, France in January 1972 un- der the title "Aspects of European Monetary Union".

Some years ago, when Principal and Professor of Economics at the infant Univer sity of Buckingham, Britain's only independent university, I was intrigued to receive an application, supported by strong recommendations from a Signora Ilde Rizzo, who wished to take some courses in public finance. As she was already an of Catania, noted for its expertise in the economics of Assistant at the University public finance, my colleagues and I brushed aside her modest request to attend undergraduate courses and enrolled her in our new graduate course. We also hoped that she might, in time, be able to gain experience in teaching and writing in English. Dr. Rizzo exceeded our highest expectations. She presented the first D. Phil thesis ever at Buckingham and defended it with consummate success. This work is a revised and extended version of her thesis, and it is a pleasure to congratu late Dr. Rizzo on its appearance, and also her publisher for recognizing its qUality. It will come as no surprise to the reader that Dr. Rizzo has already published extensively in Italian and also in English, but this is her first book in the latter language. I am glad to think that Dr. Rizzo's thesis arose out of our mutual interest in the question as to whether debt financing offered governments a major opportunity for maintaining the growth of public spending."

C. B. TILANUS, EDITOR This book tries to strengthen the ties between, on the one hand, the business administration and accounting world and, on the other, the operational research and management science world. The readership for which it is intended consists ofthe following categories: managers and professionals in organizational departments of business administration, management science, automatic data processing, etc.; management and operational research consultants; and students in academic departments of business administration, business economics, operational research, information systems, industrial engineering, etc. The book deals with the quantitative approach. to budgeting problems. Budgeting in this text is defined as the making of a financial, short-term plan for an organization. The budget is financial. Although volumes and prices play their part, the budget is finally expressed in terms of amounts of money thus allowing of the well-known two-way counting and balancing of double bookkeeping. (Whether items appear twice on the assets and liabili ties sides of balances, or are counted twice in the rows and columns of a matrix is immaterial. ) The budget is short-term. It is a detailed, quantitative plan of action in the near future. In this sense, budgeting is opposed to strategic planning which considers the course of action to be taken in the medium and long term. Strategic planning is of a more aggregative, qualita tive nature than is budgeting. The budget is a plan for an organization, and as such it is complete."

The character of economic life] in a society is dependent upon, among 2 other things, its political-legal-economic institutional setting. Within that institutional structure, the individuals who comprise that society attempt to cooperate with one another to their mutual advantage so as to accommodate their joint utility-maximizing endeavors. In addition, these same individuals call upon certain societal institutions to adjust the con flicting claims of different individuals and groups. In this regard, a society is perceived as both a cooperative venture for mutual advantage where there are an identity of interests and, as well, an arena of conflict where there exists a mutual interdependence of conflicting claims or interests. The manner in which a society structures its political-legal-economic institutions 1) to enhance the scope of its cooperative endeavors and 2) to channel internal political-legal-economic conflicts toward resolution, shapes the character of economic life in that society. In contemplating the structure of its institutions intended to promote cooperation and channel conflict, a society confronts several issues. At the most general level an enduring issue is how a society both perceives and then ideologically transmits (perhaps teaches or rationalizes), inter nally and/or externally, its perceptions of so-called "cooperative en deavors" and "arenas of conflict." There can be no doubt that the resultant structure of a society's institutions will reflect that society's perception as to what cooperation entails and what conflict constitutes."

A wide-ranging review of the issues and opportunities in the transfer of technology between advanced industrial countries and the countries of the Former Soviet Union. A major theme is the complex socio-technological aspects of the process, together with the related human factors and leadership requirements. The book presents a very open exchange of views on the difficult obstacles that the countries of the Former Soviet Union need to overcome and the market economy countries of the west need to understand. Issues of patents, intellectual property, personnel training, reorganization of formerly centralized economies, incentives, information exchange, and possible models for effective transfer are highlighted, together with specific examples and discussions of the most up-to-date knowledge about technology transfer. Audience: All individuals and organizations concerned with the transfer of technology, particularly those interested in a candid appraisal of the issues and opportunities for the transfer of technology and industrial and scientific cooperation between industrialized market economies and the countries of Eastern Europe and Central Asia.

Monetary Policy in a Converging Europe covers the most important monetary issues in the transition towards an Economic and Monetary Union in Europe, containing contributions from renowned experts in relevant research and policy areas. Among other things, the contributions discuss the scope for inflation targeting, monetary interdependencies within the core' ERM countries, money demand within the European Union, the difference between the monetary transmission mechanisms in the various European countries, and the preferred exchange rate policy in Stage Two of EMU. The book provides an excellent overview of current issues for anyone interested in monetary policy in a converging Europe.

Environmental economics addresses the issues that arise on the boundaries between economic systems and natural systems, such as pollution and natural resource de pletion and degradation. Like any other branch of applied economics, it has drawn its tools and techniques from the wide range already available in economics gener ally, selecting, adapting and extending these to meet its own particular requirements in its own particular context. Here, as elsewhere in economics, public policy analy sis requires quantitative assessments of the economic impact of different policy choices. Perhaps the most distinctive contribution of environmental economics has been the development of techniques for the economic valuation of environmental goods and services in the absence of markets for such goods and services, or in the presence of markets that are at best imperfect or incomplete. Nevertheless policy analysis still relies on one or another of three broad groups of methods used in eco nomics generally. One is project appraisal, which at the micro level provides an evaluation ofthe costs and benefits ofinvestment options to inform the choice among them, while at the macro level policy analysis rests either on computable general equilibrium (CGE) models or on economy-wide macroeconometric models. All models are simplifications, designed to focus attention on the important fea tures ofthe problem at hand, and neglecting other features that might for a different problem assume greater importance.

Essays on Money, Banking and Regulation honors the interests and achievements of the Dutch economist Conrad Oort. The book is divided into four parts. Part 1 - Fiscal and monetary policy - reviews a variety of topics ranging from the measurement of money to the control and management of government expenditures. Part 2 - International institutions and international economic policy - looks at the international dimension of monetary and fiscal policy, with extensive discussion of the International Monetary Fund and the European Monetary Union. Part 3 - The future of international banking and the financial sector in the Netherlands - is an insider's view of the strategic choices facing financial institutions in the near future. Finally, Part 4 - Taxation and reforms in the Dutch tax system - is closest to Oort's research and practice since he has become known as an architect of the 1990 Dutch tax reform; this part is dedicated in particular to the tax reforms suggested by Oort.

An increasing body of literature concerns the economics of those highly appreciated qualities of life that are not easily provided by market exchange. Today these problems are visible as never before, for example environmental problems. But already at the dawn of industrial society the problem had been observed by Rousseau. His statements on the economy claim to take these problems into account with due importance. In this way his economic philosophy concerns a different domain of the economy from, for example, Adam Smith's work. Rousseau's philosophy attempts to consider phenomena later labeled information asymmetries and information costs, bargaining, collective good problems. Some of Rousseau's most puzzling social proposals (on theater, women, music, etc.) can be explained by his well-argued conviction that an optimal economy demands a high social morale, a communicative morale. He proposes an economic philosophy for the most important properties of richness - such as experiencing the unique, and being free although dependent on others (empowerment). It is for the adult capable of true deliberation, not for the trifle of the innocent child. He develops a concept of richness that is close to the Aristotelian capability-concept, later explored by Amartya Sen. Rousseau's economic philosophy has not been treated in a monograph before. The book should be rewarding to those interested in social theory, the history of social and economic thought, problems at the margins of market exchange, e.g. cultural economics, environmental economics, students of Rousseau and the thought of the 18th century, welfare economic theory in the direction of Arrow or Sen, and Poanyi's and others' theses about the transition from selfsufficiency to market.

Originally published in 1974, this is a detailed study of the financial administration of the Chinese government during the Ming dynasty (1368-1644), with particular attention to the sixteenth century, a topic about which very little has been published either in Chinese or any Western language. Professor Huang has worked through an enormous quantity and variety of source material - in particular the 133 substantial volumes of the Ming Veritable Records - and has compared the documents on financial matters with the entries in local gazetteers. The complicated workings of government finance present great difficulties to all specialists in Chinese financial and administrative history and in different branches of local Chinese history from the fifteenth century onwards. Professor Huang's study will provide all such researchers with an authoritative work of reference.

R. H. Coase Duncan Black was a close and dear friend. A man of great simplicity, un worldly, modest, diffident, with no pretensions, he was devoted to scholarship. In his single-minded search for the truth, he is an example to us all. Black's first degree at the University of Glasgow was in mathematics and physics. Mathematics as taught at Glasgow seems to have been designed for engineers and did not excite him and he switched to economics, which he found more congenial. But it was not in a lecture in economics but in one on politics that he found his star. One lecturer, A. K. White, discussed the possibility of constructing a pure science of politics. This question caught his imagination, perhaps because of his earlier training in physics, and it came to absorb his thoughts for the rest of his life. But almost certainly nothing would have come of it were it not for his appointment to the newly formed Dundee School of Economics where the rest of the. teaching staff came from the London School of Economics. At Glasgow, economics, as in the time of Adam Smith, was linked with moral philosophy. At Dundee, Black was introduced to the analytical x The Theory o/Committees and Elections approach dominant at the London School of Economics. This gave him the approach he used in his attempt to construct a pure science of politics."

As the demand for environmental quality is increasing and as the current GATT rules monitored by the WTO are not very suitable for environmental protection, either a new international environmental organization may be formed soon or new environmental regulations may be added to GATT. In either case, understanding of the interactions between trade and the environment will be vital. Trade and the Environment presents both the theoretical and empirical exposition of (i) the impact of trade liberalization on environmental quality; (ii) the impact of environmental regulations on international competitiveness; and (iii) strategic trade and environmental policies. An important feature of Trade and the Environment as compared to earlier books is that it brings together the reciprocal interactions between trade and the environment. It can be used as the main or complementary textbook for a course on trade and the environment.

Investment is crucial to the development of a nations economy and welfare. In contrast to the situation in the United States, investment activity in Europe has been quite modest over the past few years. This volume gathers together a number of papers by prominent researchers in the field of investment. It provides an overview of recent developments in this area and presents new empirical findings on the determinants and implications of the investment process in European countries. Among the topics examined are the role played by taxation, uncertainty and the financial systems, as well as the relevance of corporate governance to the investment process. Two chapters are dedicated to infrastructure investment and foreign direct investment.

Setting the issue "Most economists consider the marked increase in automatic stabilizers a highly favorable development with respect to maintenance of economic stability". Besides the rare privilege of having being signed by both Milton Friedman and Paul Samuelson (Depres,Friedman, Hart, Samuelson, and Wallace [1950]), among others, this sentence expressed as soon as 1950 the consensus view on the stabilizing effect of fiscal rules governing tax revenue and public expendi tures and transfers. This positive ex ante assessment will have been confirmed ex post as part of the explanation for post war stabilization (Burns [1960], de Long and Summers [1986], Moore and Zarnovitz [1986]). However, it becomes disputed in both its positive and normative aspects. Many institutional changes since the eighties point at curbing back the transfer mechanisms underlying automatic stabilizers, and legal restraints on deficits such as the US balanced budget amendment or the European Maastricht criteria would involve serious risks for the future of stabilizers. Under such rules "the government would become, almost inevitally, a destabilizer rather than a stabilizer" said Joseph Stiglitz, quoted by the New York Times (April 1995)). "Built-in stabilizers are automatic fiscal adjustments that reduce the national income multiplier and thus cushion the effects of changes in autonomous spend ing on the level of income" (Pechman [1987]). Early analyses of the automatic fiscal stabilizers include the contributions of A. G. Hart [1945], R. Musgrave and M. Miller (1948) and E. C. Brown (1955).

This comprehensive book describes and analyzes the substance and politics of public budgeting at the national, state, and local levels of government. In doing so, it takes a comparative approach, illustrating the distinctiveness of budgeting at each level, as well as highlighting the features common to all three. A unifying focus is the extent to which budgetary decision makers use the budget as a central vehicle to advance their policy preferences. This fully updated sixth edition provides an extensive and thorough analysis of the causes of the Great Recession, its economic consequences, and the policy responses which pushed the boundaries of conventional monetary and fiscal policy. Also new to this edition is a chapter on the intergovernmental dimensions of public budgeting, along with boxed features highlighting hands-on vignettes of contemporary practical challenges facing budget makers at the different levels of government.