Financial Margins Research Articles

An updated model of rural hospital financial distress.

To create a model that predicts future financial distress among rural hospitals. The sample included 14,116 yearly observations of 2311 rural hospitals recorded between 2013 and 2019. We randomly separated all sampled hospitals into a training set and test set at the start of our analysis. We used hospital financial performance, government reimbursement, organizational traits, and market characteristics to predict a given hospital's risk of experiencing one of three financial distress outcomes-negative cash flow margin, negative equity, or closure. The model's area under the receiver operating characteristic curve (AUC) equaled 0.87 within the test set, indicating good predictive ability. We classified 30.55% of the observations in our sample as lowest risk of experiencing financial distress over the next 2 years. In comparison, we classified 32.52% of observations as mid-lowest risk of distress, 26.40% of observations as mid-highest risk, and 10.52% of observations as highest risk. Among test set observations classified as lowest-risk, 5.78% experienced negative cash flow margin within 2 years, 1.50% experienced negative equity within 2 years, and zero observations experienced closure within 2 years. Within the highest-risk group, 61.57% of observations experienced negative cash flow margin, 43.02% experienced negative equity, and 3.33% experienced closure. Given the ongoing challenges and consequences of rural hospital unprofitability, there is a clear need for accurate assessments of financial distress risk. The financial distress model can be used by researchers, policymakers, and rural health advocates as a screening tool to identify at-risk rural hospitals for closer monitoring.

Impact of changes in anaesthesia staff assignments on billing compliance, financial margins, and costs of anaesthesia services: development and application of a margin-cost estimation tool

BackgroundThe US Centers for Medicare and Medicaid Services provide guidelines for the coverage of anaesthesia residents and certified registered nurse anaesthetists (CRNAs) by anaesthesiologists. We tested the hypothesis that changes in the anaesthesia staffing model increase billing compliance. MethodsWe analysed 13 926 anaesthesia cases performed between September 2019 and November 2019 (baseline), and between September 2020 and November 2020 (after change in staff model) at a US academic medical centre using an estimation tool. The intervention was assignment of additional 12-h weekday CRNAs plus an additional anaesthesiologist who covered weekdays after 17:00, weekends, and holidays. The proportion of cases with billing compliant coverage (covered either by solo anaesthesiologist or anaesthesiologist covering two or fewer residents or four or fewer CRNAs) was analysed using logistic and segmented regression analyses. ResultsThe change in staff model was associated with a decrease in non-optimal anaesthesia staff assignments from 4.2% to 1.2% of anaesthesia cases (adjusted odds ratio 0.25; 95% confidence interval [CI] 0.20–0.32; P<0.001) and an increase in billable anaesthesia units of 0.6 per anaesthesia case (95% CI 0.4–0.8; P<0.001). An increased revenue margin associated with optimal staffing levels would only be achieved with salary levels at the 25th percentile of relevant benchmark compensation levels. Total staff overtime for all anaesthesia providers decreased (adjusted absolute difference −4.1 total overtime hours per day; 95% CI −7.0 to −1.3; P=0.004). ConclusionsImplementation of a change in anaesthesia staffing model was associated with improved billing compliance, higher billable anaesthesia units, and reduced overtime. The effects of the anaesthesia staff model on revenue and financial margin can be determined using our web-based margin-cost estimation tool.

Evaluation of the impact of prospective payment systems on cholecystectomy: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the impact of prospective payment systems (PPSs) on cholecystectomy. A comprehensive literature review was conducted, examining studies published until December 2023. The review process focused on identifying research across major databases that reported critical outcomes such as length of stay (LOS), mortality, complications, admissions, readmissions, and costs following PPS for cholecystectomy. The studies were specifically selected for their relevance to the impact of PPS or the transition from fee-for-service (FFS) to PPS. The study analyzed six papers, with three eligible for meta-analysis, to assess the impact of the shift from FFS to PPS in laparoscopic and open cholecystectomy procedures. Our findings indicated no significant changes in LOS and mortality rates following the transition from FFS to PPS. Complication rates varied and were influenced by the diagnosis-related group categorization and surgeon cost profiles under episode-based payment. There was a slight increase in admissions and readmissions, and mixed effects on hospital costs and financial margins, suggesting varied responses to PPS for cholecystectomy procedures. The impact of PPS on cholecystectomy is nuanced and varies across different aspects of healthcare delivery. Our findings indicate a need for adaptable, patient-centered PPS models that balance economic efficiency with high-quality patient care. The study emphasizes the importance of considering specific surgical procedures and patient demographics in healthcare payment reforms.

PSII-10 Development of an interdisciplinary undergraduate and graduate course in precision livestock farming systems

Abstract The modern livestock industry is increasingly adopting data, technologies, and automation into daily husbandry and management routines and decisions. These advances in precision livestock farming (PLF) enable improved financial margins, sustainability, efficiency, and animal productivity and welfare. However, there is currently a gap between the engineers and data scientists designing the technologies and the animal scientists and caretakers using them. At North Carolina State University a novel course on PLF Systems for undergraduate and graduate students was developed in the Department of Animal Science. Through lecture delivery, livestock production scenarios, scientific literature, and data-based homework assignments students explored data collection, management, analysis, and data-based decision making. Students gained hands-on experience with a variety of sensor types and signal processing through lab-based activities. Basic hardware and software development concepts were explored during an Arduino-based microcontroller activity. The course was developed and refined using student feedback to include additional sensor and lab-based days and additional in-class supported activities utilizing Excel for data manipulation, processing, and presentation. Self-reported student learning results were collected across two semesters (19 students; 18 Animal Science, 1 Biological Engineering) with84% of students indicated the course was effective in increasing their ability to evaluate and implement technology in livestock production systems and 74% of students reported increased knowledge of coding and software, as well as their ability to clean, analyze, and make sense of raw data. The topics and delivery methods implemented in this course could inform the basis for development of similar interdisciplinary PLF courses at other academic institutions.

Economic indicators evaluation to study the feasibility of a solar agriculture farm: A case study

The 209 kWp solar agricultural farm at Dayalbagh Educational Institute's Dairy Campus in Agra, India, is the subject of this economic analysis. This study analyzes economic indicators relevant to agriculture food production, such as gross financial margins, farm profits, and cost-benefit ratios. Other measured variables include NPV (net present value), PB (payback period), and LCOE (levelized cost of electricity) of solar power generation to determine the economic viability of this agrivoltaics (production of solar energy and agriculture on the same land) APV project. Farm profit and gross financial margins both are positive values of 161, 907 INR (Indian Rupees) and 316, 907 INR, respectively. The cost-benefit ratio was 1.5.The economic factors of solar energy generation were studied for two systems: surface-mounted or ground-mounted solar systems and an elevated solar system with agriculture production on the same ground (APV or agrivoltaics). Both systems had the same production capacity. Two different hypothetical situations were used for each system. In the first situation (Case Study A), the assumption was that solar power performance would remain constant during operation. In the second situation (Case Study B), the assumption was that annual performance would be reduced by 0.5 %.The results show that APV is better than the surface-mounted system because there is no significant difference between the payback periods of APV and surface-mounted systems; the NPV of APV is greater than the surface-mounted solar system for both the study case A and case B and the LCOE of APV is 55 % less than the LCOE of the surface-mounted solar system.

"AGRIVIGIL: ENHANCED THEFT DETERRENCE FOR IRRIGATION MACHINERY"

The rampant theft of water pumps in rural India poses a severe challenge to farmers, significantly undermining their irrigation capabilities and, by extension, crop health and productivity—particularly in regions susceptible to unpredictable rainfall and drought. This theft not only inflicts immediate equipment loss but also propels farmers, who typically operate within narrow financial margins, into further economic hardship due to the inability to afford replacements. The consequent delays in planting and irrigation lead to reduced crop yields and heightened financial strain. The vulnerability of these essential tools is amplified by the remote locations of farms and a pronounced lack of security measures, rendering water pumps an easy target for thieves. This dire situation underscores the urgent need for a comprehensive water pump theft deterrence system, which is essential not only for protecting valuable agricultural equipment but also for safeguarding the livelihoods of farmers. By leveraging advanced technology to provide real-time alerts and deter potential thefts, such a system can serve as a critical defence mechanism, enabling farmers to concentrate on their vital work without the looming threat of loss. The implementation of effective theft deterrence measures, supported by community, law enforcement, and policy maker collaboration, is crucial in ensuring the economic well-being and sustainability of rural Indian agriculture.

Predictive modelling of total operating room time for Laparoscopic Cholecystectomy using pre-operatively known indicators to guide accurate surgical scheduling in a critical access hospital

The financial margin of rural and critical access hospitals highly depends on their surgical volume. An efficient operating room is necessary to maximise profit and minimise financial loss. OR utilisation is a crucial OR efficiency metric requiring accurate case duration estimates. The patient's age, ASA, BMI, Mallampati score, previous surgery, the planned surgery, the surgeon, the assistant's level of experience and the severity of the patient's disease are also associated with operative duration. Although complex machine-learning models are accurate in operative prediction, they are not always available in resource-limited hospitals. Laparoscopic cholecystectomy (LC) is one of the most common surgical procedures performed and is one of the few procedures performed at critical access and rural hospitals. The accurate estimation of the operative duration of LC is essential for efficient OR utilisation. We hypothesise that a multivariate linear regression prediction model can be constructed from a set of pre-operatively known, easily collected variables to maximise OR utilisation and improve operative scheduling accuracy for LC. We further hypothesise that this model can be implemented in resource-limited environments, such as critical access hospitals.

Artificial intelligence-driven scalability and its impact on the sustainability and valuation of traditional firms

The objective of this study is to determine the impact of artificial intelligence (AI) on the earnings before interest, taxes, depreciation, and amortization (EBITDA) of firms as a proxy of their financial and economic margins by improving revenues and minimizing expenses. This impact is positive on the market value and scalability by improving the economic and financial sustainability of companies. The methodology is based on a business plan that considers the savings obtained by a traditional firm implementing AI. Specifically, a sensitivity analysis will demonstrate that AI savings impact key parameters, leading to economic and financial sustainability. Additionally, a mathematical interpretation, based on network theory, will be produced to provide and compare the added value of two ecosystems (without and with AI that adds up new nodes and strengthens the existing ones). The main contribution of this paper is the combination of two unrelated approaches, showing the potential of AI in scalable ecosystems. In future research, this innovative methodology could be extended to other technological applications.

Compassionomics: The Science and Practice of Caring

PurposeTo summarize the scientific evidence that compassion can measurably improve patient outcomes, healthcare quality and safety, and the well-being of healthcare providers, and to consider specific strategies for cultivating compassion and better communicating it to patients. DesignPerspective MethodsWe selectively review the literature on compassion in health care, including obstacles to its expression and the demonstrated effects of provider compassion on patient outcomes, healthcare quality and cost, and provider well-being. We also review evidence regarding the trainability of compassion, discuss proven methods for cultivating individual compassion, and recommend strategies for incorporating it into routine medical practice. ResultsCompassion is the emotional response to another's pain or suffering, accompanied by a desire to alleviate it. Review of the literature shows that compassionate health care measurably improves physical and psychological patient outcomes, increases patient adherence, improves healthcare quality and safety, increases financial margins, and prevents physician burnout. Psychophysiological research demonstrates that empathy and compassion can be actively cultivated through intentional practice. Validated models of compassion-based interactions can facilitate the consistent expression of compassion in daily medical practice. ConclusionsGiven its many proven benefits to patients, healthcare organizations, and providers, compassion should be cultivated by healthcare providers and systems, and considered an essential component of optimal medical care.

Effects of the COVID-19 Pandemic on Logging Contractors in Sweden: A Survey on Personnel Absenteeism, Safety Measures and Economic Impacts

Forestry contractors perform the majority of forestry work in Sweden. Many contractors have small financial margins and may therefore be sensitive to disturbances. Recent years have been extraordinary due to the COVID-19 pandemic, and the objective of this study was to clarify how Swedish logging contractors were affected by it. In 2022, a survey was sent to 1175 companies registered to perform logging, and finally, the responses of 205 contractors were analyzed. The results show that 32% of the contractors experienced a higher absence of personnel during the pandemic. A correlation between the number of employees and the degree to which the company suffered from personnel absenteeism was identified. The majority of contractors implemented safety measures to reduce the risk of infection, usually concerning personal hygiene and social contacts in the workplace. At the time of the study, 51% of the logging contractors perceived that their financial situation was worse than before the pandemic, with those primarily engaged in logging having been hit harder than those with a more varied range of services. The study concludes that, overall, the contractors seem to have handled the pandemic quite well, but high fuel prices and inflation pose major challenges to their finances.

Capital Structure and Productivity of Listed Commercial Banks in Ireland

Profitability serves as one of the determinants of both capital structure and stock returns in Ireland. This paper looks at bank specific profitability. Researchers take into consideration two actions of financial institution performance: bank productivity (determined as profits separated by properties), and financial institution passion margins (measured as web interest income split by assets). It is commonplace to highlight that in order for a company to have the needed sources in regards to properties, they need to elevate the capital. The years given that the onset of the global financial situation has actually brought about significant architectural adjustments in the financial sector. The crisis revealed considerable weaknesses in the financial system of Ireland as well as the prudential framework, bring about too much financing and also risk-taking unsupported by ample capital as well as liquidity buffers. The impacts of the crisis have taxed financial growth, monetary stability and also financial institution performance in several territories including in Ireland, although the headwinds have begun to subside. Technical adjustment, increased non-bank competitors as well as changes in globalization are still broader ecological difficulties facing the financial system. Regulators have reacted to the crisis by reforming the international prudential structure and improving supervision. The study was a literature based in which literature from far and wide were reviewed to derive study themes. The findings revealed that Banks in Ireland have boosted their durability to future risks by significantly accumulating funding and also liquidity barriers. The boosted use anxiety testing by banks and also managers since the situation additionally attends to greater strength on a positive basis, which ought to aid support credit circulations in excellent as well as hard times. Furthermore, progressed economic situation financial institutions have moved to even more stable funding resources and also purchased more secure as well as less complex assets. Several of these changes may be driven partly by intermittent aspects, such as accommodative monetary policy, and also hence may lessen as conditions transform. Qualitative evidence indicates that financial institutions have significantly enhanced their threat management and also internal control practices. Although these modifications are tough to analyze, scientists point to substantial range for further enhancements, in particular because of the inherent unpredictability regarding the future development of risks. The research concludes that the financial obligation ratios make contrast of the overall debt with the complete properties owned by the company and a low proportion shows that a company depends much less on debt while a high percentage suggests that a firm count a lot more on financial debt money. The findings of this research study have important policy implications on the individual banks in Ireland, the industry and the macro levels. Since most of the reviewed studies found a negative correlation between the financial leverage and the firms value, the research study recommend that bank financial managers should decrease the finance leverage they employ in their capital structure in order to increase firms value. Keywords: Capital, Structure, Productivity, Listed, Commercial, Banks, Ireland.

Complementing family firm and managerial views of doing business through management accounting tools

Contributions to the family firm literature have given attention to different challenges that family firms have to face in their life cycle when organisational complexity increases and managerial processes are required. This paper investigates how management accounting (MA) tools enable family and managerial views of doing business to complement each other during the professionalisation process. In particular, the paper discusses a longitudinal case study on a family firm’s professionalisation, when an external advisor introduced financial ratio analysis and contribution margin reports. The case evidence shows that MA tools, by facilitating communication amongst family firm members and the external advisor, favours the complementing between family firm and managerial views of doing business during the professionalisation process. When simultaneously trusting family firm and managerial views of doing business, family firm members had the chance to interpret business facts differently, discovering new business opportunities. The paper contributes to the family business literature examining the professionalisation process through the pragmatic constructivist (PC) perspective that analyses the main traits of family firm and managerial views of doing business, stressing the relevance of values in interpreting business facts and in identifying factual possibilities. On this issue, the PC perspective is useful in understanding the role of MA tools as a communication basis for enabling the complementing of different views of doing business during the professionalisation process.

Central bank digital currency: Payment choices and commercial bank profitability

This study examines how the issuance of a central bank digital currency (CBDC) affects consumers' payment instrument choices, asset allocation decisions, and the profitability of financial intermediaries. Specifically, we advance a theoretical model in which introducing an interest-bearing CBDC expands market participants' payment and investment options but also poses a potential threat to financial intermediaries if it raises their borrowing costs significantly. The existence of a network externality further complicates the analysis by affecting consumers' choice of payment mechanism. Our results suggest that the issuance of a CBDC is a double-edged sword for an economy. Although it provides additional payment and investment options for market participants, it increases competition and weakens financial intermediaries' margins.

Empowering Rohingya Refugees through Islamic Microfinance Exploring Prospects and Challenges in Bangladesh

This research examines the potential and problems of Islamic microfinance for Rohingya refugees in Bangladesh. Many Rohingya Muslims have left Myanmar due to the refugee crisis. These refugees cannot work because they lack banking services. Islamic microfinance can solve financial marginalization based on fairness, social justice, and ethics. This study aims to assess Islamic microfinance's prospects and potential benefits, identify, and analyse the challenges of implementing such programs for Rohingya refugees, explore its role in promoting entrepreneurship and socioeconomic integration, and provide recommendations for effective implementation. Islamic microfinance targeting Rohingya refugees in Bangladesh is understudied. Islamic microfinance for Rohingya refugees is neglected in microfinance literature. This study examines Islamic microfinance's potential and problems to fill this research vacuum and expand knowledge. This study is to inform refugee policymakers, practitioners, and humanitarian organizations. Understanding the opportunities and limitations of Islamic microfinance programs might help Rohingya refugees empower and integrate by tailoring interventions to their needs and ambitions. This study used qualitative semi-structured interviews with NGO experts in Cox's Bazar, Bangladesh's Islamic microfinance industry for Rohingya refugees. Interview replies and document evaluations will provide insight into experts' viewpoints and experiences. Islamic microfinance empowers Rohingya refugees in Bangladesh. This research explores opportunities and problems to assist policymakers and practitioners in successfully implementing Islamic microfinance projects, boosting Rohingya refugees' chances for a sustainable future.

Cost-Effectiveness of Bone Cement With and Without Antibiotics: A Broader Perspective

Background Periprosthetic joint infections (PJIs) and periprosthetic femur fractures (PFFs) increase total costs of care. Retrospective registry/institutional studies with selection bias and underpowered meta-analyses have corrupted the evidence base regarding antibiotic-laden bone cement (ALBC) use in total knee arthroplasties (TKAs). Clinical practice guidelines (CPGs) recommend using cement fixation of femoral components in hip fracture patients to prevent PFFs, but have no recommendations regarding ALBC. Hip osteoarthritis CPGs have no bone cement recommendations regarding prevention of PJIs or PFFs. ALBC is potentially cost-effective by reducing PJIs, PFFs, and reducing implant costs. Methods A systematic review was conducted to identify randomized controlled trials (RCTs), meta-analyses, and registry reports related to the efficacy of ALBC in reducing PJIs and cemented femoral fixation in reducing PFFs. Numbers needed to treat (NNT) are calculated. Cost-effectiveness margins per case are calculated. Results A pooled analysis of four TKA RCTs found ALBC reduces PJI by 0.94% (p=0.027), NNT 106. A total hip arthroplasty (THA) meta-analysis found ALBC reduces PJI by 0.58% (p&lt;0.0001), NNT 172. A hip hemiarthroplasty (HH) RCT found high-dose dual-antibiotic ALBC reduces PJI by 2.35% (p=0.0474), NNT 43. A THA registry report found that cemented fixation compared to ingrowth fixation reduced PFFs by 0.44% (p&lt;0.0001), NNT 229. A pooled analysis of three HH RCTs found that cemented femoral stem fixation reduced PFFs by 5.09% (p-0.0099), NNT 20. Mean PJI treatment costs are $80,000. Mean PFF treatment costs are $27,596. Mean HH cemented femoral stem cost reduction: $685. Using ALBC: TKA margin/case is $755; THA margin/case is $586; and HH margin/case is $3,925. Using plain bone cement: TKA margin/case is $0; THA margin/case is $121; and HH margin/case is $2,065. Conclusions A broader perspective demonstrates that ALBC provides significant financial margins in TKAs, THAs, and hip hemiarthroplasties. ALBC is cost-effective when including the additional costs of using ALBC in TKAs, THAs, and hip hemiarthroplasties. Hand-mixed ALBC is more cost-effective than pre-mixed ALBC in all scenarios.

The Impact of Capital Structure on the Operational Efficiency of Commercial Banks Listed on the Australian Stock Exchange

Profitability serves as one of the determinants of both capital structure and stock returns in Australia. This paper looks at bank specific profitability. Researchers take into consideration two actions of financial institution performance: bank productivity (determined as profits separated by properties), and financial institution passion margins (measured as web interest income split by assets). It is commonplace to highlight that in order for a company to have the needed sources in regards to properties, they need to elevate the capital. The years given that the onset of the global financial situation has actually brought about significant architectural adjustments in the financial sector. The crisis revealed considerable weaknesses in the financial system of Australia as well as the prudential framework, bring about too much financing and also risk-taking unsupported by ample capital as well as liquidity buffers. The impacts of the crisis have taxed financial growth, monetary stability and also financial institution performance in several territories including in Australia, although the headwinds have begun to subside. Technical adjustment, increased non-bank competitors as well as changes in globalization are still broader ecological difficulties facing the financial system. Regulators have reacted to the crisis by reforming the international prudential structure and improving supervision. The study was a literature based in which literature from far and wide were reviewed to derive study themes. The findings revealed that Banks in Australia have boosted their durability to future risks by significantly accumulating funding and also liquidity barriers. The boosted use anxiety testing by banks and also managers since the situation additionally attends to greater strength on a positive basis, which ought to aid support credit circulations in excellent as well as hard times. Furthermore, progressed economic situation financial institutions have moved to even more stable funding resources and also purchased more secure as well as less complex assets. Several of these changes may be driven partly by intermittent aspects, such as accommodative monetary policy, and also hence may lessen as conditions transform. Qualitative evidence indicates that financial institutions have significantly enhanced their threat management and also internal control practices. Although these modifications are tough to analyze, scientists point to substantial range for further enhancements, in particular because of the inherent unpredictability regarding the future development of risks. The research concludes that the financial obligation ratios make contrast of the overall debt with the complete properties owned by the company and a low proportion shows that a company depends much less on debt while a high percentage suggests that a firm count a lot more on financial debt money. The findings of this research study have important policy implications on the individual banks in Australia, the industry and the macro levels. Since most of the reviewed studies found a negative correlation between the financial leverage and the firms value, the research study recommend that bank financial managers should decrease the finance leverage they employ in their capital structure in order to increase firms value. Keywords: Capital, Structure, Productivity, Listed, Commercial, Banks, Australia.

For UW Health, Health Plan Ownership Provides Financial Stability.

For health systems seeking a path forward and upward in a value-based environment, ownership of a health plan can yield many positives, including a chance to drive value-based care, financial margin improvement, and opportunities for rewarding partnerships. However, being both a payer and a provider-a "payvider"-can make extraordinary demands on both the health system and health plan. Developing this hybrid business has been a learning experience for UW Health, an academic medical center that, like others in academic healthcare, was built on a fee-for-service model. Today, UW Health is a majority owner of what has become the state's largest provider-owned health plan. As illustrated here, health plan ownership is not for every system. The burdens are heavy. But for UW Health, it is an important component of both mission and margin.

Integrated solar PV and piezoelectric based torched fly ash tiles for smart building applications with machine learning forecasting

Solarphotovoltaic (PV) power generation projects are rapidly increasing since the necessity for electricity has increased in developing countries like India. Still, the complexity of technical requirements narrows the financial margins of the construction industry. Limited researchers have investigated PV manufacturing, planning and techniques for electricity generation. Additionally a new method of generating power via the use of a human population has been developed. A piezoelectric transducer is used to detect the vibration. When a footstep applies pressure to the piezoelectric transducer, the pressure or force is converted to electrical energy. This experimental research investigates the photovoltaic sensors and piezoelectric transducers incorporated floor tiles in a residential building for power generation. The performance of the sensors were analysed experimentally and analytically by using machine learning models such as ARIMA time series model, Support Vector Machine (SVM) and k-nearest neighbour (KNN). The prediction models were validated through assessment matrix such as Root Mean Square Error (RMSE). From the experiments, it was observed that voltage is high during the day when a load is applied, and a low amount is acquired at night when no load is applied. And from the analytical study, the ARIMA time series model has the highest prediction accuracy. Error analysis was done to demonstrate the efficiency of the proposed models. The accuracy of the developed models can be further increased, which is subject to future research.

Finding the Financial Margin Expansion Leverage in the Medical Practice

All U.S. medical groups, especially the independents, are under financial pressure from third-party payers, both commercial and governmental. These pressures come in the form of unit price controls, services utilization constraints, and total costs of care oversight, especially for the management of chronic conditions. The only solution to the deterioration of practice operating economics and related financial performance is operating margin expansion strategies—the expansion of the margin that funds the provider compensation pool. Such strategies are available. The principal challenges to margin expansion often are products of entrenched, and frequently intractable, clinical models and related business models, together with facility constraints, and access to investment capital that doesn’t excessively draw down physician compensation.

PROFITABILITY IN ECUADORIAN PRIVATE BANKING AND FINANCIAL INCLUSION

In recent years, financial inclusion has taken importance worldwide, in this sense this research aimed to analyze the relationship between the profitability of Ecuadorian private banking and financial inclusion. The type of research used was quantitative due to it involves data from 15 banking entities between 2002 - 2019, in addition, some linear regression models were applied the same that allowed establishing the relationship among the variables, which showed a positive relationship between bank profitability and inclusion. Financial. The results obtained show that financial inclusion positively affects the profitability of banks in Ecuador. it is concluded that an increase in financial inclusion can generate an improvement in bank profitability, showing a direct and positive relationship between Loans / GDP, Financial Intermediation, Return on assets, Return on equity , Financial Net Margin, it is worth mentioning that financial inclusion allows improving the profitability of banks