Full-time Equivalent Employees Research Articles

Comparison of naloxone prescribing patterns due to educational outreach conducted by full-time and part-time academic detailers at the U.S. Veterans Health Administration

ObjectiveTo examine the impact of full-time equivalent employee (FTEE) allocation to academic detailers on naloxone prescribing at the U.S. Veterans Health Administration (VA). DesignLongitudinal nonequivalent control group posttest-only design using a random effects model. Setting and participantsClosed cohort of primary care providers exposed to academic detailing between September 1, 2016, and September 20, 2018, at VA. Outcome measuresPrevious analysis identified a cutoff of 0.40 FTEE was associated with a greater return on investment. We evaluated whether this level of FTEE allocation was associated with increases in naloxone prescribing rates and compared providers who had an interaction with an academic detailer allocated 0.4 FTEE or greater (high FTEE) to providers who interacted with an academic detailer allocated less than 0.4 FTEE (low FTEE). ResultsAmong VA primary care providers who received academic detailing, 1770 (68%) had interactions with a high FTEE academic detailer. There were no differences in demographics between providers who interacted with high FTEE and low FTEE academic detailers except for the distribution of provider classes (P = 0.004) and geographic districts (P < 0.001). Providers who interacted with high FTEE academic detailers had a greater average monthly number of naloxone prescriptions prescribed compared with low FTEE academic detailers (0.60 vs. 0.53; P = 0.005). In the random effects model, there was a 65% greater increase in the average monthly number of naloxone prescriptions prescribed among providers who interacted with a high FTEE academic detailer compared with providers who interacted with low FTEE academic detailers (P = 0.027). We also observed a dose-dependent relationship between the number of naloxone prescribed and the amount of FTEE allocated. ConclusionThis observational study highlights the potential benefits (e.g., increased naloxone prescribing) of academic detailers having more FTEE allocated. Hence, implementation of academic detailing needs to consider the amount of dedicated time for academic detailers, given competing VA priorities.

Provider Practice Competition and Adoption of Medicare's Oncology Care Model.

There is a concern that the Oncology Care Model (OCM), a voluntary bundled payment program, may incentivize mergers and acquisitions among physician practices leading to reduced competition and price increases. These concerns are heightened if OCM is preferentially adopted in competitive health care markets because it could result in reduced competition, but little is known about the characteristics of markets where OCM is adopted. To measure the association between regional market competition among medical oncologists with the initial adoption of OCM. The Herfindahl-Hirschman Index (HHI), a measure of competition, was calculated for hospital referral regions (HRRs) using secondary data from the Centers for Medicare and Medicaid Services. The relationship between HHI and OCM adoption was assessed using a 2-part regression model adjusting for the market-level number of practices, physician density, average practice size, sociodemographic characteristics, and medical resources. A count model on all HRRs was also estimated to assess an overall effect. A total of 10,788 physicians in 3,537 practices who billed Medicare for oncology services in 2015. OCM was adopted in 114 (37%) of the 306 HRRs. We found that practices in competitive health care markets were more likely to adopt OCM than in noncompetitive markets. Two-part regression analysis indicated a nonlinear relationship between HHI and OCM adoption. Average practice size, number of practices in an HRR, and the hospital bed rate were positively associated with adoption, whereas the rate of full-time equivalent hospital employees to 1000 residents was negatively associated with adoption. OCM adoption was higher in HRRs with greater competition. Careful monitoring of market-level changes among OCM adopters should be undertaken to ensure that the benefits of the OCM outweigh the negative consequences of possible changes in competition.

Burden associated with nonfatal slip and fall injuries in the surface stone, sand, and gravel mining industry

Slips, trips, and falls (STFs) pose a significant financial burden to employers and account for over 33% of the total nonfatal workers’ compensation cost in the United States. Previous analyses documenting the burden of STF incidents in the mining industry have focused on occupational fatalities or STFs during equipment ingress, egress. There is limited information on the burden of nonfatal STF incidents in the mining industry and most of it is outdated. Hence, to increase awareness and highlight the importance of STFs in the mining industry, this analysis documents the burden associated with nonfatal STF incidents at surface stone, sand, and gravel (SSG) mines from 2008 through 2017. In this time frame, nonfatal STF incidents occurred at a rate of 62 per 10,000 full-time equivalent (FTE) employees per year. Pits had a higher prevalence of injuries, but plants had a higher incidence rate. In addition, nonfatal STF incidents at surface SSG mines led to approximately 23,800 total days lost per year with an estimated cost to the mining industry of $17.5 million per year. Assessed violations that are not related to reported injuries but are related to STF hazards identified during Mine Safety and Health Administration (MSHA) inspections cost the mining industry approximately $3 million per year from 2013 through 2017. Based on the data analyzed in this study, falls to the lower level pose a higher burden in terms of cost; however, falls to the same level have a higher number of incidents and incidence rate.

Claim Costs, Musculoskeletal Health, and Work Exposure in Physical Therapists, Occupational Therapists, Physical Therapist Assistants, and Occupational Therapist Assistants: A Comparison Among Long-Term Care Jobs

Patient/resident-handling tasks are physically demanding and associated with musculoskeletal disorders (MSDs) among nursing personnel. The routine performance of such tasks by physical therapists and occupational therapists during treatment can cause similar problems. This study characterized the magnitude of MSDs and the risk factors for MSDs in physical therapists, occupational therapists, physical therapist assistants, and occupational therapist assistants (collectively called "therapy personnel" for this study) and compared them with those of other nursing home workers, especially nursing staff. This was a cross-sectional study. Workers' compensation claim (WCC) data from 1 year of experience in a long-term care company were used to compute claim rates by body region, nature, and cause of injury, and the costs per case and per full-time-equivalent employee. Data regarding musculoskeletal symptoms, use of patient/resident-lifting equipment, and perceived physical and psychological job demands were obtained from a concurrent cross-sectional survey of workers from 24 long-term care facilities. About 80% of the WCCs were related to musculoskeletal incidents in nursing aides and therapy personnel. WCC costs paid per case for therapy personnel were more than twice those for nursing staff for both ergonomic and resident-handling incidents. Prevalence of low back pain in therapy personnel was the same as in nursing aides (48%) but involved more chronic, milder pain. About half of therapy personnel reported "never" or "rarely" using patient/resident-lifting equipment. Therapy personnel, nursing aides, and housekeeping/dietary/maintenance personnel reported the highest physical job demands. Causal inference cannot be determined due to the cross-sectional nature of the survey data. Study findings are relevant only to therapy work in long-term care settings because exposures vary in other health care settings (hospitals, outpatient, and others). MSD prevalence and claim costs in therapy personnel are high enough to deserve more attention. The low use of patient/resident-lifting equipment in therapy could increase the risk for MSDs. Future studies with comprehensive ergonomic analysis of therapist tasks and recommendations to reduce injuries are warranted.

2nd Global Cryptoasset Benchmarking Study

This report reviews the impact of significant changes in the industry since the publication of the 2nd Global Cryptoasset Benchmarking Study in 2018. It provides novel insights into the state of the cryptoasset industry, having gathered data from 280 companies in 59 countries and across four main market segments – exchanges, payments, custody and mining. Highlights from the report - Full-time equivalent (FTE) employee growth slowed considerably following the late-2017 market frenzy. Respondents across all market segments, reported year-on-year growth of 21 per cent in 2019, down from 57 per cent in 2018. - The survey findings estimate that on average 39 per cent of proof-of-work mining is powered by renewable energy, primarily hydroelectric energy. Understanding the energy source of mining is important because electricity costs account for the majority of hashers’ operational expenditures – albeit with some variability across world regions – and hashers have long competed on accessing the cheapest energy source. - Aligned with 2018 findings, new survey data shows that off-chain transactions, both in terms of volumes and numbers, continue to be dominated by fiat-cryptoasset trades (and vice-versa), meaning that users primarily interact with service providers, such as exchanges, to enter and leave the cryptoasset ecosystem. - Stablecoins are becoming increasingly available. The share of service providers supporting Tether grew from four per cent to 32 per cent between 2018 and 2020, compared to 11 per cent to 55 per cent support growth for non-Tether stablecoins. This is aligned with the rising value of transactions denominated in stablecoins. - Service providers operationally headquartered in North America and Europe indicate that business and institutional clients make up 30 per cent of their customers. This figure is much lower for APAC and Latin American firms at 16 per cent and 10 per cent respectively. - The share of cryptoasset-only companies that did not conduct any KYC checks at all dropped from 48 per cent to 13 per cent between 2018 and 2020, most likely resulting from the progressive harmonisation of KYC/AML standards across jurisdictions, such as initiated by the Financial Action Task Force (FATF). The inclusion of firms exclusively supporting cryptoassets featured in FATF’s updated standards and recommendations is believed to have spurred greater compliance among this group of firms. However, this should not be interpreted as these companies becoming fully KYC compliant as some KYC checks are only applied to a subset of consumers.

Five-year trends in adenoviral conjunctivitis in employees of one medical center

To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented. Observational report with a retrospective evaluation of a current quality improvement initiative. Johns Hopkins Medicine, Baltimore, Maryland.ParticipantsJohns Hopkins Medicine employees. Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed. From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05). Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.

Jurisdictional Overlap and the Size of the Local Public Workforce

The United States is a country of many overlapping local governments. Theoretical explorations of the potential influence of this institutional arrangement abound; however, empirical evidence as the influence of such an arrangement on local public sector remains relatively thin. Using a county-level data set from 1972 to 2012, this overlap problem is explored. The results suggest that a positive relationship between the jurisdictional overlap and the size of local public workforce amounting to approximately a 1 percent increase in employment or an increase of less than one full-time equivalent employee.

Jurisdictional Overlap &amp; the Size of the Local Public Workforce

The United States is a country of many overlapping local governments. Theoretical explorations of the potential influence of this institutional arrangement abound; however, empirical evidence as the influence of such an arrangement on local public sector remains relatively thin. Instead of competing for mobile resources as suggested by Tiebout, overlapping jurisdictions utilize similar tax and voting bases introducing a potential commons problem. Using a county-level dataset from 1972 to 2012, this commons problem is explored. The results suggest that a positive relationship between jurisdictional overlap and the size of local public workforce amounting to approximately a one percent increase in employment or an increase of less than one full-time equivalent employee.

Employment and earnings of California farmworkers in 2015

The average employment of hired workers in California agriculture (NAICS 11) rose over 10% between 2005 and 2015, when some 16,400 agricultural establishments hired an average 421,300 workers who were paid a total of $12.8 billion, which was 27% of the state's $47 billion in farm sales. This means that a full-time equivalent (FTE) employee would earn $30,300, implying an hourly wage of $14.55 for 2,080 hours of work. We extracted all Social Security numbers reported by California agricultural establishments and found that the average annual pay received by the 848,000 workers who had at least one job on California farms was $20,500 in 2015, two-thirds of the average annual wage of an FTE worker, reflecting some combination of lower wages and less than full-year work.

The Total Size of an Airline and the Quality of its Flights

We examine the relationship between the total size of an airline and its service quality by analysing over 4.8 million domestic flights within the USA in 2016. The total size of an airline is measured by its total market share, total amount of assets or total number of full-time equivalent employees. Delays are a widely used proxy for service quality and the most common category of airline customer complaints. Numerous regressions have been estimated using arrival delay time and whether a flight arrives on time as dependent variables. The regressors of main interest were the total airline size and the degree of competition on the route and airport. We control for weather, congestion, date, and characteristics of the airport, flight and airplane. The results suggest that the larger the total size of an airline, the smaller its average delay time and delay occurrence. Hence, larger airlines seem to offer a higher quality in terms of delays. We also find that an origin airport with less competition may lead to more delays. Surprisingly, a less competitive route may reduce delays.

The effect of participation in Denmark’s Innovation Network program

ABSTRACTThis paper investigates Denmark’s Innovation Network program which aims to foster cooperation and knowledge sharing on research and innovation between knowledge institutions and companies in an effort to promote knowledge-based growth and productivity. Consistent with recent research on the effects of business network formation, this paper finds that participation in the Innovation Network increases labor productivity and total factor productivity by almost 7 and 13 percent respectively after four years. In addition, participants in the Innovation Network program are about 5 percentage points more likely to participate in other Danish innovation programs in the subsequent four years, explaining one mechanism by which the Innovation Network facilitates productivity growth. Generally, those firms with lower than (industry) median levels of full time equivalent employees realize the largest benefits from program participation. Despite small sample sizes, evidence that particular networks experience even larger gains is presented.

The quality reporting reality at a large Academic Medical Center: Reporting 1600 unique measures to 49 different sources

Objective: This paper explores the complexity and costs associated with quality reporting at a large, tertiary Academic Medical Center (AMC). Methods: For each quality measure reported during fiscal year (FY) 2014, we noted the associated agency or registry and any repeated use of identical measures (measure overlap). In addition, the cost of quality reporting was examined – including personnel, registry expenses, and rewards and penalties. Results: The AMC reported over 1600 unique measures to 49 different sources; measure overlap was 9%. This effort cost $2,367,168, including 24.8 full-time equivalent employees hired specifically to conduct or support quality reporting. Pay-for-performance rewards and penalties totaled $29,197. As a result, $2,337,971 was the FY 2014 cost of quality reporting. Conclusions: There are financial and personnel burdens associated with quality reporting and considerable inefficiencies. As the number of metrics increase, measures need to be carefully assessed, standardized across agencies, and incorporated into electronic health records. The following core competencies are addressed in this article: Systems-based practice, Practice-based learning and improvement.

Report of the results of the International Clinical Cytometry Society and American Society for Clinical Pathology workload survey of clinical flow cytometry laboratories.

Thorough review of current workload, staffing, and testing practices in clinical laboratories allows for optimization of laboratory efficiency and quality. This information is largely missing with regard to clinical flow cytometry laboratories. The purpose of this survey is to provide comprehensive, current, and accurate data on testing practices and laboratory staffing in clinical laboratories performing flow cytometric studies. Survey data was collected from flow cytometry laboratories through the ASCP website. Data was collected on the workload during a 1-year time period of full-time and part-time technical and professional (M.D./D.O./Ph.D. or equivalent) flow cytometry employees. Workload was examined as number of specimens and tubes per full time equivalent (FTE) technical and professional staff. Test complexity, test result interpretation, and reporting practices were also evaluated. There were 205 respondent laboratories affiliated predominantly with academic and health system institutions. Overall, 1,132 FTE employees were reported with 29% professional FTE employees and 71% technical. Fifty-one percent of the testing performed was considered high complexity and 49% was low complexity. The average number of tubes per FTE technologist was 1,194 per year and the average number of specimens per FTE professional was 1,659 per year. The flow cytometry reports were predominantly written by pathologists (57%) and were typically written as a separate report (58%). This survey evaluates the overall status of the current practice of clinical flow cytometry and provides a comprehensive dataset as a framework to help laboratory departments, directors, and managers make appropriate, cost-effective staffing decisions. © 2016 International Clinical Cytometry Society.

Impact of public seed-funding on academic spin-offs

In the entrepreneurial economy of today, it is not the multinational firms which are the predominant driver in the creation of new knowledge, but the individual entrepreneur. Correspondingly, new ventures of small size are leading in commercializing new knowledge and transferring it to the market. This economic shift has been reflected by broad entrepreneurship policies, which aim at supporting the individual on the challenge of a high-growth start-up. However, prior experience shows that uniform entrepreneurship policies do not address the individual needs in different countries and ecosystems adequately. In this paper, we study the performance of academic spin-offs that received public funding from the German EXIST Business Start-Up Grant, a support program which aims at increasing the number of innovative start-ups from academia. Using a control group matching approach, we provide evidence that these start-ups are smaller by two full time equivalent employees, generate 1.7 times higher losses and have a nearly three times lower return on capital than science-based entrepreneurial firms with comparable characteristics in the first 5 years after foundation. We interpret these results to be primarily caused by the inferior financial contracting structure of the program compared to private venture capital funding and by the resulting adverse selection and incentive effects on the entrepreneurs. The evidence calls for rethinking public interventions in a national system of entrepreneurship.

The minimum wage, a competitive wage, and the price of a burger: Can competitive wages be offered in limited-service restaurants?

ABSTRACTThe purpose of this article was to examine the effect that higher wages and health care benefits have on costs and prices in limited-service restaurants. In order to compensate for higher wages, prices would have to increase between 4 and 25% and/or product size would have to be scaled back between 12 and 70%. With tax credits that are available in the next few years, the Affordable Care Act will have a minimal effect on limited-service restaurants with fewer than 25 full-time equivalent employees. The extent to which higher wages and more benefits will help ameliorate turnover must be balanced with the cost of turnover and the potential effect on sales.

Rural Hospital Mergers and Acquisitions: Which Hospitals Are Being Acquired and How Are They Performing Afterward?

The number of stand-alone rural hospitals has been shrinking as larger health systems target these hospitals for mergers and acquisitions (M and As). However, little research has focused specifically on rural hospital M and A transactions. Using data from Irving Levin Associates' Healthcare M and A Report and Medicare Cost Reports from 2005 to 2012, we examined two research questions: (1) What were the characteristics of rural hospitals that merged or were acquired, and (2) were there changes in rural hospital financial performance, staffing, or services after an M and A transaction? We used logistic regression to identify factors predictive of merger, and we used multiple regression to examine various hospital measures after an M or A. Study results showed that hospitals with weaker financial performance but lower staffing levels and staffing costs were more likely to merge or be acquired. Statistically weak evidence suggested that operating margins declined after the merger; stronger evidence suggested reductions in salary expense. There was no statistically significant evidence of changes to the number of full-time equivalent (FTE) employees, the service lines that were included in the study, capital expenditures, or the amount of debt financing among the hospitals that merged or were acquired. M and A may not result in a rapid influx of capital, a relief of debt burden, or an improvement in bottom-line profitability. However, M and A may be a viable option for maintaining the hospital and the access to care it provides.

Local Public Health Department Characteristics Associated With Likelihood to Participate in National Accreditation.

We examined factors associated with completing, initiating, or intending to pursue voluntary national accreditation among local health departments (LHDs). We examined National Association of County and City Health Officials 2010 and 2013 profile data in a pooled cross-sectional design with bivariate and multivariable regression analyses. We conducted individual multivariable models with interest in accreditation and likely to accredit as outcome variables, comparing changes between 2010 and 2013. LHDs with formal quality improvement programs are significantly more likely to have initiated or completed the accreditation process (odds ratio [OR] = 7.99; confidence interval [CI] = 1.79, 35.60), to be likely to accredit (OR = 2.41; CI = 1.65, 3.50), or to report an interest in accreditation (OR = 2.32; CI = 1.67, 3.20). Interest was lower among LHDs in 2013 than in 2010 (OR = 0.56; CI = 0.41, 0.77); however, there was no difference regarding being likely to accredit. LHDs with a high number of full-time equivalent employees were more likely to indicate being likely to accredit or interest in accreditation. Quality improvement may facilitate the accreditation process or be a proxy measure for an unmeasurable LHD attribute that predicts accreditation.

The Impact of Privatization on Efficiency and Productivity: The Case of American Public Hospitals

Public hospitals typically operate in more challenging environments than private hospitals. Research suggests that privatization is one of the strategies that struggling public hospitals adopt to stay competitive. The purpose of this study was to examine whether privatization of public hospitals enhances efficiency and productivity. We used a national sample of non-federal acute care public hospitals in 1997 that was tracked through 2013, resulting in a cohort of 436 hospitals (7,386 hospital-year observations). Privatization was defined as conversion from public to either private not-for-profit or private for-profit status. Efficiency was measured by current assets turnover (CATO), fixed assets turnover (FATO), occupancy rate, full-time equivalent (FTE) employees per occupied bed, and work hours per adjusted patient day. Productivity was measured by case mix adjusted admissions per FTE. We controlled for organizational and market factors. Linear regressions with hospital and year fixed-effects models were used to test the hypotheses. Privatization from public to private status was associated with increased efficiency in terms of its positive associations with CATO (β =0.63) and FATO (β =0.23) and its negative association with FTE employees per occupied bed (β =-0.93) all at (p ≤ 0.001). Privatization was associated with increased productivity (β= 0.83; p ≤ 0.001).

Effectiveness of safety-engineered devices in reducing sharp object injuries.

Sharps injuries remain a common factor in occupational exposure of healthcare workers to blood-borne viruses. The extent to which the introduction of safety-engineered devices has been effective in reducing such injuries among healthcare workers is unclear. To investigate the incidence of sharp object injury among healthcare workers in the Capital Health Region of Alberta, Canada and to determine the effectiveness of the introduction of safety- engineered devices in preventing these. All reports of sharp object injuries to Capital Region Workplace Health and Safety offices from healthcare workers 2003-10 were analysed. Rates of sharp object injury were compared before (2006), during (2007-08) and after (2009-10) the introduction of safety-engineered devices, adjusting for other potential risk factors using Poisson regression and log-linear models. Between 2003 and 2010, a total of 4707 sharp object injuries were reported from 15 healthcare facilities. The sharp object injury rate per 1000 full-time equivalent employees per year declined from 35 before the introduction period to 30 during the introduction period (rate ratio [RR]: 0.88, 95% confidence interval [CI]: 0.78, 0.99) among most healthcare workers, but then rebounded again slightly after the intervention. Physician risks showed little change during the period of introduction (odds ratio [OR]: 0.99, 95% CI: 0.85, 1.14) but decreased significantly after the intervention (OR: 0.83, 95% CI: 0.71, 0.97). The introduction of safety-engineered devices was associated with a modest reduction in reported sharp object injuries but this appeared to be relatively short-lived for most workers.

0010 The importance of conducting regular safety inspections in small and medium size enterprises0010 The importance of conducting regular safety inspections in small and medium size enterprises

ObjectivesA considerable effort has been made to examine the health and safety of employees in large-sized enterprises. However, there has not been much attention given to the organisation of work,...