Total Margin Research Articles

COMMERCIAL VEGETABLE SUPPLY CHAINS IN THE TRADITIONAL MARKET OF BOGOR CITY THAT GIVE TO FARMERS

The price gap between farmers and retailers in commercial vegetables like spinach, tomatoes, potatoes and shallots in Bogor City was predicted as a result from the high trading margin. The research aims to analyze income, margin and farmer share obtained by commercial vegetable supply chain actors in Bogor City. The study was conducted in March - October 2017 at the Bogor Traditional Market and the Jambu Traditional Market. The selection of respondents used the purposive sampling and snowball sampling method. Result shows that the R / C ratio of farmers is lower than that of traders. The R/C ratio received by farmers is 1,48, while that received by traders is 2,64. The average Farmer Share (41,2%) is lower than the seller share (58,8%). The average marketing margin is Rp 14,576.5. The supply chain that take side to farmers regarding to the value of R/C, the total margin and the farmer's share value are found in potato commodities because it has a higher R / C ratio than traders, higher farmer shares than traders, and trading margin that lower than the three other commodities compared

High Medicaid Nursing Homes: Organizational and Market Factors Associated With Financial Performance.

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. The purpose of this study is to examine the organizational and market factors that may be associated with better financial performance among high Medicaid nursing homes. Data sources included Long-Term Care Focus (LTCFocus), Centers for Medicare and Medicaid Services’ (CMS) Medicare Cost Reports, CMS Nursing Home Compare, and the Area Health Resource File (AHRF) for 2009-2015. There were approximately 1108 facilities with high Medicaid per year. The dependent variables are nursing homes operating and total margin. The independent variables included size, chain affiliation, occupancy rate, percent Medicare, market competition, and county socioeconomic status. Control variables included staffing variables, resident quality, for-profit status, acuity index, percent minorities in the facility, percent Medicaid residents, metropolitan area, and Medicare Advantage penetration. Data were analyzed using generalized estimating equations with state and year fixed effects. Results suggest that organizational and market slack resources are associated with performance differentials among high Medicaid nursing homes. Higher financial performing facilities are characterized as having nurse practitioners/physician assistants, more beds, higher occupancy rate, higher Medicare and Medicaid census, and being for-profit and located in less competitive markets. Higher levels of Registered Nurse (RN) skill mix result in lower financial performance in high Medicaid nursing homes. Policy and managerial implications of the study are discussed.

Value Chain Analysis of Head Cabbage: The Case of Kofele and Kore Districts in West Arsi Zone, Oromia National Regional State, Ethiopia

Cabbage is highly nutritious, and it is an economically important vegetable in Ethiopia and one of the most widely cultivated in West Arsi zone especially at Kofale and Kore districts. The study was aimed to analysis head cabbage value chain in Kofale and Kore districts with the specific objectives of identifying head cabbage value chain actors and examining the performance of actors in the chain in the study area. Data were collected from both primary and secondary sources. The primary data were generated by household survey using a pre-tested structured questionnaire and key informant interview using checklists. The data were collected from 120 farmers, 50 traders and 50 consumers and analyzed using STATA software. Value chain actors of head cabbage identified in the study area includes input suppliers, producers, rural collectors, brokers, wholesalers, retailers, and consumers. Five market channels were identified. The highest total gross margins were 79.28% in channel II. The highest gross marketing margin of producers markets channels are 85.56% in channel IV. From total quantity of head cabbage produced only 33.48% supplied to the market in the study area. Policy implications drawn from the study findings include the need to improve farmers’ knowledge and experience on head cabbage production and marketing, encouraging adult education through extension service, improving land allocated for head cabbage, improving productivity and volume sales of head cabbage, improving market information access, expanding accessibility of market infrastructure and strengthening supportive institutions like credit access are recommended. In addition to this the study suggests that it shall be better to improve the farmers’ market margins from collectors and wholesalers by strengthening farmers-traders linkage through reducing brokers’ exploitation and solving related production and marketing problems in the study area. Keywords: Value chain analysis, Head cabbage, Marketing margin, Market Performance, Ordinary least square model, and Kofele and Kore districts. DOI : 10.7176/JAAS/52-05

Structure, Conduct and Performance of Groundnut Markets: The Case of Fogera Woreda, South Gondar Zone of Amhara Regional State

This paper looks at and assesses the structure, conduct and performance of groundnut markets in Fogera Woreda, South Gondar Zone of Amhara Regional State. Households and traders concerned in groundnut were interviewed for obtaining primary data. The study was conducted by incorporating from two kebeles of 175 groundnut producing households and seven markets of 34 traders. A multi stage sampling procedures were employed to select sample producers while for groundnut traders snowball sampling techniques was used. The result shows that nine major groundnut marketing channels were identified and using the respondents a total of 7432.8 quintals of groundnuts were transacted in 2015/16 production season and among its rural assemblers and urban wholesalers purchased about 66.7% and 29.33% of the total produce respectively. The analysis of the market structure indicates that the concentration ratio of 76.61% at Bahirdar market, which shows an oligopolistic market structure and which resulted in a groundnut market conduct characterized by a market strategy in which the traders have an upper hand in fixing the price of the groundnut as well as effecting payment by the time in favor of the traders. Concerning the market performance, the findings show that the benefit from groundnut marketing is skewed to few actors in the market chain. Notably, street vendors had the highest gross marketing margin with estimated share of 51% found in the channel III and followed processors and urban retailers with estimated share of 43.7% and 38.89% in channel I and II of the consumer’s price respectively. The highest total gross marketing margin found in channel IX which accounts for 64.81% of the consumer’s price and followed by channel VII and VIII which accounts each with estimated share of 64.05% of the consumer’s price. The lowest producers’ share is appropriated in channel IX which accounts 35.19% of the consumer’s price. The findings from this study, so strongly recommended that establishing well organized cooperatives for reducing the inefficiency due to high marketing margin as well as the oligopolistic market structure.

The 3-D Volumetric Measurement Including Resected Specimen for Predicting Renal Function AfterRobot-assisted Partial Nephrectomy

ObjectiveTo investigate the relationship between postoperative renal function and resected cortex margin volume calculated by a 3-dimensional reconstruction technique based on the resected specimen, and to determine predictors of renal function after robot-assisted partial nephrectomy. MethodsA total of 114 patients underwent robot-assisted partial nephrectomy from 2014 to 2018. Patients without a 1 mm slice computed tomography or renal scintigraphy were excluded. We identified the margins of the tumor from each resected specimen with 2 mm margin being added as the ischemic margin. The volume of the renal cortex was calculated automatically using 3-dimensional volume analyzer software. The total margin volume was excluded from the ipsilateral cortex volume to calculate the cortex volume split. Predicted estimated glomerular filtration rate (eGFR) was calculated using the change in cortex volume and then compared with the actual eGFR. ResultsEighty-two patients were included in this retrospective study. Sixty-six patients (80%) were cT1a. A strong correlation was observed between renal scintigraphy split and pre- and postoperative cortex volume split (Pearson correlation coefficient r = 0.9330 and 0.8742, respectively). The predicted eGFR correlated strongly with post 1, 3, 6, and 12 months eGFR (r = 0.8929, 0.9294, 0.9320, and 0.8952, respectively). Preoperative relative renal function and total cortex margin volume were independent risk factors for decreasing postoperative renal function. ConclusionThis precise volumetric assessment that includes the resected margin is an alternative to renal scintigraphy for predicting postoperative relative renal function. The healthy cortex margin volume calculated by the reconstruction technique is an independent risk factor of decreasing postoperative renal function.

Image-guided study of inter-fraction and intra-fraction set-up variability and margins in reverse semi-decubitus breast radiotherapy

BackgroundThis study aimed to evaluate the inter-fraction set-up error and intra-fraction motion during reverse semi-decubitus (RSD) breast radiotherapy, and to determine a planning target volume (PTV) margin.Material and methodsPre- and post-treatment cone-beam computed tomography (CBCT) scans were prospectively acquired at fractions 1, 4, 7, 8, 11, and 14 for 30 patients who underwent RSD breast radiotherapy. Online correction for initial set-up error greater than 5 mm or 2° was performed and post-correction CBCT was acquired. An off-line analysis was performed to quantify initial and residual inter-fraction set-up errors and intra-fraction motion in three-dimensions. Patient inter-fraction errors were analysed for time trends during the course of radiotherapy. PTV margins were calculated from the systematic and random errors.ResultsThe initial inter-fraction population systematic errors were 1.8–3.3 mm (translation) and 0.5° (rotation); random errors were 1.8–2.1 mm (translation) and 0.3–0.5° (rotation). After online correction, the residual inter-fraction population systematic errors were 1.2–1.8 mm (translation) and 0.3–0.4° (rotation); random errors were 1.4–1.6 mm (translation) and 0.3–0.4° (rotation). Intra-fraction population systematic and random errors were ≤ 1.3 mm (translation) and ≤ 0.2° (rotation). The magnitude of inter-fraction set-up errors in the anterior-posterior direction, roll, and yaw were significantly correlated with higher body weight and body mass index (BMI). The inter-fraction set-up error did not change significantly as a function of time during the course of radiotherapy. The magnitude of intra-fraction motion was not correlated with patient characteristics and treatment time. The total PTV margins accounting for pre-correction and intra-fraction errors were 6.5–10.2 mm; those accounting for post-correction and intra-fraction errors were 4.7–6.3 mm.ConclusionsCBCT is an effective modality to evaluate and improve the inter-fraction set-up reproducibility in RSD breast radiotherapy, particularly for patients with higher BMI. Intra-fraction motion was minimal during RSD breast radiotherapy.

Analisis Efisiensi Pemasaran Ikan Tuna Segar Di Kabupaten Pacitan

<p><em>This study aims to determine the pattern of marketing channels, the role and function of marketing agencies, cost, profit, marketing margins, as well as examine the most economically efficient fresh tuna fish marketing channels in Pacitan. The research location is in Pelabuhan Perikanan Pantai (PPP) Tamperan Pacitan. Methods of sample selection was accidental sampling for fishermen and snowball sampling for marketing agencies. The results showed that (1) there are three marketing channels of fresh tuna, namely, the Marketing channel I (fisherman- collector- retailer- household consumers), the channel II (fisherman-collector- industrial consumers in the city) channel III (fishermen – collector – wholesalers). (2) collector has exchange function and physical function, wholesalers have an exchange function, physical function and function facilities, while retailers have exchange function and physical function. (3) In the first line the total cost of Rp 1.3.14,83 / kg, the total profit of Rp 4685.17 / kg, total marketing margin of Rp 6000.00 / kg and the farmer's share of 71.43%. total cost marketing of channel II is Rp 2195.75 / kg, the total profit of Rp 2804.25 / kg, the total margin is Rp 5000.00 / kg and the farmer's share of 83.33%. total cost marketing channel III is Rp 7.455 90 / kg, the total profit of Rp 3544.10 / kg, total marketing margin is Rp 11,000 / kg and the farmer's share of</em><em>78.43%. (4) Channel II is the most efficient channel economically with farmer's percentage share of 83.33%.</em></p>

EHR IMPLEMENTATION AMONG NURSING HOMES: IS IT ASSOCIATED WITH BETTER FINANCIAL PERFORMANCE?

While electronic health records (EHR) implementation has the potential to improve quality and financial performance, the rate of EHR adoption is relatively low in nursing homes. This study explores whether EHR implementation is associated with better financial performance, among resource-constrained nursing homes (85% or higher Medicaid census). Survey data on EHR implementation among a national sample of 242 high-Medicaid nursing homes in 2017 was merged with secondary data (LTCFocus, Area Resource File, and Medicare Cost Reports). The dependent variable consisted of the total profit margin (net income/revenues). The independent variable consisted of five categories of EHR functionalities (administrative functions, documentation, order entry, results viewing, and clinical tools) derived from 23 items. Control variables consisted of organizational and market factors. Data were analyzed using multivariable regression with state fixed effects. Results shows a positive relationship between the scope of EHR implementation and total margin (β=3.92, p<0.05). However, only the documentation (β=0.35, p<0.05) and order entry (β=1.26, p<0.05) functionalities were found to have a positive association with financial performance. Documentation provides resident information, such as demographics, problem list, and medication administration and treatment records. Order entry provides resident information on medication orders and other medical orders. These EHR functionalities may be particularly important for coordination of care and in reducing duplication. High Medicaid nursing homes face unique resource challenges, which may affect the degree of EHR implementation. However, despite the initial costs of EHR implementation, it has the potential to reduce costs and ultimately improve financial performance among these resource-constrained nursing homes.

Strategi Pemasaran Kelapa Sawit Melalui Pendekatan Analisis Structure Conduct And Performance (SCP) di Kabupaten Simalungun

The purpose of this study was to determine the marketing strategy of palm oil using a structure, behavior and marketing performance approach to: (1) Analyze the market structure of the palm oil industry in Tanah Jawa District, Simalungun Regency. (2) Analyzing the marketing function so that it is known the behavior of the palm oil market in Tanah Jawa District, Simalungun Regency. (3) Analyzing the margin and farmer share so that the performance of the palm oil industry is known in the Tanah Jawa District of Simalungun Regency. (4) Analysis of the relationship between the structure, behavior and performance of the palm oil industry in Tanah Jawa District, Simalungun Regency. The analytical method used in this research is marketing channel analysis and market structure analysis which is seen from market concentration and market entry barriers. Analysis of market behavior seen from the marketing function, namely the exchange function, physical function and facility functions. Analysis of market performance seen from the farmer share and marketing margin. Based on the results of research conducted, the market structure of the palm oil industry in Tanah Jawa District, Simalungun District is an imperfect competition market that is oligopolistic, with an average market concentration of 83 percent. This means that the market structure in Kecamatan Tanah Jawa is grouped in strict oligopoly and the average barriers to market entry are 9 percent, so there is no obstacle to enter the market in Tanah Jawa District, Simalungun Regency. Market behavior in the palm oil industry in Tanah Jawa District, Simalungun District can be seen from the pricing strategy and product strategy. The price strategy is carried out by collusion between market participants, namely making the highest production costs in consideration of sales prices. Product strategy is done by classifying products based on size, price and product quality. There are several marketing institutions, namely farmers, small agents, large agents, factories. Each marketing agency performs marketing functions. In marketing activities the existence of capital ties by farmers with small agents and large agents causes contractual ties. Market performance analysis (Market Performance) of palm oil in Tanah Java District, Simalungun District shows that there are 3 marketing channels with different margins. The highest total margin is found in marketing channel III, which is 34.06 percent, the more marketing institutions involved, the higher the marketing margin and the lower farmer share. The most efficient marketing channel is the marketing channel I (farmer-factory).

Correlates of interorganizational relationship strategies among critical access hospitals.

Interorganizational relationships (IORs) between hospitals and other health care providers have many potential benefits for critical access hospitals (CAHs) that operate in resource-constrained environments. Given the potential benefits of IORs, especially for CAHs, it is important to identify the conditions that support or hinder IOR development. However, most research examining IORs isolates individual types of relationships while ignoring the practical reality that many hospitals participate in a portfolio of relationships simultaneously. The aim of the study was to examine the IOR strategies of CAHs as a function of market and organizational characteristics. The sample consisted of CAHs operating in the United States between the years 2002 and 2012. For each year, hospitals were assigned to one of four mutually exclusive IOR categories: (a) no IOR, (b) vertical IOR only, (c) horizontal IOR only, and (d) both vertical and horizontal IOR. Organizational characteristics were categorized as structural, operational, and financial. Environmental characteristics were categorized as sociodemographic, physical, and health delivery system-related. A multinomial logistic regression model was used to assess the relationship between IOR strategies and organizational and environmental characteristics, with results reported as average marginal effects. Approximately 41% of the CAHs were pursuing a combined vertical and horizontal IOR strategy, 20% were pursuing a vertical IOR-only strategy, 18% were pursuing a horizontal IOR-only strategy, and 21% were not engaged in an IOR strategy. Among the organizational characteristics, the type of IOR strategy used by a hospital varied as a function of ownership, total margin, days cash on hand, number of community orientation activities, and census. In contrast, among the environmental characteristics, only the number of community health centers in the community was associated with the type of IOR strategy pursued. CAHs' construction of IOR portfolios may be more dependent on organizational attributes than by environmental conditions.

Probabilistic cumulative dietary risk assessment of pesticide residues in foods for the German population based on food monitoring data from 2009 to 2014

Cumulative dietary risks for the German population owing to pesticide residues in foods were assessed using food monitoring and consumption data. Based on grouping principles for cumulative assessment groups (CAG) as defined by the European Food Safety Authority, probabilistic modelling gave cumulative long- and short-term dietary exposures relevant to the nervous and thyroid system. Compound specific toxicological reference values were considered to assess the total margins of exposure (MoEs) for each CAG, allowing an assessment of the cumulative dietary consumer risk. For the German population, no public health concerns were identified for 6 of 11 CAGs. For three CAGs high uncertainties remained, since MoEs were less than the usually required threshold of 100 for the upper confidence interval of the modelling uncertainty. For two CAGs relevant to the nervous and thyroid system, possible health risks cannot be excluded with the selected approach. Most potent risk drivers were chlorpyrifos and the group of dithiocarbamates (expressed as propineb). For regulatory decisions on possible cumulative dietary health risks the limitations of the published approaches and the absence of harmonized data sources for robust refinements have to be considered. Future research to reduce this high uncertainty is considered necessary in this area.

Fractionated Gamma Knife Radiosurgery as Initial Treatment for Large Skull Base Meningioma.

We present our experience on the hypofractionated Gamma Knife radiosurgery (FGKS) for large skull base meningioma as an initial treatment. We retrospectively reviewed 23 patients with large skull base meningioma ≥10 cm3 who underwent FGKS as the initial treatment option. The mean volume of tumors prior to radiosurgery was 21.2±15.63 cm3 (range, 10.09~71.42). The median total margin dose and marginal dose per fraction were 18 Gy (range, 15~20) and 6 Gy (range, 5~6), respectively. Patients underwent three or four fractionations in consecutive days with the same Leksell® frame. The mean follow-up duration was 38 months (range, 17~78). There was no mortality. At the last follow-up, the tumor volume was stationary in 15 patients (65.2%) and had decreased in 8 patients (34.8%). Six patients who had cranial neuropathy at the time of FGKS showed improvement at the last clinical follow-up. Following FGKS, 4 patients (17%) had new cranial neuropathy. The trigeminal neuropathy was the most common and all were transient. The mean Karnofsky Performance Status score at pre-FGKS and the last clinical follow-up was 97.0±10.4 points (median, 100) and 98.6±6.9 (median, 100) points, respectively. FGKS has showed satisfactory tumor control with functional preservation for large skull base meningiomas. Further prospective studies of large cohorts with long term follow-up are required to clarify the efficacy in the tumor control and functional outcome as well as radiation toxicity.

The contribution of livestock to urban resilience: the case of Bamako, Mali

Urban livestock keeping is increasing in many sub-Saharan African cities, but detailed contextual information on its extent, challenges, and potential is limited. A cross-sectional household study was done in 2010 in Bamako, Mali. Thirty-two of 67 quarters were randomly selected with selection probability proportional to the size of the human population of the communes. Questionnaire interviews were done with a head of household in 1141 households, comprising 19,816 people in total. Sheep were kept by 16% (95% CI 14–18), while 21% (95% CI 17–24) kept poultry. The sheep to human ratio was 4:100, with an extrapolated city-wide population of 67,636 sheep (95% CI 61,018–75,595). The poultry to human ratio was 11:100, with an extrapolated city-wide population of 191,802 chickens (95% CI 176,212–208,772). For urban livestock holders, household-level enterprise gross margins were calculated for sheep production at USD 103 and poultry production at USD 50 annually. The annual gross margin was estimated at USD 35 per sheep and USD 17 per chicken. Based on these figures, the city-wide urban livestock total gross margin for Bamako in 2010 was estimated at USD 5.6 million. Detailed population data help clarify the urban livestock animal human interface in diverse contexts and highlight the important contributions that urban small-holder production adds to food security and resilience. The potential for urban livestock production informs decision-makers in developing adapted, sustainable policies in resource-constrained environments.

The Privatization of Public Hospitals: Its Impact on Financial Performance.

This study examined the effects of public hospitals' privatization on financial performance. We used a sample of nonfederal acute care public hospitals from 1997 to 2013, averaging 434 hospitals per year. Privatization was defined as conversion from public status to either private not-for-profit (NFP) or private for-profit (FP) status. Financial performance was measured by operating margin (OM) and total margin (TM). We used hospital level and year fixed effects linear panel regressions with nonlagged independent and control variables (Model 1), lagged by 1 year (Model 2), and lagged by 2 years (Model 3). Privatization to FP was associated with 17% higher OM (Model 2) and 9% higher OM (Model 3), compared with 3%, 4%, and 6% higher OM for privatization to NFP for all three Models, respectively. Privatization to FP was associated with 7% higher TM (Model 2) and privatization to NFP was associated with 2% higher TM (Model 3).

The influence of animal traits on feedlot profitability of Santa Gertrudis cattle in South Africa

ABSTRACTApproximately 75 per cent of South Africa’s beef is finished by feedlots. The profitability of the beef industry remains under pressure due to various external factors. Previous research has shown that many factors influence feedlot performance and profitability. It is, however, very difficult to judge an animal’s inherit feedlot performance before it enters the feedlot. The aim of this study was to explore the relationship between the animal traits of Santa Gertrudis bulls and the feedlot profitability of these bulls. Analysed traits included the sheath score, capacity score and build score as high scores for these traits are believed to be associated with better feedlot performance. The data for this study was collected from 48 Santa Gertrudis bull calves. The profitability of feeding cattle was expressed as the Total Margin (TM) and Feed Margin (FM). Given the nature of the dependant variables, Ordinary Least Squared regressions were used for the analyses with TM and FM as dependent variables. Results show that although both models were significant, the sheath score was the only individual trait that proved to be significantly correlated with both TM and FM. Sheath score proved to be negatively correlated with TM and FM while it was expected, through popular belief, to be positively correlated. This implies that animals with lower sheath scores, thus with sheaths closer to their bodies, perform better in the feedlot and may affect the TM and FM positively. The magnitude of this trait still remains under question and further research is required.

Marketing Margins for Imported and Local Rice in Akure, Ondo State, Nigeria

The study was carried out in Akure, Ondo State. Multi stage and sampling technique procedure was used which involved purposive and random sampling methods in selecting the respondents with the aid of well-structured questionnaire with interview schedule. Descriptive statistical analysis, budgetary techniques, marketing margin analysis as well as Gini-coefficient and Herfindahl Hirshman Index was used for the analysis of variables. The result reviewed that more of the imported brands of rice in all the four market sampled than the local rice, with local rice margin as percentage of total marketing margin (16.95%) lower than that of local rice (17.78%) the average marketing efficiency of 349.91% and 467.89% were obtained from imported and local rice respectively while the Gini- coefficient (GC) Herfindahl Hirshman Index (HHI) values of 0.68 and 0.28 were obtained reviewing that rice marketing were highly concentrated with non-competitive practices showing disparity in earnings. The prevailing duration stocks were held in shops by trader was three to four weeks and the major sources of obtaining market information was mobile phone. The study recommends provision of storage facilities for the traders and also improvement in the quality of local rice with policy implementation that discourage importation of commodity as a way out of boosting and encouraging local rice production and its consumption.

The Research on Anti-dumping, Cost and Chinese Export: Based on Multilateral Resistance Term of Gravity Model

Using country-industry data, this study investigates the effect of anti-dumping on Chinese export via Multilateral Resistance Term of Gravity Model. Begin with the effect of anti-dumping on total export, we further investigate the mechanism between them with extensive margin and intensive margin theory in Dutt et al. (2013). We find that, anti-dumping has a statistically significant and negative effect on total export, extensive margin and intensive margin, and the increase of variable cost is the mechanism of negative effect between anti-dumping and export.

Complementarity and bargaining power

Bargaining power in vertical channels depends critically on the or the opportunity cost to each player should negotiations fail. In a multiproduct context, disagreement profit depends on the degree of substitutability among the products offered by the downstream retailer. Horn and Wolinsky (1988) use this fact to argue for the clear importance of complementarity relationships on bargaining power. We develop an empirical framework that is able to estimate the effect of retail complementarity on bargaining power, and margins earned by manufacturers and retailers in the French soft drink industry. We show that complementarity increases the strength of retailers' bargaining position, so their share of the total margin increases by almost 28% relative to the no-complementarity case.

Medicare Payment Penalties and Safety Net Hospital Profitability: Minimal Impact on These Vulnerable Hospitals.

To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition. Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations. Bivariate and multivariate analysis of pooled cross-sectional data. Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins. Safety net hospitals appear to rely on nonpatient care revenues to offset higher penalties for the years studied. While reassuring, these funding streams are volatile and may not be able to compensate for cumulative losses over time.

Analisis Usaha Pertanian Brokoli (Brassica Oleracea L) (Studi di Desa Sumber Urip, Rejang Lebong, Bengkulu)

This research was conducted with the purpose to: (1) Determine the system of financing farming Broccoli, (2) Calculate farm income of Broccoli, (3) Investigate marketing channels of Broccoli,(4) Calculate its marketing margin and Knowing marketing efficiency Broccoli in Sumber Urip village District of Rejang Lebong Bengkulu. Respondents of Broccoli Farmers are censused 45 Farmers while marketing agencies are determined with Snowball Sampling, total Respondent marketing agencies are 25 Respondent. The result of this research indicated that the average farmers in the Sumber Urip village their own capital resources obtained from previous farming Broccoli. The averaged income of Broccoli as Rp 5.850.717/Ut/MT. The marketing analysis indicated that the only Broccoli marketing channel in Sumber Urip village was through Farmers, Countryside Wholeseller, Tradders Districts, Town Wholeseller, Retailers and Final Consumers. The marketing margin analysis showed that the total marketing margin Broccoli is Rp 10.942/Kg. Broccoli Marketing efficiency analysis results in Sumber Urip shows that every marketing agencies Broccoli studied all efficient it can be seen from the value criteria Countryside Wholeseller is 1.28, Tradders Districts 5.52, Town Wholeseller is 1,83 and Retailers 19,21.