Aims and objectives. To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions. Background. Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis. Design. A cross-sectional design. Method. A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used ( p < 0·05). Results. The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high. Conclusions. Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice. Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.

The Baltic sea has always been an important transit hub for neighboring countries and the sea have made ​​it possible for the countries to trade with each other and thus create an international trade among themselves to each other. During 1700-1800's, the production took off and because of the mercantilism international trade developed. To establish their exchange rate, many countries have followed different standards, such as the gold standard where the currency's value was determined from the value of the corresponding quantity of gold which implies that the exchange rates were fixed. Based on the gold standard different theories was developed, such as the law of one price and purchasing power parity with the principles that a single currency will have the same purchasing power in other countries, which implies that a commodity should be bought for the same amount of currency, whether it is domestic or foreign. These theories have been studied several times, both for the short and long term, with the few countries to a greater number.

In order to test this, two econometric tests of the variables were made​​, stationarity test and cointegration test. The stationarity test showed that all variables except the time series that was used to test relative PPP suffered from non-stationarity and therefore needed to be differentiated to be used to test the PPP. The cointegration test showed that no one of the time series suffered of cointegration and therefore further correction models was not needed to be done.

The results from the econometric estimates showed that absolute and relative PPP could not be confirmed, nor denied, since no significant coefficients were identified. In the testing of real exchange rate for relative PPP significant time series were given but not in accordance with the nullhypothesis and therefore the null hypothesis is rejected that the relative PPP holds. From the results it is concluded that the PPP cannot be confirmed without that further studies must be done.

This paper examines the oil price-macro economy relationship by means of analyzing the impact ofoil price on Industrial production, real effective exchange rate, long term interest rate and inflation rate for a sample of ten OECD countries using quarterly data for the period 1970q1-2011q1.The impact of oil price shock on industrial production is negative and occurs with a lag of one year. However, the impact has weakened considerably compared to the 1970s. The impact on real effective exchange rate is negative/positive for a net importer/exporter, and the magnitude of the shock depends on the county´s share of net import/export of total world demand/supply. Interest rates are affected negatively, through increase in inflation rates following the oil price shock. The effect tends to die out after 5-8 quarters following the shock for most of the variables and countries. This paper also applies alternative methods to test for unit root and cointegration, which takes into account for structural breaks in the data. The weakness of Phillips-Peron test is clearly demonstrated in the case of inflation rates and interest rates, where the test falsely considered the series to be non-stationary when they in fact are stationary around a structural break. There is also strong evidence of cointegration between oil price and inflation rates and between oil price and interest rates, especially when taking account for structural breaks.

A Swedish radon data set, consisting of more than 8000 measurements of residential radon levels in about 50% of the Swedish municipalities were analysed using a multilevel approach.

The results were compared with those of a single-level analysis. We found that there was a significant variability between municipalities. The point estimates of the population mean radon levels were similar (geometric mean 60 Bq/m3 and arithmetic mean 106 Bq/m3).

The analysis shows the advantages of multilevel modeling compared with a single-level OLS model.

A single-level model results in too optimistic standard errors, about 25% of those of the multilevel

model which can lead to erroneous conclusions.

In a multilevel model including house type as a fixed effect (single-family house, row house, or apartment in multi-family house), the estimates of the fixed effect of house type were similar for the single-level and the multi-level models

This paper describes an alternative approach for testing for the existence of trend among time series. The test method has been constructed using wavelet analysis which has the ability of decomposing a time series into low frequencies (trend) and high-frequency (noise) components. Under the normality assumption, the test is distributed as F. However, using generated empirical critical values, the properties of the test statistic have been investigated under different conditions and different types of wavelet. The Harr wavelet has shown to exhibit the highest power among the other wavelet types. The methodology here has been applied to real temperature data in Sweden for the period 1850-1999. The results indicate a significant increasing trend which agrees with the 'global warming' hypothesis during the last 100 years.

Quarterly data for the period 1960:1 to 1997:2, conventional tests, a bootstrap simulation approach and a multivariate Rao's F-test have been used to investigate if the causality between government spending and revenue in Finland was changed at the beginning of 1990 due to future plans to create the European Monetary Union (EMU). The results indicate that during the period before 1990, the government revenue Granger-caused spending, while the opposite happened after 1990, which agrees better with Barro's tax smoothing hypothesis. However, when using monthly data instead of quarterly data for almost the same sample period, totally different results have been noted. The general conclusion is that the relationship between spending and revenue in Finland is still not completely understood. The ambiguity of these results may well be due to the fact that there are several time scales involved in the relationship, and that the conventional analyses may be inadequate to separate out the time scale structured relationships between these variables. Therefore, to investigate empirically the relation between these variables we attempt to use the wavelets analysis that enables us to separate out different time scales of variation in the data. We find that time scale decomposition is important for analysing these economic variables.

This study examines the effect on respondents' willingness to pay to reduce mortality risk by the order of the questions in a stated preference study. Using answers from an experiment conducted on a Swedish sample where respondents' cognitive ability was measured and where they participated in a contingent valuation survey, it was found that scale sensitivity is strongest when respondents are asked about a smaller risk reduction first ('bottom-up' approach). This contradicts some previous evidence in the literature. It was also found that the respondents' cognitive ability is more important for showing scale sensitivity when respondents are asked about a larger risk reduction first ('top-down' approach), also reinforcing the result that a 'bottom-up' approach is more consistent with answers in line with theoretical predictions for a larger proportion of respondents.

We test for gender, class, and ethnic discrimination in the Norwegian rental housing market by using fake application letters. Females, individuals with high job status, and ethnic Norwegians are more likely to receive positive responses. For example, being an Arabic man and working in a warehouse is associated with a 25 percentage point lower probability of receiving a positive response when showing interest in an apartment, as compared to an ethnically Norwegian female economist. We conclude that gender, class, and ethnic discrimination do exist in the Norwegian housing market, and ethnic discrimination seems to be the most prevalent form of discrimination.

In 1994 the EU directive of packaging waste was adopted. The result was that all EU member states developed different systems to manage packaging waste and recycling. This paper examines the various systems and the factors that affect the level of recycling. This is done by a cross-sectional study between countries. The results of my study suggest that take-back system generates less recycling than other systems, the mandatory deposit system can affect the recycling in a positive way. The recycling might be higher in a full cost system where the producers account for 100 percent of the funding. High national targets may provide higher recycling. Other factors such as high GDP per capita, older systems and high population density seems to have a positive effect on the recycling of glass, but no significant effect on the recycling of plastics. A positive correlation between fees and recycling were found, but the results are not completely reliable because of the data used for fees is very uncertain. I suspect that there are other variables not investigated that influence recycling. Because of that it is difficult to establish a general model that explains the level of recycling in a country. This makes it difficult for an authority to decide what instruments to use to increase recycling. 

During a longer period of time the interests has been low, and is expected to remain low for some time. Life-insurance companies offer different types of life-insurances for households, insurances that helps the households to even its lifeconsumption. The insurancepremiums that the life-insurance companies receives is placed in different financial assets, and is therefore exposed to financial risks. A big part of the life-insurance companies investment is placed in bonds, and a lower interest means that the return on bonds decrease. Lower returns on bonds could cause the the life-insurance companies financial strength to worsen. The lower return on bonds could also increase the life-insurance companies will to allocate their investments to more risks in search for higher returns. The aim of this essay is to investigate whether the solvency of life-insurance companies is affected by the interest, and if the interest corresponds to how life-insurance companies allocate their investments regarding risk.

To fulfill the aim of the essay, regressionanalysis has been performed. The result from the regressionanalysis with solvency as dependent variable and interest as independent variable shows that the solvency of life-insurance companies is not affected during the observed period of time. Results from regressionanalysis with percentage of investments placed in bonds as dependent variable and interest as independent variable shows that the percentage of bonds generally shrinks when the rent decreases, and life-insurance companies allocate therefore probably favouring assets of higher risk. However results concerning risk exposure for different life-insurance companies varies, some life-insurance companies increase exposure against risk, while some decrease.

In order for Sweden’s health care system to function as efficiently as possible the allotment of payment between government and patient must be balanced, both in terms of price and the number of general practitioner visits. In this study we will go into the analysis of the relationship between the cost efficiencies and changes against the count of patients seen by a general practitioner. The results of the collected data show that there is no difference or any sign of exploitation of primary care, considering the price change.

The reception of refugees is an important and highly current topic today. Refugee flows to Sweden increases as unrest in other countries increases. This leads to that issues arise around the refugee reception and the effects it create.

In Sweden, the county administrative boards (länsstyrelser) are negotiating on behalf of the state with municipalities on how many refugees each municipality are prepared to welcome. In these negotiations, questions arise regarding the impact of the reception and some issues are difficult, if not impossible to answer. The county administrative boards were unable to answer the question about what net economic impact arises, as an effect of the refugee reception. And, because of lack of research it proved difficult to answer the question even when doing research for this thesis.

This thesis tries to explore the net economic effects, but also some particularly interesting factors that affect the number of refugees a municipality chooses to welcome. The authors have based this thesis on research that investigates the national net impact of refugee reception, and tried to adapt the research to local conditions. National research has been used to try to answer the question whether municipalities can expect positive or negative net economic impact of the reception

Statistics are kept on some levels but not to a satisfactory extent resulting in a skewed, if not outright misleading picture, of how it actually looks in the municipalities. Therefore, the authors have chosen not to estimate a total figure on the net effects that arise. The thesis does, however, discuss the benefits municipalities receive from the state for the reception. Furthermore the thesis discusses the effects that arise in the municipal equalization system. In order to explain the effect caused by the municipal equalization system, this system has been explained fairly detailed.

This thesis thus tries to sort out the direct payments the municipalities receive from the state for the reception, as well as the largest expenditures the municipalities is expected to have. Also the effects in the municipal equalization system is sorted out. 

The results from this study are used to compare the marginal willingness to pay for risk reductions and calculate corresponding values of statistical life for road, fire and drowning accidents in Sweden. The values were estimated using a mail survey with 5200 respondents where each respondent was required to answer nine different dichotomous willingness to pay questions which were varied according to accident type, base line risk, risk reduction and cost. The risk reductions were expressed as mortality risk for adult Swedes. The questionnaire also contained socioeconomic and risk related questions.



We find that

- Women are more likely to take actions in order to reduce their mortality risk.

- Older respondents are more likely to take actions in order to reduce their risk of dying by fire and road accidents, but not drowning.

- Respondents who live in apartment blocks are less likely to take actions to reduce their mortality risk.

- Respondents who have had a previous bad experience with road accidents are more likely to take mortality risk reducing actions.

- Respondents who found the valuation questions easy to answer are more likely to take actions.



Using results from at probit regression model we find the value of statistical life for road accidents to be 20.2 million Swedish kronor (⬠2.2 million), 13.3 million kronor (⬠1.4 million) for fire accidents, and 12.4 million kronor (⬠1.3 million) for drowning accidents. Our results therefore suggest that different values should be used in a cost-benefit framework depending on the accident type.



The value of statistical life for road accidents is within the span of other Swedish estimates where several studies using contingent valuation methods with WTP-questions have arrived at values between 17 and 24 million Swedish kronor (Persson et al, 1996; Persson et al, 2001; Hultkrantz et al, 2006; Svensson, 2007). Further comparison is not possible because we are unaware of any other studies that estimate the value of statistical life using WTP-questions for fire and drowning accidents.



The respondents were also asked whether they believed they could affect the level of risk and also questioned on the extent of their concern regarding the different types of accidents. The responses indicate that while subjects believe that they can affect the risk levels of all three accident types, they believe that they can control the risk for road accidents to a lesser extent for road accidents than for the others. Similarly, although subjects do not worry about the mortality risks to any large extent, there is a clear difference between road accidents and the other causes. It may be the case that these two factors cause the differences in value of statistical life estimates for road accidents on one hand and fire and drowning accidents on the other hand. The results that subjective beliefs of the risk such as dread and voluntariness influences the value of statistical life is in line with suggestions by Slovic (1987), Savage (1993) and Chilton et al (2006)

We design a donations vs. own money choice experiment comparing three different

treatments. In two of the treatments the pay-offs are hypothetical. In the first of these, a short

cheap talk script was used, and subjects were required to state their own preferences in this

scenario. In the second, subjects were asked to state how they believed an average student

would respond to the choices. In the third treatment the pay-offs were real, allowing us to use

the results to compare the validity of the two hypothetical treatments. We find a strong

hypothetical bias in both hypothetical treatments where the marginal willingness to pay for

donations are higher when subjects state their own preferences but lower when subjects state

what they believe are other students preferences. The explanation is probably a self-image

effect in both cases. We find that it is mainly women who are prone to hypothetical bias in

this study

We study whether salient media coverage of refugees drowning in the Mediterranean affects individual xenophobic attitudes. We combine a randomized survey experiment - a variant of the classic trolley dilemma' - that implicitly elicits individual attitudes towards foreigners, with variation in interview timing, and find that such issue salience significantly decreases xenophobic attitudes by 2.2 percentage points. Our results thus support the idea that exposure to news describing immigrants as victims (instead of a threat) can significantly affect public opinion and mitigate bias against immigrants.

The numbers of elderly increase every year and the amount of older people with a license will increase as well. When getting older, it is natural that the reaction time, hearing and vision will change and these are all important features for traffic safety. Doctors in Sweden are required to report to the Swedish Transport Agency if an individual does not seem appropriate to drive. It is not common that doctors ask their patients about their physical health and ability to drive, the questions are only asked in about 60 percent of the physical evaluations and because of that, inappropriate license holders may proceed to use a vehicle. The majority of countries within the European Union embrace some kind of upper age limit to provide drivers with a valid license and several countries have compulsory medical examinations for license holders at a certain age. It is only Sweden together with six other EU countries that does not provide any license controls for elderly and in this study a cost benefit analysis is designed to determine whether controls for drivers over the age of 75 would reduce deaths and injuries caused by traffic accidents and thus increase welfare.

The countries that apply driving license controls have different rules how the controls are designed and the study presents how it works in some of the countries. Further, research within the area shows that license controls does not have any sufficient effect on traffic safety. It cannot with certainty be said how many lives are saved and the amount injuries that could be reduced by an introduction of these tests. Thus, these numbers are adopted without any sufficient evidence and from this an assumption of the cost benefit analysis will show that an introduction of license controls would not generate a welfare increase in Sweden.

Based on the result it is possible to conclude that Sweden has made a good assessment to have only a reporting requirement for physicians but the reports must be stricter. Although the result shows that license controls for people over the age of 75 should not be imposed, nevertheless traffic safety for elderly should be further developed, for example with simplifying left turns and improve public transportation.

The European Union have actively worked for an economic and social communion and equalisation for a long time. The internal market is one of the political measures the EU is behind and operates through the four freedoms: free movement of goods, services, persons and capital. Economic theories make evident predictions on how wages and prices will even out with free movement of labour, goods, services and capital. Despite the different political measures there are differences between the member States and the purpose of this essay is therefore to inquire the development during the 21st century and whether EU has had the positive effect desired? The essay will examine whether the differences between the EU member States has decreased and more specifically whether wages in the EU have converged. The study covers 24 countries during the years 2001-2015. The two accepted measures  s-and b-convergence are used to examine wage convergence. The methods aim to measure whether impoverished countries have grown faster than the richer countries and thus caught up. The methods also aim to examine if the difference between the countries have decreased. The results obtained show that wage convergence has actually occurred during the years examined. Impoverished countries have had a higher wage growth than the richer countries. Also, the measurement of the differences between wages has decreased over time and this show wage convergence

To what degree are preferences determined by fundamental and stable value orientations, or are they vulnerable to exogenous shocks to issue saliency? We exploit that the second round of the European Social Survey was conducted around the time when Mohammed Bouyeri murdered Theo van Gogh on 2 November 2004. The murder was covered extensively across Europe and led to a debate about the impact of mass immigration. We consider the murder as a natural experiment which allows us to explore how a shock to issue saliency affects immigration policy preferences. We compare preferences of those interviewed right before the murder (control group) with those interviewed right after the murder (treatment group). We find robust evidence of a significant treatment effect in a pooled analysis with country fixed effects. However, when we allow the treatment effect to vary across countries, we find evidence of more support for restrictive policy in only three countries (Norway, Spain, and Slovakia).

A woman's labor market participation and risk of divorce are argued to be important explanatory factors for the gender gap in political preferences. We utilize a Norwegian data set which allows a rigid test of these arguments because it includes information on vote choice, preferences regarding child and elder care spending, and extensive information on the relationship with the current partner. We find a gender gap in political preferences, but no evidence that it can be explained by women's risk of divorce, while the impact of labor market participation is not robust across specifications. To some extent, the gender gap in voting is driven by unmarried women voting left.

Using large samples of persons born in 1985 we investigate the relationship between theneighbourhood where young people grew up and the probability that they will receive socialassistance when aged 19 to 21, for the three Swedish metropolitan regions - Stockholm,Gothenburg and Malmö. We also investigate to what extent use of social assistance receiptand other parental characteristics affect the probability of social assistance receipt as a youngadult. Logistic regressions are estimated for the majority population and “visible minorities”.A main result is that the rate of social assistance receipt in the neighbourhood has a sizableeffect on the probability of receiving social assistance as a young adult. We discuss severalpossible explanations for this. We also find that the probability of receiving social assistanceis negatively correlated with having completed secondary school and positively correlatedwith having become a young mother. The probability of social assistance receipt is stronglypositively linked to social assistance receipt in the parental home and negatively linked toincome in the parental home. Having parents with long educations decreases the probabilityof receipt for the majority population while among “visible minorities” it does not thoughreceipt decreases by year since immigration.

BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.

AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.

METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.

RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.

DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.

RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.

The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.

This paper is a study how students at a high school in Falun, Sweden, estimates their

performance in an upcoming math test which is then compared with the actual grade the

student performed. The students who participated also answered questions related to “risk

situations” to examine whether there is a correlation between how students estimate their

performance in the context and their risk behavior, and if the students act like economic

models assume. In agreement with previous studies, the boys in the survey tended to be

overconfident in their performance. The girls in the study were neither over- nor

underconfident in her performance and no significant difference in the estimation of one's

performance between the sexes could be proven. The proportion of boys who considered

themselves to take greater risk than class average was greater than the proportion of girls in

the question. No linear relationship between estimation of performance and risk behavior or

differences in risk behavior could be found between the sexes.

Objectives: To investigate whether routinely collected data from hospital episode statistics could be used to identify the gynaecologist Rodney Ledward, who was suspended in 1966 and was the subject of the Ritchie inquiry into quality and practice within the NHS.

Design A mixed scanning approach was used to identify seven variables from hospital episode statistics that were likely to be associated with potentially poor performance. A blinded multivariate analysis was undertaken to determine the distance (known as the Mahalanobis distance) in the seven indicator multidimensional space that each consultant was from the average consultant in each year. The change in Mahalanobis distance over time was also investigated by using a mixed effects model.



Setting: NHS hospital trusts in two English regions, in the five years from 1991-2 to 1995-6.



Population: Gynaecology consultants (n = 143) and their hospital episode statistics data.



Main outcome measure Whether Ledward was a statistical outlier at the 95% level.



Results: The proportion of consultants who were outliers in any one year (at the 95% significance level) ranged from 9% to 20%. Ledward appeared as an outlier in three of the five years. Our mixed effects (multi-year) model identified nine high outlier consultants, including Ledward.



Conclusion: It was possible to identify Ledward as an outlier by using hospital episode statistics data. Although our method found other outlier consultants, we strongly caution that these outliers should not be overinterpreted as indicative of "poor" performance. Instead, a scientific search for a credible explanation should be undertaken, but this was outside the remit of our study. The set of indicators used means that cancer specialists, for example, are likely to have high values for several indicators, and the approach needs to be refined to deal with case mix variation. Even after allowing for that, the interpretation of outlier status is still as yet unclear. Further prospective evaluation of our method is warranted, but our overall approach may be potentially useful in other settings, especially where performance entails several indicator variables.

Abstract

Women constitute a clear minority in the field of information and communications technology (ICT) in higher education as well as in the job market. At the same time, this field is expected to have a shortage of qualified people in the future. Do women and men engineering graduates have the same career opportunities? This article problematizes the relationship between higher education in engineering and opportunities on the job market. The results show that men reach higher positions to a greater extent than women, and that women remain in low-qualification jobs to a greater extent than men.

Kvinnor utgör en klar minoritet inom området informations- och kommunikationsteknologi, både inom den högre utbildningen och på arbetsmarknaden. Artikeln problematiserar relationen mellan den högre tekniska utbildningen och positioner på arbetsmarknaden. Får kvinnor och män samma utbyte av sin ingenjörsexamen i arbetslivet? Resultaten visar att män i större utsträckning än kvinnor når högre positioner. Vidare ser vi att kvinnor stannar i lågkvalificerade jobb i högre utsträckning än män.