Private sector entities can invest in and own the means of healthcare provision, creating opportunities and risks for health systems. While private investment can enhance access to capital, promote competition, and foster innovation, it can also exacerbate incentives for providers to engage in supplier-induced demand, undue price increases, quality compromises, and ‘cherry-picking’ of the most profitable patients and services. Despite the growing presence of private investors in the healthcare sector, heterogeneity in investor types remains poorly understood. This limits the ability of policymakers to consider whether, and to what extent, regulatory intervention is called for in relation to different forms of investor-ownership. By drawing on principal-agent theory, this article begins to address this gap by presenting a typology of investor-ownership in health services provision. Examining the policy relevance of such a typology, we present a case study analysis of current regulations directed at ownership across five countries, representing different health system models. We find that regulatory frameworks that differentiate between types of for-profit investor-ownership are largely absent in Europe, but more developed in the US. We argue that growing private investments require a combination of entry regulation and behavioural oversight to better align the incentives of investor-owners with public health objectives.

This work focuses on explaining both grammatical universals of word order and quantitative word-order preferences in usage by means of a simple efficiency principle: dependency locality. In its simplest form, dependency locality holds that words linked in a syntactic dependency (any head–dependent relationship) should be close in linear order. We give large-scale corpus evidence that dependency locality predicts word order in both grammar and usage, beyond what would be expected from independently motivated principles, and demonstrate a means for dissociating grammar and usage in corpus studies. Finally, we discuss previously undocumented variation in dependency length and how it correlates with other linguistic features such as head direction, providing a rich set of explananda for future linguistic theories.

We study how donors decide about which charity to give to. To this end, we construct a theoretical model that clarifies the conditions under which the stand-alone benefit from giving, the charity price (i.e. the fundraising expenditure and overhead costs claimed by the charity providing services), and the information cost (i.e. the cost of information acquisition) inform giving decisions. We define the price of giving as the sum total of charity price and information cost. The model shows that giving decisions might be affected by a price–information trade-off—a condition where donors care about the charity price because they want their donations to maximise charitable output, but dislike searching for the charity price because it is costly. The literature is then reviewed to test the explanatory power of the theoretical model. The review provides evidence in favour of a price–information trade-off.

“Resilience and the Management of Nonprofit Organizations” is a book that explores the concept of resilience management for nonprofit organizations. The authors, Dennis Young and Elizabeth Searing, argue that the current paradigm of nonprofit management, which focuses on trustworthiness and efficiency, needs to be revised to adequately address the challenges facing nonprofit organizations. They propose a new paradigm based on resilience, which they define as the ability of organizations to adapt to changing circumstances and continue serving their missions effectively. The book provides strategies for anticipating and preparing for crises, explores the various dimensions of organizational resilience, and offers management strategies for achieving organizational resilience. It also discusses the need for “organizational slack” in order to be flexible and adaptable in the face of challenges.

Over the last two decades, nonprofit organizations in the United Kingdom (UK) have faced increased pressure to measure their activities in order to demonstrate their competency, to achieve legitimacy, and to obtain funding. This paper draws from recent literature in the sociology of science to examine quantification in the British voluntary sector as a historically situated and socially constructed process. Using archival and secondary documents, I find that quantification is not a new practice for charities in the UK; moreover, while they have employed metrication in the past, what activities nonprofits have measured, and the importance of measurement for their organizational success, has altered over the course of the century.

This article begins by describing the major characteristics and the origins of multi-level governance (MLG). It then discusses the alleged novelty of MLG practices, whether MLG achieves its goals in terms of policy efficiency and acceptance, and the possible consequences of governance networks for the democratic quality of political decisions. In relation to these matters, it concludes that there is a gap between the intensity of theoretical debate and a lack of systematic empirical research. It thus seeks to provide some indications about promising avenues for ‘second generation’ research that would allow us to give more substantial answers to controversial questions concerning MLG.

Key stakeholders in the UK charity sector have, in recent years, advocated greater accountability for charity performance. Part of that debate has focussed on the use of conversion ratios as indicators of efficiency, with importance to stakeholders being contrasted with charities’ apparent reluctance to report such measures. Whilst, before 2005, conversion ratios could have been computed from financial statements, changes in the UK charity SORP have radically altered the ability of users to do this. This article explores the impact on the visibility of such information through an analysis of the financial statements of large UK charities before and after the 2005 changes. Overall, the findings suggest that, despite the stated intention of increasing transparency in respect of charity costs, the application of the changes has resulted in charities ‘managing’ the numbers and limiting their disclosures, possibly to the detriment of external stakeholders.

Hundreds of thousands of people in Europe are daily receiving food, thanks to local food banks, run basically by volunteers who collect donations and distribute them to organizations. In this paper, data from a sample of food banks working in 13 European countries are analysed using Data Envelopment Analysis (DEA), trying to learn about their profiles and find some clues about the efficiency of their operations, comparing them according to variables such as the number of volunteers and permanent staff, the tonnage of food delivered and the number of people served. Significant inefficiencies were found in the sector as a result of high performance of some food banks, thus setting a high level standard of operational efficiency. Some additional results regarding food bank sizes and performance are presented.

What should mostly matter is how successful environmental policies are at satisfying citizens’ policy preferences (e.g., reducing carbon emissions), relative to the policies’ cost. Yet, across 6 studies (N = 2759, 2 pre-registered), we found that French citizens tended to be rather insensitive to policy efficiency. In Experiments 1a–d (N = 854), citizens regarded an environmental policy driven by an altruistic intention that turned out to be inefficient as being more commendable than a policy motivated by selfishness that dramatically reduced carbon emissions. In Experiment 2 (N = 1105), altruistic but low efficiency policies were supported only slightly less than selfish but highly efficient policies. Independent manipulation of intent and efficiency indicated low sensitivity to large differences in efficiency expressed numerically, and substantial sensitivity to actors’ intentions. Moreover, moral commitment predicted stronger support for any environmental policy addressing the issue, regardless of its efficiency. Finally, Experiment 3 (N = 800) found that introducing reference points and qualitative appraisals of a policy’s impact and financial cost can nudge participants towards greater attention to its efficiency. Our paper highlights the importance of using contextual and qualitative (vs. numeric) descriptions of policies to make citizens more focused on their efficiency.

Geographic information systems (GIS) are computer-based spatial mapping tools widely used in public health to examine service availability and access disparities and healthcare utilization. While GIS has supported evidence-based health planning in various domains, its application in mental healthcare service delivery remains underexplored. Our scoping review aimed to address this gap by exploring the scope and type of GIS usage in studying three dimensions of mental health (MH) service delivery (availability, accessibility and utilization), across all geographical locations, settings and populations. We conducted a scoping review following the Joanna Briggs Institute methodology. We included peer-reviewed English-language studies using GIS to examine service delivery (availability, accessibility or utilization) for any MH condition diagnosed through standardized criteria or validated tools. Seven databases were searched (Medical Literature Analysis and Retrieval System Online [MEDLINE], PsycINFO, Excerpta Medica Database [Embase], Global Health, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane Central Register of Controlled Trials [CENTRAL] and Web of Science) between January and April 2024. This review included 58 studies predominantly from high-income countries. A wide range of GIS methods were employed across studies, including hotspot analysis, network analysis and spatial analysis. Six studies explored availability, generally through measures like distribution of facilities across a population, and resource availability within 5–10-mile network buffers. Forty-six studies explored the spatial accessibility of MH services and substance-use treatment facilities using GIS. Six studies examined service utilization patterns. Equity emerged as a recurring theme across all three dimensions. GIS has the potential to emerge as a powerful tool in MH research, particularly in mapping disparities, informing service delivery and identifying high-risk zones. Expanding GIS use in trial design, implementation science and policy advocacy could help bridge critical gaps in MH service delivery, ensuring more equitable and data-driven decision-making.

Women and Property inheritance is a complex issue in India. The Hindu Succession Laws give women inheritance rights on ancestral, acquired, and agricultural land. This has led to an increase in their bargaining power and a consequential increase in transaction costs, which ideally should challenge the ex-ante and ex-post HSAA 2005, Coasean cooperative equilibriums. While the normative Coasean theorem propounds the dismantling of cooperation with the rise in bargaining, the Hobbesian framework believes that cooperation can exist through coercion. This process, in which women have bargaining rights yet cooperate, happens through “covert coercion.” Despite increased bargaining powers, women are conflicted between inheritance and maintaining familial ties, where covert coercion forces them to let go of inheritance. The article investigates this conflict women face through the lens of Law, normative Coasean and Hobbesian frameworks, psychological costs, and their Lived Reality. Further, this article investigates various efficiency criteria.

This commentary examines how early health technology assessment can mitigate risks during the development of innovative technologies.