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Almost all firms have taken measures to reduce the employee health claim cost component of health care expense. Many large firms have also been able to reduce the transaction costs of health insurance by changing to partial or full self‐insurance. For smaller firms the self‐insurance decision involves careful weighing of cash flow and tax considerations against risk consequences. This paper analyzes the risk trade offs inherent in the self‐insurance decision. A case study illustrates how cash flow and tax considerations affect the cost of partial and full self‐insurance for a medium size firm.

In 2005 Manchester United was taken over by US businessman Malcolm Glazer, in part because of the club's brand name prominence in the global sport of soccer. This paper examines how Manchester United rose to a pre-eminent position in world football through its on-field performances and its off-the-field management strategies. It shows how the club took its storied history into world markets to take full advantage of globalisation, the opportunities extended through the English Premier League's reputation and developments in global media technologies. Astute management of club resources is identified as the major factor in global brand management.

It is demonstrated that the Austrian school in economics had very different ideas about the creation and change of social institutions and especially about the relation of state and market, which is still one of the fundamental problems of economic theory. Menger′s fundamental distinction of pragmatic and organic institutions and Wieser′s contrary model are discussed, followed by the “impossibility theorem” of Mises and the contrary position of Schumpeter. Hayek′s liberation model of society is presented and criticised, and finally Menger′s position is interpreted as one of moderate liberal interventionism.

Patient safety indicators (PSIs) were developed as a tool for hospitals to identify potentially preventable complications and improve patient safety performance. The study aimed at measuring the incidence of the Agency for Healthcare Research and Quality (AHRQ) PSI03 (pressure ulcer [PU] rate) and to identify the association between PSI03 and clinical outcomes including death, readmission within 30 days and length of stay (LOS) at the cardiothoracic surgery hospital at Ain Shams University, Cairo, Egypt.

An exploratory prospective cohort study was conducted to follow up patients, who fulfilled the inclusion criteria, from admission until one month after discharge at the cardiothoracic surgery hospital. Data were collected through basic information and follow-up sheets. The total number of included participants in the study was 330.

PSI03 incidence rate was 67.7 per 1,000 discharges. Patients aged 60 years and above had the highest risk among all age groups. In patients who developed PSI03, the risk ratio (RR) of death was 8.8 [95% CI (3.79–20.24)], RR of staying more than 30 days at the hospital was 1.5 [95% CI (1.249–1.872)] and of readmission within 30 days in patients who developed PSI03 was 1.5 [95% CI (0.38–6.15)]. In the study’s hospital, the patients who developed PSI03 were at higher risk of death and stayed longer at the hospital than patients without PSI03. This study demonstrated a clear association between PSI03 and patient outcomes such as LOS and mortality. Early detection, prevention and proper management of PSI03 are recommended to decrease unfavorable clinical outcomes.

The importance of PSIs lies in the fact that they facilitate the recognition of the adverse events and complications which occurred during hospitalization and give the hospitals a chance to improve the possible clinical outcomes. Therefore, the current study aimed at measuring the association between AHRQ PSI03 ( PU rate) and the clinical outcomes including death, readmission within 30 days and the LOS at the cardiothoracic surgery hospital at Ain Shams University. This study will provide the hospital management with baseline data for this type of adverse event and guide them to develop a system for identifying the high-risk group of patients and to upgrade relevant hospital policies and guidelines that lead to improved patient outcomes.