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Multilevel paradigms have permeated organizational research in recent years, greatly advancing our understanding of organizational behavior and management decisions. Despite the advancements made in multilevel modeling, taking into account complex hierarchical structures in data remains challenging. This is particularly the case for models used for predicting the occurrence and timing of events and decisions—often referred to as survival models. In this study, the authors construct a multilevel survival model that takes into account subjects being nested in multiple environments—known as a multiple-membership structure. Through this article, the authors provide a step-by-step guide to building a multiple-membership survival model, illustrating each step with an application on a real-life, large-scale, archival data set. Easy-to-use R code is provided for each model-building step. The article concludes with an illustration of potential applications of the model to answer alternative research questions in the organizational behavior and management fields. ispartof: Organizational Research Methods vol:24 issue:2 pages:412-442 status: published

Multilevel paradigms have permeated organizational research, greatly advancing our understanding of organizational behavior and management decisions. Despite advancements in multilevel modeling, ta...

Objective To define the differences in emergency room usage patterns between patients with and without medical insurance coverage. Methods A retrospective analysis of the database of 34 642 consecutive patient visits to an urban hospital emergency room over a period of 509 days. Arrival times and admission rates were compared for insured and uninsured patients. Results A total of 46.8% of insured patients arrived at night or during the weekend versus 51.7% of the uninsured. Slightly more insured patients were admitted (18.6 versus 15.4%), both after their visit during the daytime (20.6 versus 17.1%) and outside daytime hours (16.3 versus 13.8%). The uninsured population was younger. Conclusion Uninsured patients arrived more frequently during weekends and at night than insured patients. They were on average less likely to be admitted to the hospital. Demographic differences between both groups seemed to play an important role in the admission rate. Despite differences in emergency room usage patterns, it cannot be concluded that either group used the emergency room in excess of the other.

Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly.

The purpose of this paper is to determine the optimal size of educational organisations. We assume that the global cost consists of two parts: a public cost of supplying education characterised by scale economies and a private transport cost showing diseconomies. Combining both components leads to a cost function that allows the optimal scale to be derived. Using information on the fixed cost of supplying a study field, the student density and the transport cost, it is possible to determine the optimal number of students in each of the study fields. It follows that the actual size is far from optimal.

This study estimates a multiproduct translog cost function for the entire population of 1011 Flemish secondary schools in order to determine the degree of ray and product specific (dis)economies of scale as well as the degree of (dis)economies of scope. Three types of schools and seven major study fields can be distinguished. Student loads in these study fields are used as outputs produced by the schools. Evidence is found for ray economies of scale for the three types of schools, even at output levels of 300% of the actual means. Although the cost elasticities of six out of seven outputs are close to zero, most of the values indicating the degree of product specific economies of scale are negative (suggesting diseconomies of scale). However, this can be explained by the considerable scope effects which are incorporated in the definition of the product specific economies of scale.

Since demand for hospital services is subject to substantial variability, the relationship between uncertain demand, excess capacity, hospital costs and performance should be investigated thoroughly. In this paper a waiting time indicator to proxy hospital standby capacity is incorporated into a multi-product translog cost function for Belgian general care hospitals. The indicator is derived from queuing theory and improves on the conventionally used (inverse of the) occupancy rate. The multi-product stochastic frontier specification allows calculation of cost elasticities and marginal cost of seven hospital departments, as well as the degree of economies of scale and scope and enables identification of differences in efficiency.

Empirical hospital cost function studies can be divided into two categories: studies estimating traditional multi-product cost functions and studies including demand uncertainty (assuming that hospitals provide standby capacity to cope with uncertain demand and stressing that the relationship between the uncertain demand, excess capacity and costs should be investigated). Most studies include (the inverse of) the occupancy rate in a relatively basic cost function. The first contribution of this paper is to incorporate an indicator of reserve capacity into a genuine multi-product cost function. The second contribution is to propose an alternative indicator to proxy the reserve margin. The often used occupancy rate has an important shortcoming: the same occupancy rate can hide different turnaway probabilities and waiting times, obscuring the true degree of reservation quality. Since turnaway probabilities and waiting times are typical queuing theory indicators, an indicator for average waiting time (derived...

SummaryThis study estimates two multi-product cost functions for the entire population of 773 Flemish secondary schools supplying a six-year study program. From the estimated parameters of a quadratic and a generalised translog cost function the degree of ray and product specific (dis)economies of scale as well as the degree of (dis)economies of scope is determined. The paper also describes how marginal costs and cost elasticities can be derived. Three major study fields can be distinguished. Student loads in each of these study fields are used as output variables. Evidence is found for ray economies of scale and global economies of scope. Especially in technical education product specific economies of scale could be realised. Cost savings by supplying two study fields jointly (pairwise scope effects) are also considerable.

In recent years, concerns have risen regarding the Flemish teacher labour market : there is a fear of a decreasing quality of inflowing students in teacher education programmes. In this paper we investigate the transition from secondary school to higher education in Flanders, more specifically to professional teacher education programms (i.e. Bacherlor in Education). We used merged administrative databases from the Flemish Department of Education in order to construct a longitudinal dataset, enabling to track individual students from secondary to higher education. We obtained data from the entire population of secondary school leavers in the academic year 2004-2005 (n=51.902). These data allow tracking individual students during their higher education career from the academic year 2005-2006 until 2011-2012. The data include individual demographic student characteristics, detailed individual enrolment information in secondary education and higher education and a number of secondary school characteristics. Since pupils are nested in schools and in municipalities multilevel estimation techniques were used to model the transition from secondary education to various potential higher education programmes. Both random intercepts and random slopes models were estimated. Our findings show that the odds of enrolment in teacher education programs are highly influenced by several individual, secondary school and regional characteristics. While the differences with academic bachelors have been found to be more pronounced when considering most of the determinants, the inflow in teacher education was also found to be substantially different from the inflow in other professional programs. However, not all variance that is detected at the level of secondary schools can be explained by secondary school characteristics.