Dino Numerato

Health care performance comparison using a disease-based approach: The EuroHOPE project

This article describes the methodological challenges associated with disease-based international comparison of health system performance and how they have been addressed in the EuroHOPE (European Health Care Outcomes, Performance and Efficiency) project. The project uses linkable patient-level data available from national sources of Finland, Hungary, Italy, The Netherlands, Norway, Scotland and Sweden. The data allow measuring the outcome and the use of resources in uniformly-defined patient groups using standardized risk adjustment procedures in the participating countries. The project concentrates on five important disease groups: acute myocardial infarction (AMI), ischemic stroke, hip fracture, breast cancer and very low birth weight and preterm infants (VLBWI). The essentials of data gathering, the definition of the episode of care, the developed indicators concerning baseline statistics, treatment process, cost and outcomes are described. The preliminary results indicate that the disease-based approach is attractive for international performance analyses, because it produces various measures not only at country level but also at regional and hospital level across countries. The possibility of linking hospital discharge register to other databases and the availability of comprehensive register data will determine whether the approach can be expanded to other diseases and countries.

Who Says “No to Modern Football?” Italian Supporters, Reflexivity, and Neo-Liberalism

This study explores the complexities and ambiguities of the recent increase in criticism among football supporters of so-called “modern football.” Drawing on existing elaborations of the concept of reflexivity in sociology, this contribution theoretically extends the hegemony/resistance analytical framework that has commonly been used to portray the criticism of football supporters in strict opposition to neo-liberal trends. The examination of the social and symbolic mechanisms surrounding anti-neo-liberal campaigning suggests that the slogan has been embraced by heterogeneous actors with contrasting topics, values, beliefs, and opinions. Considering the different reactions of contested anti-neo-liberal institutions and the context in which these processes take place, it has been demonstrated that protests and reflexive discursive practices can both inhibit and enhance the transformative potential of the “Against modern football” slogan.

Comparing ischaemic stroke in six European countries. The EuroHOPE register study.

The incidence of hospitalizations, treatment and case fatality of ischaemic stroke were assessed utilizing a comprehensive multinational database to attempt to compare the healthcare systems in six European countries, aiming also to identify the limitations and make suggestions for future improvements in the between‐country comparisons.

The dark side of social capital: an ethnography of sport governance.

This article extends the discussion on the ‘dark side’ of social capital in sport which has recently been increasingly conceptualized in civil society studies. We define the dark side of social capital as situations in which trust, social ties and shared beliefs and norms that may be beneficial to some persons are detrimental to other individuals, sport movements, or for society at large. Furthermore, we understand the dark side of social capital as attempts to manipulate and misuse trust to achieve a particular interest. We argue that the majority of studies using the notion of the dark side have investigated primarily sport practice rather than sport governance and have focused on either the macro- or micro-level, neglecting the meso-level. Additionally, previous studies have focused primarily on the exclusive role of bonding social networks at the expense of linking social capital and manipulation of trust. To contribute to reducing these gaps, our analysis draws on evidence gathered during a multi-sited ethnographic study of Czech and Italian sport associations governing football, handball and sailing.

Mortality and Length of Stay of Very Low Birth Weight and Very Preterm Infants: A EuroHOPE Study

The objective of this paper was to compare health outcomes and hospital care use of very low birth weight (VLBW), and very preterm (VLGA) infants in seven European countries. Analysis was performed on linkable patient-level registry data from seven European countries between 2006 and 2008 (Finland, Hungary, Italy (the Province of Rome), the Netherlands, Norway, Scotland, and Sweden). Mortality and length of stay (LoS) were adjusted for differences in gestational age (GA), sex, intrauterine growth, Apgar score at five minutes, parity and multiple births. The analysis included 16,087 infants. Both the 30-day and one-year adjusted mortality rates were lowest in the Nordic countries (Finland, Sweden and Norway) and Scotland and highest in Hungary and the Netherlands. For survivors, the adjusted average LoS during the first year of life ranged from 56 days in the Netherlands and Scotland to 81 days in Hungary. There were large differences between European countries in mortality rates and LoS in VLBW and VLGA infants. Substantial data linkage problems were observed in most countries due to inadequate identification procedures at birth, which limit data validity and should be addressed by policy makers across Europe.

The institutionalisation of regional public sport policy in the Czech Republic

This paper deals with the emerging processes of creation and implementation of regional public policies on sport in the Czech Republic since 2001. It analyses the dynamics between the sport voluntary sector and the public administration. The paper captures the major tenets of the regional public policy for sport and explores the barriers undermining its effective functioning. It is argued that the Czech regional public sport policies are limited by two types of constraints; structural and cognitive. Whereas the structural constraints are defined in terms of politicisation, bureaucratisation, lack of evidence in the policy-making process and lack of interaction, the cognitive constraints are related to the lack of knowledge, the lack of information, the low recognition of sport in the context of other policy issues and the negative public image of public administration. Furthermore, a typology of different styles of support for sport and a typology of different strategies employed by sport associations and clubs to obtain funding are identified. The paper, thus, presents five ideal-types of the regional public support of sport: progressive, bureaucratic, political-clientelist, delegated, and marginalised. Moreover, four different strategies adopted by the sport movement are defined: the adaptation strategy; the pragmatic strategy; the strategy of the marginalised; and the strategy of resignation. The study is based on a qualitative methodology, using a combination of techniques such as semi-structured interviews with public administration officers and representatives of the Czech sport movement, secondary analysis of documents and observations.

Czech Sport Governing Bodies and Social Capital

The main objective of the study is to explore the mechanisms influencing the nature of civic engagement in sport federations with a particular interest in barriers undermining their functioning. The article is based on the multi-sited ethnographic study in three sport governing bodies in the Czech Republic (handball, football and sailing) and uses a combination of techniques such as participant and non-participant observation, semi-structured interviews and secondary analysis of available documents. The main barriers identified are seen as a product of encounters between local and national levels of sport governing bodies. The concept of social capital with its structural, relational and cognitive dimensions is presented as a tool to grasp the phenomena under study.

Corruption and public secrecy: An ethnography of football match-fixing

The topic of corruption has recently moved from the periphery to the centre of social scientific attention. Notwithstanding the increased interest, research into corruption has been empirically limited and under-theorized. This study addresses that gap by providing an ethnographic account of football match-fixing in the Czech Republic. By qualitatively analysing both primary and secondary data, this study examines match-fixing and corruption through the lens of the concept of public secrecy. Three different, narrowly intertwined forms of match-fixing are identified: direct corruption, mediated corruption and meta-corruption. By conceptualizing match-fixing as a public secrecy, the study explores how the publicly secret nature of match-fixing is normalized and how the match-fixing complex is reinforced by a compromising complicity of social actors who are both victims and principals. Although this study focuses on a sport-related example, it has both theoretical and empirical implications for a sociological understanding of corruption outside the sphere of sport.

Between small everyday practices and glorious symbolic acts: sport-based resistance against the communist regime in Czechoslovakia

This essay presents a socio-historical interpretation of sport-based resistance against the communist regime in Czechoslovakia. It argues that the sphere of sport was never absolutely subordinated to the prevailing political order and it maintains that sport provided a space for expressions of resistance. Such resistance is not just evident in cases of large demonstrations during which Czech and Slovak sport celebrities reinforced public protests with grand symbolic and mass-mediated gestures. The same level of importance to opposition against the dominant power can be attributed to small everyday practices. Hence, while considering glorious acts of resistance and protest with a large-scale impact, the study simultaneously explores subtle and everyday subversive strategies that have appeared in public participation in sport. The study is based on a secondary analysis of documents and on semi-structured interviews with a number of representatives from the Czech sport movement.

Le reti sociali e i professionisti in sanità: una review della letteratura

Negli ultimi anni le riviste cliniche e di management hanno moltiplicato il numero di studi sul tema delle reti sociali e del capitale sociale dei professionisti nel settore sanitario. La complessita dei task, l’elevata incertezza e la crescente necessita di rispondere in tempi adeguati alle richieste dei pazienti hanno reso di vitale importanza la gestione delle interdipendenze tra organizzazioni, gruppi e singoli professionisti in questo settore. La vastita di contributi richiede un’analisi sistematica della letteratura. Questo articolo presenta una review dei principali lavori scientifici che riguardano il tema delle reti sociali e del capitale sociale tra professionisti in sanita. L’analisi riguarda 76 articoli scientifici selezionati con l’ausilio della piattaforma ISI Web of Knowledge. L’articolo riassume gli antecedenti e le conseguenze delle reti sociali tra i professionisti. La conoscenza di questi antecedenti e di queste conseguenze puo essere utile a policy maker e manager aziendali per progettare le aziende sanitarie e facilitare l’introduzione di qualsiasi innovazione organizzativa.