Time spent on erythropoietin stimulating agents administration in hemodialysis centers in Panama: a time and motion study

Objectives: There is a lack of data in Panama on the potential differences in total healthcare professional (HCP) time between routine administrations of short-acting erythropoietin simulating agents (ESAs) (i.e. epoetin alfa) and continuous erythropoietin receptor activator (CERA) (i.e. methoxy polyethylene glycol–epoetin beta). This study aimed to quantify the HCP time associated with a single administration of epoetin alfa and CERA for the treatment of anemic patients with chronic kidney disease (CKD) on hemodialysis.

Methods: This was a multi-center, cross-sectional study, using a time-and-motion methodology. Costs related to HCP time and consumables usage associated with administration of epoetin alfa and CERA were estimated.

Results: Based on 60 administrations of either CERA or epoetin alfa, the estimated savings in mean total active HCP time were 2.34 (95% confidence interval?=?1.87–2.81) min (–30%) per administration. When extrapolating to a full year’s treatment with intravenous ESA, it would require a total of 20.3 (95% CI?=?19.90–20.71) h of HCP time for epoetin alfa vs 1.1 (95% CI?=?1.01–1.19) h for CERA per patient per year. Estimated savings in active HCP time per patient per year were 19.20 (95% CI?=?19.20–19.21) h (–95%). This, in turn, translates into staff cost efficiency that favors Mircera with an estimated annual saving of $78.24 (95% CI?=?78.24–78.28) (–95%) per patient.

Conclusions: Data from a real-world setting showed that the adoption of CERA could potentially lead to a reduction in active HCP time.

• Highlights

• Few comparative data have explored the costs and potential savings of using long-acting erythropoietin–stimulating agents (ESA) instead of short-acting ESAs to treat anemia in CKD patients on hemodialysis.

• This time-and-motion study shows that use of CERA reduces total healthcare professional time and could represent a save for an institution in a real-world setting in Panama.

     

Why Regulation Is Needed in Emerging Markets in the Tourism Sector

The neoclassical ideal has defended the idea that markets, in a context of limited regulation, reach an optimal equilibrium automatically. We analyze this assertion in an applied manner with a case study of the emerging online market of intermediation of tourist apartments. The lack of regulation in this market causes many social and economic impacts on local communities, which can jeopardize the survival of the activity. We conclude that an analysis of markets that considers only prices results in a limited view. All externalities and their effects on the population must be taken into account, as well as the interests of the individuals involved, apart from profit‐making.     

Publishing? You can count on knowledge,experience, and expectations

Quality & Quantity - The study based on an online survey covering 655 researchers from hard and soft sciences addresses the influence of different conditions on academic publishing. Results...     

Investigating Growing Inequality in Mozambique

In this paper, we investigate the long‐term trend of consumption inequality in Mozambique. We show that an imbalanced growth path disproportionally benefited the better‐off and caused increasing inequality, especially in more recent years, curbing the necessary reduction in poverty. Using a regression decomposition technique, our results suggest that this trend was strongly associated with the higher attained education of household heads and with the changes in the structure of the economy (with less workers in the public and subsistence sectors). The trend was, however, mitigated by the tendency for the higher level of attained education and the smaller public sector to become associated with less inequality over time. These results point to the importance of accelerating the expansion of education and improving the productivity of the large subsistence sector to lower inequality in line with the sustainable development goals.     

Trade credit versus bank credit: a simultaneous analysis in European SMEs

Small Business Economics - Trade credit and bank credit constitute two of the most important external sources of finance for small firms. The purpose of this paper, first and foremost, is to...     

Is the emperor wearing new clothes? A social assessment of the European Union 2007–2013 financial framework

ABSTRACT

Over the years, European leaders have proudly waved a social flag as one of the European Union’s (EU) constituent and differentiating elements. This commitment is assessed here through the social footprint of the European 2007–2013 multiannual financial framework among the EU countries and, worldwide, using an extended multiregional input–output model. The focus is on the quantity and the quality of income and jobs generated. We find that well-known differences among its northern, southern and eastern regions threaten the EU’s intentions for high social standards, enabling first- and second-class winners. Core EU countries account for the most of the Funds and, thus, most of the positive economic and social impacts, mainly through spillovers from peripheral regions. Beyond the EU borders, Funds expenditures induce capital compensation boosts in emerging countries not balanced by a similar labor compensation impulse. Indeed, China captures the bulk of low-skilled and temporary employment.     

Austerity Policies in the Eurozone: What Can We Learn After the Crisis?

International Advances in Economic Research -     

The Weakness Of Symbolic Boundaries: Handling Exclusion Among Montevideo's Squatters

This article argues that material conditions limit the possibilities of symbolic boundaries becoming markers of social differentiation, especially among stigmatized groups. Using squatter settlements in Montevideo, Uruguay, as a case study, it shows that symbolic boundaries are hard to maintain when material conditions and the stigmas associated with certain places work against them. Based on participant observation and oral histories, it analyses how squatters experienced the move to a squatter settlement. It argues that, for many, it was a way to resist exclusion, a struggle to belong to the city and to protect a social position that structural changes under neoliberalism had put at risk. This required engaging in difficult symbolic boundary work to distinguish themselves from cantegriles—poor and crowded older shantytowns—and claim dignity as workers and residents of a regular city neighbourhood. Yet, there were many limits to their fight in an increasingly fragmented city. Through follow‐up visits to several settlements over almost two decades and tracking the case in the local press, through available survey data and secondary literature, this article offers a longitudinal perspective of symbolic boundaries in the making.     

Emotional prototypes,emotional memory usages,and customer satisfaction

In this study, we investigated the positive and negative emotion concepts in the prototype perspective and then tested them on customer satisfaction. By studying 612 customers in luxury restaurants, we found that two levels of customer emotions (i.e. positive and negative emotions) as a super-ordinate level, 4 positive emotions (i.e. contentment, happiness, love, and pride) and 5 negative emotions (i.e. anger, fear, sadness, shame, and disgust) as a basic level, and 49 specific emotions as a subordinate level are significantly related to customer satisfaction. We also examined the moderating role of emotional memory (EM) usage in the relationship between consumers’ emotions and their satisfaction. We found that product (food and beverage)-related EM strengthens and service-related EM usage weakens the relationship between customers’ negative emotions and their satisfaction. Interestingly, we found that positive and negative emotions are significantly related to customer satisfaction regardless of experience and store-related EM usage.     

La medición del capital intelectual y su impacto en el rendimiento financiero en empresas del sector industrial en México

Currently knowledge is considered an essential resource to contribute to the creation and generation of competitive advantage in organizations. The human factor as an intangible resource of a company has become a main value generator, and even though both knowledge management and intellectual capital are intangibles that can be measured in the financial reports of companies, their position as main value generators is not reflected in financial information. In Mexico, industrial sector companies need to promote the creation of intellectual added value based on its own abilities, which reside on their intellectual capital. The value added intellectual coefficient (VAIC?), with its components, is a tool that contributes to achieving this goal, and helps to identify the positive impact on key factors such as financial profitability, market capitalization and level of share value.