Remittances and the Dutch Disease: Evidence from Panel Data for 18 Developing Countries

In this paper, using the GMM technique we attempt to empirically investigate the Dutch disease effect of remittances. The analyses are based on an annual balanced panel data set for 18 developing countries, which have remittances to GDP ratio of 5 percent and above, over the years 1999–2015. It is found that an inflow of remittances has a positive effect on economic growth, whereas it leads to a depreciation of the real effective exchange rate.     

The association between the severity of chronic kidney disease and medical costs among patients with type 2 diabetes

Aims: Examine healthcare costs across chronic kidney disease (CKD) stages for US patients with type 2 diabetes (T2D).

Materials and methods: IQVIA Real World Data Adjudicated Claims linked electronic medical records and insurance claims from January 1, 2012 through March 31, 2017 were used for this retrospective study. Adults diagnosed with T2D and comorbid CKD were included. General linear models incorporating splines were constructed, and information from these regressions were used to inform the relationship between medical costs and CKD. Multivariable analyses controlled for patient characteristics, vital signs, general health, prior medication use, prior visit to specialists, index A1c, and year of index date.

Results: There were 6,645 individuals who met the study criteria. Results generally indicate sharp increases in annual total medical costs and non-drug medical costs in the 1?year post-period for patients with Stage 4 or 5 CKD (estimated glomerular filtration rate [eGFR]?≤?30?mL/min/1.73 m²) with each 1 point reduction in eGFR from 30 associated with an increase of $1,870 in all-cause total medical costs (p?<?0.0001) and $1,805 of all-cause non-drug medical costs (p?<?0.0001). Similarly, each point decline below 30?mL/min was associated annual cost increases of $1,701 for CKD-related total medical costs, $1,695 for CKD-related non-drug medical costs, $173 for diabetes-related medical costs, and $187 for diabetes-related non-drug medical costs (all p?<?0.0001).

Limitations: The investigation included only patients with medical insurance and laboratory test results, and results may not be generalizable to all T2D patients with CKD. The methodology allowed us to determine associations, not causation, and potential confounders, such as duration of diabetes, diet, exercise, or social support, could not be assessed.

Conclusions: Results indicate there are sharp and significant increases in medical costs among T2D patients with Stage 4 and 5 CKD compared to those with earlier stages of CKD.     

浅析公路路基病害及对策

随着我国经济社会的不断发展,人民生活水平的不断提高,对公路的需求越来越多。公路路基的病害是多种多样的,其直接影响着公路能否正常使用,如何有效解决公路路基的病害也就成为了人们关注的焦点,下面就公路路基病害的成因,预防措施及解决的方法进行探讨。     

Chronic Diseases, Labor Supply and Medical Expenditure at Older Age: Evidence from China

China has undergone a rapid epidemiological transition from infectious diseases to chronic diseases. Using data from the China Health and Retirement Longitudinal Study (CHARLS), this paper documents the profile of chronic diseases among older Chinese people, estimates the impact of the onset of chronic diseases on the labor supply, and examines the correlation between the prevalence of chronic diseases, a household’s medical expenditure and the role of health insurance in reducing medical costs. Empirical results show that the prevalence of chronic diseases is extremely high among older Chinese people and increases sharply with age. We find significant negative effects from the onset of chronic diseases on an individual’s livelihood at work. The estimation results by age and education suggest that the labor supply of the older and more highly educated people is more sensitive to the onset of chronic diseases. We also show that there can be a substantial indirect loss of individual and household income due to the onset of chronic diseases by limiting the labor supply. We find that the prevalence of chronic diseases is significantly associated with higher out-of-pocket medical expenditure. The reduced-form estimation results suggest that people with insurance have lower medical expenditure caused by minor chronic diseases, but this is only the case for women and urban residents. However, health insurance contributes little in reducing medical expenditure caused by major chronic diseases.     

效率提高会吞噬就业吗？旅游产业升级的就业效应研究

文章构建了旅游产业升级的就业效应测算模型,将旅游产业升级的就业效应分解为就业创造和就业破坏两个方面,并从总量、结构以及行业异质性三个角度对2000-2014年中国旅游产业升级的就业创造和破坏机制进行了研究。结果表明：(1)中国旅游产业升级总体上具有积极的就业增长效应,但由于旅游产业功能升级不足,旅游产业升级的就业创造效应主要来源于规模扩张和结构变动。(2)各行业就业增长与其效率滞后性基本呈现为正相关的关系,说明在旅游业内部存在鲍莫尔成本病问题。(3)住宿业就业创造与旅游总产出增长之间出现了此消彼长的两难困境。未来中国旅游产业升级应注重与文化产业融合,推进旅游向审美化、品质化、体验化方向发展。     

Costs of providing infusion therapy for patients with inflammatory bowel disease in a hospital-based infusion center setting

Aims: Inflammatory bowel disease (IBD) (e.g. ulcerative colitis [UC] and Crohn’s disease [CD]) severely impacts patient quality-of-life. Moderate-to-severe disease is often treated with biologics requiring infusion therapy, adding incremental costs beyond drug costs. This study evaluates US hospital-based infusion services costs for treatment of UC or CD patients receiving infliximab or vedolizumab therapy.

Materials and methods: A model was developed, estimating annual costs of providing monitored infusions using an activity-based costing framework approach. Multiple sources (published literature, treatment product inserts) informed base-case model input estimates.

Results: The total modeled per patient infusion therapy costs in Year 1 with infliximab and vedolizumab was $38,782 and $41,320, respectively, and Year 2+, $49,897 and $36,197, respectively. Drug acquisition cost was the largest total costs driver (90–93%), followed by costs associated with hospital-based infusion provision: labor (53–56%, non-drug costs), allocated overhead (23%, non-drug costs), non-labor (23%, non-drug costs), and laboratory (7–10%, non-drug costs).

Limitations: Limitations included reliance on published estimates, base-case cost estimates infusion drug, and supplies, not accounting for volume pricing, assumption of a small hospital infusion center, and that, given the model adopts the hospital perspective, costs to the patient were not included in infusion administration cost base-case estimates.

Conclusions: This model is an early step towards a framework to fully analyze infusion therapies’ associated costs. Given the lack of published data, it would be beneficial for hospital administrators to assess total costs and trade-offs with alternative means of providing biologic therapies. This analysis highlights the value to hospital administrators of assessing cost associated with infusion patient mix to make more informed resource allocation decisions. As the landscape for reimbursement changes, tools for evaluating the costs of infusion therapy may help hospital administrators make informed choices and weigh trade-offs associated with providing infusion services for IBD patients.     

Caregiver priorities for endpoints to evaluate treatments for Prader-Willi syndrome: a best–worst scaling

Abstract

Objectives: Prader-Willi syndrome (PWS) is a rare genetic disorder associated with varying degrees of hyperphagia, obesity, intellectual disability, and anxiety across the affected individuals’ lifetimes. This study quantified caregiver priorities for potential treatment endpoints to identify unmet needs in PWS.

Methods: The authors partnered with the International Consortium to Advance Clinical Trials for PWS (PWS-CTC) and a diverse stakeholder advisory board to develop a best–worst scaling instrument. Seven relevant endpoints were assessed using a balanced incomplete block design. Caregivers were asked to determine the most and least important of a sub-set of four endpoints in each task. Caregivers were recruited nationally though patient registries, email lists, and social media. Best–worst score was calculated to determine caregiver priorities; ranging from 0 (least important) to 10 (most important). A novel kernel-smoothing approach was used to analyze caregiver endpoint priority variations with relation to age of the PWS individual.

Results: In total, 457 caregivers participated in the study. Respondents were mostly parents (97%), females (83%), and Caucasian (87%) who cared for a PWS individual ranging from 4–54 years. Caregivers value treatments addressing hyperphagia (score?=?7.08, SE?=?0.17) and anxiety (score?=?6.35, SE?=?0.16) as most important. Key variations in priorities were observed across age, including treatments targeting anxiety, temper outbursts, and intellectual functions.

Conclusions: This study demonstrates that caregivers prioritize hyperphagia and, using a novel method, demonstrates that this is independent of the age of the person with PWS. This is even the case for parents of young children who have yet to experience hyperphagia, indicating that these results are not subject to a hypothetical bias.     

血栓通治疗冠心病有效性和安全性的Meta分析

目的综合评价血栓通治疗冠心病的有效性和安全性,为临床治疗决策提供科学依据。方法利用计算机检索文献,并进行筛选,在对纳入文献进行方法学质量评价后,应用RevMan5.0软件,采用固定效应模型或随机效应模型对纳入文献进行Meta分析。结果本研究共纳入31篇文献,质量评级均为C级。在心电图总有效方面,血栓通单用VS复方丹参单用、血栓通联用其它药物VS复方丹参联用其它药物、血栓通联用硝酸甘油VS硝酸甘油、血栓通联用其它药物VS其它药物比较,RR及95%CI分别为1.45（1.29～1.62）、1.19（1.01～1.41）、1.22（1.10～1.34）、1.28（1.19～1.38）,差异具有统计学意义。在心绞痛总有效方面,血栓通联用其它药物VS其它药物、血栓通联用硝酸甘油VS硝酸甘油比较,RR及95%CI分别为1.28（1.19～1.38）、1.30（1.15～1.48）,差异具有统计学意义。敏感性分析验证了结果的稳定性。结论血栓通不论是单用还是与其它药物联合应用,在心绞痛和心电图总有效方面均较其它药物优秀。     

国家审计与地区相对贫困治理——基于2008—2017年市级面板数据的实证研究

基于我国257个城市2008—2017年的面板数据,实证检验国家审计“经济体检”各功能对相对贫困治理成效的影响,并进一步探究国家审计各功能的协同作用、公众参与对国家审计促进相对贫困治理的调节作用以及国家审计对地区相对贫困治理促进作用的异质性。研究发现：国家审计“治已病”“防未病”和“经济体检”综合功能的发挥能显著促进相对贫困治理成效,而“查病”功能则没有直接对地区相对贫困治理产生促进作用;“查病”功能能够与“治已病”“防未病”功能发挥协同效应,产生更为明显的相对贫困治理成效;公众参与程度的提高能强化国家审计对相对贫困治理的促进作用;国家审计对相对贫困治理的促进作用在财政依赖程度、公共服务缺口大小不同的地区存在异质性。     

基于Logistic方程的流行病随机模型教学研究

本文讨论了医学院校数学教学改革的必要性,并结合流行病随机模型理论,详细展示了现代医学科研新模式下的医学数学课堂教学过程,对实验结果进行了分析。同时,明确了新形势下医学院校数学教师的教学任务。