A SHAPLEY DECOMPOSITION OF MULTIDIMENSIONAL CHRONIC POVERTY IN ARGENTINA

This paper proposes a Shapley decomposition to analyse the evolution of chronic poverty in a multivariate setting using a chronic poverty measure proposed by Alkire and colleagues. The decomposition makes possible to assess a vast array of information to find the drivers of change in chronic poverty, and could be a valuable tool in the way public policy programmes focus resources. We present an empirical application of the changes in chronic poverty in Argentina during the period 2004–12 using the Permanent Household Survey. We found that households with older adults show great persistence of multidimensional chronic poverty in time while the employment indicators is found to be an important driver of the intensity of chronic poverty.     

Reduced medical spending associated with increased use of a remote diabetes management program and lower mean blood glucose values

Abstract

Aims: Many new mobile technologies are available to assist people in managing chronic conditions, but data on the association between the use of these technologies and medical spending remains limited. As the available digital technology offerings to aid in diabetes management increase, it is important to understand their impact on medical spending. The aim of this study was to investigate the financial impact of a remote digital diabetes management program using medical claims and real-time blood glucose data.

Materials and methods: A retrospective analysis of multivariate difference-in-difference and instrumental variables regression modeling was performed using data collected from a remote digital diabetes management program. All employees with diabetes were invited, in a phased introduction, to join the program. Data included blood glucose (BG) values captured remotely from members via connected BG meters and medical spending claims. Participants included members (those who accepted the invitation, n?=?2,261) and non-members (n?=?8,741) who received health insurance benefits from three self-insured employers. Medical spending was compared between people with well-controlled (BG ≤ 154?mg/dL) and poorly controlled (BG > 154?mg/dL) diabetes.

Results: Program access was associated with a 21.9% (p?<?0.01) decrease in medical spending, which translates into a $88 saving per member per month at 1 year. Compared to non-members, members experienced a 10.7% (p?<?0.01) reduction in diabetes-related medical spending and a 24.6% (p?<?0.01) reduction in spending on office-based services. Well-controlled BG values were associated with 21.4% (p?=?0.03) lower medical spending.

Limitations and conclusions: Remote digital diabetes management is associated with decreased medical spending at 1 year. Reductions in spending increased with active utilization. It will be beneficial for future studies to analyze the long-term effects of the remote diabetes management program and assess impacts on patient health and well-being.     

Cost-utility of risperidone compared with standard conventional antipsychotics in chronic schizophrenia

SUMMARY

The high costs and the efficacy of risperidone warrant a systematic pharmacoeconomic evaluation in order to assess its relative cost-utility. The purpose of this study was to evaluate the costs and utilities of treatment in chronic schizophrenia. To achieve this, a cost-utility analysis, which compared risperidone to haloperidol and two depot antipsychotics: haloperidol decanoate and fluphenazine decanoate was conducted. A deterministic decision analysis was used to model chronic schizophrenia over one year. Probabilities were obtained from clinical trials for each medication that were combined using a random effects single arm meta-analysis. Utility values for different health states were obtained by patient interview. A government payer perspective was adopted for this analysis.

The study results demonstrate that risperidone is a dominant therapy in this baseline analysis since it is associated with the lowest overall cost and highest number of quality-adjusted life-years (QALYs). Compared with haloperidol, risperidone might save $6,510 (CAN$) per year while producing 0.04 more QALYs per average patient.     

Anthropometric failure and persistence of poverty in rural India

Recent studies have drawn attention to the high prevalence of stunting among children in rural India. In fact, these estimates point to more pervasive deprivation than conventional measures of poverty based on income or consumption expenditure shortfalls imply. Since stunting reflects cumulative nutritional and health deprivation, it is likely to persist despite higher incomes. With a view to shedding some new light on this issue, an analysis of the determinants of stunting is carried out, based on a recent all‐India survey of rural households. While income matters, other factors acting independently of it matter too. These include household size, whether household head is male, caste affiliation, mother’s age at marriage, mother’s age, age composition of children, male–female wage differences, hygiene and sanitation facilities, and prices of food items. So, while higher incomes will help mitigate stunting, careful attention must also be given to enhancing women’s autonomy through more remunerative employment opportunities for them, enabling households to improve hygiene and sanitation facilities, and facilitating more competitive local markets for food.     

如何应对品牌战略实施中的“寄生”与“株连”问题

在简要分析目前广泛存在的品牌“寄生”与“株连”问题及其成因的基础上，文章提出以品牌资源优势为主要战略依托的企业应该力求做大规模、增强实力，提高抵御因被模仿而带来的各种风险的能力。在采取的具体策略上，可以紧密结合企业自身实际，积极选择一些切实可行的有效路径主动进取，从而走出被“寄生”或受“株连”的困境。     

中国区域房价泡沫测度及空间传染性研究——基于2001-2005年35个大中城市面板数据的实证分析

本文以我国城市房地产价格泡沫为研究对象,利用2001-2005年全国35个大中城市的面板数据对各城市房地产价格泡沫大小进行测算以及对区域间房价泡沫的传染性进行研究。在适应性预期的框架下对各大中城市的房价泡沫测算的结果显示,城市房价泡沫大小与房价的高低并不存在必然联系。另外,利用CD检验统计量对各区域城市间的房价泡沫的相关性进行检验认为,房价泡沫在区域间以及区域内城市之间存在传染,东部地区城市间传染性最强,而西部地区城市与北部地区城市之间的传染性不显著;同时,本文也对各地区城市间房价泡沫的传染态势进行了分析。     

The Economic Value of Air-Pollution-Related Health Risks in China: A Contingent Valuation Study

The economic value of preventing adverse health effects related to air pollution is estimated using contingent valuation in three diverse locations in China. Values are estimated for three health endpoints: cold, chronic bronchitis, and fatality. Alternative statistical models are tested to study their impact on estimated willingness to pay (WTP) and on the relationship between WTP and respondent characteristics. Using the official exchange rate, the sample-average median WTP to prevent an episode of cold ranges between US$3 and US$6, the WTP to prevent a statistical case of chronic bronchitis ranges between US$500 and US$1,000, and the value per statistical life ranges between US$4,000 and US$17,000. Estimated mean values are between two and thirteen times larger. Our estimates are between about 10 and 1,000 times smaller than estimates for the US and Taiwan using official exchange rates. Indoor air quality, measured for a subset of respondents, shows no consistent relationship with WTP.     

生态伦理观对我国旅游开发与规划影响初探

我国旅游业走过了几十年的发展历程，取得了很大的成就，但同时旅游开发也带来了一些负面的环境影响。为了解决旅游开发和生态环境之间的矛盾，生态伦理学观念被引入到旅游开发中来。本文分析了我国旅游开发中存在的主要问题，介绍了目前生态伦理观的内涵，认为生态伦理观是人们更加理性地、科学地从事旅游开发活动，确保旅游业的可持续发展的理论基础，据此提出了基于生态伦理观的旅游规划和开发策略。     

多种病原物混合浸染的昆虫流行病模型

两种或两种以上的病原物同时浸染昆虫寄主时, 病原物之间的相互作用表现为偏 利、偏害、中性及竞争等类型,寄主群体的病症可呈多种形式[1]。根据单种病菌的重叠浸染原理, 建立了多种病原物混合浸染时以温度、病原接种量、虫龄及湿度为因子的昆虫流行病模型,由模 型可计算寄主群体中不同病原物的致病比率,及寄主群体的总发病率,给出了模型的参数求解算 法,以及病原物相互作用类型的判定准则,这类模型可用于多种病原物混合浸染的昆虫流行病预 测,也可作为多种病原物混合施用防治害虫的最优化模型。     

Leadership through action learning: a bottom-up approach to ‘best practice’ in ‘infection prevention and control’ in a UK NHS trust

This article reports on the outcomes of an action learning leadership intervention in a National Health Service (NHS) acute trust in partnership with a UK business school. This contribution provides an empirical example of the potential benefits of non-hierarchical leadership. Over a three-year period, 45 nurses took part in an initiative designed to reduce the number of health care associated infections (HCAI) in a large NHS acute trust. By 2010, serious reportable infections were reduced by around 300, providing an efficiency benefit in the region of £3 million and improved patient safety. The turnaround is significant, and although not exclusively attributable to this initiative, the trust is convinced that the intervention has been pivotal.