Anxiety disorders,major depressive disorder and the dynamic relationship between these conditions: treatment patterns and cost analysis

Abstract

Objective: To determine the treatment pattern and impact on healthcare costs of anxiety disorders and major depressive disorder (MDD), and influence of their concomitance and subsequence.

Methods: A retrospective cohort study was conducted using a US reimbursement claims database. Adult patients with an incident diagnosis of anxiety or MDD (index date) were included. Their sociodemographic data, diagnoses, healthcare resource use and associated costs were collected over the 6 months preceding and 12 months following index date.

Results: A total of 599,624 patients were identified and included. Patients with phobia or post-traumatic stress disorder had the highest 12-month costs ($8,442 and $8,383, respectively). Patients with social anxiety disorder had the lowest costs ($3,772); generalized anxiety disorder ($6,472) incurred costs similar to MDD ($7,170). Costs were substantially increased with emergence of anxiety during follow-up in MDD patients ($10,031) or emergence of MDD in anxiety patients ($9,387). This was not observed in patients with both anxiety and MDD at index date ($6,148).

Conclusion: This study confirms the high burden of costs of anxiety, which were within the same range as MDD. Interestingly, the emergence of anxiety or MDD in the year following a first diagnosis of MDD or anxiety, respectively, increased costs substantially. Major limitations were short follow-up and lack of absenteeism costs.     

Healthcare costs of stroke and major bleeding in patients with atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants

Objective: To assess long-term healthcare costs related to ischemic stroke and systemic embolism (stroke/SE) and major bleeding (MB) events in patients with non-valvular atrial fibrillation (NVAF) treated with non-vitamin K antagonist oral anticoagulants (NOACs).

Materials and methods: Optum’s Clinformatics Data Mart database from 1/2009–12/2016 was analyzed. Adult patients with ≥1 stroke/SE hospitalization (index date) were matched 1:1 to patients without stroke/SE (random index date), based on propensity scores. Patients with an MB event were matched to patients without MB. All patients had an NOAC dispensing overlapping index date, ≥12?months of eligibility pre-index date, and ≥1 NVAF diagnosis. The observation period spanned from the index date until the earliest date of death, switch to warfarin, end of insurance coverage, or end of data availability. Mean costs were evaluated: (1) per-patient-per-year (PPPY) and (2) at 1, 2, 3, and 4?years using Lin's method.

Results: The cost differences were, respectively, $48,807 and $28,298 PPPY for NOAC users with stroke/SE (n?=?1,340) and those with MB (n?=?3,774) events compared to controls. Cost differences of patients with vs without stroke/SE were $49,876, $51,627, $57,822, and $60,691 at 1, 2, 3, and 4?years post-index, respectively (p?p?Limitations: Limitations include unobserved confounders, coding and/or billing inaccuracies, limited sample sizes over longer follow-up, and the under-reporting of mortality for deaths occurring after 2011.

Conclusions: The incremental healthcare costs incurred by patients with vs without stroke/SE was nearly twice as high as those of patients with vs without MB. Moreover, each additional year up to 4?years after the first event was associated with an incremental cost for patients with a stroke/SE or MB event compared to those without an event.     

A Course in Economic Forecasting: Rationale and Content

This note shows that the impact of an increase in product price on factor demand in the typical textbook depiction is overstated to the point of indicating that competitive firms demand factors even when marginal product is negative.     

独立院校非会计专业基础会计教学改革初探

随着市场经济的不断发展,企业的经济业务日趋复杂,开设基础会计学课程的专业越来越多,对会计理论和实务的要求也越来越高。独立学院作为一种新的教学模式,现已成为我国高等教育事业不可或缺的一部分。基础会计学作为经济管理类专业的必修课程,对会计学专业和非会计专业学生的日后学习和工作都起到了奠定财务知识基础的作用。如何使非会计专业学生学好基础会计学,能够学以致用,是独立学院的教学改革过程中亟待解决的现实问题。     

互联网背景下市场营销专业课程思政教育的探索与实践——以“消费者心理与行为”课程为例

"课程思政"建设已纳入高校思想政治教育体系,借助专业课教学开展思政教育已成为高校思政教育研究热点,市场营销专业课程思政建设也在全面推进。为探索互联网背景下市场营销专业课的课程思政建设,以"消费者心理与行为"课程为例进行教学实践,提出课程分析、课程思政融入主题的选择、教学方法设计等课程思政建设的关键问题解决方案,增强思政教育的时代感和实效性,以期为市场营销专业全面推进课程思政建设提供有价值的参考。     

并购重组中大股东补偿承诺与中小股东权益保护——基于苏宁环球与世荣兆业的比较案例研究

我们对2007年以来并购重组中大股东盈利补偿的统计发现,补偿方式主要有两种:现金补偿和股份回购(或赠送股份)补偿,而且具有明显的时间特征,即2009年11月之前均采用现金补偿方案,之后基本上采用了股份回购(或赠送股份)的补偿方案。在此基础上,通过上市公司和大股东两个层面分析出两种补偿方案均在一定程度上保护了中小股东的权益,其中,股份回购方案比现金补偿方案更能改善上市公司财务状况和经营业绩,同时更能制约大股东在并购重组活动中对过高评估或过高盈利预测的冲动,因而更能保护中小股东权益。     

The Status of Econometrics in the Economics Major: A Survey

In this article, the authors describe the place of econometrics in undergraduate economics curricula in all American colleges and universities that offer economics majors as listed in the U.S. News & World Report “Best Colleges 2010” guide (U.S. News & World Report 2009). Data come from online catalogs, departmental Web sites, and online course syllabi. About one-third of the schools require econometrics of all students majoring in economics, about half require it of none, and a sixth require it of some, but not all, economics majors. Among universities with economics PhD programs and liberal arts colleges, almost all those ranked in the top 10 require it. Below the top 10, there is little correlation between ranking and econometrics requirements. Liberal arts econometrics classes are much more likely to require research projects than their counterparts in universities.     

The Rocky Road to Legacy: Lessons from the 2010 FIFA World Cup South Africa Stadium Program

This article describes how the management and organization of the South African 2010 FIFA World Cup stadium program shaped the current legacy of an oversupply of overdesigned and underutilized stadiums. The article identifies seven key factors that explain the differences between expected benefits and the actual legacy. Identification of these factors contributes to the increasing academic interest in explaining the poor legacy outcomes of mega‐events. In conclusion, we recommend that future host country governments defragment their stadium programs by establishing a World Cup Delivery Authority (WCDA), with responsibility for the leadership and coordination of the stadium program.     

江苏省耕地保护区划研究

文章以江苏省58个县级行政区为区划单元,应用主成分析法得出影响耕地保护的4个主成分,在此基础上应用聚类分析法初步得出耕地保护区,再结合定性分析最后确定六大耕地保护区。从区划结果看,与江苏省综合农业区划相一致,与客观实际能很好地吻合,说明应用综合数值分析模型研究耕地保护区划是成功的。最后,对得出的六大耕地保护区进行了简要的分析,为有计划分区制定耕地保护政策、措施提供了理论基础。     

对我国本科经济学专业课程结构和课程内容的调研

在所调研的十二所高校中,各高校都为毕业生设定了较为广泛的就业范围,有些高校也将学生学术深造和出国留学设定为培养目标之一。各高校对学生获得学位的最低学分要求存在差异,学位总学分要求的均值为155.5学分,除了实践教学类学分,课堂教学总学分要求的均值为142.7学分。各高校对于经济学基础课程的设置具有一致性。鉴于多元宏观思潮的影响,各高校对中级宏观经济学课程内容的侧重点存在差异。相对于经济学原理课程,中级经济学课程更加重视对学生数学能力的训练。各高校定性类课程的开设也存在较大差异。