The economic burden of depression among adults with rheumatoid arthritis in the United States

Aims: Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients’ health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to assess healthcare utilization, expenditures, and work productivity among patients with RA with or without depression.

Materials and methods: Data from adult patients who had at least two visits each related to RA and depression over a 1-year period were extracted from the Truven Health MarketScan research databases. Outcomes comprised healthcare resource utilization, work productivity loss, and direct healthcare costs comparing patients with RA with depression (n?=?3,478) vs patients with RA without depression (n?=?43,222).

Results: Patients with RA and depression had a significantly greater relative risk of hospitalization and number of all-cause and RA-related hospitalizations, utilization of emergency services, days spent in the hospital, physician visits, and RA-related surgeries compared with RA patients without depression. Patients with RA and depression had a higher risk of and experienced more events and days of short-term disability compared with patients without depression. The incremental adjusted annual all-cause and RA-related direct costs were $8,488 (95% CI = $6,793–$10,223) and $578 (95% CI = –$98–$1,243), respectively, when comparing patients with RA and depression vs RA only.

Limitations: The current analysis is subject to the known limitations of retrospective studies based on administrative claims data.

Conclusions: This study suggested increased healthcare utilization, work productivity loss, and economic burden among RA patients due to comorbid depression. These findings emphasize the importance of managing depression and including depression as a factor when devising treatment algorithms for patients with RA.     

Effet des Evolutions Techniques et des Changements de la Spécialisation Internationale sur les Marchés du Travail et les Systèmes Productifs: Comment les Statisticiens Pourraient-ils Relever les Défis?

Thinking about future needs and about what can reasonably be expected as feasible in the next century, how should producers of statistics direct their activity? Increasing complexity and diversity of needs leads us to recognize that, between producers and users of statistics, a mediating role is more and more often played by analysts and research workers who are requesting above all good data bases. Concerning infrastructures for statistics on productive systems, coordination between accountants and statisticians will be crucial, as well as adaptation of the constraints which, because of excessive worry about confidentiality, could prevent establishment or use of data bases. In an increasingly competitive world, where private firms will sell analyses and informations, particularly on very large enterprises, the public statistical service will remain essential in all respects. Intangible investments, innovations and many aspects of the internal organization of firms will create formidable challenges. Information on employment and labour markets has been much developed during the past decades; but on a few specific and difficult issues progress is still needed: lifecyles in the working-age population, acquisition of knowledge and skills in formal education and on the job, matching labour supplies and demands, and so on. Particular attention will have to be given to the lower levels of cultural and professional skills.     

Investment in quality upgrade and regulation of the internet

This paper studies the investment decision by a monopolistic internet service provider (ISP) in different regulatory environments. We consider that the ISP can technically provide separate quality upgrades to two vertically differentiated content providers (CPs). Our results show that if unregulated, the ISP could optimally provide asymmetric quality upgrades to both CPs, in favor of the high-quality CP. This subsequently increases the degree of content differentiation, softening competition between the CPs. Imposing a nondiscrimination regulation that forces the ISP to provide an equal quality upgrade to both CPs, however, reduce the ISP’s investment incentive and social welfare. Furthermore, the social planner provides preferential treatment to the high-quality CP if the degree of substitutability is sufficiently low. In contrast, it is socially optimal to prioritize the low-quality CP if the contents are sufficient substitutes, or provide exclusivity if vertical differentiation is high.

     

Profitability and factor demands under uncertainty

Summary The medium term relationship between wages and employment very much concerned Jan Tinbergen in the 30's and is concerning us again today. Precisely analyzing the demands for labor and capital is a prerequisite for understanding this relationship. With this purpose two propositions are here scrutinized: the productive capacity that a firm chooses mainly depends on its expectations about future demand and on the profitability of production; the desired capital intensity mainly depends on the relative cost of capital with respect to labor. In the model uncertainty of future prospects and irreversibility of investment play the major roles.Second Tinbergen Lecture, delivered on October 8, 1988, in The Hague for the Royal Netherlands Economic Association.     

Competition with asymmetric regulation of mobile termination charges

The aim of this paper is to explore the effectiveness of asymmetric regulation, which allows a new mobile network operator to set higher termination rates than the incumbent operator. We assume that there are two market segments: one in which operators compete on equal terms, with a new technology, and the other in which the entrant is at a disadvantage since the technology it offers is inferior to the incumbent??s. Results show that asymmetric regulation can create favorable conditions that allow the entrant to strengthen its market positioning, and enhance consumer net utilities and social welfare. This highlights the importance of the degree of network asymmetry and the ways in which consumers are split between the two market segments. Lastly, we show that asymmetric regulation can create greater investment incentives for the entrant which could effectively enhance social welfare. These findings can provide useful insights for regulatory policy.     

Aggregate implications of micro asset market segmentation

An extensive empirical literature finds that micro asset markets are segmented from one another. We develop a consumption-based asset pricing model to quantify the aggregate implications of a financial system comprised of many such segmented micro asset markets. We specify exogenously the level of segmentation that determines how much idiosyncratic risk traders bear in their micro market and calibrate the segmentation to match facts about systematic and idiosyncratic return volatility. In our benchmark model traders bear 30% of their idiosyncratic risk, the unconditional aggregate equity premium is 2.4% annual, and the welfare costs of segmentation are substantial, 1.8% of lifetime consumption.     

Access prices,unbundling and product variety in European Internet markets

A fundamental policy in European broadband regulation is unbundled access to the local loop of the incumbent telephone company. We present comparative static results that show as the access price decreases, the retail price decreases, the variety of plans offered by Internet service providers increases and the quantity of each variety increases when a threshold condition is met. Using data from 18 European countries from 2006 to 2012, we find empirical support for these results when Internet product variety is measured by variation in download speeds.