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.     

A political ideology lens on social entrepreneurship motivations

ABSTRACT

The traditional literature regarding social entrepreneurship does not question the political dimension. On the contrary, it tends to de-politicize societal issues. A growing number of researchers underline how this perspective cannot address the complexity and the dialogical nature of social entrepreneurship. However, while there may be a case for incorporating a political perspective, there is currently no conceptual framework to systematically inform an empirical exploration of the role played by the political vision of entrepreneurs. In this paper, we use the concept of political ideology to offer a solid framework to show how politics can shape social entrepreneurs’ motivations. More precisely we identify three political profiles – anti-statist, reformist and neoliberal – which shape the motives to engage in social entrepreneurship. We take an embedded case study approach of 17 social entrepreneurs involved in a social innovation boot camp and reveal the existence of both, left and right-wing approaches in social entrepreneurship.     

Day-of-the-Week Effects in the Long-Run Performance of Initial Public Offerings

This study examines the influence of day-of-the-week patterns in security returns on long-run IPO underperformance. Comparisons are made between the IPOs in Ritter's [20] database, and a constructed set of matching firms based on SIC code and size, using NYSE, AMEX, and NASDAQ securities. It is found that virtually all of the IPO underperformance occurs on Mondays and Tuesdays and that the degree of underperformance significantly differs from other days. Thus, a common explanation may exist for the general day-of-the-week pattern in security returns and IPO long-run underperformance.     

A consumer education programme based on the Transtheoretical Model of Change

MONEY 2000? is a successful consumer education programme that was implemented by Cooperative Extension personnel in over two dozen states of the USA between 1996 and 2002. One of the unique features of this programme is that it was based on the Transtheoretical Model of Change (TTM), a framework that has been widely used to study health‐related behaviour changes such as smoking cessation. This paper first describes how the MONEY 2000? programme was developed around major constructs contained within the TTM. Findings are reported from a survey conducted with participants in the first two states that delivered the programme. The findings suggest that several change processes used by MONEY 2000? participants are associated with specific stages of change. In addition, there may be differences in behavioural changes between participants who increased their savings and those who reduced their debts.