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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.  相似文献   
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军民融合产业园区高质量发展对于推进军民深度融合、在全国形成可复制可推广经验具有重要意义。军民融合协同创新通过促进新知识涌现、推进新产业集聚发展,最终汇聚经济发展新动能,驱动园区高质量发展。在提出军民融合协同创新驱动园区高质量发展的机理与组织框架基础上,将发展模式归纳为以分享经济为背景的资源共享模式、以新型研发机构为核心的第三方模式、以产业联盟为核心的产业链拓展模式和以交易平台为核心的“PPP”模式,最后提出相关对策建议。  相似文献   
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企业创新是国家经济可持续增长的关键,受到管理层意愿的影响,因而需要对内部经营者的权力进行制衡。以2010-2018年我国A股上市公司为研究样本,实证检验管理层权力制衡强度对企业创新投资的影响,以及不同债务约束情境下高商业信用配置、高负债水平的调节效应,此外,还考察了产权性质的差异化影响。研究表明,管理层权力制衡强度越大,企业创新投资水平越高;高商业信用强化了该促进作用,而高负债水平弱化了该促进作用。进一步研究发现,管理层权力制衡强度与企业创新投资的关系在民企中更显著;国企能够更好地获得和运用商业信用,使其高商业信用对该关系的强化效应更显著;民企具有更强的债务约束,其高负债水平对该关系的弱化效应更明显。  相似文献   
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We study the effect of the educational diversity of managers on the performance of team‐managed mutual funds using a large sample of U.S. equity funds from 1994 to 2013. We consider diversity in terms of both final educational degree and field of educational specialisation. We find that, in general, both types of diversity have a positive impact on fund performance, and our results are robust over a wide range of performance metrics and changes in market conditions.  相似文献   
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我们选择市场经济,是因为迄今为止的历史证明市场经济是可以富其国裕其民的。然而,我们所要的富裕,不是少数人的富裕,而是人民群众的共同富裕。不仅要富裕,而且必须是共同富裕的市场经济。因此,我们必须对市场经济进行改造,创造出我们自己的市场经济,这就是有中国特色的社会主义市场经济。该文遵循实事求是和历史唯物主义的原则,从市场经济旨在提高效率、社会主义则是坚持党的领导和社会公正、路径依赖和历史沿革体现了市场经济的中国特色等四个方面论证了中国共产党领导全国人民选择社会主义市场经济是一个具有历史必然性的伟大选择。这样的选择使得中国经济发展和人民富裕。  相似文献   
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文章基于利益相关者理论的视角,选取青海省海东市互助县小庄村为案例地,通过田野调查和文献梳理分析出核心利益相关者的利益诉求和矛盾冲突,并构建乡村旅游核心利益相关者协调发展评价体系,采用EWM-Fuzzy综合评价模型和灰色关联模型对地方政府、旅游企业、社区居民及外来游客四类核心利益相关者利益诉求的紧急程度、利益关系协调发展状态及整体协调发展关系进行测评分析。研究表明,小庄村四类核心利益相关者对不同利益诉求的整体感知较好,不同利益诉求的紧急程度和协调发展状态均存在如下较大差异:四类核心利益相关者的利益诉求主要处于中度协调和轻度协调两种发展状态,优质协调发展状态的利益诉求表现相对较少,且存在濒临失调发展状态的利益诉求表现;小庄村旅游核心利益相关者相互间的协调发展关系呈现出多元化的发展状态,地方政府、旅游企业同其他利益相关者的利益关系协调发展的影响大小顺序完全一致,地方政府、社区居民同其他利益相关者的利益关系协调发展的影响大小顺序相对应,而外来游客、社区居民同其他利益相关者的利益关系协调发展的影响大小顺序基本相反;小庄村旅游核心利益相关者协调发展路径组合未达到纳什均衡状态,其协调发展模式为非对称互惠协调发展模式。上述验证结果与小庄村旅游发展的实际情况基本吻合,证明了评价体系的科学性。  相似文献   
9.
This study aims to empirically evaluate the predictors that influence sustainability performance among manufacturing firms. Leadership and management, green and lean practices, and guanxi were examined to determine whether these predictors are directly and/or indirectly affecting sustainability performance; 160 valid responses were collected and partial-least-squares-structural-equation-modeling (PLS-SEM) was used to analyze the data. The results showed that leadership and management positively influenced green and lean practices and green and lean practices positively influenced sustainability performance. Leadership and management also positively influenced guanxi. Interestingly, leadership and management and guanxi do not exert a significant direct influence on sustainability performance. The findings contributed to the development of the resource-based-view theory further by empirically exploring the significance of leadership and management coupled with green and lean practices as competencies and capability to drive sustainability performance. The testing of the dual mediators' effects further added value to this study.  相似文献   
10.
We exploit an influential 1991 Delaware court ruling to examine simultaneously two types of conservatism that play important roles in resolving creditor–owner agency conflicts: contracting conservatism and reporting conservatism. The ruling expanded managerial fiduciary duties in favor of creditors for Delaware-incorporated firms in the vicinity of insolvency. In those firms, following the ruling, debt contracts are less likely to include conservative adjustments to accounting numbers used for covenant compliance (i.e., contracting conservatism decreases), while public financial reporting becomes more conservative (i.e., reporting conservatism increases). The decrease in contracting conservatism is concentrated in firms that exhibit a greater increase in reporting conservatism, suggesting that reporting conservatism is more cost-effective in resolving agency conflicts. In addition, the substitution effect is more pronounced in firms facing greater business uncertainty and firms with greater board independence.  相似文献   
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