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.     

Target‐Setting,Pay for Performance,and Quality Improvement: A Case Study of Ontario Hospitals’ Quality‐Improvement Plans

This study examines whether difficult targets and quality indicators in executives' pay‐for‐performance (P4P) plans affect performance. The impact of target‐setting and P4P plans on quality improvement in the public sector is unclear. The Ontario government initiated the Quality Improvement Plan (QIP), which requires hospitals to set targets for quality indicators annually and link executive pay to target achievement since 2011. Analyzing Health Quality Ontario's database and hospitals' 2012–2013 QIPs, this study shows greater quality improvement in hospitals with difficult targets than hospitals with easy targets or without assigned targets; however, the positive impact disappears for high‐performance hospitals relative to their peers. We find no significant effect of the use of quality indicators in executives' P4P plans on quality improvement. Copyright © 2018 ASAC. Published by John Wiley & Sons, Ltd.     

Review: Chinese public administration and finance—a call for a new theory,research and dialogue

In implementing its national strategy to achieve global leadership, China needs a new public administration theory that integrates political administration, economic management and social regulation. Even so, China has already started to promote its brand of political and economic development abroad. Therefore new comparative research and dialogue is called to explore the universality of Chinese and Western public administration ideas.     

New development: China renews reform of central–local fiscal relations and provides for basic national public services

China’s reform on central–local fiscal reform has slowed down in recent years. The appointment of a new finance minister experienced in local government affairs is expected to renew the reform affirmed by the Chinese Communist Party (CCP) congress in late 2017. China has unprecedentedly identified a comprehensive list of 81 national basic public services as entitlements. Eighteen of them are subject to national and local standards, and co-financed by central and local governments. A new cost-sharing method for 10 of these services classifies sub-national jurisdictions into five tiers, in which the central government’s share declines from 80% to 10%. These measures, effective in 2019, aim at creating a ‘harmonious and moderately prosperous society’.     

Labour market characteristics and surviving import shocks

This paper investigates whether different labour market characteristics amplify or dampen the local labour market impacts from Chinese import competition exposure. I exploit state‐level variation in initial, pre‐shock labour market characteristics and regional variation across local labour markets in exposure to Chinese imports for identification. I find that local labour markets in states with higher union density experience more severe adverse consequences as a result of increased import exposure. Conversely, higher initial minimum wages help mute the negative impacts of the China shock. I also provide some evidence that exceptions to employment‐at‐will legislation can affect employment responses to increased Chinese imports. Finally, examining all policies together in an index, I show that higher levels of policies intended to benefit and protect workers can actually magnify the extent of the damage inflicted by import competition. My results suggest that initial labour market characteristics and policies can play an important role in understanding why local labour markets react differently to trade shocks.     

Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure,illustrated by studies of British voting behaviour

Quality & Quantity - Many ecological- and individual-level analyses of voting behaviour use multiple regressions with a considerable number of independent variables but few discussions of their...     

Firms’ performance following the initial resignation of independent directors: evidence from Taiwan

This study investigates the operating performance of firms listed on the Taiwan stock exchange following the initial resignation of independent directors. The results show that the firms’ operating performance following the resignation of these directors has not only deteriorated, but is also significantly below the industry average. In addition, firms with a relatively severe agency problem, including firms that have lower insider or institutional shareholdings, receive audit opinions other than unqualified opinions or change their auditors prior to the resignation of the independent directors, tend to perform more poorly following the resignation.     

Political uncertainty and labour investment efficiency

ABSTRACT

We examine the impact of political uncertainty on the labour investment efficiency (LIE) of a firm. Using a sample of Chinese firms, we test the market discipline and managerial entrenchment hypotheses. Our findings suggest that political uncertainty adversely affects LIE. The results are consistent with the managerial entrenchment hypothesis. That is, firms hire more labour in a period of increased information asymmetry due to the political uncertainty, which deteriorates LIE. Our findings are robust to a battery of alternative measures of LIE and estimation methods. We conduct several additional analyses and document that the adverse impact of political uncertainty is stronger when the newly appointed government official is older, the firm is state-owned, the firm belongs to a politically sensitive industry or the firm operates in locations with stringent labour protection. By contrast, when the firm locates in a region with weak Chinese government intervention or after President Xi Jinping’s anti-corruption campaign, the adverse impact of political uncertainty on LIE is less pronounced. Last, we document that after hiring more labour, firms receive tangible and intangible benefits in terms of receiving more loans, collect more government subsidies, and able to re-establish some political connection but at the cost of lower performance.