Impact of youth injuries on the uninsured farm family's economic viability

The objective of this study is to estimate the impact of youth injuries on the uninsured farm family's economic viability. Using farm prototypes, we compared farm profits with costs of farm youth injuries. We built profit models for two types of farms, dairy and soybean farms. Then we estimated the cost impact of farm youth injuries of different levels of severity on a farm family with no health insurance. A severe child injury that requires at least 10 days of hospitalisation would cost almost equal to the operating profit of the average dairy farm with no health insurance and would turn the operating profit of the average soybean farm into a severe loss of $99,499. Prevention of child agricultural injuries would significantly improve the financial situation for farm families that lack health insurance.     

Impact of youth injuries on the uninsured farm family's economic viability

The objective of this study is to estimate the impact of youth injuries on the uninsured farm family's economic viability. Using farm prototypes, we compared farm profits with costs of farm youth injuries. We built profit models for two types of farms, dairy and soybean farms. Then we estimated the cost impact of farm youth injuries of different levels of severity on a farm family with no health insurance. A severe child injury that requires at least 10 days of hospitalisation would cost almost equal to the operating profit of the average dairy farm with no health insurance and would turn the operating profit of the average soybean farm into a severe loss of $99,499. Prevention of child agricultural injuries would significantly improve the financial situation for farm families that lack health insurance.     

The employer costs of motor vehicle crashes

The latest published estimate of the cost of US motor vehicle crashes to employers is for 1989. This study estimates annual employer costs in 1998-2000. Incidence was estimated with occupational injury data and motor vehicle crash data for 1998-2000. Employer costs were estimated from Federal estimates of crash costs by source of payment using data on the percentage of varied payment streams (e.g. health insurance, sick leave) paid by employers. Motor vehicle crash injuries on and off the job cost employers almost $60 billion annually, including $16.3 billion in fringe benefit costs; $25.2 billion in property damage, workplace disruption and other non-fringe costs; and $18.4 billion in wage-risk premiums. Traffic safety programmes can reduce the fringe benefit bill without reducing the benefits offered to employees. Eliminating alcohol-impaired and unrestrained driving would save employers $15.2 billion annually.     

Costs of unintentional injuries among children in an urban slum community in Kampala city,Uganda

Abstract

Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N?=?415, 58.7%) suffered injuries than females (N?=?291, 41.2%). The average out-of-pocket expenditure on treating an injury was US $24.1 [standard deviation (SD)?=?±$62.8] and mean school days lost were 25 days (SD?=?±51.8). Road traffic injuries (RTIs) resulted in higher costs [mean difference was US $51.1 (95% CI: $11.4–$90.8)] compared to injuries that, for example, occurred at school. In a Ugandan slum community, unintentional childhood injuries resulted in high out-of-pocket expenditures and missed school attendance. The costs varied widely depending on external causes of the injury. These findings highlight the need to invest in population level injury prevention interventions to reduce injury costs by households.     

An Economic Analysis of Requirements to Prevent Handheld Hair Dryer Water Immersion Electrocutions in the USA

Before 1987, when handheld hair dryers were not required to protect against water immersion electrocutions, there were almost 16 such electrocutions annually in the USA. This article presents a retrospective evaluation of the benefits and costs of the 1987 and 1991 immersion protection requirements of the voluntary hair dryer safety standard in the USA. The benefits are based on estimates of the reduced risk of electrocution resulting from the requirements, and the valuation of the reduced risk derived from willingness to pay studies of the “value of statistical life” found in the economics literature. The costs were defined as the incremental costs associated with incorporating the immersion protection technology into handheld hair dryers. The study found that the requirements were highly effective and may have reduced the immersion-related mortality rate by almost 97%. The expected present value of the estimated benefits of the requirements amounted to about $4.56 per dryer in 2014 dollars and substantially exceeded the costs of about $2 per dryer. The primary outcome measure, the expected net benefits (i.e., benefits minus costs) of the requirements, amounted to an average of about $2.56 per hair dryer, over the hair dryer’s expected product life. Given sales of about 23 million handheld hair dryers annually, the present value of the expected net benefits associated with 1 year’s production would have amounted to about $58.9 million. A sensitivity analysis showed that the major findings were robust with respect to changes in the underlying parameters of the analysis. The study also discusses the factors leading to a high rate of effectiveness estimated for the immersion protection requirements.     

New directions in injury surveillance: Development of a model for continuous monitoring of direct medical costs

Information on the costs of injuries is an important additional instrument in setting priorities for injury prevention. The importance of this instrument is increasingly being recognized by health policy makers. The objective of this study was to develop a model which continuously monitors the direct medical costs of injuries in The Netherlands. This model should provide information on the direct medical costs of injuries at any time and for any selection of injury categories. It is an incidence-based model according to the ‘bottom up’ principle. Homogeneous patient groupings with respect to health care use are defined. The groupings are based on existing classifications from the literature and the experience of medical experts, and are defined by means of seven criteria: nature of care provided, body region of the injury, type of injury, severity of injury, age, complications, and sex of the patient. Several cost elements are distinguished (e.g., general practitioner help, hospital care, nursing home care). For each cost element, relevant patient groupings are determined. The new Dutch Injury Surveillance System (LIS) for injuries treated in an A&E department is an important source for incidence data. This article presents the design of the model as adopted by the Working Group on the Costs of Injuries of the European Consumer Safety Association (ECOSA).     

Narrow Framing and Retirement Savings Decisions

Theoretical studies suggest narrow framing underlies individuals' saving decisions. When narrow framing is applied to retirement savings decisions, narrow framers tend to make decisions about present consumption without considering future consumption, i.e., saving for consumption in retirement. Time preference for the present and narrow framers' preference to maintain the status quo lead to a decision that is less likely to increase savings for retirement. This study provides empirical evidence that narrow framing bias affects retirement savings decisions. Using a two‐part model, the probit estimation indicates narrow framers anticipated being less willing to increase retirement savings contributions compared to broad framers, and the OLS regression estimates that narrow framers anticipated contributing less than broad framers. Here, narrow framers anticipated being less willing to increase retirement savings (62.6% vs. 71.9%) and contributing less ($70.90 vs. $88.40) than broad framers, thus providing empirical evidence regarding the effects of behavioral biases on financial decisions.     

Injuries,inequalities and health in Europe

Injuries account for a significant burden of mortality, morbidity, disability and health care costs. They differentially affect age and sex groups and reveal massive inequalities in occurrence within and between countries in Europe. Within countries, the poor suffer most and have least ability to change their exposures to risk. Addressing inequalities in injury occurrence would play a valuable role in reducing the differential burden of ill-health between rich and poor. Despite the evidence for many effective injury-related interventions, limited attention has been devoted to addressing injuries as a public health priority. This paper questions why attention has been limited to date and suggests policy action to support injuries being addressed as a mainstream concern by national and international health policy-makers. The paper briefly highlights the public health burden of injuries and violence; illustrates the range of inequalities that characterise their occurrence; highlights the scope for public health action and considers the extent to which policies that reduce the overall burden of injuries may also reduce inequalities in their occurrence; and finally examines why there has been a limited policy response to date and suggests ways of advancing the agenda.     

Using social marketing to enhance hotel reuse programs

Hotels are increasingly sponsoring social marketing programs to encourage voluntary reduction of towel and linen use. These programs reduce water usage thus benefiting the environment. They also reduce hotels' laundering costs. Two controlled experiments were conducted to assess behavioral intentions and attributions as a result of such programs. Results demonstrate that response is most positive when savings from the program are donated to charity. When evidence is provided suggesting that a majority of hotel guests participate (social proof), the impact of how savings are used is reduced. This is especially pronounced for those traveling on business. Fit between the charity and the reuse program is inconsequential. The authors discuss implications.     

Money in a “Safe” place: Money anthropomorphism increases saving behavior

Saving has an important impact on consumers’ lives and life satisfaction. However, various indices indicate that consumers do not save enough. This research shows that a simple change in the perception of money by imposing humanlike characteristics (i.e., money anthropomorphism) can significantly increase savings. Specifically, we posit that imbuing money with humanlike characteristics can enhance both saving intention and real saving behavior because humanized money is considered to be capable of experiences such as pain or joy (perception of experiences) and, as a result, is more vulnerable and in need of protection (perception of vulnerability). By inserting money clipart or using first-perception language to describe money, we manipulate money anthropomorphism in six studies. In behavioral studies, we show that these money anthropomorphism manipulations increase real saving behavior by 18%. In addition, several alternative accounts, including warmth perception of money, autonomy toward money, perceived control over money, feeling guilty about spending money, and perceived importance of money, are ruled out. Furthermore, the results show that when the target account to keep money is considered risky, the positive money anthropomorphism on saving disappears. The findings provide important and practical implications for increasing personal savings.     

Bending and Stretching the Health Care Cost Curve

The Patient Protection and Affordable Care Act of 2010 (PPACA) has a number of provisions that aimed at slowing the rate of growth of health care spending. This paper examines the most prominent of these provisions and finds them to be seriously flawed and unlikely to deliver savings as intended. They are either too weak or liable to compromise quality. Moreover, some of the most important drivers of health care costs, such as fee for service payments to physicians under Medicare or limitations on physician liability are not addressed adequately. Thus, it is unlikely that the PPACA in its present form will do much to reduce the growth rate of health care expenditures.     

Mid-life and older workers: job displacement and health care coverage

The purpose of this study was to explore factors influencing the likelihood that workers would have health care coverage following job displacement. The sample was drawn from the Current Population Survey: Displaced Worker Supplement (January 1988) and consisted of 840 workers aged 45 years and older. The workers lost jobs because of plant closings, relocations or because of slack work At the time of the survey, 567 displaced workers indicated that they had health care coverage. Logistic analysis revealed that prior health care coverage, new earnings of males and family incomes of $20,000 or more impacted the likelihood that these displaced workers would have health care coverage. However, workers subsequently re-employed in new jobs (over 35 hours a week) were less likely to have health care coverage.     

Improving Incentives in Health Care Spending

Although U.S. economic growth is likely to continue to be robust, the growth of private and public spending on health care presents long-run public policy challenges. To meet these challenges health care resources must be used more efficiently. Currently, there are few incentives to put health care dollars to the highest value use. This is true in both public and private spending. An important element of the problem lies in the tax-preferred treatment given to employer-provided insurance but not to out-of-pocket spending. The resulting bias towards first-dollar insurance coverage means that consumers are insulated from the real costs of the health care that they consume and have little reason to evaluate whether the benefits are greater than those costs. Moreover, they seldom have sufficient price and quality information to make informed decisions. Health Savings Accounts (HSAs) are a promising way to remove the tax-penalty for enrolling in catastrophic insurance and paying for routine care out of pocket. Given the information that they need, consumers would then have more choices and more control, strengthening their role in reducing waste, improving efficiency, and promoting competition. Coupled with other policies, HSAs can be a critical component in moving toward an efficient and equitable health care system. JEL Classification I11     

Sports injuries and injury-preventive behavior related to hockey and volleyball in the Netherlands

Abstract

In a survey of hockey and volleyball players, the number and nature of sports injuries, the percentage of players taking injury-preventive measures (warming up before and cooling down after playing and the use of gum-shields and knee caps) and the main reasons for taking these measures have been assessed by self-reports in a questionnaire. The questionnaire for hockey players was answered by 635 respondents, the questionnaire for volleyball players by 711 players. For both hockey players and volleyball players, an incidence of about 500 injuries per 1000 players per year was found. Almost all volleyball players warmed-up before the last game played and 86% wore knee caps. About 25% of all hockey- and volleyball players took part in cooling down after this game. A gum-shield was used by 25% of the hockeyplayers. Surprisingly, players who took part in cooling down appeared to have a higher number of injuries than those who did not.     

Dynamic market impacts of generic dairy advertising

Generic advertising of fluid milk and cheese represents the principal promotional activity undertaken with the $370 million per year provided by dairy farmers and fluid milk processors. This article describes a stock-flow-feedback simulation model that includes 17 intermediate and final dairy products, short-term and long-term milk supply response and government policies that influence the impacts of generic advertising on net revenues for dairy farmers. Permanent increases in generic advertising expenditures increase net revenues for dairy farmers, with a cumulative net benefit to cost ratio of 2.8. Permanent decreases produce a larger reduction in net revenues and indicate a net benefit to cost ratio larger than 4.5. Spending a larger proportion of existing generic advertising funds on cheese rather than fluid milk would also markedly increased dairy farmer net revenues. Generic advertising increases net revenues for dairy farmers even when industry supply response and government regulation are accounted for.     

Saving behaviours: first wave baby boomers

The combination of lower saving rates in the 1980s, high consumer debt, and the impact of the baby boomer generation moving into retirement in an uncertain economic environment creates increasing concern for the financial state of the American household. This study explored the saving behaviours of baby boomers. The family management-systems model was used as the framework for the study. Research questions included whether saving behaviours were related to income, education and presence of dependent children. Data are from the 1983 National Survey of Consumer Finances. The 1980s represent a decade critical to first wave baby boomers and their continued influence on American society. A study of their saving behaviours provides information necessary to help plan for their future needs. Frequency counts and cross-tabulations of demographic data provide a profile of saving behaviours and attitudes toward risk and liquidity. Marital status and presence of children were significantly related to reasons for savings. Income, marital status, education and presence of children indicated a significant effect on net worth and attitude towards risk. Income and presence of children affected attitude towards liquidity. Income level was the strongest predictor of net worth as a measure of saving behaviours.     

The cost of childhood injury in France

Injuries are a major public health problem worldwide. In the USA, injuries cause 146, 400 deaths annually, with 31 million non-fatal injury visits to emergency departments (EDs). EDs thus represent an important source of injury data. The primary objective of the current study was to describe the epidemiology of injury-related ED visits and assess injury-related utilization of health care resources in an inner-city hospital in Indiana, using data stored in a computerized medical record system. It involved a retrospective review of the records for injury visits to EDs and injury admissions over a 3-year period. The variables extracted and analysed included patients' demographics, external cause of injury, diagnosis, length of stay, ED and hospital charges. A total of 60,470 injury-related ED visits were made, the majority of patients were male (61.6%), uninsured (63.1%), treated in ED and discharged (98.4%). The leading causes of injury were falls (18.8%), motor vehicle crashes (18.4%), assaults (17.6%), being struck (11.2%) and overexertion (10.6). Firearms caused most injury deaths (32.4%; n = 314); motor vehicle crashes were the leading cause of hospitalization (26.6%; n = 642) and also the most expensive to treat as inpatients (mean charge $19,190). The mean charge per patient treated and discharged was $150 compared to $11,116 for patients admitted. These findings demonstrate the value of computerized medical records in capturing and storing E-coded injury data. The system generates data that can be used for epidemiological surveillance and injury prevention at the local level, and for assessment of impact of specific injuries on health care resources.     

Pension Freedom Day in the United Kingdom: Early evaluation of consumer response

Understanding decumulation decisions in retirement is an important component of public policy that influences pension regulations in aging societies. This research examined a recent, substantial change to pension regulation in the United Kingdom: the newly established flexibility to obtain a lump‐sum payout from personal or occupational pension savings. Conducting an online survey of individual’s eligible to take advantage of the Pension Freedom regulation, we find that almost half of study participants plan to obtain a lump‐sum payout, on average £33,741, intending it for an average of three different investments or purchases. The decision to obtain a lump‐sum withdrawal was related to better knowledge of the new regulation. It was also more likely among older respondents and those not worried about a decline in standard of living during retirement. Dispositional measures did not affect the lump‐sum decision. Close to one‐third of study participants still planned to invest retirement savings into an annuity, especially those who retire at a later age, have concerns about care costs and worry about decline in standard of living in retirement. Comments about the changes to pension regulation were slightly more positive than negative. From our analysis of the effect of the Pension Freedom regulation on savings decumulation decisions, we conclude that the new Pension Freedom regulations do meet consumer demands, and demonstrate that pension knowledge and retirement expectations, in particular, influence consumer evaluations. We further conclude that annuity investments continue to play a role for older adults in the United Kingdom, especially for those concerned about meeting financial needs during retirement.     

The Effects of Market Concentration and Horizontal Mergers on Hospital Costs and Prices

Antitrust advocates believe that horizontal consolidation in hospital markets can reduce competition and increase prices while merger advocates believe it can benefit consumers by reducing service duplication. This study analyzed the market conditions, operating characteristics, and costs and prices of approximately 3500 short-term general hospitals (including 112 within-market-area mergers) from 1986 to 1994 to investigate the effects of market concentration, hospital mergers, and managed care penetration. The results show: a shift away from non-price competition toward price competition in health care markets; that this shift was fueled by increased market penetration by price-sensitive buyers; that horizontal hospital mergers produced average cost savings of approximately 5%, which were generally passed on to consumers as lower prices; that cost savings were generally greater for mergers of similar-size hospitals, with a higher degree of duplicative services, and with lower pre-merger occupancy rates; and some evidence that post-merger price reductions were smaller in less-competitive markets.