Heart rate variability testing: could it change spending for rheumatoid arthritis patients in the United States? An exploratory economic analysis

Background: Autonomic nervous system (ANS) testing with heart rate variability (HRV) has been shown in early research to predict 52-week outcomes in rheumatoid arthritis (RA). HRV testing could be combined with putative ANS biologic pathways to improve treatment response for RA patients. This study explored potential costs and health outcomes of introducing HRV testing into RA treatment, without and with ANS optimization.

Methods: A decision tree exploratory economic model compared HRV testing to standard care in moderate-to-severe biologic-eligible patients over a 10-year time horizon. HRV data was derived from an observational study of RA patients (n?=?33). Patients were stratified into treatment groups based on HRV test scores indicating “low probability of response” and “moderate to high probability of response”. This study explored adding ANS optimization based on HRV score followed by clinically-appropriate treatment. Costs and quality-adjusted life-years (QALYs) for the US population were estimated.

Results: HRV testing in biologic-eligible patients decreased non-effective biologic use, reducing US healthcare costs by $34.6 billion over 10 years with QALYs unchanged. When combined with ANS optimization in biologic-eligible patients, HRV testing could increase costs by $3.6 billion over 10 years but save over 350,000 QALYs. Among all RA patients, HRV testing with ANS optimization could save over $8 billion and over 100,000 QALYs over 10 years, depending on the positive predictive value (PPV) of the HRV test.

Conclusions: The potential economic impact of introducing HRV testing and ANS optimization into RA treatment appears substantial and cost-effective based on the exploratory analysis. Additional rigorous studies are warranted in larger patient samples to better inform decision-making.     

A cross-industry analysis of intra-industry trade measurement thresholds: Canada and the United States, 1988–1999

The measurement of intra-industry trade allows for the separation of horizontal from vertical intra-industry trade using thresholds to categorize different types of trade. Using product-level data on Canada–United States international trade and corresponding cross-industry determinants, this study tests the sensitivity of these thresholds finding that previous studies may have incorrectly specified the measurement of intra-industry trade.     

Special Interest Group Formation in the United States: Do Special Interest Groups Mirror the Success of their Spatial Neighbors?

Special interest groups exert a great deal of influence over political outcomes in the United States. Understanding the determining factors for the formation of special interest groups is important. However, the literature has excluded the role of spatial neighbors. This article employs spatial econometric techniques to discriminately analyze the factors determining the number of special interest groups in a state. While geographic location is not a factor, gross state product, state general expenditures, union membership, and the percentage of manufacturing employment relationships between states are crucial in the formation of special interest groups across states.     

Putting ‘merchants of debt’ in their place: the political economy of retail banking and credit-based financialisation in Germany

Why did household debt in Germany not increase after the year 2000? This article offers a supply-side explanation for this deviant debt trajectory by tracing the historical evolution of retail banking in the German political economy. It argues that at the end of the 1990s and in the light of European Monetary Union, profitability issues and banking fragmentation became severe enough to interrupt the path towards credit-based financialisation as prevalent among other capitalist economies. These factors interacted with a traditional lack of tools and incentives for rapid credit expansion, even though they were renegotiated in the processes of financial liberalisation, internationalisation and innovation. By employing historical-qualitative as well as statistical evidence for the argument, the paper’s contribution becomes twofold. First, it introduces and conceptualises retail banking as a focal point in the analysis of national financial systems and their transformation. Second, it complicates the standard accounts of German non-financialisation and reveals the ‘contested’ character of financial reform.     

Economic burden of hypoglycemia: Utilization of emergency department and outpatient services in the United States (2005–2009)

Objective: To estimate the economic burden of hypoglycemia on the healthcare system at the national level in the US between the years of 2005–2009.

Methods: This study analyzed the National Hospital Ambulatory Medical Care Survey (NHAMCS), including emergency department (ED) and outpatient department (OPD) components, and the National Ambulatory Medical Care Survey (NAMCS). The annual rates of ED and OPD visits associated with hypoglycemia were reported. Subsequent medical services after disposition were studied. The unit cost of specific medical service was estimated from the Medical Expenditure Panel Survey (MEPS). All annualized costs were adjusted to US 2009 dollars. We also estimated the rates of injury and ambulance use incurring within a visit for hypoglycemia.

Results: The total direct medical cost of hypoglycemia was estimated as $3.49 billion in 2005 and decreased gradually to $1.84 billion in 2009. The declining trend was correlated with hospital admissions from ED, which decreased from 170 665 in 2005 to 71,751 in 2009. Consequently, the estimated annual expenditure of hospitalization for hypoglycemia from ED declined over time by more than half ($2.90 billion in 2005, $1.25 billion in 2009). Injury was reported among 9.5% of the ED visits for hypoglycemia. Ambulances were used among 58% of the ED visits for hypoglycemia.

Conclusion: Hypoglycemia poses a significant burden on the healthcare system; however, annual direct medical cost of severe hypoglycemia in the US decreased over the 5 years studied, which is attributable to tremendous decrease in need of hospitalization following an ED visit.     

“Cleansing the air at the expense of waterways?” Empirical evidence from the toxic releases of coal-fired power plants in the United States

Environmental policies in the United States have primarily taken the form of media-specific regulations that emphasize end-of-pipe pollution control. This can lead to the shifting of pollution across environmental media, thereby having the potential to solve one environmental problem by creating a new problem. This study uses data from 228 coal-fired power plants that report to the Toxics Release Inventory to conduct an empirical examination of the extent to which media-specific regulation has caused power plants to shift their toxic air releases to waterways, land, or transfers for offsite recycling facilities. Controlling for plant-level fixed effects, scale of production, and environmental inspections and enforcement under air regulation, this study finds that adopting tougher air pollution regulation that designates counties as being in nonattainment status with the National Ambient Air Quality Standards significantly increased toxic releases to waterways and land.     

ICT Investment and Economic Growth in the 1990s: Is the United States a Unique Case?: A Comparative Study of Nine OECD Countries

This paper compares the impact of information and communication technology (ICT) capital accumulation on output growth in Australia, Canada, Finland, France, Germany, Italy, Japan, the United Kingdom, and the United States. Over the past two decades, ICT contributed between 0.2 and 0.5 percentage point per year to economic growth, depending on the country. During the second half of the 1990s, this contribution rose to 0.3 to 0.9 percentage point per year. Despite differences between countries, the United States has not been alone in benefiting from the positive effects of ICT capital investment on economic growth nor was the United States the sole country to experience an acceleration of these effects. ICT diffusion and ICT usage play a key role and depend on the right framework conditions, not necessarily on the existence of a large ICT-producing sector.     

Segregation and gender wage gaps in the private and the public sectors: an analysis of Danish linked employer–employee data, 2002–2012

This paper examines the relation between segregation and the gender wage gap in the public and the private sectors in Denmark from 2002 to 2012. The analysis shows that male–female differences in the share of females in occupations, industries, establishments and job cells (occupations within establishments) constitute 46 % of the raw gender wage gap in the private sector, while segregation in the public sector accounts for as much as 63 %. Segregation thus plays a substantially more important role in accounting for the gender wage gap in the public sector than in the private sector. While the importance of segregation for wage formation decreased substantially in the public sector over time, it only decreased slightly in the private sector. Although the remaining gender wage gap, after controlling for segregation, is close to zero in the public sector, a substantial within-job cell differential remains after controlling for segregation in the private sector.     

Turgot: a critic of physiocracy? An analysis of the debates in Éphémérides du Citoyen and in correspondence with Dupont

Abstract

Anne-Robert-Jacques Turgot (1727–1781) is one of the few French economic theorists who led a political career and held ministerial office. He continues to intrigue both historians and historians of economic thought where his relationship with the physiocrats is concerned. Does Turgot fully share their belief system, or does he only borrow a few elements from it? Is he a critical author of this school of thought? To date, no agreement has been reached on this subject. This paper attempts to answer some of these questions in an objective manner, drawing on the evidence provided by texts and therefore minimising the interpretations. The sources we will primarily refer to are the Éphémérides du citoyen and Turgot's correspondence with Dupont. We will revisit the economic themes of large- and small-scale farming, as well as savings, and discuss Turgot's views on slavery and the “sectarian spirit” of the physiocrats.     

An Empirical Test of the “Financial Accelerator” in China: Evidence from the Chinese Industrial Enterprises Database

The purpose of this paper is to test the applicability of the “financial accelerator” mechanism to China. Using the Chinese Industrial Enterprises Database, we find strong evidence suggesting that the employment and investment of leveraged firms are less responsive to aggregate fluctuations. This finding goes against the implications of the “financial accelerator”. To make sure our empirical result is reliable, we have done several robustness checks using different estimation methods and subsamples.     

Network Access Regulation and Competition Policy: An Assessment of the “Direct-Plus-Opportunity Cost” Regime and Policy Options

A fundamental issue when determining competition policy, especially in vertically integrated industries, is the formulation of interconnection charges. Recently an influential set of theories on network access price has been put forward under the broad heading of direct-plus-opportunity cost regime (DOCR). This paper deals with two distinct but related aspects of DOCR. The first part of the paper considers the policy implications of an access regime determined by DOCR. Its compatibility in attaining contestable outcomes in the final goods market and its effect on welfare gains, especially producer's surplus, are evaluated. Secondly, the paper empirically applies a version of DOCR to the UK contract gas market, and the simulated outcomes and possible scenarios are considered.     

Compound Voids and Unproductive Entrepreneurship: The Rise of the “English Fever” in China

China has emerged as an economic power due, in part, to government policies that opened China to the world and created a modern consumer culture. One of these policies is the advancement of English-language education, including private providers, which has spawned the “English Fever” phenomenon. We use the unique context of the private English-language education industry in China to illustrate the concept of “compound (institutional) voids” and their relationship to unproductive entrepreneurship. Our contribution is in untangling some of the complexities related to institutional relationships, and in describing how compound voids increase the likelihood of rent-seeking behavior.     

Punitive Entanglements: The “War on Gangs” and the Making of a Transnational Penal Apparatus in the Americas

This paper analyses the export-import business of penal policies that accompanies the “war on transnational street gangs” between the United States and Central America. It argues that far from being a unidirectional export of punitive politics from the United States towards Central America, many of these punitive exports travel “back home”. This creates transnational punitive entanglements that contribute to the contingent convergence of punitive geopolitics and domestic politics in the guise of a transnational penal apparatus that integrates law enforcement agencies and military forces, securocratic epistemic communities and national political entrepreneurs into a functionally cohesive but decentred transnational security structure engaged in a multilayered punitive containment of transnational street gangs across the Americas.     

Awash in a Sea of Confusion: Benefit Corporations,Social Enterprise,and the Fear of “Greenwashing”

In the last five years, the majority of U.S. states enacted benefit corporation legislation, creating a new legal form of business that embraces the “triple-bottom line” of people, planet, and profit. Benefit corporation status provides legal protections for directors and officers, who may now balance social and environmental impact with shareholder returns. It also creates rich opportunities for social entrepreneurs, gives investors more socially responsible options, and offers a helpful designation for consumers. I describe the history and purpose of benefit corporations, evaluate their pros and cons, and argue that safeguards against “greenwashing” make benefit corporations a valuable business form of social enterprise.     

Institutionalizing “the Public Interest” in Public Utility Regulation: Harry M. Trebing and the Second Wave of Reform

John R. Commons and colleagues established the basic model for independent public utility regulation in the United States at the turn of the twentieth century, based on documented market and public interest failures. After limited success and repeated failures in the implementation of regulation, Harry M. Trebing and others at the Federal Communications Commission (FCC) in the late 1960s and 1970s revised and strengthened the model as well as the implementation capabilities of regulators, based on the regulatory weaknesses and unique opportunities for reform in the telecommunication industry. This model was then adapted to improve the regulation of other public utilities. Whereas the new model has also had limited success, the experience accumulated through it has prepared the ground for an inevitable third wave of regulatory reform.     

Overview of the special issue on “Rethinking Risks in International Financial Markets: Modeling Tools and Applications”

This short paper provides an overview of the special issue “Rethinking Risks in International Financial Markets: Modeling Tools and Applications” which features high-quality research papers that have been presented at the 7th International Finance Conference (IFC7). This selection of papers tackles an important issue in financial economics, which is “risk modeling, assessment and management” at both firm and market levels in the aftermath of the recent global financial crisis 2008–2009.     

Specific investment,relational governance and cooperation risk: from the perspective of farmers in China’s “Company+Farmers” alliance

The ‘Company+ Farmers’ alliance is the main organization for China’s agricultural industrialization management. Based on the survey data of farmers cooperating with companies in Guangdong and Jiangxi Provinces, this article explores the relationship among farmers’ specific investment, the relational governance of the alliance and farmers’ cooperation risk. The results show that the relational governance of the alliance can be divided into cognitive relational governance and coordinated relational governance. Among these types, cognitive relational governance can significantly promote farmers’ specific investment. However, with the increase in farmers’ specific investment, farmers’ cooperation risk is significantly improved, and the coordinated relational governance can significantly enhance the role of farmers’ material-specific investment in promoting cooperation risk. Therefore, agricultural enterprises can use cognitive relational governance to encourage farmers’ specific investment, and the specific investment of farmers must rely on a contract governance mechanism.