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1.
Background and aims:Randomized controlled trials have shown that a once-daily prolonged-release (PR) tacrolimus formulation (PR tacrolimus; Advagraf), is non-inferior to a twice-daily immediate-release (IR) tacrolimus formulation (IR tacrolimus; Prograf) in terms of biopsy-proven acute rejection, graft failure and mortality in renal transplant recipients. However, relative to IR tacrolimus, PR tacrolimus exhibits reduced tacrolimus trough concentration variability, which has been associated with reduced graft failure. Based on these data, the present study evaluated the cost of switching UK renal transplant patients from IR tacrolimus to PR tacrolimus.Methods:UK-specific data on acute rejection, graft failure, and mortality were used to construct a budget impact model to assess the costs of switching from IR tacrolimus to PR tacrolimus on a 1:1?mg:mg basis. The model assumed that 3.1% of patients on PR tacrolimus had high tacrolimus trough concentration variability compared with 17.4% on IR tacrolimus, based on a study comparing PR tacrolimus and IR tacrolimus pharmacokinetics. A relative graft failure risk of 2.38 was applied to high variability patients based on data from a tacrolimus variability study in which 10/148 patients with low variability experienced graft failure, compared with 24/149 in the high variability group. Cost data were taken from the British National Formulary and 2012–2013 NHS tariff information.Results:The mean per-patient cost (including tacrolimus, concomitant immunosuppressive medications, dialysis after graft failure, and treatment for acute rejection) was GBP 26,941 (standard deviation [SD]?=?GBP 2765) with PR tacrolimus vs GBP 30,356 (SD?=?GBP 3085) for IR tacrolimus over a 5-year period, corresponding to a saving of GBP 3415 (SD?=?GBP 516) per patient or GBP 341,500 in a hypothetical 100-patient transplant center. Cost savings were driven primarily by lower dialysis costs resulting from the lower proportion of PR tacrolimus patients with high tacrolimus trough concentration variability (leading to lower graft failure risk).Limitations:The main limitation of the study was the use of heterogeneous data sources to capture the effect of within-patient variability on graft failure. The most important difference between the studies was the definition of the threshold between low and high within-patient variability. This was explored in sensitivity analyses in which the inter-arm difference in the inter-arm proportions of patients with high and low variability was abolished.Conclusions:Converting UK renal transplant recipients from IR tacrolimus to PR tacrolimus was associated with lower pharmacy and dialysis costs. 相似文献
2.
Daniels F Laporte A Lemieux-Charles L Baumann A Onate K Deber R 《Nursing economic$》2012,30(4):201-206
To mitigate nurse shortages, health care decision makers tend to employ retention strategies that assume nurses employed in full-time, part-time, or casual positions and working in different sectors have similar preferences for work. However, this assumption has not been validated in the literature. The relationship between a nurse's propensity to exit the nurse profession in Ontario and employment status was explored by building an extended Cox Proportional Hazards Regression Model using a counting process technique. The differential exit patterns between part-time and casual nurses suggest that the common practice of treating part-time and casual nurses as equivalent is misleading. Health care decision makers should consider nurse retention strategies specifically targeting casual nurses because this segment of the profession is at the greatest risk of leaving. Nurse executives and nurse managers should investigate the different work preferences of part-time and casual nurses to devise tailored rather than "one-size fits all" nurse retention strategies to retain casual nurses. 相似文献
3.
《Journal of medical economics》2013,16(12):1050-1059
Abstract
Background and aims:
While short-term kidney graft survival has gradually improved over time, improvements in long-term graft survival have been more modest. One key clinical factor limiting improved longer-term outcomes is antibody-mediated rejection (AbMR), the incidence of which appears to be higher in patients who are non-adherent to immunosuppressants. Recent data show that adherence can be improved by reducing pill burden. The aim of the present study was to model the incidence and economic consequences of graft loss and AbMR in patients taking once- vs twice-daily tacrolimus in the UK. 相似文献4.
The determinants of municipal tax rates in British Columbia 总被引:5,自引:0,他引:5
In this paper we study the regional pattern of municipal business property tax rates in the province of British Columbia. Reduced-form tax-setting equations produce some evidence that municipal governments respond to tax changes in neighbouring jurisdictions. A joint investigation of the determinants of tax base and municipal taxation decisions, however, reveals that it is difficult to interpret this response as arising primarily out of competition over tax base. There is also some evidence that municipal tax rates are sensitive to taxes set on the same base by super-municipal bodies. JEL Classification: C33, H71
Les déterminants des taux d'imposition municipale en Colombie Britannique. Dans ce mémoire, les auteurs étudient le pattern régional des taux d'imposition municipale sur la propriété foncière commerciale dans la province de la Colombie Britannique. On montre à l'aide d'un modèle en forme réduite d'équations de définition des taux d'imposition que les gouvernements municipaux réagissent aux changements dans les taux d'imposition dans leur voisinage. Cependant, un examen conjoint des déterminants de la base d'imposition et des décisions municipales montre qu'il est difficile d'interpréter cette réaction comme émanant d'une concurrence fiscale. On montre aussi que les taux d'imposition municipale sont sensibles aux niveaux de fiscalité imposés sur la même base par les autorités supra-municipales. 相似文献
Les déterminants des taux d'imposition municipale en Colombie Britannique. Dans ce mémoire, les auteurs étudient le pattern régional des taux d'imposition municipale sur la propriété foncière commerciale dans la province de la Colombie Britannique. On montre à l'aide d'un modèle en forme réduite d'équations de définition des taux d'imposition que les gouvernements municipaux réagissent aux changements dans les taux d'imposition dans leur voisinage. Cependant, un examen conjoint des déterminants de la base d'imposition et des décisions municipales montre qu'il est difficile d'interpréter cette réaction comme émanant d'une concurrence fiscale. On montre aussi que les taux d'imposition municipale sont sensibles aux niveaux de fiscalité imposés sur la même base par les autorités supra-municipales. 相似文献
5.
In this paper we examine empirically the impact of privatisation on output in the UK, through macroeconomic transmission channels.
While most privatisation studies focus on microeconomic shocks, namely at the firm level, we are interested to see whether
a large scale privatisation policy, as the one pursued in the UK in the 1980 and 1990s, had a measurable impact on output.
This may contribute to the ex post evaluation of this policy and complement the microeconomic evidence. We use quarterly data
from 1979 to 1998 of privatisation proceeds, as our impulse policy variable, and of private consumption, gross fixed capital
formation, net government expenditures, as transmission channels, and aggregate output as our final response variable. The
econometric methodology is based on Structural Vector Auto-regressive models and Impulse Response Functions. Non-stationarity
and cointegration properties of the time series have also been considered. We find that privatisation shocks do not have an
impact in the consumption-output model, but have a moderate and transitory impact in the investment and the public expenditures
models. Such positive demand effects, however, have not been completely matched by supply side effects, and, consequently,
privatisation in the UK did not contribute to a sustained economic growth.
相似文献
Massimo FlorioEmail: |
6.
王立志 《新疆财经学院学报》2009,(4):66-70,74
隐私权是现代社会最重要的新兴基本人权之一,英国是普通法系的代表性国家,但长期以来英国法律不承认独立的隐私权,因此造成英国隐私权法律制度发展严重滞后。英国在隐私权刑法保护方面不但条文稀少,且相对零散,难以对隐私法益形成有效保护。但英国隐私权刑法保护并非一无是处,英国刑法独特的责任制度和刑罚制度在对隐私权刑法保护中别具一格,值得予以高度评价和特别关注。 相似文献
7.
Niklas S. Dürr 《Applied economics letters》2017,24(13):950-955
We investigate the characteristics of cities gaining access to the German interurban bus network in the first two years following the deregulation of the industry in January 2013. Applying both parametric and semi-parametric survival models, we find strong evidence that the probability of a city to be added to a provider’s network increases not only with the mere size of its population but also with further demographic characteristics such as average income or the share of young and old inhabitants. Additionally, while an increasing importance of tourism has a further positive effect, a rising automobile density is imposing a significantly negative impact on the probability of a city to gain access to the network. 相似文献
8.
Kerry Liu 《Research in Economics》2019,73(1):66-71
Based on quarterly data between Q4, 2008–Q4, 2017, this study examines the interest rates pass-through from policy rate to lending rates, and more broadly, the determinants of lending rates in China. The results show that while there is a certain level of pass-through from money market rates to lending rates, and the interest rates pass-through has improved after the interest rate liberalization completion on October 2015, this pass-through is also negatively affected by the asset quality of commercial banks and shadow banking activities as well. This study also finds that the macroeconomic condition also affects the lending rates. 相似文献
9.
经济转型中的企业退出机制--关于北京市中关村科技园区的一项经验研究 总被引:21,自引:0,他引:21
本文运用来自北京市中关村科技园区的一套独特数据 ,从企业退出这个角度探讨决定中关村高科技企业成长的相关因素 ,尤其是企业的效率因素、企业负债和所有制性质 (或行政隶属关系 )对退出的影响。本文的基本发现是 ,效率高低日益成为决定中关村高科技企业生存的重要因素 ,这表明经过二十多年的经济改革开放 ,市场力量的重要性已日渐上升。另一方面 ,企业负债也成为制约企业生存与成长的重要因素。但是 ,企业净资产负债率对不同所有制企业的退出的影响也不尽相同 ,国有企业总体上不受其影响 ,而且行政隶属关系越高 ,所受影响也就越小 ;但净资产负债率对非国有企业则形成显著的压力。这说明传统计划体制下的预算软约束问题仍然没有消失。我们的研究还表明 ,随着时间的推移 ,行政隶属关系和所有制性质本身对企业生存提供的保护作用正在递减。 相似文献
10.
商业关系解体诱因、过程与退出策略选择 总被引:1,自引:0,他引:1
蔡双立 《中南财经政法大学学报》2004,(4):51-58
客户关系管理不仅需要掌握关系成功获得与良好维持的艺术,还要学会"问题关系"的改善、恢复与退出技能.关系固有因素决定了关系解体的内在因素,关系衍生因素是关系解体突变或渐变的外在因素.关系解体过程分为评估、决策、沟通、网络沟通、退出和恢复七个阶段,退出策略选择分为利己和利他两种导向,不同导向选择形成了不同的退出策略组合和关系解体后果.关系行为、沟通方式、资源纽带和关系参与者契约改变是观察关系质量变化的最主要变量. 相似文献
11.
Maxym Chaban 《Journal of Macroeconomics》2011,33(4):793-806
This paper examines empirically how exogenous changes in the terms of trade affect the real exchange rate through the relative price of traded goods with Canada–US data. The relative price of traded goods is constructed using prices at the dock and retail prices. The first measure emphasizes the importance of home bias in consumption of traded goods. The second measure highlights the importance of distribution services required for consumption of traded goods. It is found that terms of trade shocks affect the relative price of traded goods using both measures. A possible interpretation of empirical findings is that home bias and distribution services are important for understanding the relative price of traded goods. 相似文献
12.
This paper studies the political economy of realignments to fixed exchange rates and suggests that the use of realignments is less likely when there are political benefits from stable exchange rates and when linkages across other issue areas increase the costs of realignment. More specifically for the case of the European Monetary System (EMS), the expectation is that realignments are related to partisanship, support for the broader European integration, trade integration, resource transfers from the European Community, as well as countries reacting to the political and economic costs of realignment in other EMS members. Hypotheses are tested using binomial logit models on monthly data on exchange rate realignments for all EMS countries from 1979 to 1993. I find lower realignment risk for left wing policy-makers and countries with more trade links to Germany, whereas more intra-European Community resource transfers appear to go to countries facing higher realignment risk. Also, realignments are less likely when the rest of EMS member countries have stable international reserves and their governments are pro-European. 相似文献
13.
康洪艳 《中南财经政法大学学报》2006,(1):107-111
风险企业家和风险资本家,对于风险投资的退出方式的偏好由于双方利益的冲突从而出现不完全一致,风险投资主体双方以可转换证券为融资工具,利用可转换证券所具备的控制权相机转移的特性,可以最大限度地实现风险投资退出的帕累托最优。 相似文献
14.
15.
Environmental determinants of banking efficiency in Austria 总被引:1,自引:0,他引:1
Franz R. Hahn 《Empirica》2007,34(3):231-245
The great majority of Austrian banks operate on a regional or local basis and only a few banks provide their services on a
national or even international scale. Obviously, the market environments regional or local banks face are different from that
of nationwide operating banks. Casual evidence suggests that local markets condition is a very important external determinant
of banking efficiency. Thus, not controlling for market conditions may substantially bias the measurement of managerial efficiency
particularly of locally operating banks. In this paper we assess the internal technical efficiency (or X-efficiency) of the
Austrian banking sector with the focus on environmental and non-controllable factors critical to banking markets. Analytically,
we apply a multiple-stage approach based on a slacks-based DEA model (SBM) and a censored regression model, respectively.
In order to cope with the inherent dependency problem of DEA-based efficiency analysis when incorporated into regression analysis
we apply a Bootstrap estimator. In so doing we attempt to overcome the dependency problem which plagues the power of standard
regression analysis based on DEA processed data. The empirical analysis is based on an unbalanced panel of data covering more
than 800 Austrian banks ranging over 1995–2002.
相似文献
Franz R. HahnEmail: |
16.
县域经济就是以县域为基本单元进行资源配置的经济。针对陕西省的县域经济的现状,提出以特色农业为基础、以工业化为导向、以民营经济为主体、以城镇化为支撑、以制度创新为动力的战略,以期能对陕西省乃至全国的县域经济发展提供参考。 相似文献
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18.
Shandre M. Thangavelu Liu Haoming Park Cheolsung Ang Boon Heng James Wong 《Applied economics》2013,45(29):4641-4649
This article uses the Singapore Labour Force survey data to examine the determinants of workers’ participation in training programmes in Singapore. The results show that different socio-demographic and employment related characteristics affect the training participation of workers. Well-educated and better paid workers are much more likely to participate in training programmes than others. Age has a positive impact on training participation for younger workers (under 37 years), but a negative effect on older workers’ participation. The results also indicate that occupational affiliations have a significant impact on training participation. We also find that married workers seem to be less likely to participate in training programmes, but the difference between married and single is only significant at the 10% level. Finally, gender does not have any significant effect at any conventional level although the coefficient on the female dummy is positive, suggesting females might be slightly more likely to participate in training programmes. 相似文献
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20.
Bruce T. Elmslie 《Applied economics》2013,45(28):3452-3462
This study contributes to the literature by providing an empirical analysis of the determinants of marital and general happiness. The empirical analysis is conducted using US data from the General Social Survey (GSS) and an Ordered Probit Model. We also attempt to overcome the endogeneity problem between marital happiness and infidelity using a recursive bivariate probit model. One of the advances of this study is to show that the determinants of marital happiness differ between men and women in interesting ways. While infidelity has similar effects for both sexes, we find that women have a detectable preference for a traditional division of labour within the household. In addition, social class, religion, age, children and income have differential effects between men and women. In particular, for marital happiness we find diminishing returns from household income for women and satiation for men. Hence, we find that most of the existing literature has left hidden important differences in the determinants of marital happiness between men and women. 相似文献