Time spent on erythropoietin stimulating agents administration in hemodialysis centers in Panama: a time and motion study

Objectives: There is a lack of data in Panama on the potential differences in total healthcare professional (HCP) time between routine administrations of short-acting erythropoietin simulating agents (ESAs) (i.e. epoetin alfa) and continuous erythropoietin receptor activator (CERA) (i.e. methoxy polyethylene glycol–epoetin beta). This study aimed to quantify the HCP time associated with a single administration of epoetin alfa and CERA for the treatment of anemic patients with chronic kidney disease (CKD) on hemodialysis.

Methods: This was a multi-center, cross-sectional study, using a time-and-motion methodology. Costs related to HCP time and consumables usage associated with administration of epoetin alfa and CERA were estimated.

Results: Based on 60 administrations of either CERA or epoetin alfa, the estimated savings in mean total active HCP time were 2.34 (95% confidence interval?=?1.87–2.81) min (–30%) per administration. When extrapolating to a full year’s treatment with intravenous ESA, it would require a total of 20.3 (95% CI?=?19.90–20.71) h of HCP time for epoetin alfa vs 1.1 (95% CI?=?1.01–1.19) h for CERA per patient per year. Estimated savings in active HCP time per patient per year were 19.20 (95% CI?=?19.20–19.21) h (–95%). This, in turn, translates into staff cost efficiency that favors Mircera with an estimated annual saving of $78.24 (95% CI?=?78.24–78.28) (–95%) per patient.

Conclusions: Data from a real-world setting showed that the adoption of CERA could potentially lead to a reduction in active HCP time.

• Highlights

• Few comparative data have explored the costs and potential savings of using long-acting erythropoietin–stimulating agents (ESA) instead of short-acting ESAs to treat anemia in CKD patients on hemodialysis.

• This time-and-motion study shows that use of CERA reduces total healthcare professional time and could represent a save for an institution in a real-world setting in Panama.

     

Using capabilities to project growth, 2010–2030

We forecast average annual GDP growth for 147 countries for 2010–2030. We use a cross-country regression model where the long-run fundamentals are determined by the countries’ accumulated capabilities and the capacity to undergo structural transformation.     

Inflation,growth, and distribution: The Brazilian economy after the post war

Abstract

Following Marglin and Bhaduri (1990 Marglin, S.A., and Bhaduri, A. “Profit Squeeze and Keynesian Theory.” In S.A. Marglin and J. Schor (eds.), The Golden Age of Capitalism. Reinterpreting the Postwar Experience. Oxford: Clarendon, 1990. [Google Scholar]), the purpose of this paper is to investigate empirically the interaction between income distribution and growth of aggregate demand during the 1951–89 period in Brazil. Applying Hein and Vogel’s (2008) methodology we conclude that the Brazilian economy showed a profit-led demand regime. In a context of high inflation, high concentration of markets, and wage control, retained profits were the main source to finance new capital. In this sense, we found a large sensitivity of investment relative to the wage share, a result that is compatible with a consumption pattern based on high income, which supported the growth trend with low wages observed during the period.     

A Problem with Some Estimations and Interpretations of the Mark-up in Manufacturing Industry

This paper evaluates the methodological foundations of some recent attempts to estimate econometrically the degree of market power and the degree of returns to scale in manufacturing. The method discussed is based on estimating the aggregate production function in growth rate form. It is argued, following an argument made in another context by Phelps Brown, Shaikh & Simon, that as the data used in empirical analyses are in value terms (i.e. monetary values at constant prices), the parameter derived as a mark-up can be reinterpreted simply as a coefficient from the income accounting identity, which takes a value of unity subject to omitted variable bias. Thus, it cannot be unambiguously interpreted as a mark-up. It is also shown that the large estimates of the degree of increasing returns to scale are similarly flawed. The argument also has implications for understanding cyclical fluctuations of the Solow residual, which turns out to be largely the result of the procyclical fluctuations of the profit rate.We conclude by questioning whether the aggregate production function can ever be statistically tested or, in other words, whether it is capable of being refuted, as opposed to its parameters being merely estimated.     

British Managers' Attitudes and Behaviour in Industrial Relations: A Twenty-Year Study

A unique longitudinal study of Britain's managers conducted in 1980, 1990 and 2000 permits comparisons of managerial attitudes and behaviour in industrial relations over twenty years. We find clear evidence of the relationship between macro‐level political and economic movements of the period from 1980 up until the late 1990s on managerial attitudes, the impact of changes in power relations and the ‘lag effect’ of institutions. The most unexpected findings are the modest rise of managerial unionism in the 1990s and the limited evidence of the replacement of collective bargaining by either individual or group involvement or by employee financial participation.     

A History of the Founding and Early Years of AFEE

During the late 1950s, institutionalists started organizing themselves amid the decline of institutional economics, leading to the 1965 founding of the Association for Evolutionary Economics (AFEE). We analyze the history of the movement to found AFEE and its early years. We use archival evidence, much of it previously unpublished, to provide a detailed history of these early years. We also present an account of AFEE that highlights the role of different interpretations of institutional economics in building the association. In addition, we provide a brief history of the early years of the Journal of Economic Issues (JEI).     

INSOLVENCY PREDICTION IN THE PRESENCE OF DATA INCONSISTENCIES

In this paper we use data inconsistencies as an indicator of financial distress. Traditional models for insolvency prediction normally ignore inconsistent data, either by removing or replacing it. Instead of removing that information, we propose a new variable to capture it; using it together with traditional accounting variables (based on financial ratios) for the purpose of insolvency prediction. Computational tests use three datasets based on the financial results of 2033 Brazilian Health Maintenance Organizations over 7 years (2001 to 2007). Sixteen classification methods were used to evaluate whether or not the new variable impacted solvency prediction. Tests show a statistically significant improvement in classification accuracy – average results improve 1.3 (p = 0.003) and 1.8 (p = 0.006) percentage points, for 10‐fold and leave‐one‐out cross‐validations respectively. In addition, the analysis of false positives and false negatives shows that the new variable reduces the potentially harmful misclassification of false negatives (i.e. financially distressed companies being classified as financially healthy) and also reduces the estimated overall error rate. Regarding the extensibility of the results, even though this work uses data from Brazilian companies only, the calculation of the financial ratios variables, as well as the inconsistencies, could be extended to most companies worldwide subject to governmental accounting regulations aligned with the International Financial Reporting Standards. Copyright © 2014 John Wiley & Sons, Ltd.     

Asymmetric rivalry within and between strategic groups

Our study examines asymmetric rivalry within and between strategic groups defined according to the size of their members. We hypothesize that, owing to several forms of group‐level effects, including switching costs and efficiency, strategic groups comprising large firms expect to experience a large amount of retaliation from firms within their group and accommodation from the group comprising smaller firms. Small firms, on the other hand, expect to experience a small amount of retaliation from the group comprising large firms and no reaction from the other firms in their group. We estimate the effect of group‐level strategic interactions on firm performance. Our analysis reveals that the rivalry behavior within and between groups is asymmetric, which supports the dominant‐fringe relation between firms, as described in our hypothesis. Copyright © 2013 John Wiley & Sons, Ltd.