Medical resource utilization and costs for total hip arthroplasty: benchmarking an anterior approach technique in the Medicare population

Aims: The anterior approach (AA) for total hip arthroplasty (THA) is associated with more rapid recovery when compared to traditional approaches. The purpose of this study was to benchmark healthcare resource utilization and costs for patients with THA via AA relative to matched patients.

Materials and methods: This study queried Medicare claims data (2012–2014) to identify patients who received THA via an AA from experienced surgeons, and matched these patients to a control cohort (all THA approaches). Direct and propensity-score matching were employed to maximize similarity between patients and hospitals in the two cohorts. Hospital length of stay (LOS), the proportion of patients discharged to home or home health, and post-acute claim payments during the 90-day episode were assessed. Generalized estimating equations were applied to control for imbalances between the cohorts and clustering of outcomes within hospitals.

Results: A total of 1,794 patients were included after patient matching. Patients who received AA had significantly lower mean hospital LOS vs patients in the control group (2.06?±?1.36 vs 2.98?±?1.58 days, p?<?.0001). The adjusted proportion of patients discharged to home was nearly 20 percentage points higher in the AA cohort vs the control cohort (87.3% vs 68.7%, p?<?.0001). Post-acute claim payments for AA patients were nearly 50% lower than those for control patients ($4,139 vs $7,465, p?<?.0001).

Conclusion: AA patients had significantly lower post-acute care resource use when compared to control patients. Further research is warranted to evaluate the cost effectiveness of AA among surgeons of varying experience levels.     

Some Simple Economics of Open Source

There has been a recent surge of interest in open source software development, which involves developers at many different locations and organizations sharing code to develop and refine programs. To an economist, the behavior of individual programmers and commercial companies engaged in open source projects is initially startling. This paper makes a preliminary exploration of the economics of open source software. We highlight the extent to which labor economics, especially the literature on 'career concerns', and industrial organization theory can explain many of these projects' features. We conclude by listing interesting research questions related to open source software.     

Relationships among Strategic Capabilities and the Performance of Women-Owned Small Ventures

This study of small, life-style ventures owned by women focuses on the strategic, firm-level factors related to business performance. A theoretical model drawing on the resource-based theory is developed and tested empirically. The model includes strategic capabilities, management styles, and their relation to performance. It is tested empirically on a sample of 220 Israeli female business owners. Analysis reveals that life-style venture performance is highly correlated with certain aspects of the business owner's skills as well as the venture&apops;s resources. Paradoxically, the owner/managers in the sample rate their skills and their venture's resources as being weak in precisely those areas that correlate positively with business performance. These findings suggest that performance of life-style ventures owned by women depends more on marketing, financial, and managerial skills than on innovation.     

Internationalization of Chinese Entrepreneurial Firms

This article uses the resource‐based and internationalization theories to explain the export behavior of Chinese entrepreneurial firms. Based on multiyear data on Chinese firms from the Global Entrepreneurship Monitor (GEM), we show that contextualized resource‐based theory can adequately explain some of the variation in export behavior among young Chinese firms. Exports by small Chinese firms are driven by the social and intellectual capital of the entrepreneur and their entrepreneurial proclivity, and the innovativeness/uniqueness of the product/offering. © 2013 Wiley Periodicals, Inc.     

Venture capital investment cycles: The impact of public markets

It is well documented that the venture capital industry is highly volatile and that much of this volatility is associated with shifting valuations and activity in public equity markets. This paper examines how changes in public market signals affected venture capital investing between 1975 and 1998. We find that venture capitalists with the most industry experience increase their investments the most when public market signals become more favorable. Their reaction to an increase is greater than the reaction of venture capital organizations with relatively little industry experience and those with considerable experience but in other industries. The increase in investment rates does not affect the success of these transactions adversely to a significant extent. These findings are consistent with the view that venture capitalists rationally respond to attractive investment opportunities signaled by public market shifts.     

The Future of Private Equity

After a period of robust growth, the private equity industry has experienced a marked decline. In the wake of the 2008 economic crisis, the future of the venture and buyout industries seems unclear. This speech discusses four possible scenarios for the future of the private equity industry by examining the short‐ and long‐run determinants of private equity supply and demand. Possible scenarios include Recovery, Back to the Future, The Limited Partners' Desertion, and A Broken Industry. Although support is given for each of the scenarios, a clear prediction for the future remains difficult. The future of the private equity market is likely to be the subject of debate for some time to come.     

Fear of rejection? Tiered certification and transparency

Product quality certifiers may not reveal the identity of unsuccessful applicants/sellers for three reasons. First, they respond to the desire of individual sellers to avoid the stigma from rejection. Second, nontransparency helps a certifier to increase his market power by raising the stigma from lower‐tier certification. Third, transparency does not help screen among heterogeneous sellers. Strategic complementarities arise as sellers move down the certification pecking order and lead to the stigmatization of the lower tiers. Mandating transparency benefits the sellers but has an ambiguous impact on buyers, who actually become less informed about product quality.