Economic burden of sarcoidosis in a commercially-insured population in the United States

Background: Sarcoidosis is a multi-system inflammatory disorder characterized by the presence of non-caseating granulomas in involved organs. Patients with sarcoidosis have a reduced quality-of-life and are at an increased risk for several comorbidities. Little is known about the direct and indirect cost of sarcoidosis following the initial diagnosis.

Aims: To provide an estimate of the healthcare resource utilization (HCRU) and costs borne by commercial payers for sarcoidosis patients in the US.

Methods: Patients with a first diagnosis of sarcoidosis between January 1, 1998 and March 31, 2015 (“index date”) were selected from a de-identified privately-insured administrative claims database. Sarcoidosis patients were required to have continuous health plan enrollment 12 months prior to and following their index dates. Propensity-score (1:1) matching of sarcoidosis patients with non-sarcoidosis controls was carried out based on a logistic regression of baseline characteristics. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched groups over the 12-month period following the index date (“outcome period”).

Results: A total of 7,119 sarcoidosis patients who met the selection criteria were matched with a control. Overall, commercial payers incurred $19,714 in mean total annual healthcare costs per sarcoidosis patient. The principle cost drivers were outpatient visits ($9,050 2015 USD, 46%) and inpatient admissions ($6,398, 32%). Relative to controls, sarcoidosis patients had $5,190 (36%) higher total healthcare costs ($19,714 vs $14,524; p?p?p?Background: Sarcoidosis is a multi-system inflammatory disorder characterized by the presence of non-caseating granulomas in involved organs. Patients with sarcoidosis have a reduced quality-of-life and are at an increased risk for several comorbidities. Little is known about the direct and indirect cost of sarcoidosis following the initial diagnosis.

Aims: To provide an estimate of the healthcare resource utilization (HCRU) and costs borne by commercial payers for sarcoidosis patients in the US.

Methods: Patients with a first diagnosis of sarcoidosis between January 1, 1998 and March 31, 2015 (“index date”) were selected from a de-identified privately-insured administrative claims database. Sarcoidosis patients were required to have continuous health plan enrollment 12 months prior to and following their index dates. Propensity-score (1:1) matching of sarcoidosis patients with non-sarcoidosis controls was carried out based on a logistic regression of baseline characteristics. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched groups over the 12-month period following the index date (“outcome period”).

Results: A total of 7,119 sarcoidosis patients who met the selection criteria were matched with a control. Overall, commercial payers incurred $19,714 in mean total annual healthcare costs per sarcoidosis patient. The principle cost drivers were outpatient visits ($9,050 2015 USD, 46%) and inpatient admissions ($6,398, 32%). Relative to controls, sarcoidosis patients had $5,190 (36%) higher total healthcare costs ($19,714 vs $14,524; p?<?0.001). Sarcoidosis patients also had significantly more work loss days (15.9 vs 11.3; p?<?0.001) and work loss costs ($3,288 vs $2,527; p?<?0.001) than matched controls. Sarcoidosis imposes an estimated total direct medical cost of $1.3–$8.7 billion to commercial payers, and an indirect cost of $0.2–$1.5 billion to commercial payers in work loss.

Conclusions: Sarcoidosis imposes a significant economic burden to payers in the first year following diagnosis.     

Bees in the medieval economy: religious observance and the production,trade, and consumption of wax in England,c. 1300–1555

The high and late middle ages saw a significant increase in demand for beeswax, a fundamental component of medieval Christian devotion, spurred by both changing socio‐economic conditions and shifts in religious practice. The vast quantities of wax needed for churches and religious foundations in England drove a thriving international trade spanning from the hinterland of Novgorod to the port of Lisbon, while at the same time encouraging widespread domestic beekeeping. This article considers the impact of supply‐side constraints and increasing demand on wax prices, calculating the cost and quantity of wax purchased by large foundations, parish churches, and individual offerings, to reveal the hitherto underexplored impact of religious consumption on the medieval economy.     

Utilizing a Value of Information Framework to Improve Ore Collection and Classification Procedures

This case study utilizes a value of information decision framework to provide mine managers guidance regarding the purchase of ore grade scanners. LKAB's Kiruna mine produces three types of iron ore to meet long-term contractual agreements on a monthly basis. There is a priori uncertainty regarding the ore type in any given mineable section of the orebody. In addition, there is extracted ore type uncertainty that is introduced by the mining process. These uncertainties are better understood by obtaining more precise (real-time) information. In addition, a better understanding of the uncertainties can improve the quality of operational decisions and increase the overall profitability of the mine. This case study provides a framework for measuring the economic impact of information purchases in a mining context and discusses the implications of those findings.     

Work and Life Integration: Organizational,Cultural, and Individual Perspectives – Edited by Ellen Ernst Kossek and Susan J. Lambert Work‐Life Balance in the 21st Century – Edited by Diane M. Houston

Books reviewed: Work and Life Integration: Organizational, Cultural, and Individual Perspectives edited by Ellen Ernst Kossek and Susan J. Lambert. Lawrence Erlbaum Associates, Mahwah, NJ and London, 2005, xxviii + 570 pp., ISBN 0 8058 4616 6, $42.50, paper. Work‐Life Balance in the 21st Century edited by Diane M. Houston. Palgrave Macmillan, Basingstoke, UK, 2005, xv + 271 pp., ISBN 1 4039 2062 1, £50.00.     

Personality traits,basic individual values and GMO risk perception of twitter users

Abstract

The present study investigates how the most foundational factors to individual differences – personality traits and personal values – affect the perceived safety of genetic modification and their relative importance. Publicly available communication data from 522 Twitter accounts discussing genetically modified foods and their safety was processed in two steps. First, accounts were categorized by the researchers as viewing GM foods as either safe or not safe. Second, using the IBM Watson platform, the Twitter communication data were subjected to lexical analysis to assign scores according to the Five Factor Model for personality traits and Schwartz’s basic individual values to the individual accounts. Logistic regression analyses were performed to determine how perceived GM food safety is linked to personality traits and individual values. Although both traits and values significantly contribute to explaining GM attitudes, personality traits strongly moderate the effect of individual values on risk perception.     

Proposal for a capital market-based guaranty scheme for the financial industry

In this paper, we introduce a capital market-based financial guaranty system as an alternative to current insurance guaranty funds and deposit insurance systems. The guaranty system secures clients’ claims for the event of default by the financial company using a special purpose vehicle which issues bonds to investors. The proposed system, analogous to a credit-linked note, consists of one guaranty vehicle for each financial company. In a first step, we present equations in order to derive the two main input parameters of the special purpose vehicle: the premium and the principal. Subsequently, we analyze the impact of different investment actions taken by the financial companies protected by the guaranty vehicle on various shortfall measures. We find that it will be necessary to restrict the investment volume of investors from the financial industry in order to avoid systematic risk within the proposed guaranty scheme. By deriving practical implications, we show that the capital market-based solution has some key benefits compared to current deposit insurance and insurance guaranty schemes.     

Dancing in the dark: post-trade anonymity,liquidity and informed trading

We analyze the impact of post-trade anonymity on liquidity and informed trading in an order driven stock market. The German stock market introduced the Central Counterparty (CCP) in March 2003 for German equities traded on its anonymous electronic trading platform Xetra leading to a major change in its existing transparency regime. Before the introduction trader IDs were revealed to the counterparties of a trade, with the introduction of the CCP even after the transaction the traders remain anonymous. Previous theoretical and empirical research documents that pre-trade anonymity results in increased liquidity, while results on post-trade anonymity are mixed. We find a significant increase in liquidity measured through a reduction of 25% in implicit transaction costs. We also document that the arrival rate of informed traders is reduced in the anonymous setting. Following recent findings of Bloomfield et al. (J Finan Econ 75:165–199, 2005) that informed traders take on the role of liquidity providers we interpret our findings as indication that informed traders change their behavior in providing liquidity more aggressively in an anonymous environment.     

A performance analysis of participating life insurance contracts

Traditional life insurance products, in particular participating life insurance contracts, are often criticized. Their performance is often said to be poor compared to other investment alternatives. Interestingly, this perception appears to persist although very little research has been conducted into the performance of participating life insurance contracts. But are participating life insurance contracts actually bad for policyholders? We conduct a performance analysis based on contracts offered in the German market, in order to provide evidence to support decision making by policyholders.     

US Families 2025: In search of future families

Parenting defines and cultivates gender roles for men and women, from both biological and cultural angles. From scanning the latest trends, issues, and social pulses on parenting, families and the gender roles encapsulated, it is evident that changes are taking place: dual-income families, a health insurance crisis, family-work conflicts, bioengineering, same-sex marriage, and increasing health concerns — just some of the issues — are changing in the US, while families and gender roles are being shaped and reshaped in the process. In this article, four alternative future scenarios generate implications that challenge mainstream assumptions about the future of parenting and reveal possibilities for future male and female roles. Four scenarios (Mr. & Mrs. Right Now, Marriage Marketplace, The New Waltons for the 21st Century, and Desperate Housewives) emerged from an informal workshop held at the University of Houston, Clear Lake (UHCL) February 19, 2005.