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31.
    
Objective: This economic analysis extends upon a recent epidemiological study to estimate the association between hypotension control and hospital costs for septic patients in US intensive care units (ICUs).

Methods: A Monte Carlo simulation decision analytic model was developed that accounted for the probability of complications—acute kidney injury and mortality—in septic ICU patients and the cost of each health outcome from the hospital perspective. Probabilities of complications were calculated based on observational data from 110?US hospitals for septic ICU patients (n?=?8,782) with various levels of hypotension exposure as measured by mean arterial pressure (MAP, units: mmHg). Costs for acute kidney injury (AKI) and mortality were derived from published literature. Each simulation calculated mean hospital cost reduction and 95% confidence intervals based on 10,000 trials.

Results: In the base-case analysis hospital costs for a hypothetical “control” cohort (MAP of 65?mmHg) were $699 less per hospitalization (95% CI: $342–$1,116) relative to a “case” cohort (MAP of 60?mmHg). In the most extreme case considered (45?mmHg vs 65?mmHg), the associated cost reduction was $4,450 (95% CI: $2,020–$7,581). More than 99% of the simulated trials resulted in cost reductions. A conservative institution-level analysis for a hypothetical hospital (which assumes no benefit for increasing MAP above 65?mmHg) estimated a cost decline of $417 for a 5?mmHg increase in MAP per ICU septic patient. These results are applicable to the US only.

Conclusions: Hypotension control (via MAP increases) for patients with sepsis in the ICU is associated with lower hospitalization cost.  相似文献   
32.
This article presents statistical evidence which supports Lester Telser's 1960 hypothesis, that when vertical restraints are made illegal, intrabrand competition results which diminishes the provision of point-of-sale, special services. This results because of the public goods problem exhibited by the special services. Increased special service provision by the national manufacturer must then substitute for the special service provision left unfilled by the wholesaler. Evidence relating to the efficacy of such substitution is also presented.  相似文献   
33.
  总被引:2,自引:0,他引:2  
In a two-period duopoly model, this paper considers a foreign firm's choice between licensing and FDI and studies the relative impact of these modes of technology transfer on the incentives for innovation of that firm and its domestic rival. Relative to licensing, FDI limits technology spillovers to the domestic firm but dissipates more rents in the product market. Internalization allows the foreign firm to build on an existing technological advantage. While the local firm develops its best technology if initial licensing is followed by FDI, the foreign firm transfers the most efficient technology under FDI in both periods.  相似文献   
34.
    
A multiphase study involving 1,285 respondents was conducted to answer an important yet overlooked question: for a job requiring frequent informal communication with superiors, should an organization focus more on selecting employees with higher trait‐like willingness to communicate or on providing an environment where the flow of communication is easy and aided? We found support for the latter. Further, we observed that subordinates alter their communication behaviors based on the perception of superior's power, politics in the organization, and their own political skills. The study contributes to a better understanding of how situational variables affect subordinate‐superior upward communication. Implications of the study are also discussed. © 2016 Wiley Periodicals, Inc.  相似文献   
35.
  总被引:1,自引:0,他引:1  
This article looks at desertification — both on a global scale and as it relates to Africa. Desertification is defined here as the diminution or destruction of the biological potential of the land, and is caused basically by overuse of inherently fragile productive systems. After distinguishing between desertification and drought (two closely related ecological hazards), the author goes on to outline the terrible effects of desertification and the impact it has on the world population's ability to feed itself. Finally, recommendations to halt and reverse desertification are looked at together with attempts to mobilize the resources needed to face this global problem.  相似文献   
36.
    
As the outsourced internal audit function (IAF) and real earnings management are attracting widespread attention among firms, it is vital for stakeholders to understand how these two practices affect the quality of financial reporting. This study examines how the expertise of an external IAF provider reduces real earnings management. Using a pooled panel data regression of 928 firm‐observations, we find that the external IAF provider's firm‐specific expertise is significantly associated with lower real earnings management. Conversely, we report no such association for external IAF providers with industry expertise. These findings are robust under a battery of sensitive analyses. The results of additional analyses show that the industry and firm‐specific expertise of external IAF provider interact with each other, resulting in a significant reduction in real earnings management. We also find significant differences in the IAF quality between big4 and second‐tier audit firms in which the latter are associated with lower real earnings management and the former with higher real earnings management. Finally, we observe low real earnings management for important clients and/or those with influential CEOs if the external IAF provider has firm‐specific expertise.  相似文献   
37.
    
We studied how the pursuit of bilateral free‐trade agreements (FTAs) affects the likelihood of achieving multilateral free trade. We derive and compare the stable Nash equilibria of two games of trade liberalization: in the FTA game, each country can either form an FTA with one of its trading partners or both of them or none of them, whereas in the (restricted) No FTA game, purely bilateral FTAs are not permitted. The major result is that there exist circumstances under which the freedom to pursue (discriminatory) bilateral FTAs is necessary for achieving multilateral free trade.  相似文献   
38.
Timing of Entry under Externalities   总被引:1,自引:0,他引:1  
Received August 23, 2000; revised version received May 14, 2001  相似文献   
39.
The welfare impacts of electrification are well documented in the literature, including the effects of electricity on school enrolment. However, the spillover effects of electrification on children's achievement levels are scarce. We use three complementary but distinct econometric models to establish a causal relationship between electrification and test scores using nationally representative household panel data from India. We find positive results irrespective of the choice of econometric model, and these results seem to be mediated by changing time-use patterns of children with access to electricity. We first exploit the plausibly exogenous variation in access to electricity due to a universal electrification program in the state of West Bengal in India and we find positive effects of electrification on children's test scores. By age group, we find that younger cohorts benefit more in terms of their reading scores than older cohorts. Then, to ascertain external validity of these results, we replicate them over a nationally representative sample using fixed effects and instrumental variables estimation and find similar results. At the intensive margin, we find that access to more hours of electricity positively affects test scores. We identify an increase in time spent by children on study-related activities as the potential channel for these results.  相似文献   
40.
This article argues that any analysis of a Phillips curve should include the real interest rate in addition to inflation and real wages as any changes in the interest rate changes the labour–capital input mix in the production process leading to a change in the level of employment in the economy. To justify this argument a Phillips curve model is developed, which includes the real interest rate in addition to inflation and real wages. After the diagnosis of the time series properties of the data, an error correction model is developed and estimated using a set of US annual data from 1948 to 1996. The estimated parameters of the model do suggest that one should really take into consideration of the real interest rate while analysing the Phillips curve. A non-nested test (F-test) also suggests that the Phillips curve model with real interest rate as an additional variable performs better than the conventional method that does not include the real interest rate.  相似文献   
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