The association between the severity of chronic kidney disease and medical costs among patients with type 2 diabetes

Aims: Examine healthcare costs across chronic kidney disease (CKD) stages for US patients with type 2 diabetes (T2D).

Materials and methods: IQVIA Real World Data Adjudicated Claims linked electronic medical records and insurance claims from January 1, 2012 through March 31, 2017 were used for this retrospective study. Adults diagnosed with T2D and comorbid CKD were included. General linear models incorporating splines were constructed, and information from these regressions were used to inform the relationship between medical costs and CKD. Multivariable analyses controlled for patient characteristics, vital signs, general health, prior medication use, prior visit to specialists, index A1c, and year of index date.

Results: There were 6,645 individuals who met the study criteria. Results generally indicate sharp increases in annual total medical costs and non-drug medical costs in the 1?year post-period for patients with Stage 4 or 5 CKD (estimated glomerular filtration rate [eGFR]?≤?30?mL/min/1.73 m²) with each 1 point reduction in eGFR from 30 associated with an increase of $1,870 in all-cause total medical costs (p?<?0.0001) and $1,805 of all-cause non-drug medical costs (p?<?0.0001). Similarly, each point decline below 30?mL/min was associated annual cost increases of $1,701 for CKD-related total medical costs, $1,695 for CKD-related non-drug medical costs, $173 for diabetes-related medical costs, and $187 for diabetes-related non-drug medical costs (all p?<?0.0001).

Limitations: The investigation included only patients with medical insurance and laboratory test results, and results may not be generalizable to all T2D patients with CKD. The methodology allowed us to determine associations, not causation, and potential confounders, such as duration of diabetes, diet, exercise, or social support, could not be assessed.

Conclusions: Results indicate there are sharp and significant increases in medical costs among T2D patients with Stage 4 and 5 CKD compared to those with earlier stages of CKD.     

India's Economic Reforms: Achievements and Next Steps

This paper reviews the impact of India's reforms since 1991 on the performance of the Indian economy. It shows that the reforms definitely achieved a significant acceleration in growth and they also succeeded in reducing poverty. However, they have been less successful in generating good quality jobs. There was progress in providing better access to education, health services ,and clean drinking water and sanitation, but less than was hoped. The area where performance has been most disappointing is environmental sustainability. The paper concludes by identifying some of the critical policy challenges in the years ahead.     

Teaching courses in macroeconomics and monetary policy with Bloomberg analytics

In this article, the authors illustrate the use of Bloomberg for analyzing topics in macroeconomics and monetary policy in economics and finance courses. The hands-on experience that students gain from such a course has many benefits, including deeper learning and clearer understanding of data. The authors describe goals and learning objectives, then compare Bloomberg with Federal Reserve Economic Data (FRED). In addition, they provide examples of how to use Bloomberg in the classroom, describe how to have students perform sector analysis, show how Bloomberg tools are useful for analyzing monetary policy, discuss how to use Bloomberg to analyze the financial sector, and illustrate the platform’s use in a case study.     

The Canadian productivity stagnation, 2002–2014

Total factor productivity (TFP) growth in Canada between 2002 and 2014 has been only 0.16% per year. This figure is substantially smaller than that of the United States, or that of Canada in the past. We perform multiple counterfactual exercises to show that this small TFP growth cannot be accounted for by several compositional effects or mismeasurements of factors of production. We identify two key sectors (mostly Mining and to a lesser extent Manufacturing) that drive all of the TFP growth difference with the United States. Despite the lack of TFP growth, Canada has experienced sustained income growth due to a prolonged period of appreciation of the terms of trade (while US terms of trade have deteriorated), making real income in the two countries grow at similar rates.     

Anticorruption reforms,tax evasion,and the role of harassment

We examine the impact of anticorruption reforms on tax evasion when corruption and potentially harassment are endemic among tax auditors. We find that the threat of harassment may counterintuitively boost the impact of such anticorruption reforms on tax evasion and also eliminate corruption. Specifically, a moderate anticorruption policy can discontinuously reduce tax evasion to a level even below that under no corruption. Further strengthening of such policy can nonetheless prove counterproductive and increase tax evasion. On the contrary, in the absence of harassment, a moderate anticorruption reform induces higher tax evasion and sustenance of bribery. In this case, only a large reform can reduce tax evasion and eliminate corruption.     

Corporate social responsibility,vertical product differentiation and international competition

Would a foreign firm’s consumer‐oriented corporate social responsibility (CSR) activities be rewarded by an importing country’s voluntary tariff reduction? The current paper addresses this question in an import‐competing duopoly model with vertical product differentiation. It is shown that the tariff will decrease if the foreign firm switches from a purely profit‐driven firm to a CSR firm. A consumer‐oriented CSR strategy will always hurt the domestic firm’s profit, whereas the relationship between the foreign firm’s profit and CSR sensitivity (the degree to which a firm cares about consumer welfare) is invertedly U‐shaped. When firms’ decisions to switch to CSR are endogeneized, only the foreign firm will become a CSR firm.     

Determinants of the allocative,cost and scope efficiencies of Indian banks

ABSTRACT

This study aims to investigate the impact of competition on determinants of allocative, scope and cost efficiencies of Indian scheduled commercial banks (SCBs). Specifically, the study, analyzes the impact of the second round of licensing on the efficiency of Indian SCBs. This is the first paper to measure scope efficiency of Indian banks and analyze its determinants. A two-stage analysis is performed on a balanced panel dataset of Indian SCBs for the period 1999–2016. In the first stage, the allocative, cost and scope efficiencies for each bank are estimated following the data envelopment analysis approach. In the second stage, internal determinants of the stated efficiency measures are estimated following the system of the generalized method of moments approach. The findings suggest that competition has not resulted in enhancing the efficiency of Indian SCBs. Among factors that can influence efficiency, it is seen that size does matter. Larger banks can enhance the efficiency of SCBs. It is also seen that having more foreign banks improves the overall efficiency of SCBs. However, before embarking on further rounds of licensing, the study posits that market-driven correction to succeed, it is imperative to address sunspots in the form of investor or borrower repression.     

CASINOS,HOTELS, AND CRIME

This paper examines the links among casinos, hotels, and crime using Indiana's counties for 1994‐2004. In estimating casinos' impacts, I introduce a measure of casino activity in addition to variables related to the timing of casino opening. I test whether or not the number of hotel rooms affects crime rates. Increased casino activity reduces crime rates except for burglary, where crime rates rise after a lag. Leaving out a measure of casino activity appears to create a serious specification error. Finally, including problem crime data plagued by incomplete reporting affects the estimated impact of casinos on crime. (JEL R11, L83)