Economic evaluation among Chinese patients with nosocomial pneumonia caused by methicillin-resistant staphylococcus aureus and treated with linezolid or vancomycin: a secondary,post-hoc analysis based on a Phase 4 clinical trial study

Objective:

To assess cost-effectiveness of linezolid vs vancomycin in treating nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA-NP) in China and the impact of renal failure on healthcare resource utilization (HCRU) and costs.

Methods:

Cost-effectiveness analysis was conducted based on data from the ZEPHyR trial, with efficacy measured by treatment success and costs calculated from HCRU. Confidence intervals (CI) for cost, efficacy and incremental cost-effectiveness ratios (ICER) were calculated by non-parametric bootstrap. Chi-square test was used for renal failure rate and t-test for HCRU/cost comparisons. Impact of renal failure was assessed using regression model.

Results:

Data from 448 patients (1:1 linezolid:vancomycin) were analyzed. More patients treated with linezolid achieved success (55% [95% CI?=?48–62%]) than with vancomycin (45% [38–52%]). Treatment cost were ¥79,551 (95% CI?=?¥72,421–¥86,680) for linezolid vs ¥77,587 (¥70,656–¥84,519) for vancomycin in Beijing, ¥90,995 (¥82,598–¥99,393) vs ¥89,448 (¥81,295–¥97,601) in Guangzhou, ¥82,383 (¥74,956–¥89,810) vs ¥80,799 (¥73,545–¥88,054) in Nanjing and ¥59,413 (¥54,366–¥64,460) vs ¥57,804 (¥52,613–¥62,996) in Xi’an. Per successful treatment, the ICER of linezolid over vancomycin were ¥19,719

(?¥143,553 to ¥320,980) (Beijing), ¥15,532 (?¥185,411 to ¥349,693) (Guangzhou), ¥15,904 (?¥161,935 to ¥314,987) (Nanjing) and ¥16,145 (?¥100,738 to ¥234,412) (Xi’an). From simulations, the majority of linezolid cases had greater efficacy and higher costs and more than one third had greater efficacy and lower costs. More vancomycin patients developed renal failure (15% vs 4%, p?<?0.001). Patients with renal failure had higher cost (Nanjng: ¥100,449 (SD?=?¥65,080) vs ¥74,944 (SD?=?¥49,632), p?=?0.002).

Conclusion:

Linezolid was more cost-effective than vancomycin in treating MRSA-NP from a Chinese payer’s perspective, and associated with less renal failure, HCRU and cost.     

Accounting for Varying Setting Preferences Among Moose Hunters

Recreation planners and managers realize the importance of different tastes and preferences among recreationists. This fact is explicit in recreational planning efforts and in the theories developed to understand recreational behaviors. While market segmentation approaches steeped in behavioral theory provide a rich source of information to planners and managers, we argue that such exogenous market segmentation approaches alone are insufficient to understand the degree of variability in tastes and preferences among recreationists. In this paper we employ a random parameters logit model to account for both the extent and sources of heterogeneity in preferences among recreationists. We illustrate the random parameters logit choice model with an application to the stated choices for hunting sites by moose hunters from northwestern Ontario. The application shows that the random parameters logit represents a considerable improvement over multinomial logit models based on market segmentation approaches.     

The effect of health,cosmetic and social antismoking information themes on adolescents’ beliefs about smoking

The paper examines the effect of long-term health-related and short-term social and physical antismoking information on adolescents’ beliefs about smoking. Findings from a UK school-based study indicate that antismoking information about the short-term effects of smoking, such as cosmetic (e.g. yellow teeth and fingernails and smelly clothes) and fitness, have a greater impact on beliefs than long-term health-related information. The implications for the design of antismoking campaigns are explored.     

Pakistan's agricultural exports,determinants and its potential: an application of stochastic frontier gravity model

The most important and imperative objective of the developing nations is rapid economic growth and exports are generally considered as an engine for economic growth. Being an agro-based economy, agriculture exports play pivotal role not only in economic growth but also in socioeconomic uplifting. This study aims at evaluating main determinants of agricultural exports of Pakistan by applying stochastic frontier gravity model over the period of 1995–2014 for a sample of 63 countries. In addition, the study also analyzes whether there is any untapped export potential between Pakistan and the trading partners in agriculture sector. The results confirm the consistency of gravity model for agriculture exports of Pakistan. Likewise, the estimates also point out that bilateral exchange as well as tariff rates also effect agriculture exports. The study has also incorporated the effect of common border, common culture, colonial history and preferential trading agreements by including their respective dummies. The study confirms the significance of each factor, except common language, with their respective magnitude. Moreover, technical efficiency estimates reveal that Pakistan has great export potential with neighboring, Middle Eastern and European countries.     

Government Revenue and Child and Maternal Mortality

Open Economies Review - Most maternal and child deaths result from inadequate access to the critical determinants of health: clean water, sanitation, education and healthcare, which are also among...     

Does education reduce homicide? A panel data analysis of Asian region

Quality & Quantity - Education may play an active role in enhancing the abilities of people. It does not only help in training for the professional field but is one of the most influential ways...     

Can a path to peace promote export growth? Evidence from Pakistan and its trading partners

Quality & Quantity - This study has investigated the connection between peace and performance of Pakistan’s export sector. The interstates conflicts, terrorist activities and war elements...     

Unexplained gaps and Oaxaca–Blinder decompositions

We analyze four methods to measure unexplained gaps in mean outcomes: three decompositions based on the seminal work of Oaxaca (1973) and Blinder (1973) and an approach involving a seemingly naïve regression that includes a group indicator variable. Our analysis yields two principal findings. We show that the coefficient on a group indicator variable from an OLS regression is an attractive approach for obtaining a single measure of the unexplained gap. We also show that a commonly-used pooling decomposition systematically overstates the contribution of observable characteristics to mean outcome differences when compared to OLS regression, therefore understating unexplained differences. We then provide three empirical examples that explore the practical importance of our analytic results.     

基于部分加密XML文档的访问控制研究

作为在Internet上信息表示、传输和存储的标准,XM L在W eb上得到越来越广泛的应用。利用X M L作为访问控制的表达形式将会使得系统具有良好的灵活性和可操作性。文章提出了一种基于XM L数据加密技术和依据访问控制规则建立关系表访问技术的X M L数据文档访问控制方案。     

Corporate social responsibility and bank liquidity creation

Under the stakeholder theory hypothesis, reputable corporate social responsibility (CSR) banks are expected to attract more loans and deposits, which in turn strengthens their ability to create liquidity. Our findings support this view. Further analyses reveal that the positive effect of CSR on liquidity creation differs depending on bank size, bank capital, and type of financial crisis. In addition, deposit growth, loan growth, lending rate, and funding rate are potential channels through which CSR influences bank liquidity creation. The findings are not driven by an endogeneity issue.