Income smoothing behavior of U.S. banks under revised international capital requirements

The use of the loan-loss provision to smooth reported income by large bank holding companies is a much-investigated practice. To the extent that the variability of net income is a measure of risk, income smoothing may reduce the perceived riskiness of the bank and thus increase stock value. Managers may have added incentive to smooth income in response to the structure of their compensation package. The Basel Accord of 1988 phased in new definitions of regulatory capital for banks. These changes have increased the incentives for income smoothing. Most previous studies on income smoothing and loan-loss reserves predate the implementation of the Basel Accord. Others use data that include the transition period. This study revisits the subject, using only post-Accord data. Results of this study are compared with previous results. The evidence confirms the continued existence of income smoothing and supports the proposition that banks have become more aggressive in using loan-loss reserves as a tool for income smoothing.     

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study

Aims: This study investigated annual medical costs using real-world data focusing on acute heart failure.

Methods: The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed.

Results: On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1?day, medical expenses increased by 6.7%.

Limitations: Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated.

Conclusion: It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.