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31.
Maureen J. Lage Kristina S. Boye Jay Patrick Bae Jianmin Wu Reema Mody Fady T. Botros 《Journal of medical economics》2019,22(5):447-454
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. 相似文献
32.
Performance lies arise both from individual and from situational causes, but in this article, the attention is on situational causes. These are generally triggered by loyalty to the coalition, which is expressed through the continued use of performance lies. Because performance lies help create a boundary around the coalition that insulates its activities from top management, performance lies enable members of the coalition to exercise a greater degree of internal control. Naturally, such lies are dysfunctional, resulting in the avoidance of difficult issues and problems and compromising the organization's ability to adapt to a changing environment based on accurate information. 相似文献
33.
34.
Elias J. Jabbour Martin F. Mendiola Melissa Lingohr-Smith Jay Lin Dinara Makenbaeva 《Journal of medical economics》2013,16(11):1113-1118
AbstractObjective: To develop an economic model to evaluate changes in healthcare costs driven by restricting usage of branded tyrosine kinase inhibitors (TKIs) through substitution with generic imatinib among chronic myeloid leukemia (CML) patients in a typical Oncology Care Model (OCM) practice, and examine the impact on Performance-Based Payment (PBP) eligibility.Methods: An Excel-based economic model of an OCM practice with 1,000 cancer patients during a 6-month episode of care was developed. Cancer types and proportions of patients treated in the practice were estimated from an OCM report. All-cause healthcare costs were obtained from published literature. It was assumed that if a practice restricts usage of branded TKIs for newly-diagnosed CML patients, 80% of the market share of branded imatinib and 50% of the market shares of 2nd-gen TKIs would shift to generic imatinib. Among established TKI-treated patients, it was assumed that 80% of the market share of branded imatinib and no patients treated with 2nd-gen TKIs would shift to the generic.Results: Four CML patients were estimated for a 1,000-cancer patient OCM practice with a total baseline healthcare cost of $51,345,812 during a 6-month episode. If the practice restricts usage of branded TKIs, the shift from 2nd-gen TKIs to generic imatinib would reduce costs by $12,970, while shifting from branded to generic imatinib lowers costs by $25,250 during a 6-month episode. Minimum reductions of $3,013,832 in a one-sided risk model and $2,372,010 in a two-sided risk model are required for PBP eligibility; the shift from 2nd-gen TKIs to generic imatinib would account for 0.4% and 0.5% of the savings required for a PBP, respectively.Conclusions: This analysis indicates that the potential cost reduction associated with restricting branded TKI usage among CML patients in an OCM setting will represent only a small proportion of the cost reduction needed for PBP eligibility. 相似文献
35.
We analyze both theoretically and empirically, the effect of aid volatility and its interaction effect with institutional quality on per capita economic growth. Our theoretical model, in which an aid-recipient government, operating in an institutional environment of some given quality (making choices over the distribution of aid), predicts that a negative effect of aid volatility on growth is mitigated by stronger institutional quality. We use panel data covering the period 1984–2004 for 78 countries to test this theoretical prediction. Using Generalised Methods of Moments (GMM) we find the relationship between growth and aid volatility is significantly negative and depends on institutional quality. Our baseline results are robust to various computations of aid volatility and foreign aid, time periods, sub-samples and additional covariates. 相似文献
36.
John C. Beghin Barbara El Osta Jay R. Cherlow Samarendu Mohanty 《Contemporary economic policy》2003,21(1):106-116
The article analyzes the welfare cost of the U.S. sugar program using a multimarket model of U.S. sweetener markets. The latter includes raw crops, sugar extraction and refining, and sweetener users (food-processing industries and final consumers). The authors address the industrial organization of food industries using sweeteners and treat the United States as a large importer. With the removal of the program, this article estimates (all figures in 1999 dollars) that in 1998 cane growers, sugar beet growers, and processors would have lost $307, $650, and $89 million, respectively; sweetener users would have gained $1.9 billion. World prices would have increased by 13.2%. The deadweight loss of the program is estimated at $532 million. 相似文献
37.
这是公司发展史上策划最周详的过渡之一.两年前,微软公司董事长比尔·盖茨宣布,他将放手在这家他与别人共同创建的公司的日常管理责任,把更多的时间投入慈善事业.从那以后,盖茨和微软公司首席执行官史蒂芬·巴尔默提拔了那些将会接替盖茨,为微软公司开发技术、战略和远景的人. 相似文献
38.
39.
Using a difference-in-differences estimation framework and state-level data, we investigate the potential role of HIV/AIDS in contributing to declining abortion utilization in the United States. Our results suggest that the perceived risk of HIV contraction negatively affected unwanted pregnancies. Specifically, a 10% increase in HIV incidence is associated with 0.34–1.1% fewer abortions per live births, an effect that can account for at least one-tenth of the sharp decline in abortions observed from the early 1980s to mid-1990s. 相似文献
40.
Jay S. Coggins 《Review of Industrial Organization》1995,10(3):339-359
From 1963 to 1989, the International Coffee Agreement controlled world trade in coffee. Like an export cartel, the organization included coffee exporters and importers as members. This paper seeks to understand the behavior of the ICA by treating it as an optimizing entity, which from social choice theory we know to be inherently troublesome. A social choice rule is specified for the ICA that is virtually implementable in Nash equilibrium. The empirical results provide arationalizing argument for the ICA, in the sense that if it sought to maximize the specified criterion function, we would expect it to behave precisely as it did behave. 相似文献