Healthcare resource utilization among commercially insured patients with cold agglutinin disease in the United States

Abstract

Aims: Cold agglutinin disease (CAD) is a rare subtype of autoimmune hemolytic anemia associated with increased thromboembolism risk and early mortality. Healthcare resource utilization (HRU) in CAD has not been reported. We aimed to compare HRU of patients with CAD with a matched non-CAD cohort in the United States.

Materials and methods: Patients with CAD were identified from 2006 to 2016 in the Optum-Humedica database using CAD terms in clinical notes and hematologist review. Patients were required to have Integrated Delivery Network records and ≥6 months’ follow-up before and after the first CAD mention date (index date). Patients with CAD were matched to a non-CAD cohort based on demographics. Multivariate analyses assessed inpatient hospitalizations, outpatient visits, emergency room visits, and transfusion use between cohorts 6 months before and 12 months after the index date.

Results: Of 814 patients with CAD, 410 met inclusion criteria and were matched to 3,390 patients without CAD. Mean age of patients with CAD was 68.0 years; approximately 62% were female. In the 12 months after the index date, mean inpatient hospitalizations (0.83 vs. 0.25), outpatient visits (17.26 vs. 6.77), emergency room visits (0.55 vs. 0.32), and transfusion days (1.05 vs. 0.05) were higher for patients with CAD than the matched non-CAD cohort (all p?<?.0001). Similarly, in the 6 months before the index date, patients with CAD had higher HRU than matched patients without CAD for all measures evaluated.

Limitations: Results of this study are based on patient information from the Optum-Humedica database, which is limited to commercially insured patients and may not represent the overall CAD population.

Conclusions: CAD places a substantial burden on patients and healthcare systems. In addition, the high HRU for patients with CAD observed in the 6 months before diagnosis indicates that disease awareness and better diagnostic practices may be needed.     

Diffusion of mobile telephony in India: An empirical study

Diffusion of new technology is an important driver of economic growth. In this paper, diffusion of mobile telephony in India is studied. There is a vast diffusion potential in this country which needs to be exploited efficiently and in a rational way. This paper investigates the social, technological, economical and political (STEP) factors that have influenced the diffusion process of mobile telephony especially the diffusion speed. The epidemic model, which is widely employed in the diffusion studies of mobile telephony, is used for the study. The data is fitted into logistic, gompertz, and bass models by nonlinear least squares and it is found that gompertz model best describes the diffusion process of mobile telephony in India. The study reveals that competition and government intervention played a significant role in accelerating the diffusion speed of mobile telephony by making the technology affordable. It is found that mobile telephony is a substitute for fixed line telephony in India. The findings will be useful in taking managerial decisions with respect to factors in forecasting and controlling the diffusion process of emerging technologies.     

The Indian broadband plan: A review and implications for theory

Given the benefits of ubiquitous broadband deployment and availability that include economic growth, participation in the Internet economy and increased competitiveness, several countries have launched major national initiatives to accelerate broadband deployment including supporting such initiatives often as a part of their fiscal stimulus plans. These include Afghanistan, Australia, Brazil, India, Japan, New Zealand, South Korea, Singapore, Sweden, UK and USA and the European Union as a whole.     

The performance implications of power–trust relationship: The moderating role of commitment in the supplier–retailer relationship

The current research examines how coercive power and non-coercive power affect trust and how these relationships are affected by affective and calculative commitment. It also expands the understanding of the role of an under-researched dimension of performance, i.e., strategic performance, and studies it as a mediating variable in the relationship between trust and financial performance. The proposed model is empirically tested using Partial Least Squares (PLS) in supplier–retailer channel in Taiwan. The findings reveal that affective commitment has a positive moderating effect on the negative relationship between coercive power and trust, while calculative commitment has a negative moderating effect on the positive relationship between non-coercive power and trust. The results also indicate that strategic performance partially mediates the effect of trust on financial performance. The research advances theoretical understanding on the complex power–trust relationship and provides insights into the role of commitment in both enabling and undermining channel relationships. The findings highlight the importance of building affective commitment in channel relationships and the critical role of strategic performance in the trust–financial performance relationship.     

Business travellers' connections to home: ICTs supporting work‐life balance

This paper examines the role of information communication technology in enabling connections to home for work‐related travellers. Although digital connectivity for work‐related tasks are well researched, the use of digital technology for home communication is under‐researched. The study draws on a qualitative study of UK‐based organisations and business travellers to explore how these travellers use ICTs for personal use while ‘on the move’. The findings reveal that organisations are supportive of work‐life balance for employees, but fail to consider specific needs of those whose work takes them away from home. For business travellers, insights are gained into practices around connecting to home and the value of this virtual presence for relationships with family while absent and work‐life balance. The study identifies and discusses practice occurring around three activities; checking in, maintaining relationships with home and sharing experiences.     

Sell on the news: Differences of opinion,short-sales constraints,and returns around earnings announcements

Miller [1977. Risk, uncertainty, and divergence of opinion. Journal of Finance 32, 1151–1168] hypothesizes that prices of stocks subject to high differences of opinion and short-sales constraints are biased upward. We expect earnings announcements to reduce differences of opinion among investors, and consequently, these announcements should reduce overvaluation. Using five distinct proxies for differences of opinion, we find that high differences of opinion stocks earn significantly lower returns around earnings announcements than low differences of opinion stocks. In addition, the returns on high differences of opinion stocks are more negative within the subsample of stocks that are most difficult for investors to sell short. These results are robust when we control for the size effect and the market-to-book effect and when we examine alternative explanations such as financial leverage, earnings announcement premium, post-earnings announcement drift, return momentum, and potential biases in analysts’ forecasts. Also consistent with Miller's theory, we find that stocks subject to high differences of opinion and more binding short-sales constraints have a price run-up just prior to earnings announcements that is followed by an even larger decline after the announcements.     

Inflation and Default Dynamics

Changes in inflation, particularly if they are sharp, can have important consequences for nominal contracts, especially debt instruments such as fixed-rate bonds. This paper examines the intricate dynamics of inflation and defaults. The experience of the United States during the past four decades is subjected to empirical analysis to examine how the nature of the relationship changed as we shifted from a high inflation to a low inflation regime. The paper is organized as a three-part study. We initially examine the U.S. default experience, as summarized in Moody's speculative grade default rate, along with industry differences. The paper then scrutinizes U.S. inflation dynamics as seen in different summary measures of the general price level and delves into pricing power issues. The study proceeds to examine co-movements in the inflation and default series from a theoretical and empirical standpoint and the results confirm the intuitive postulate: higher the inflation rate, the more pricing power companies have; greater pricing power leads to, better earnings and repayment abilities for firms and a lower incidence of defaults.     

Project Assistance versus Budget Support: An Incentive-Theoretic Analysis of Aid Conditionality

Foreign aid is conveyed predominantly in the form of project assistance, rather than general budgetary support for the recipient government. Most theoretical explanations of this phenomenon center on the possibility of a divergence of preferences, or opinions, between donor and recipient. Projects or conditional transfers, rather than “cash”, may then be ways by which donors align the recipients’ incentives more closely with their own preferences. This paper proposes an alternative, complementary, explanation, based on information asymmetries between voters in donor nations, and their aid agency administrators. If voters are uncertain about the “type” of their administrator agent, who is better informed about the efficacy of alternative policies, then project assistance may be chosen, even when budget support provides a more efficient alternative. JEL no. F35, O19, D82     

CDS contract initiations: REIT board monitoring and corporate decision outcomes

In this article, we investigate whether the negative creditor governance shock due to the initiation of credit default swap (CDS) contracts results in monitoring substitution effects between bondholders and shareholders. Using several mechanisms to test increased shareholder monitoring such as board structure, CEO–chair duality, and institutional ownership, we show that shareholder monitoring increases post-CDS contract initiation. We examine board decision outcomes and show that incentive compensation is higher for real estate investment trusts (REITs) post-CDS initiation. Furthermore, we find that post-CDS initiation, REITs undertake more acquisitions that are more likely to be paid for with stocks and take longer to complete than non-REITs. Finally, we find that REITs industry-adjusted cash holdings and dividend yield increases post-CDS initiation.     

The determinants and consequences of across-the-board trade restrictions in the U.S. economy

This paper examines the effect of macroeconomic fluctuations in the determination of across-the-board trade restrictions in the U.S. economy.

The empirical results reported show that generalized trade intervention is most immediately affected by wealth transfer abroad through the trade balance and not by a slowing in employment growth. Furthermore, trade restrictions are associated with a decline in the stock market and aggregate employment.