Impact of treatment with liposomal bupivacaine on hospital costs,length of stay,and discharge status in patients undergoing total knee arthroplasty at high-use institutions

Aims: Post-surgical pain experienced by patients undergoing total knee arthroplasty (TKA) can be severe. Enhanced recovery after surgery programs incorporating multimodal analgesic regimens have evolved in an attempt to improve patient care while lowering overall costs. This study examined clinical and economic outcomes in hospitals using liposomal bupivacaine (LB) for pain control following TKA.

Methods: This retrospective observational study utilized hospital chargemaster data from the Premier Healthcare Database from January 2011 through April 2017 for the 10 hospitals with the highest number of primary TKA procedures using LB. Within these hospitals, patients undergoing TKA who received LB were propensity-score matched in a 1:1 ratio to a control group not receiving LB. Outcomes included hospital length of stay (LOS), discharge status, 30-day same-hospital readmissions, total hospitalization costs, and opioid consumption; only patients with Medicare or commercial insurance as the primary payer for TKA were considered.

Results: The study population included 20,907 Medicare-insured patients (LB?=?10,411; control =10,496) and 12,505 patients with commercial insurance (LB?=?6,242; control?=?6,263). Overall, LOS was 0.6?days shorter with LB (p?p?P?p?p?Limitations: Costs were estimated using Premier charge-to-cost ratios and limited to goods and services recorded in the chargemaster. Findings from these 10 hospitals may not be representative of other US hospitals.

Conclusions: In a sub-set of 10?US hospitals with the highest use of LB for TKA, LB use was associated with shorter hospital LOS, increased home discharge, lower total hospitalization costs, and decreased opioid use after TKA.     

Time-varying beta: a boundedly rational equilibrium approach

The conditional CAPM with time-varying betas has been widely used to explain the cross-section of asset returns. However, most of the literature on time-varying beta is motivated by econometric estimation using various latent risk factors rather than explicit modelling of the stochastic behaviour of betas through agents’ behaviour, such as momentum trading. Misspecification of beta risk and the lack of any theoretical guidance on how to specify risk factors based on the representative agent economy appear empirically challenging. In this paper, we set up a dynamic equilibrium model of a financial market with boundedly rational and heterogeneous agents within the mean-variance framework of repeated one-period optimisation and develop an explicit dynamic behaviour CAPM relation between the expected equilibrium returns and time-varying betas. By incorporating the two most commonly used types of investors, fundamentalists and chartists, into the model, we show that there is a systematic change in the market portfolio, risk-return relationships, and time varying betas when investors change their behaviour, such as the chartists acting as momentum traders. In particular, we demonstrate the stochastic nature of time-varying betas. We also show that the commonly used rolling window estimates of time-varying betas may not be consistent with the ex-ante betas implied by the equilibrium model. The results provide a number of insights into an understanding of time-varying beta.     

Gender differences in optimism

This article examines gender differences in optimism about the economy. We measure optimism using Swedish survey data in which respondents stated their beliefs about the country’s future economic situation. We argue that this measure of optimism is preferable to common measurements in the literature since it avoids confounding individuals’ economic situation with their perception of the future and it can be compared to economic indicators. In line with previous research, we find that men are more optimistic than women; however, men are also more prone to be wrong in their beliefs about the future economic situation. Furthermore, in sharp economic downturns, the gender differences in optimism disappear. This convergence in beliefs can be explained by the amount of available information on the economy.     

One Bridge,Two Towns and Three Countries: Anticipatory Geopolitics in the Greater Mekong Subregion

The proposed bridge between Chiang Khong and Houay Xay will form the remaining crucial link of the Asian Highway 3, connecting Bangkok to Kunming, a project highly anticipated in the Greater Mekong Subregion's (GMS) development. With China funding half the cost of the bridge, it signifies a strong player in the economic borderland. The article seeks to uncover the locals' thoughts and feelings of the bridge to raise awareness of ‘voices’ from the Thai-Lao border in relation to the further destinations the bridge will serve. The local perceptions of the proposed bridge are used to provide a form of comprehension of anticipatory cross-border geopolitical relations between the Thai-Lao border and China. Drawing on the concepts of critical geopolitics, anti-geopolitics and geoeconomics, it concludes by underscoring the need to listen to local perceptions at the Thai-Lao border as they signal potential ill-feelings that could jeopardise future cross-border geopolitical ties and trade.     

Ethnic Enclavisation and State Formation In Kosovo

there is no abstract     

Effective rates of protection and the Fordney-McCumber and Smoot-Hawley Tariff Acts: comment and revised estimates

This paper provides corrected calculations of the effective rate of protection for a wide disaggregation of US industries under the two important interwar tariff regimes.     

Der Vorsorge-Albtraum

Economic forecasts for the German economy expect German GDP to grow by less than 1% in 2013. The expectations of the industry are better still — only the representatives of the automotive industry think their future growth will not be higher than the German economy on average. The construction industry expects growth of 1.5% for 2013, due to a boom in new residential construction. The chemical industry had to hold its own in a difficult economic environment marked by weak global growth, the public debt and currency crisis in the euro zone, and — connected with this — the recession in Southern Europe. According to the recent outlook of the ZVEI, production (adjusted for price) of the German electrical and electronic industry will grow by 1.5% in 2013. Despite a difficult economic environment, the VDMA economists expect further growth in production for machinery and plant manufacturers of 2% in real terms for 2013. The main impulses will likely be set by foreign demand, especially from non-EMU member states.     

CEO risk incentives and firm performance following R&D increases

In this study we analyze how CEO risk incentives affect the efficiency of research and development (R&D) investments. We examine a sample of 843 cases in which firms increase their R&D investments by an economically significant amount over the period of 1995–2006. We find that firms with higher sensitivity of CEO compensation portfolio value to stock volatility (vega) are more likely to have large increases in R&D investments. More importantly, we find that high-vega firms experience lower abnormal stock returns and lower operating performance compared to their low-vega counterparts following the R&D increases. Our main results hold in a variety of robustness tests. The results are consistent with the conjecture that high-vega compensation portfolios may induce managers to overinvest in inefficient R&D projects and therefore hurt firm performance.     

Johannes Karup

Abstract

J. G. Kyd &; G. H. Maddex: Some Actuarial Aspects of Unemployment Insurance. Tvungen Arbejdsløshedsforsikring indførtes i Storbritannien ved Part II of the National Insurance Act 1911, omfattende et begrænset Antal Fag og ca. 2 ¼ Mill. Personer. Under Krigen var Arbejdsløshed ukendt, men da det kunde ventes, at Krigens Ophør vilde føre til stor Arbejdsløshed, blev Rammerne for Arbejdsløshedsforsikringen i 1916 udvidet til at omfatte Ammunitionsarbejderne. En storstilet Statsunderstøttelse udover Forsikringen bevirkede, at Arbejdsløshedsfonden kunde vedblive at vokse, saaledes at man endog i 1919 knnde forhøje de normale Ydelser fra de oprindelige 7 s. til 10 s. om Ugen, uden at forhøje Bidragene.     

A Comparison of Decision Criteria for Capital Investment Decisions

Capital investment decisions, at least the quantitative portion, are usually based on one of several possible decision criteria. The analysis and calculations required to base the capital investment decision on one criterion only require a relatively small extension to allow the decision to be based, or at least compared, on several decision criteria. This paper analyzes seven capital investment decision criteria, including six objective and one subjective one, and illustrates how a typical capital investment problem can be analyzed on the basis of the seven decision criteria. Computer simulation is used to determine the outcomes of the hypothetical capital investment projects.