Background: Sarcoidosis is a multi-system inflammatory disorder characterized by the presence of non-caseating granulomas in involved organs. Patients with sarcoidosis have a reduced quality-of-life and are at an increased risk for several comorbidities. Little is known about the direct and indirect cost of sarcoidosis following the initial diagnosis.Aims: To provide an estimate of the healthcare resource utilization (HCRU) and costs borne by commercial payers for sarcoidosis patients in the US.Methods: Patients with a first diagnosis of sarcoidosis between January 1, 1998 and March 31, 2015 (“index date”) were selected from a de-identified privately-insured administrative claims database. Sarcoidosis patients were required to have continuous health plan enrollment 12 months prior to and following their index dates. Propensity-score (1:1) matching of sarcoidosis patients with non-sarcoidosis controls was carried out based on a logistic regression of baseline characteristics. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched groups over the 12-month period following the index date (“outcome period”).Results: A total of 7,119 sarcoidosis patients who met the selection criteria were matched with a control. Overall, commercial payers incurred $19,714 in mean total annual healthcare costs per sarcoidosis patient. The principle cost drivers were outpatient visits ($9,050 2015 USD, 46%) and inpatient admissions ($6,398, 32%). Relative to controls, sarcoidosis patients had $5,190 (36%) higher total healthcare costs ($19,714 vs $14,524; p?0.001). Sarcoidosis patients also had significantly more work loss days (15.9 vs 11.3; p?0.001) and work loss costs ($3,288 vs $2,527; p?0.001) than matched controls. Sarcoidosis imposes an estimated total direct medical cost of $1.3–$8.7 billion to commercial payers, and an indirect cost of Background: Sarcoidosis is a multi-system inflammatory disorder characterized by the presence of non-caseating granulomas in involved organs. Patients with sarcoidosis have a reduced quality-of-life and are at an increased risk for several comorbidities. Little is known about the direct and indirect cost of sarcoidosis following the initial diagnosis.
Aims: To provide an estimate of the healthcare resource utilization (HCRU) and costs borne by commercial payers for sarcoidosis patients in the US.
Methods: Patients with a first diagnosis of sarcoidosis between January 1, 1998 and March 31, 2015 (“index date”) were selected from a de-identified privately-insured administrative claims database. Sarcoidosis patients were required to have continuous health plan enrollment 12 months prior to and following their index dates. Propensity-score (1:1) matching of sarcoidosis patients with non-sarcoidosis controls was carried out based on a logistic regression of baseline characteristics. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched groups over the 12-month period following the index date (“outcome period”).
Results: A total of 7,119 sarcoidosis patients who met the selection criteria were matched with a control. Overall, commercial payers incurred $19,714 in mean total annual healthcare costs per sarcoidosis patient. The principle cost drivers were outpatient visits ($9,050 2015 USD, 46%) and inpatient admissions ($6,398, 32%). Relative to controls, sarcoidosis patients had $5,190 (36%) higher total healthcare costs ($19,714 vs $14,524; p?<?0.001). Sarcoidosis patients also had significantly more work loss days (15.9 vs 11.3; p?<?0.001) and work loss costs ($3,288 vs $2,527; p?<?0.001) than matched controls. Sarcoidosis imposes an estimated total direct medical cost of $1.3–$8.7 billion to commercial payers, and an indirect cost of $0.2–$1.5 billion to commercial payers in work loss.
Conclusions: Sarcoidosis imposes a significant economic burden to payers in the first year following diagnosis. 相似文献
The System of Rice Intensification (SRI) is claimed to be a novel approach to rice cultivation that is both more productive and more sustainable than conventional methods. Such claims have been challenged or dismissed by many rice scientists, however. Despite the lack of clear and unequivocal endorsement by science, SRI seems to have spread widely and rather quickly to many rice-growing regions, including various areas of India. This paper discusses how and considers why SRI seems to have attracted the support of diverse stakeholders in Indian rice farming. As such, the SRI phenomenon should be taken seriously. Nevertheless, many scientific questions remain to be answered, concerning the biophysical mechanisms involved in SRI and their effects on plant performance and crop yields, the true spread of SRI practices among farmers and the system’s impacts on farm livelihoods, rice production and resource use. Indian enthusiasm for SRI implies a level of dissatisfaction with conventional approaches to rice intensification and a demand for new methods that can address the perceived problems and challenges of agriculture in the future. 相似文献
Under less restrictive assumptions than in previous contributions, this paper highlights various patterns of profit rate dynamics that are common to the countries under scrutiny. Without a substantial re-distribution of income in favour of profits, the profit rate declines. When labour productivity is weak the profits/wages ratio declines leading to a decline in the profit rate, also due to capital deepening. Developments in the capital-labour ratio tend to increase the organic composition of capital while those in the ratio between the capital price deflator and the average wage tend to decrease it. Falls in the profit rate took place in countries with a weak technological change with episodes of Marxian bias. Employment shifted from low to high capital intensity sectors, from low to high organic composition industries and from low to high productivity sectors. Rising strength of labour and realization failures tend to have a greater role than rising organic composition in cyclical profit rate dynamics. Over the cycle, the first mechanism is also the first one to show up, while the others tend to follow it. Theoretical and policy implications are offered. 相似文献
This paper presents a study of how companies in New Zealand's electricity and gas retail sector communicate their Corporate Environmental Citizenship (CEC) on the World Wide Web. The natural environment is the focal issue for analyzing the way these companies present their commitment to the community and society in general, for two reasons. First, concern for and management of the natural environment is one of the most important social issues facing corporations. Second, prior empirical studies of corporate communication of social responsibility initiatives have investigated the extent and content of these messages without focusing on a particular issue. A content analysis of the web pages of 18 companies in an environmentally sensitive industry was chosen to investigate which environmental issues and stakeholder groups are given priority and how companies' attitudes to stakeholders and relationships with them are described. The results demonstrate an instrumental reformist moral position underlying their online communications. This philosophy was present in the environmental issues most frequently mentioned and in the principles motivating their Corporate Environmental Citizenship activities. While the majority of companies presented their environmental initiatives on their web sites, most did not employ interactive features to encourage dialogue with stakeholders and enhance these relationships. 相似文献
ABSTRACTThe current paper offers a new conceptual model to understanding innovation processes in professional service firms, to make hidden relationships more explicit and to find out what are the issues still unexplored. The paper employs a systematic literature review, and draws upon original categorizations of extant literature, to identify main processes for each category of PSFs. It unveils connections among a wide range of factors setting a conceptual model for innovation pathways and highlighting neglected questions relevant from both the theoretical and the practical perspectives. 相似文献
Dynamic changes in the business environment are significantly impacting supply chain logistics, resulting in unprecedented personnel demands. Organizational theorists suggest that personnel management is associated with better performance. However, relatively little is known about effective human resource practices within the logistics industry. The learning organization concept offers logistics organizations a theoretical rationale for promoting learning environments to better leverage employees' knowledge, skills, and abilities and improve performance. This research examines logistics managers' perceptions of individual level learning behavior within their organizations and its relationship to firm performance. 相似文献
In this paper we present an overview of GDP and productivitygrowth patterns in OECD countries over the past decade, on thebasis of harmonized data. Our evidence suggests that fast-growingcountries generally shared three characteristics: improvementsin labour utilization; a generalized enhancement in human capital;and rapid shifts in the composition of physical capital towardsinformation and communication technology (ICT) equipment. Particularly,we show that technological change embodied in new ICT capitalgoods has been a primary source of output and productivity growthin ICT-using sectors. The international comparison allows relatinggrowth patterns to institutional and policy indicators, therebyoffering some preliminary insights into the potential sourcesof growth disparities. Cross-country evidence yields some tentativesupport to the idea that institutional factors affecting competitionin the product market are likely to affect productivity patterns,especially in a period of rapid diffusion of a general-purposetechnology (such as ICT). 相似文献