Healthcare resource utilization and costs in patients with newly diagnosed acute myeloid leukemia

Abstract

Aim: Acute myeloid leukemia (AML) is associated with high disease burden. This analysis estimated HRU and costs among newly diagnosed AML patients in a US commercially insured population.

Materials and methods: This was a retrospective observational study using the IMS Health PharMetrics Plus and Hospital Charge Detail Master databases. Patients included adults who were newly diagnosed with AML between January 2007 and June 2016 (“study period”). Patients with <12 months of continuous enrollment prior to the index date were excluded, as were those whose first diagnosis was AML in remission/relapse, those diagnosed with acute promyelocytic leukemia, those on Medicare supplemental insurance, or those with a diagnosis of AML in remission/relapse without evidence of treatment during the study period. Patients were stratified by receipt of AML treatment (chemotherapy/hematopoietic cell transplantation [HCT]), and their follow-up was partitioned into initial, remission, and relapsed health states. Mean HRU and costs were tallied by treatment and, for treated patients, by health state and time since entry into health state (≤6 vs >6 months).

Results: A total of 9,455 patients met study criteria, including 6,415 (68%) treated and 3,040 (32%) untreated patients, with mean follow-up of 18.3 and 16.4 months, respectively. Mean age was 55 years in treated patients and 60 years in untreated patients. Mean total costs per patient were $386,077 in treated patients and $79,382 in untreated patients. For treated patients, 60% of total costs ($231,867 per patient) were incurred during the initial health state, representing time without remission/relapse. Mean monthly total healthcare costs were $21,055 and $4,854 among treated and untreated patients, respectively.

Limitations and conclusions: HRU and costs of managing AML patients are substantial. In treated patients, the majority of costs were incurred during the initial treatment period, without claims indicating remission/relapse.     

Estimating labour supply disequilibrium with fixed-effects random-coefficients regression

Long-term contracting, adjustment costs, or efficiency wages can make a worker supply fewer (more) hours than desired at the current economic opportunity set. A regression model with cross-correlated random coefficients is used to obtain new theoretically based measures of the direction and relative intensity of labour supply disequilibrium. Among prime-aged male hourly paid workers in the United States during 1978–82, evidence of widespread underemployment is found. Among primeaged male salaried workers, some overemployment appears. Regressions incorporating person-specific fixed effects are consistent with a life-cycle labour supply model for salaried workers and suggest a need for fresh ways to include short-run labour demand forces in micro labour supply models of hourly paid workers.     

An empirical investigation of customer market analysis–a microfoundation for macroeconomics

The slow adjustment and stickiness of output prices is widely regarded as an important determinant of macroeconomic behaviour. Recently, a number of writers have argued that customer market analysis can provide a microfoundation for price stickiness. This paper develops the theory of a firm selling in a customer market and investigates the empirical implications of the theory. The model is shown to imply a particular pattern of behaviour between retail prices and wholesale prices. Data on retail and wholesale prices for the United States, the United Kingdom and Australia at various levels of aggregation is investigated and found to support the predictions of the customer market model. In the conclusion the macroeconomic implications of the empirical conslusions are drawn out.     

An ordered response model of test cricket performance

The paper analyses the prediction of test cricket outcomes using an ordered response model. The results, based on data over the period 1994 to 1999, suggest that the ordered categorized production outcome of test cricket (win, draw, loss) can be explained by simple measures of the batting and bowling labour inputs. For example, across all countries the model correctly predicts 71% of test cricket outcomes. Further, it is found that losses are correctly predicted most often at 81% of the sample but that the model faces its biggest challenge predicting test match draws-only getting 57% of these cases correct. Also analysed are the circumstances in which the model produces incorrect predictions and it is found that the most common events are unsuccessful last innings runs chases; successful last innings runs chases and rain-affected matches. An analysis of failed model predictions in terms of country factors suggests that (relative to all other countries) Pakistan has a higher tendency to be involved in such matches, whereas Sri Lanka has a higher tendency to be involved in matches that are ‘predictable’. A ‘style’ analysis using this model suggests that five test cricket styles are evident. Style I is that of ‘Bowling and Batting Performance’ and describes Pakistan, the West Indies and (perhaps to a lesser extent) Zimbabwe. Style II is that of ‘Batting Performance’ and describes England, New Zealand and (perhaps to a lesser extent) India. Style III is ‘Bowling Performance’ and describes Australia. Style IV is ‘Bowling Performance/Batting Strike Rate’ and describes South Africa. Finally, Style V is ‘Bowling Performance and Strike Rate’ and describes Sri Lanka. Finally, the model is used to analyse which country can claim to be the world champions of test cricket over the sample period. In an initial analysis based on average performance over this period, South Africa has the best claim. However, in a ‘heavyweight title’ contest between South Africa and Australia, Australia has the superior claim.     

MEETING THE NEEDS OF TOURISTS: THE ROLE AND FUNCTION OF AUSTRALIAN VISITOR INFORMATION CENTERS

Visitor information centers are primarily responsible for promoting local tourism products and services; and consequently, have direct impacts upon the economic, social, and recreational well‐being of the region in which they are located. Research highlights the importance of tailoring center facilities and services to meet the needs and interests of the traveling public, yet there are few studies specifically designed to pinpoint visitors' information requirements. This study was conducted during the mid‐year school holidays and explores tourists' use and perceptions of 18 Australian visitor information centers in Queensland, Victoria, Western Australia, and Northern Territory. It uses Pearce's (2004 Pearce, P. L. 2004. The functions and planning of visitor centers in regional tourism.. Journal of Tourism Studies, 15(1): 8–17.  [Google Scholar]) Four Plus model to explore the functions of centers, identifies features that tourists regard as important, and provides an insight into the information needs and travel planning practices of those who use visitor information centers.     

A content analysis of the comment letters to the FASB and IASB: Accounting for contingencies

In this study, we read and analyze 369 comment letters written in response to the IASB's Exposure Draft (ED) of Proposed Amendments to IAS 37 and the FASB's Exposure Draft of Proposed Amendments to FASB Statement No. 5. We also examine how responses to the IASB ED are affected by whether or not the use of IFRS is mandated or permitted by the respondent's country. Although responses were overwhelmingly unfavorable to both EDs, more support was shown for the IASB's proposal to eliminate the probability recognition criterion than for the FASB's proposal to amend the U.S. GAAP disclosure rules. Users responding to the FASB ED provided significantly more intense support than corporate preparers, financial preparers, and legal practitioners. Significantly more respondents to the IASB ED were from countries required or permitted to use IFRS than from countries required to report under their national GAAP. In addition, constituents required or permitted to use IFRS were significantly more likely to express an unfavorable response to the ED and to cite relevance to support their position.     

Public policy dilemma—gender equality mainstreaming in UK policy formulation

The UK government has committed itself to improving the representation of women in public service and has introduced a number of legislative measures, policies and development programmes to do this. In 2006, the government enacted a regulatory duty, placed on public sector organizations, to mainstream gender equality in policy and service delivery. This article explores the extent to which this duty could promote gender equality and makes some recommendations for improving the representation of women.     

What’s powering wind? The effect of the U.S. state renewable energy policies on wind capacity (1994–2012)

As of 2012, 29 states had enacted a Renewable Portfolio Standard (RPS), while 37 states had at least one utility offering Green Power Purchasing (GPP) to their customers. The goal of both policies is to promote the adoption of clean, renewable energy. This article examines the influence of these polices on wind capacity across the United States from 1994–2012, a period of significant expansion of the wind generation market. The analysis focuses on wind because as compared with other modern renewable energy sources, wind is the only renewable energy source to make significant inroads into the U.S. electricity generation market. My findings indicate that while there have been significant increases in commercial scale wind generation capacity, neither RPS nor GPP programmes had a significant influence on within state wind capacity additions.     

Connectivity in East Asia

As Asian economies have become more connected through physical and institutional infrastructure, the region's trade has grown and changed. Intraregional trade has increased its share, in large part through the expansion of trade in intermediates in connection with development of global value chains. At the same time, as part of the same process and as part of the structural transformation that underlies most economic development, the share of services in Asia's trade has risen. Policies that support the development of regional infrastructure and the flow of goods and services, as well as factors of production, can increase the benefits from connectivity. Meanwhile, regional cooperation has a key role to play in mitigating negative impacts that may arise from the vulnerabilities that accompany greater connectivity.