Incremental costs associated with myocardial infarction and stroke in patients with type 2 diabetes mellitus: an overview for economic modeling

Objective:

To identify cost estimates related to myocardial infarction (MI) or stroke in patients with type 2 diabetes mellitus (T2DM) for use in economic models.

Methods:

A systematic literature review was conducted. Electronic databases and conference abstracts were screened against inclusion criteria, which included studies performed in patients who had T2DM before experiencing an MI or stroke. Primary cost studies and economic models were included. Costs were converted to 2012 pounds sterling.

Results:

Fifty-four studies were identified: 13 primary cost studies and 41 economic evaluations using secondary sources for complication costs. Primary studies provided costs from 10 countries. Estimates for a fatal event ranged from £2482–£5222 for MI and from £4900–£6694 for stroke. Costs for the year a non-fatal event occurred ranged from £5071–£29,249 for MI and from £5171–£38,732 for stroke. Annual follow-up costs ranged from £945–£1616 for an MI and from £4704–£12,926 for a stroke. Economic evaluations from 12 countries were identified, and costs of complications showed similar variability to the primary studies.

Discussion:

The costs identified within primary studies varied between and within countries. Many studies used costs estimated in studies not specific to patients with T2DM. Data gaps included a detailed breakdown of resource use, which affected the ability to compare data across countries.

Conclusions:

In the development of economic models for patients with T2DM, the use of accurate estimates of costs associated with MI and stroke is important. When country-specific costs are not available, clear justification for the choice of estimates should be provided.     

International patent analysis as a tool for corporate technology analysis and planning

New, techniques of international patent anabsis are illustrated and resultsfrom preliminary validity tests of these techniques are presented. Indicators of technological activity, technological significance and commercial potential are constructed, and used to analyze fiber-based opto-electronic couplers and monoclonal-antibody-based diagnostic kits at the levels o f the technology, nation and firm. The international patent indicators are found to be closely correlated with R&D expenditures, scientific publications and new product introductions. They also relate to these indicators in ways that moke sense as specified in simple regression models of the innovation process. Comparisons of patent analysis results with expert opinion (for two process technologies) reveal that technology–level analyzes conform quite well with expert opinion, but national – and firm–level analyes vary from a low to a modest correlation with expert opinion. The authors conclude that the techniques can provide important information for corporate technology management, but that studies of additional technologies and further validity tests are needed.     

The implications of job matching for retirement health insurance and leave benefits

This paper focuses on potential reasons for variations in benefit packages, in particular variations in the availability of retirement health insurance and leave. An important feature of our analysis is that we do not start with heterogeneity in workforces to explain fringe benefit differences across employers. It would be straightforward to say that differences across employers in fringe benefit packages simply represent differences in the preferences of their workforces. Rather, we focus on heterogeneity across employers as an important source of differences in fringe benefit packages. Preliminary evidence is found supportive of the predicted differences in the likelihood of such fringe benefits as retirement health insurance and leave based upon two variables–the extent of on-the-job training offered by the employer and the size of the employers. We also examine the implied links between these fringe benefits and such variables as average tenture and the proportion of the workforce that is female.     

“SWEEPING THE HEAVENS FOR A COMET”: WOMEN,THE LANGUAGE OF POLITICAL ECONOMY,AND HIGHER EDUCATION IN THE US

Abstract

The importance of increased levels of education in improving the status of women throughout the world is well established. Higher levels of education are associated with lower birth rates, higher incomes, and greater autonomy for women. Yet, women's struggle to have a voice in higher education has been fraught with difficulties in the US and worldwide, particularly in overcoming widely held perceptions that limit their entrance into certain academic fields, tenured positions, and elite universities. This essay examines the role political economy has played in providing narratives that rationalize women's limited participation in higher education. By examining the representation of women in the academic culture of the nineteenth- and twentieth-century US, we can perhaps better understand women's struggle to obtain an authoritative voice in higher education worldwide.     

Behavioral health benefits: key to a healthy workforce

Mental disorders exact a heavier toll on workplace productivity than do physical illnesses, but a complete behavioral health program is often looked upon as just one more driver of rate increases. Properly understood, promoted and utilized, however, behavioral health benefits can contribute to decreased absenteeism and increased productivity, and even help offset the treatment costs of medical disorders.