Cost-effectiveness of Access to Critical Cerebral Emergency Support Services (ACCESS): a neuro-emergent telemedicine consultation program

Aims: Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective.

Methods: A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not.

Results: The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3?h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952–$4,438) per patient and increase QALYs by 0.20 (0.14–0.22). This increase in QALYs equates to ～73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model.

Conclusion: The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).     

Sources and Measurement of Agricultural Productivity and Efficiency in Canadian Provinces: Crops and Livestock

This paper measures and assesses the variation in total factor productivity (TFP) growth among Canadian provinces in crops and livestock production over the period 1940–2009. It also determines if agricultural productivity growth in Canada has recently slowed down as indicated by earlier studies. The paper uses the stochastic frontier approach that incorporates inefficiency to decompose TFP growth into technical change (TC), scale effect (SE), and technical efficiency change. The results indicate that productivity changes were mainly driven by TCs for crops, while the productivity changes in livestock was mainly driven by SEs and technical progress. Though change in technical efficiency is mainly positive (except for New Brunswick and Nova Scotia), its contribution to productivity growth was very little for the provinces. We also found that over the entire period, the productivity growth rates for the crop subsector are on average higher for the Prairie provinces than for the Eastern and Atlantic provinces. On the other hand, the productivity growth rates in the livestock subsector are on average higher in the Eastern and Atlantic provinces than in the Prairie region with the exception of Manitoba. Finally, we found that though there is some evidence of a recent decline in productivity growth for the crops subsector, there is no such evidence in the livestock subsector.     

CEO Risk‐Taking Incentives and the Cost of Equity Capital

In this paper, we show that the sensitivities of an executive's wealth to changes in stock prices (deltas) decrease the implied cost of equity capital while the sensitivities of an executive's wealth to changes in stock volatility (vegas) increase the implied cost of equity capital. Our findings demonstrate that shareholders understand the risks of firms’ future projects as embedded in executive compensation and price these risks into the cost of equity capital accordingly. The findings have strong implications for optimal executive compensation contract design, project evaluation and cost of capital estimation.     

Spectrum Licensing,Policy Instruments and Market Entry

Competition policy attempts to address the potential for market failure by encouraging competition in service markets. Often, in wireless communication service markets, national regulatory authorities seek to encourage entry via the spectrum assignment process. Instruments used include the assignment mode (auction or beauty contest), setting aside licenses and providing bidding (price and quantity) credits for potential entrants, and making more licenses (spectrum blocks) available than there are incumbent firms (excess licenses). The empirical analysis assesses the effectiveness of these policy instruments on encouraging entry. The econometric results show that the probability of entry is enhanced by using auction assignments and excess licenses. Furthermore, quantity, but not price, concessions encourage entry.     

Economic growth and balance-of-payments constraint in Vietnam

Abstract

Our paper examines the long-run relation between economic growth and current account equilibrium in Vietnam, using a multicountry balance-of-payments-constrained growth model. We find that for the whole sample (1985–2010) Vietnam grew less than the rate predicted by the model. We also find that the balance-of-payments-constrained growth rate shifted after the 1997 Asian crisis. Since the relative price effect is neutral, the volume effects dominate in setting the balance-of-payments constraint. On the one hand, owing to the high income elasticities of exports, growth in advanced countries has a strong multiplier effect on the Vietnamese economy. On the other hand, this effect is hindered by a strong “appetite” for imports coming from Asia. Finally, we assess the impact of the current crisis on Vietnam’s growth for the period 2011 to 2017.     

Causality and wage price inflation in West Germany 1964–1979

Zusammenfassung Kausalit?t und Lohn-Preis-Inflation in Westdeutschland 1964–1979. — In diesem Aufsatz wird ein Vierteljahresmodell der Lohn- und PreisInflation in Westdeutschland (1964 bis 1978) entwickelt. Es verwendet das Konzept der Phillips-Kurve, betont aber die überprüfbare Lohndruck-Hypothese und enth?lt die folgenden sechs Variablen: Konsumentenpreise, Effektivl?hne, Streiks, Tarifl?hne, Nachfrage nach Arbeitskr?ften und die Geldmenge M 1. Mit Hilfe des Konzepts der Wiener-Granger-Kausalit?t und kürzlich entwickelter Methoden der multivariaten Zeitreihenanalyse entsteht ein empirisches Kausalit?tsmodell der Lohn-Preis-Inflation für Westdeutschland. Dieses Modell stützt in starkem Ma\e die Lohndruck-Theorie und weist der Geldversorgung eine unbedeutende Rolle zu. Eine zweiseitige Kausalit?t besteht zwischen den Effektiv- und den Tarifl?hnen, so da\ es unangebracht ist, zeitlich verteilte Lags anzunehmen für die Tarifl?hne in der Lohngleichung oder umgekehrt für die Effektivl?hne in der Gleichung der Tarifl?hne. W?hrend sich als Hauptursache der Lohninflation die Inflationserwartungen und die Tarifl?hne identifizieren lassen, geh?ren zu den wichtigsten Ursachen der Preisinflation die erwarteten Preissteigerungen und die Erh?hung der Kapazit?tsauslastung.

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Résumé Causalité et l’inflation de prix et de salaire en Allemagne de l’Ouest 1964–1979. — Dans cet article l’auteur formule un modèle trimestriel de l’inflation de salaire et de prix pour l’Allemagne de l’Ouest sur la période de 1964.1 à 1978.4. Le modèle utilise les éléments fondamentaux de la courbe de Phillips, mais souligne l’hypothèse testable des déterminants de ?wage-push? et consiste de six variables économiques principales: les prix de consommation, les salaires nominaux, les grèves, les salaires contractuels minimum, la demande de la main-d’oeuvre et les disponibilités monétaires (M1). L’auteur applique le concept de causalité de Wiener-Granger aussi bien que des méthodes des séries chronologiques multivariates développées récemment et obtient un modèle empirique de causalité. Le modèle fortement supporte la théorie de ?wage-push? et révèle un r?le insignifiant des disponibilités monétaires. Une causalité deux-voies peut être observée entre les salaires nominaux et les salaires contractuels minimum. Par conséquent, il n’est pas indiqué de spécifier une structure des décalages retards distribués pour les salaires contractuels dans l’équation de salaire ou, qui est équivalent, pour les salaires nominaux dans l’équation de salaires contractuels minimum. Pendant que l’inflation anticipée et les salaires contractuels sont regardés comme les causes principales de l’inflation de salaire les facteurs décisifs de l’inflation de prix incluent les augmentations des prix attendues et l’augmentation de l’utilisation des capacités.

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Resumen Causalidad e inflation salarios-precios en Alemania Occidental 1964–1979. — En este artícule se formula un modelo trimestral de inflatión de salarios y precios para Alemania Occidental en el período 1964.1 a 1978.4. Este modelo se basa en la racionalidad de la curva de Phillips pero pone enfasis en la hipótesis comprobable de determinantes de presión de salarios y consiste de seis variables económicas importantes: precios al consumidor, salarios monetarios, huelgas, tasas de salarios mínimos negociados, demanda por trabajo y oferta de dinero M1. Usando el concepto de causalidad Wiener-Granger y métodos de series de tiempo multivariables desarrollados recientemente se obtiene un modelo empérico causal de inflatión salarios precios para Alemania Occidental. Este modelo da fuerte apoyo a la teoría de presión de salarios y revela un papel insignificante para la oferta de dinero. Hay una doble causalidad (o de feedback) presente entre salarios monetarios y tasas salariales minimas negociadas y, tomo tal, la práctica de especificar una estructura de rezago distribuida para estas tasas salariales en la ecuación de salarios, o equivalentemente, para salarios monetarios en la ecuación de tasas salariales mínimas negociadas es inapropiada. Mientras que las principales causas de la inflatión salarial se pueden identificar como inflatión anticipada y tasas salariales mínimas negociadas, las principales causas de la inflatión de precios incluyen aumentos de precios esperados y el aumento de la capacidad utilizada.

     

Responses to World Oil and Coal Shocks, in a Short-Run Fuel Substitution Tax Model

This article examines effects on major Australian macroeconomic and structural variables of simultaneous shocks to world oil and black coal prices. The illustrative numerical results have been produced with the short-run fuel substitution tax model, ORANI-LFT. The current version of that model reflects the Australian Governmet's pre-1988 oil regulatory framework, and the simulations reported in this study reflect the recent switch from significant dependence on crude oil levy revenue to petroleum products excise revenue. Empirical results show that combined world oil and coal price shocks lead to substantially different effects than would occur from an oil shock alone. A major implication of this, for a small open economy such as Australia, is that particular attention has to be paid to the interdependence of world energy market, both when analysing the effects of such shocks and when formulating appropriate macroeconomic and energy policy responses. It is also pointed out how the model could be modified for investigating effects under deregulated oil market regimes.     

On the choice of functional form in stochastic frontier modeling

This paper examines the effect of functional form specification on the estimation of technical efficiency using a panel data set of 125 olive-growing farms in Greece for the period 1987–93. The generalized quadratic Box-Cox transformation is used to test the relative performance of alternative, widely used, functional forms and to examine the effect of prior choice on final efficiency estimates. Other than the functional specifications nested within the Box-Cox transformation, the comparative analysis includes the minflex Laurent translog and generalized Leontief that possess desirable approximation properties. The results indicate that technical efficiency measures are very sensitive to the choice of functional specification. Perhaps most importantly, the choice of functional form affects the identification of the factors affecting individual performance – the sources of technical inefficiency. The analysis also shows that while specification searches do narrow down the set of feasible alternatives, the identification of the most appropriate functional specification might not always be (statistically) feasible. First version received: November 1999/Final version received: July 2001 RID="*" ID="*"  The authors wish to thank Almas Heshmati, Robert Romain, and an anonymous referee for insightful comments and suggestions. Special thanks go to the associate editor who handled the paper, and whose careful reading and suggestions have improved the paper substantially. The second author wishes to acknowledge the financial support from “President SSHRC” from the University of Saskatchewan. The usual caveats with respect to opinions expressed in the paper apply. Senior authorship is shared. This is University of Nebraska-Lincoln Agricultural Research Division Article No. 13270.