The economic burden of depression among adults with rheumatoid arthritis in the United States

Aims: Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients’ health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to assess healthcare utilization, expenditures, and work productivity among patients with RA with or without depression.

Materials and methods: Data from adult patients who had at least two visits each related to RA and depression over a 1-year period were extracted from the Truven Health MarketScan research databases. Outcomes comprised healthcare resource utilization, work productivity loss, and direct healthcare costs comparing patients with RA with depression (n?=?3,478) vs patients with RA without depression (n?=?43,222).

Results: Patients with RA and depression had a significantly greater relative risk of hospitalization and number of all-cause and RA-related hospitalizations, utilization of emergency services, days spent in the hospital, physician visits, and RA-related surgeries compared with RA patients without depression. Patients with RA and depression had a higher risk of and experienced more events and days of short-term disability compared with patients without depression. The incremental adjusted annual all-cause and RA-related direct costs were $8,488 (95% CI = $6,793–$10,223) and $578 (95% CI = –$98–$1,243), respectively, when comparing patients with RA and depression vs RA only.

Limitations: The current analysis is subject to the known limitations of retrospective studies based on administrative claims data.

Conclusions: This study suggested increased healthcare utilization, work productivity loss, and economic burden among RA patients due to comorbid depression. These findings emphasize the importance of managing depression and including depression as a factor when devising treatment algorithms for patients with RA.     

Labour market characteristics and surviving import shocks

This paper investigates whether different labour market characteristics amplify or dampen the local labour market impacts from Chinese import competition exposure. I exploit state‐level variation in initial, pre‐shock labour market characteristics and regional variation across local labour markets in exposure to Chinese imports for identification. I find that local labour markets in states with higher union density experience more severe adverse consequences as a result of increased import exposure. Conversely, higher initial minimum wages help mute the negative impacts of the China shock. I also provide some evidence that exceptions to employment‐at‐will legislation can affect employment responses to increased Chinese imports. Finally, examining all policies together in an index, I show that higher levels of policies intended to benefit and protect workers can actually magnify the extent of the damage inflicted by import competition. My results suggest that initial labour market characteristics and policies can play an important role in understanding why local labour markets react differently to trade shocks.     

What does corporate social responsibility mean for charitable fundraising in the UK?

Coporate social responsibility (CSR) has grown enormously in the last ten years and the business case is compelling. That is not to say that CSR is the ‘silver bullet’ for achieving meaningful social change — this will require collaborative action. Part of this is a more mature relationship between charities and businesses — something beyond the worth ‘charitable donation’. Charities need to engage with business in a way that achieves mutual benefit; not ‘cap in hand’ but exploring the potential in shared objectives. Copyright © 2004 Henry Stewart Publications     

The myth of purchasing professionals’ expertise. More evidence on whether computers can make better procurement decisions

In a previous experiment, we have shown that risk assessments of purchasing experts are certainly not better than that of subjects untrained in purchasing, and worse than the decisions made by formal models (J. Purchas. Supply Manage. 9 (2003) 191–198). Since both these results are rather counterintuitive, we conducted a series of experiments geared at replication and extension of these findings. These new experiments show that our previous results are robust, and reveal an additional finding that is both worrying and puzzling. It actually seems to be the case that for the purchasing decision tasks in our experiments, experts perform worse with growing experience. It therefore seems that, at least for the kinds of purchasing decisions under study, it does not make much sense to use expert judgments at all. However, we show that there is a way in which expert judgments can be used in combination with formal models to improve the predictive accuracy of purchasing predictions. In our case, superior predictions are made when we combine the prediction of a formal model with the prediction of the ‘average expert’, thereby combining the robust linear trends as encapsulated in the formal model with the more intuitive configural rules used by experts. We provide several explanations for this phenomenon.     

Client, User and Architect Interactions in Construction: Implications for Analysing Innovative Outcomes from User-Producer Interactions in Projects

Three case studies of user/client-architect interaction, and their implications for an understanding of the design and innovation process in capital goods projects, are considered in this paper. The studies presented include a major 'City Challenge'-funded social housing development programme in the UK, a housing co-operative-driven workplace and housing scheme associated with the same programme and a new building for the business school of a major UK university. Reflecting upon existing literature on user-producer relationships, the paper draws two key conclusions from the case studies that add to this literature. The first points to the need to account for the broader strategic motivations of agents within projects. Two of the case studies describe how innovation driven by the architects involved exceeded the original requirements of the client, and in so doing reveal architects to be oriented toward non-project specific goals. The second conclusion focuses on the user/client and points to the importance of a strong and coherent 'customer vision' in 'enabling' the client to determine project outcomes more fully. Following from these conclusions, it is argued that an analysis of client/ user-producer interactions needs to account more fully for the effects of longer-term strategic planning by agents.     

Violations of Service Fairness and Legal Ramifications: The Case of the Managed Care Industry

Adapted from Chan's (2000) model depicting success of litigation, this paper argues that with the application of various legislation, health maintenance organizations' (HMOs') violations of service fairness to each group: enrollees, physicians, and hospitals give rise to each group's lawsuits against the HMOs. Various authors (Bowen et al., 1999; Seiders and Berry, 1998) indicate that justice concepts such as distributive, procedural, and interactional justice can be applied to the area of service fairness. The violation of these underlying justice principles with HMOs' service unfairness to enrollees, physicians, and hospitals is examined. A general synopsis of the ethical issues in the managed care industry is provided. The various lawsuits launched by each group: enrollees, physicians, and hospitals together with the key statutes used are discussed. This paper also highlights the provisions and ramifications of the 11 April 2000 landmark agreement that Aetna made with Texas Attorney General John Cornyn to settle the 1998 lawsuit brought against the company. Lastly, the current ethical issues in the managed care industry are further discussed. The value of this paper can be adapted to the study of organizations' service fairness violations in other industries or in the educational, governmental, and not-for-profit sectors both nationally and internationally.     

Tourism today: A geographical analysis : by D.G. Pearce Longman, Harlow, 1986, 229 pages, £9.95

Chris Cooper, of Surrey University's Department of Management Studies for Tourism and Hotel Industries, describes the uses and significance of the technique of interpretation in providing an interface between the tourist destination and the visitor. Interpretation can enhance the visitor experience by making the attributes of the resort more comprehensible.     

Foreign direct investment and vertical integration of production by Japanese multinationals in Thailand

We test the vertical model of foreign direct investment (FDI) empirically using firm level information on Japanese multinational activity in Thailand. These data allow us to investigate the effects of both home country (Japan) and host country (Thailand) characteristics on the inter-industry pattern of FDI. For 85 manufacturing industries over the period from 1985 to 1995, we find a positive influence of industry variation in skill intensity and market size in the host country and a negative effect of transport costs on the amount of FDI. These results provide strong direct econometric evidence of vertical integration of production across the countries. Journal of Comparative Economics 32 (4) (2004) 805–821.