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.     

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.     

Quality Management Systems Certification: Research Note

Although International Quality Standards 9000 certification is one of the most popular quality assurance systems in the world, its contribution to a firm's value is still a controversial issue. This project re-examines this issue by using stock market reactions to the announcements of the award of certification made by a sample of Hong Kong listed companies, as a proxy for its contribution to a firm's value. The results suggest that on average certification increased a firm's value. However, most of this value increase was incorporated into stock prices before formal announcements were published in newspapers. In addition, the contribution of certification to value was greater in smaller firms than in larger ones. This can be attributed to fewer stock traders and professional analysts following smaller firms.     

A theory of global strategic alliances: The case of the global auto industry

The theory articulated in this paper suggests that the desire to reduce demand and competitive uncertainty are two separate, important motives for alliance formation. Taking this as a starting point, we predict the configuration of horizontal alliances that we might expect to observe within an industry when firms experience these uncertainties to different degrees. An empirical test of this theory using data from the global auto industry yields results consistent with the view (1) that alliances are a device for reducing both the uncertainties that arise from unpredictable demand conditions and those that arise from competitive interdependence, and (2) that variation of demand uncertainty and competitive uncertainty across firms explains differentials in both the intensity and structure of their horizontal alliance activity.     

Price-volume relation in stocks: A multiple time series analysis on the Singapore market

We examine the price-volume relation in stocks using the multiple time series approach due to Tiao and Box (1981). This approach has the advantage of treating price and volume jointly and symmetrically (without enforcing the roles of input and output). It is free of the simultaneity bias in regression analysis and the unidirectional dynamics imposed by transfer function models. Empirical results show that there is implicit positive correlation between price and volume through their residuals. However, the results for the explicit lead and lag relations are mixed. The technical analysts' adage that volume often leads the trend of price is not supported. Nonetheless, the implicit relationship between price and volume confirms the usefulness of incorporating volume data to forecast future return. Our analysis shows that the multiple time series models outperform the univariate models in post-sample forecasts.     

From T-Bills to Stocks: Seasonal Anomalies Revisited

This paper employed eleven data series which consist of stocks, bonds, bills, equity premiums, term premiums, and various default premiums to investigate whether January seasonality reported in existing literature is robust across different states of the economy as this has important trading implications. For the periods 1926–1990, small stocks, small stock premiums, low grade bonds, and default premiums (spread between high grade, low grade and government bonds) reveal January seasonality and that the seasonality is robust across different states of the economy except for low grade bond returns and default premiums. January seasonality for low grade bond returns and low grade bond default premiums are primarily driven by results found during periods of economic expansion. Overall, January seasonality is more evident during the economic expansion periods although the magnitude of default premiums is larger during periods of economic contraction. Furthermore, prior findings of strong summer equity returns are primarily driven by the results found during the periods of economic contraction. It is also found that equity returns are generally higher during periods of economic expansion.     

Philosophical Foundations of Eminent Hong Kong Chinese CEOs’ Leadership

Because of the importance of Confucian doctrines in shaping ethical business practices under Chinese leadership, revealing the roles of other Chinese ethical doctrines in modern Chinese leadership is informative. A thorough understanding of the ethical foundations of Chinese leadership is necessary for fruitful interaction with Chinese leaders, according to cultural fit theory. The present study illustrates the philosophical foundations of business management, based on dialogues with five eminent corporate executive officers (CEOs). It reveals that the CEOs practice a style of Chinese leadership synthesizing Confucian, Daoist, Mohist, and Legalist doctrines. The Confucian doctrines advocate benevolence, harmony, learning, loyalty, righteousness, and humility. They are the most prevalent tenets that support paternalism and collectivism. The Daoist doctrines emphasize flexibility and reversion (e.g., the principle that the weak can defeat the strong). They bolster the leader’s forbearance. The Mohist doctrines underpin thrift and working with the masses whereas the Legalist doctrines inculcate self-control and innovativeness. Hence, contemporary Chinese leadership does not rely exclusively on Confucian ethics and this reflects evolution over 1000s of years.     

Strategic profiles and performance: An empirical test of select key propositions

Competing theories on internal orientation versus external orientation are examined. The relevant theories are amalgamated and condensed into a number of competing propositions that are empirically tested. The findings suggest that the internally oriented businesses as well as the externally oriented businesses underperform the efficient, marketing oriented businesses.     

Minnesota-type adaptive hierarchical priors for large Bayesian VARs

Large Bayesian VARs with stochastic volatility are increasingly used in empirical macroeconomics. The key to making these highly parameterized VARs useful is the use of shrinkage priors. We develop a family of priors that captures the best features of two prominent classes of shrinkage priors: adaptive hierarchical priors and Minnesota priors. Like adaptive hierarchical priors, these new priors ensure that only ‘small’ coefficients are strongly shrunk to zero, while ‘large’ coefficients remain intact. At the same time, these new priors can also incorporate many useful features of the Minnesota priors such as cross-variable shrinkage and shrinking coefficients on higher lags more aggressively. We introduce a fast posterior sampler to estimate BVARs with this family of priors—for a BVAR with 25 variables and 4 lags, obtaining 10,000 posterior draws takes about 3 min on a standard desktop computer. In a forecasting exercise, we show that these new priors outperform both adaptive hierarchical priors and Minnesota priors.     

Refinery mix in the U.S., Canada,and the E.E.C.

This paper examines the response of gasoline's share of a barrel of crude oil to changes in relative petroleum product prices. An inter-country comparison of the U.S., Canada, and the E.E.C. allows investigation of different parts of the production possibility frontier. In the U.S. and Canada, with relatively large amounts of cracking capacity, there is price responsiveness of the product mix to changes in relative product prices. In the U.S., both residual and distillates are substitutes in production for gasoline, but for Canada, only distillate is a substitute. Part of this difference is attributed to the U.S. oil quota. For the E.E.C. with relatively small amounts of cracking capacity there was no discernible effect of product prices on product mix.