Analysis of Domestic Factors Affecting Outward Foreign Direct Investment in Brazil

Developing markets have increasingly gained prominence in the world economy, but the domestic factors behind this success are not well established. This uncertainty may interfere with multinational expansion plans. In this article, we examine several macroeconomic and institutional factors affecting Brazilian outward foreign direct investment in 17 destination countries. We applied a pooled ordinary least squares regression over the 2001–2014 period. The findings suggest that macroeconomic factors are still statistically significant to explain investment abroad, but several institutional factors such as corruption have emerged, having a negative effect and political violence having a positive effect on Brazilian outward foreign direct investment.     

Tax compliance under horizontal and vertical equity conditions: An experimental approach

Tax compliance is a complex phenomenon, which requires to be addressed from different perspectives. We report the results of a real-effort experiment aiming at testing the effect of different equity conditions on individual tax compliance levels. We show that equity considerations seem to change individual behaviour only when a vertically unfair tax system is implemented. Also, random effects Tobit estimations show that being audited in the previous period has a negative effect on tax evasion, whereas the level of the fine paid in the previous period positively affects income underreporting. Also, we find that when subjects are in the vertical inequity condition they are significantly more likely to fully evade taxes than in the equity condition, whereas such result cannot be found in the horizontal inequity condition. Finally, we find a standard gender effect showing that female participants are less likely to evade taxes than man and that risk aversion negatively affect tax evasion behaviour.     

Labor Courts and Firing Costs: The Labor-Market Effects of Trial Delays

Employment protection is the result of labor laws as well as of institutional factors not encompassed in official legislation. Courts' delays in settling labor disputes are among those factors. Using individual data from the Italian Labour Force Survey (2008–2010) and exploiting the territorial heterogeneity in the duration of labor trials across Italian regions we investigate the effect of courts’ delays on the composition of employment. We find that labor courts' delays reduce the employment rate and increase inactivity of specific categories of workers, i.e., women, young, and low-skilled individuals; they also reduce the likelihood of accessing a permanent occupation and increase the incidence of long-term unemployment for the same groups of workers.     

The economic value of INTUITY in aortic valve replacement

Objective: The recent development of the EDWARDS INTUITY Elite? (EIE) valve system enables the rapid deployment of a prosthetic surgical heart valve in an aortic valve replacement (AVR) procedure via both the minimally invasive (MISAVR) and conventional (CAVR) approaches. In order to understand its economic value, this study performed a cost evaluation of the EIE valve system used in a MIS rapid-deployment approach (MIS-RDAVR) vs MISAVR and CAVR, respectively, compared to standard prosthetic aortic valves.

Methods: A simulation model was developed using TreeAge (and validated with MS Excel) to compare the inpatient utilization and complication costs for each treatment arm. Thirty-day clinical end-points for the MIS-RDAVR (mortality and complications) were taken from the TRANSFORM trial; and a best evidence review of the published literature was used for the MISAVR and CAVR approaches. Studies were pooled and parameter estimates were weighted by sample size in order to compare the TRANSFORM patients. Cost data (2016 USD) were taken from the Premier database. Incremental cost and cost-effectiveness was assessed and one-way/probabilistic sensitivity analyses performed to gauge the robustness of the results.

Results: MIS-RDAVR costs $2,621 less than CAVR and had lower mortality rates, making it a superior (dominant) technology relative to CAVR. MIS-RDAVR costs $4,560 more than MISAVR, but was associated with an additional 0.20 life years-per-patient. This implies a cost-effectiveness ratio of $22,903 per-life-year-gained. Thus, MIS-RDAVR is cost-effective compared to MISAVR.

Conclusions: The EIE valve system deployed in a MIS approach appears to be a cost-effective technology compared to MISAVR and CAVR. When compared to CAVR it may achieve cost savings as well. These results suggest that MIS-RDAVR confers superior economic value compared to both standard MISAVR and CAVR via lowered key complication rates (re-operation, renal complications, wound infection, TIA, endocarditis) and utilization (cross-clamp time, hospital ward days).     

Competition and physician-enabled demand: The role of managed care

Recent organizational changes in the health care sector promote greater patient participation in their treatment decisions. How physicians respond to patient-initiated requests for treatment is an issue of considerable policy interest. To study this phenomenon, we introduce the notion of physician-enabled demand and examine empirically whether this behavior responds to competitive pressures in the market and financial incentives associated with different physician payment mechanisms.We find that physician-enabled demand increases with more competition under fee-for-service reimbursement, but decreases with greater competition under managed care. This asymmetric response is quite consistent with our conceptual framework and at odds with alternative interpretations.     

Effects of fiscal policy in the Northern and Southern regions of Italy

This paper contributes to a growing body of work within ‘fiscal policy studies,’ investigating the recent role of fiscal policy on the Italian economy. Using annual data collected on a regional basis, this study estimates and compares the (impact and cumulative) fiscal multipliers across the North and the South—the less developed area—of Italy. With recourse to a simultaneous equation model for the two macro-areas of Italy, it estimates the overall impact of the measures of budget consolidation policies during the period 2011–2013. Our analysis reveals that tax increases and, with a greater impact, spending cuts, hit the South harder compared to the North.     

“Authors’ Reply: Financial and Demographic Risks of a Portfolio of Life Insurance Policies with Stochastic Interest Rates: Evaluation Methods and Applications,” Maria Giuseppina Bruno,Emanuela Camerini and Alvaro Tomassetti,October 2000 - Discussion by Fabrizio Cacciafesta

Abstract

This paper presents and compares different risk classification models for the annual number of claims reported to the insurer. Generalized heterogeneous, zero-inflated, hurdle, and compound frequency models are applied to a sample of an automobile portfolio of a major company operating in Spain. A statistical comparison between models is performed with the help of various specification tests (Score and Hausman tests for nested models, Vuong test or information criteria for nonnested ones). Interesting results about claiming behavior are obtained.     

A Monte Carlo simulation estimating US hospital cost reductions associated with hypotension control in septic ICU patients

Objective: This economic analysis extends upon a recent epidemiological study to estimate the association between hypotension control and hospital costs for septic patients in US intensive care units (ICUs).

Methods: A Monte Carlo simulation decision analytic model was developed that accounted for the probability of complications—acute kidney injury and mortality—in septic ICU patients and the cost of each health outcome from the hospital perspective. Probabilities of complications were calculated based on observational data from 110?US hospitals for septic ICU patients (n?=?8,782) with various levels of hypotension exposure as measured by mean arterial pressure (MAP, units: mmHg). Costs for acute kidney injury (AKI) and mortality were derived from published literature. Each simulation calculated mean hospital cost reduction and 95% confidence intervals based on 10,000 trials.

Results: In the base-case analysis hospital costs for a hypothetical “control” cohort (MAP of 65?mmHg) were $699 less per hospitalization (95% CI: $342–$1,116) relative to a “case” cohort (MAP of 60?mmHg). In the most extreme case considered (45?mmHg vs 65?mmHg), the associated cost reduction was $4,450 (95% CI: $2,020–$7,581). More than 99% of the simulated trials resulted in cost reductions. A conservative institution-level analysis for a hypothetical hospital (which assumes no benefit for increasing MAP above 65?mmHg) estimated a cost decline of $417 for a 5?mmHg increase in MAP per ICU septic patient. These results are applicable to the US only.

Conclusions: Hypotension control (via MAP increases) for patients with sepsis in the ICU is associated with lower hospitalization cost.     

Pricing dynamics and product quality: the case of antidepressant drugs

The rising prices of pharmaceuticals have generated considerable, and often acrimonious, debate. Yet, there is little conceptual work or empirical evidence on pharmaceutical pricing strategies or on the time paths of these prices. This study provides a conceptual framework describing the interplay between quality and product differentiation in determining the preferred pricing strategy. We hypothesize that higher quality products will engage in price skimming strategies in markets where products are sufficiently differentiated, but will choose a market penetration strategy in markets that are less differentiated. We apply an empirical analysis to brand name antidepressants during the years 1999–2002, a market where differences in quality are modest. A nationally representative data set on drug utilization and expenditures is combined with a physician survey on the quality attributes of drugs to examine the effect of drug quality on pharmaceutical pricing strategies. Results indicate that higher quality antidepressants engage in a market penetration strategy, charging initially lower prices that rise over time. At approximately 6–7 years post-entry, prices of the antidepressant drugs examined converge. Prices of higher quality antidepressants continue to increase thereafter, eventually becoming the highest priced drugs in the therapeutic class. These findings are consistent with a market in which product differentiation is modest and consumers learn which drug works best for them through experience.     

Jailer of freedom and enemy of growth?* The role of personal and social identities in educational choices

This paper develops a theoretical and empirical model on the influence of identity on educational choices which extends the existing literature in several directions. The theoretical model proposed here allows schooling choices to be independently influenced by both personal and social identities and, in contrast to previous work, the proposed empirical counterpart is derived directly from the theoretical model. The use of UK’s British Cohort Study on individuals born in 1970 allows us to identify with precision the relevant explanatory factors and to appropriately control for potentially confounding factors. Both social and personal identities are found to have substantial and statistically significant effects on educational participation decisions and these impacts are robust to a variety of specifications. The key implication is that socio-psychological factors play an important role in children’s school performance through their direct influence on the utility derived from studying.