Estimating health expectancies from two cross-sectional surveys

Health expectancies are key indicators for monitoring the health of populations, as well as for informing debates about compression or expansion of morbidity. However, current methodologies for estimating them are not entirely satisfactory. They are either of limited applicability because of high data requirements (the multistate method) or based on questionable assumptions (the Sullivan method). This paper proposes a new method, called the “intercensal†method, which relies on the multistate framework but uses widely available data. The method uses age-specific proportions “healthy†at two successive, independent cross-sectional health surveys, and, together with information on general mortality, solves for the set of transition probabilities that produces the observed sequence of proportions healthy. The system is solved by making realistic parametric assumptions about the age patterns of transition probabilities. Using data from the Health and Retirement Survey (HRS) and from the National Health Interview Survey (NHIS), the method is tested against both the multistate method and the Sullivan method. We conclude that the intercensal approach is a promising framework for the indirect estimation of health expectancies.disability, health expectancies, indirect estimation methods, multistate life tables

Excess length of hospital stay due to healthcare acquired infections. Methodologies evaluation

BACKGROUND: Healthcare acquired infections (HAI) cause an increase of burden and in particular excess length of hospital stay (LOS) accounts for approximately up to 90% of total costs. Therefore accurate estimation of extra hospital stay due to healthcare acquired infections is very important. METHODS: The authors carried out a review comparing the principal methods internationally used for estimating the excess LOS attributable to healthcare acquired infections. RESULTS: The methods described and analysed are: 1) Implicit physician assessment; 2) appropriateness evaluation protocol; 3) unmatched case-control; 4) matched case-control; 5) regression analysis; 6) multistate model. The various methodologies are described underlining advantages and limits which researchers need to know before starting any economic analysis. CONCLUSIONS: Overall, studies taking into account the time-dependent nature of HAI show to give more precise and reliable results

Rapid Computation of Thermodynamic Properties Over Multidimensional Nonbonded Parameter Spaces using Adaptive Multistate Reweighting

We show how thermodynamic properties of molecular models can be computed over a large, multidimensional parameter space by combining multistate reweighting analysis with a linear basis function approach. This approach reduces the computational cost to estimate thermodynamic properties from molecular simulations for over 130,000 tested parameter combinations from over a thousand CPU years to tens of CPU days. This speed increase is achieved primarily by computing the potential energy as a linear combination of basis functions, computed from either modified simulation code or as the difference of energy between two reference states, which can be done without any simulation code modification. The thermodynamic properties are then estimated with the Multistate Bennett Acceptance Ratio (MBAR) as a function of multiple model parameters without the need to define a priori how the states are connected by a pathway. Instead, we adaptively sample a set of points in parameter space to create mutual configuration space overlap. The existence of regions of poor configuration space overlap are detected by analyzing the eigenvalues of the sampled states' overlap matrix. The configuration space overlap to sampled states is monitored alongside the mean and maximum uncertainty to determine convergence, as neither the uncertainty or the configuration space overlap alone is a sufficient metric of convergence. This adaptive sampling scheme is demonstrated by estimating with high precision the solvation free energies of charged particles of Lennard-Jones plus Coulomb functional form. We also compute entropy, enthalpy, and radial distribution functions of unsampled parameter combinations using only the data from these sampled states and use the free energies estimates to examine the deviation of simulations from the Born approximation to the solvation free energy

Fiscal Federalism as Risk-Sharing: The Insurance Role of Redistributive Taxation

In addition to funding government and redistributing income, a redistributive tax-and-transfer system, and a progressive income tax in particular, provides insurance against the risk of uncertain future income. By providing for high taxes for high incomes, and low taxes, exemptions, and transfers for low incomes, a progressive income tax lowers the volatility of potential after-tax income relative to a lump-sum tax. This insurance function is distinct from the redistributive function of the system, since it provides a direct risk-mitigation benefit to the taxpayer himself, rather than simply redistributing income from one taxpayer to another. This article analyzes the question of at what level of government to assign the income tax role in a federal system, given both its redistributive and insurance functions. The standard view in the literature is that redistribution is best done centrally, and thus that an income tax is best used by the federal government, rather than by state governments. Yet recent work suggests that states can effectively have some role in redistribution. Income insurance, however, can be more effectively done by the federal government, because of its larger risk pool and better ability to handle revenue volatility. This article argues that states will, and likely should, use progressive income taxes as a tool of greater redistribution. At the same time, the insurance function of a progressive income tax can still be nationalized through policies that resemble re-insurance. In particular, this article looks at the idea of a multi-state rainy-day fund as a form of pooled state revenue insurance, as well as federal policies that may achieve some of the same benefits

Cooperation on Competition: The Multistate Tax Commission and State Corporate Tax Uniformity

This report explores how interstate uniformity of state corporate income taxes has varied over time, the role played by the MTC, and how likely it is that uniformity will be achieved. FRC Report 11

Report of the Georgia Governor’s Wokers’ Compensation Review Commission

The Commission appointed by Governor Barnes consists of fourteen members, three ex officio members, and seven advisory members. This group includes academics, members of the legislature, claimants attorneys, defense attorneys, representatives from the insurance industry, organized labor, the textile industry, and government agencies. It was charged by the Governor to review and evaluate Georgia’s laws and procedures affecting workers’ compensation. The Commission’s primary goal was to prepare an accurate description of the current workers’ compensation system in Georgia. More specifically, this Report provides detailed information regarding the number of claims, benefits paid to employees, employer costs, and insurance profitability. It also compares workers’ compensation costs and benefits in Georgia with those in other states, particularly our Southeastern neighbors. Our purpose is to determine whether workers’ compensation costs place Georgia employers at a competitive disadvantage in regional and national markets. In preparing this Report, the Commission relied on the most recent available reports and data collected by organizations such as the National Academy of Social Insurance, the National Council on Compensation Insurance, the Workers Compensation Research Institute, the United States Department of Labor, and the Georgia State Board of Workers’ Compensation.Workers' Compemsation, wages, unemployment, disability, indemnity

The safety case and the lessons learned for the reliability and maintainability case

This paper examine the safety case and the lessons learned for the reliability and maintainability case

Estimating health expectancies from two cross-sectional surveys: the intercensal method

Health expectancies are key indicators for monitoring the health of populations, as well as for informing debates about compression or expansion of morbidity. However, current methodologies for estimating them are not entirely satisfactory. They are either of limited applicability due to high data requirements (the multistate method) or based upon questionable assumptions (the Sullivan method). This paper proposes a new method, called the “intercensal” method, which relies on the multistate framework using widely available data. The method uses age-specific proportions “healthy” at two successive, independent cross-sectional health surveys, and, together with information on general mortality, solves for the set of transition probabilities that produces the observed sequence of proportions healthy. The system is solved by making realistic parametric assumptions about the age patterns of transition probabilities. Using data from the Health and Retirement Survey and from the National Health Interview Survey, the method is tested against both the multistate method and the Sullivan method. We conclude that the intercensal approach is a promising framework for the indirect estimation of health expectancies

Estimating recruitment and survival in partially monitored populations

In evolutionary and ecological studies, demographic parameters are commonly derived from detailed information collected on a limited number of individuals or in a confined sector of the breeding area. This partial monitoring is expected to underestimate survival and recruitment processes because individuals marked in a monitored location may move to or recruit in an unobservable site. We formulate a multi-event capture-recapture model using E-SURGE software which incorporates additional information on breeding dispersal and the proportion of monitored sites to obtain unbiased estimates of survival and recruitment rates. Using simulated data, we assessed the biases in recruitment, survival and population growth rate when monitoring 10-90% of the whole population in a short- and a long-lived species with low breeding dispersal. Finally, we illustrate the approach using real data from a long-term monitoring program of a colony of Scopoli's shearwaters Calonectris diomedea. We found that demographic parameters estimated without considering the proportion of the area monitored were generally underestimated. These biases caused a substantial error in the estimated population growth rate, especially when a low proportion of breeding individuals were monitored. The proposed capture-recapture model successfully corrected for partial monitoring and provided robust demographic estimates. Synthesis and applications. In many cases, animal breeding populations can only be monitored partially. Consequently, recruitment and immature survival are underestimated, but the extent of these biases depends on the proportion of the area that remains undetected and the degree of breeding dispersal. We present a new method to obtain robust and unbiased measures of survival and recruitment processes from capture-recapture data. The method can be applied to any monitored population regardless of the type of nests (e.g. artificial or natural) or breeding system (e.g. colonial or territorial animals), and it only relies on an estimate of the proportion of the monitored area. The unbiased estimates obtained by this method can be used to improve the reliability of predictions of demographic population models for species' conservation and management.Research funds were provided by the Spanish Ministries of Science, Economy and Competitiveness (refs. BOS2003-01960, CGL2006-04325/BOS, CGL2009-08298, CGL2013-42203-R, JCI-2011-09085)Peer Reviewe