Factors Affecting Physicians Early Retirement Intentions: Implications For Healthcare Delivery

Several authors have postulated that changes in the healthcare system, such as the growth in managed care, decreasing reimbursement, and the movement toward more integrated healthcare systems, perceived negatively by mature physicians, may contribute to their early retirement.  This, in turn, may produce adverse effects on the availability of medical care.  This study explores this and other related issues through analysis of data obtained from a survey of nearly four thousand physicians regarding factors potentially relevant to their early retirement decision.  While managed care is perceived to be an important factor in the early retirement decision of physicians, it does not necessarily lead to earlier retirement.  Physicians rank financial and personal factors as more important in their retirement decision.  Several of these factors significantly impact their expected early retirement age.  The results have several important implications for healthcare delivery relating to the retention or early retirement of effective practicing physicians, succession planning, and seamless generation of income

Is There Any Difference In The Retirement Intentions Of Female And Male Physicians?

Since the percentage of active female physicians in the United States is increasing rapidly, their retirement behavior will represent an important organizational and policy consideration in years to come.   The present study, is the first to explore possible differences in retirement intentions among female versus male physicians.  Findings are based on data obtained from a random national survey of nearly four thousand physicians regarding factors potentially relevant to their retirement.  Our empirical analysis identifies several factors that are correlated with male and female physicians retirement intentions.  Significant factors affecting male physicians retirement decisions include: expected social security income, pension income, the availability of early retirement incentives, decreasing annual income, current age, the existence of dependents in the family, years of service as a physician, the health status of ones spouse, stress/burnout, personal interests, the availability of part-time jobs, and general working conditions.  In the case of female physicians significant variables are: other expected income, perceived adequacy of retirement income, current age, years of service, work stress/burnout, the availability of part-time jobs,  and the employment setting.  An understanding of these factors is potentially important for healthcare administrators in dealing with the retention and retirement issues of the female and male physicians and may lead to more effective institutional decision making in this regard

The Effects Of Unions On Wages By Occupation In The Public Sector

This study examines union wage premiums by occupation in the public sector in the U.S. for the 2000-2004 period.  In examining union-nonunion wage differences for public sector workers in occupations accounting for 66 percent of all public workers in the 2000-2004 Current Population Survey, we find positive and statistically significant union premiums for 27 out of 41 occupations examined.  We also find large differences among occupations, with miscellaneous teachers and instructors receiving a 61 percent premium, secretaries and administrative assistants receiving a 5 percent premium, and 14 occupations receiving no statistically significant premium.  In comparing union premiums by occupation between the private and public sectors, we find, in most cases, that private sector premiums are larger than public sector premiums.  Finally, an Oaxaca decomposition shows that the majority of the differential between private sector union premiums and public sector union premiums appears to be due to differences in the way unions reward workers in the private and public sectors, not because of differences in the types of workers in the private and public sectors

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Retirement Intentions Of Female Versus Male Physicians

Since the percentage of active female physicians in the United States is increasing rapidly, their retirement behavior will represent an important organizational and policy consideration in years to come. The present study, is the first to explore possible differences in retirement intentions among female versus male physicians. Findings are based on data obtained from a random national survey of nearly four thousand physicians regarding factors potentially relevant to their retirement. Our empirical analysis identifies several factors that are correlated with male and female physicians retirement intentions. Significant factors affecting male physicians retirement decisions include: expected social security income, pension income, the availability of early retirement incentives, decreasing annual income, current age, the existence of dependents in the family, years of service as a physician, the health status of ones spouse, stress/burnout, personal interests, the availability of part-time jobs, and general working conditions. In the case of female physicians significant variables are: other expected income, perceived adequacy of retirement income, current age, years of service, work stress/burnout, the availability of part-time jobs, and the employment setting. An understanding of these factors is potentially important for healthcare administrators in dealing with the retention and retirement issues of the female and male physicians and may lead to more effective institutional decision making in this regard

DETERMINANTS OF LABOR MARKET BEHAVIOR OF REGISTERED NURSES: THE CASE OF NEBRASKA

The basic objective of this study was to identify the possible determinants of the labor market behavior of the registered nurses in Nebraska. To accomplish this end, two models were developed. The first model describes the labor force participation rates of registered nurses which was studied by means of probit analysis. The second model is concerned with the number of hours worked by registered nurses. Multiple regression analysis was used in this model to estimate the coefficients of the independent variables. Cross-sectional data, which were used in both models, were obtained by sending 650 questionnaires throughout the State of Nebraska. A total of 419 questionnaires (65 percent) were returned, of which 385 (60 percent) were usable. Age, experience, non-labor income, the presence of children under six years of age, the availability of part-time jobs, the working relationship between nurses and nursing administration, and work conditions were found to be significant determinants of labor force participation of nurses. The most important variables influencing the decisions of nurses concerning the amount of time devoted to labor market work were the wage rate, non-labor income, age, the presence of children under six years of age, availability of part-time jobs, the relative wage, and type of nursing employment. It is concluded that the provisions of subsidized child care facilities, greater flexibility in work scheduling, the admission and employment of more non-white nurses, especially blacks, to the nursing profession, the reconstruction of the compensation and promotion schedules for experience and performance, increasing hourly wage of nurses, and improvement in the work environment might all increase the supply of nursing services both in the short-run and the long-run and also improve the nurse\u27s productivity

Analysis Of Faculty Retirement Intention: Using A Proportional Odds Model

This paper uses data from a random national sample of faculty, age 50 and older, and explores factors affecting faculty member's retirement decisions for three expected retirement age categories.  The variables such as end of mandatory retirement, age, current salary, expected others sources of income, early retirement incentives, and years of education have a significant effect on faculty retirement decisions.  An understanding of these factors can help decision making for staffing purposes

The influence of low-intensity resistance training versus high-intensity resistance training on left ventricular structure and function of healthy adolescent boys using Echocardiography

Background: The study on the influence of different protocol of resistance training on left ventricular of adolescent boys dose have its limitation. The aim of this study was to determine the influence of low-intensity resistance training versus high-intensity resistance training on left ventricular structure and function of healthy adolescent boys by echocardiography. Materials and Methods: Twenty-four subjects volunteers, 15 to 18 years old were randomly assigned to three groups in the eight-member low-intensity resistance training (40% to 60% maximum strength), high-intensity resistance training (70% to 90% maximum strength) and control group. Protocol training was conducted 8 weeks, 3 sessions. Variables were measured using one and two-dimensional echocardiography at rest and special formulas. Results: In the post-test to pre-test, in low-intensity resistance training group means values, left ventricular posterior wall thickness at end-systole (P=0.028) and resting heart rate (P=0.017) showed significant increase and decrease respectively. In post-test, it was shown a significant increase means values left ventricular posterior wall thickness at end-systole and left ventricular mass index in low-intensity resistance training group than high-intensity resistance training group (P=0.007 and P=0.005 respectively) and control group (P=0.005 and P=0.0015 respectively) and mean value left ventricular mass in low-intensity resistance training group than high-intensity resistance training group (P<0.007). Conclusion: Low-intensity resistance training than high-intensity resistance training in healthy adolescent boys caused some changes in left ventricular structure and function, probably these changes were associated with increased volume and pressure load