Estimating the Economic Impact of Disease on a Local Economy: The Case of Diabetes in the Lower Rio Grande Valley of Texas

The purpose of this study is to investigate the economic impact of wage reductions that people experience from contracting diabetes. Incorporating wage reduction information into an input-output model reveals that as diabetics' wages decrease by $1.00, production and income in the local economy decline by$0.36 and $0.38, respectively.Health Economics and Policy,

Managed Health Care and Technical Efficiency in the USA

By focusing exclusively on consumer benefit, previous studies of the effects of managed care have ignored important hospital efficiency gains. This study uses data from the 1992-1996 US Health Care Cost and Utilization Project, National Inpatient Sample to estimate a stochastic frontier model of hospital technical efficiency. After controlling for hospital and market area variables, the study finds strong evidence that increased managed care insurance in any given market is associated with improved technical efficiency in area hospitals. Using a two-stage estimation technique (Battese and Coelli 1995), the estimates are more efficient than for two-stage methods found in most of the literature

Comparing Batsmen Across Different Eras: The Ends of the Distribution Justifying the Means

The debate over the quality of modern batsmanship in cricket parallels the debate over the disappearance of the 0.400 hitter in baseball. This paper shows that as bowling and fielding skills have improived over time, the best batting averages in cricket, which are in the right tail of the distribution, have declined. This does not imply poorer batting skills. Both decadal standard deviations and coefficients of variation reveal wider variations in batting averages in previous decades, especially the 1940s. The batting average actually measures batting skill in relation to bowling and fielding skills, the latter of which, it is argued, have improved over time. Therefore, by mistakenly interpreting the batting average as an absolute measure of batsmanship, cricket experts and fans under-appreciate the skill of modern batsmen. The paper attempts to make a meaningful comparison of modern batsmen to non-modern batsmen through use of the Z transformation

Mixed Public/Private Health Insurance as an Evolutionary Game

Most of the theoretical literature on private health insurance given a universal public alternative is partial equilibrium and static in nature. However, empirically, equilibria in these markets can take time to emerge and depend on other markets. This paper develops a dynamic game that describes the co-evolution of the public/private insurance and the public/private hospital markets. With a modest set of differential equations, a pattern of growth emerges wich is distinctly non-linear

Managed Care Insurance and Health Cost Inflation: An Evolutionary Game Approach

The effect of managed care insurance contracts such as health maintenance organisations and preferred provider organisations on health costs is controversial. For some time periods and areas, there is a strong negative relationship bteewen managed care penetration in a market and health costs. Other researchers have found a positive relation between managed care penetration and health costs. Traditional fee for service premiums in a market area may decline as managed care penetration increases when managed care market share is low, only to increase as maaged care pentration increases when its market share is high. This paper seeks to provide a theoretical explanation for the various health cost/premium inflation patterns found at different levels of market share for managed care insurers

The educational aspirations and psychological well-being of adopted young people in the UK

Much is hypothesised but little is known about the effects of early adversity on school experience, academic attainment and career aspiration for children and young people adopted from care. Drawing on data from Wave 1 of the Youth (10‒15 years old) Questionnaire (n = 4899) from the United Kingdom Household Longitudinal Survey (UKHLS), also known as Understanding Society, this study explored differences between young people adopted (n = 22) and a matched comparison group (n = 110) on measures of educational and occupational aspirations and psychological well-being. Adopted young people reported higher externalising and total difficulties scores (based on the SDQ, Goodman, 1997) than the general population comparison group, but equivalent internalising symptoms. Adopted children were more likely to show an intention to seek full-time work at the end of compulsory schooling. These findings align with previous research regarding the psychological well-being of adopted children, contribute new knowledge about the aspirations of young people adopted from care and highlight methodological issues when utilising large-scale panel survey data for narrowly defined sub-groups

Missed opportunities for diagnosis and treatment of diabetes, hypertension, and hypercholesterolemia in a Mexican American population, Cameron County Hispanic Cohort, 2003-2008

Introduction Diabetes, hypertension, and hypercholesterolemia are common chronic diseases among Hispanics, a group projected to comprise 30% of the US population by 2050. Mexican Americans are the largest ethnically distinct subgroup among Hispanics. We assessed the prevalence of and risk factors for undiagnosed and untreated diabetes, hypertension, and hypercholesterolemia among Mexican Americans in Cameron County, Texas. Methods We analyzed cross-sectional baseline data collected from 2003 to 2008 in the Cameron County Hispanic Cohort, a randomly selected, community-recruited cohort of 2,000 Mexican American adults aged 18 or older, to assess prevalence of diabetes, hypertension, and hypercholesterolemia; to assess the extent to which these diseases had been previously diagnosed based on self-report; and to determine whether participants who self-reported having these diseases were receiving treatment. We also assessed social and economic factors associated with prevalence, diagnosis, and treatment. Results Approximately 70% of participants had 1 or more of the 3 chronic diseases studied. Of these, at least half had had 1 of these 3 diagnosed, and at least half of those who had had a disease diagnosed were not being treated. Having insurance coverage was positively associated with having the 3 diseases diagnosed and treated, as were higher income and education level. Conclusions Although having insurance coverage is associated with receiving treatment, important social and cultural barriers remain. Failure to provide widespread preventive medicine at the primary care level will have costly consequences

Effects of antenatal betamethasone on preterm human and mouse ductus arteriosus: comparison with baboon data.

BackgroundAlthough studies involving preterm infants ≤34 weeks gestation report a decreased incidence of patent ductus arteriosus after antenatal betamethasone, studies involving younger gestation infants report conflicting results.MethodsWe used preterm baboons, mice, and humans (≤276/7 weeks gestation) to examine betamethasone's effects on ductus gene expression and constriction both in vitro and in vivo.ResultsIn mice, betamethasone increased the sensitivity of the premature ductus to the contractile effects of oxygen without altering the effects of other contractile or vasodilatory stimuli. Betamethasone's effects on oxygen sensitivity could be eliminated by inhibiting endogenous prostaglandin/nitric oxide signaling. In mice and baboons, betamethasone increased the expression of several developmentally regulated genes that mediate oxygen-induced constriction (K+ channels) and inhibit vasodilator signaling (phosphodiesterases). In human infants, betamethasone increased the rate of ductus constriction at all gestational ages. However, in infants born ≤256/7 weeks gestation, betamethasone's contractile effects were only apparent when prostaglandin signaling was inhibited, whereas at 26-27 weeks gestation, betamethasone's contractile effects were apparent even in the absence of prostaglandin inhibitors.ConclusionsWe speculate that betamethasone's contractile effects may be mediated through genes that are developmentally regulated. This could explain why betamethasone's effects vary according to the infant's developmental age at birth