An Economic Approach to the Regulation of Direct Marketing

The growing ubiquity of electronic media and the almost total absence of cost in mass distributions of direct marketing have exacerbated the problem of the increasing intrusion of direct marketing into the privacy of citizens. The Author proposes utilization of a microeconomic social welfare analysis to guide policymakers in determining what forms of direct media should be regulated and what the most effective forms of regulation are likely to be. Sending and receiving costs provide the key factors in determining the extent of the welfare-reducing marketing and marketing aversions, but the Author points to a number of other factors as well, including impact on third parties, impact of economic and technological factors, and changes in volume and targeting in traditional channels. The Author\u27s analysis suggests that increasing the receiver\u27s ability to process information by imposing labeling requirements on distributors could increase welfare without having to resort to the more sweeping and inefficient opt-in or opt-out programs. Many of these solutions can be effectuated by industry and, thus, do not necessarily require government intervention. In the absence of effective industry-based solutions, the Author contends that a complete ban on direct marketing may be required in the electronic media in particular

An Economic Approach to the Regulation of Direct Marketing

The growing ubiquity of electronic media and the almost total absence of cost in mass distributions of direct marketing have exacerbated the problem of the increasing intrusion of direct marketing into the privacy of citizens. The Author proposes utilization of a microeconomic social welfare analysis to guide policymakers in determining what forms of direct media should be regulated and what the most effective forms of regulation are likely to be. Sending and receiving costs provide the key factors in determining the extent of the welfare-reducing marketing and marketing aversions, but the Author points to a number of other factors as well, including impact on third parties, impact of economic and technological factors, and changes in volume and targeting in traditional channels. The Author\u27s analysis suggests that increasing the receiver\u27s ability to process information by imposing labeling requirements on distributors could increase welfare without having to resort to the more sweeping and inefficient opt-in or opt-out programs. Many of these solutions can be effectuated by industry and, thus, do not necessarily require government intervention. In the absence of effective industry-based solutions, the Author contends that a complete ban on direct marketing may be required in the electronic media in particular

Improving the assessment of vancomycin-resistant enterococci by routine screening.

BackgroundAs infection with vancomycin-resistant enterococci (VRE) increases in hospitals, knowledge about VRE reservoirs and improved accuracy of epidemiologic measures are needed. Many assessments underestimate incidence by including prevalent carriers in at-risk populations. Routine surveillance cultures can substantially improve prevalence and incidence estimates, and assessing the range of improvement across diverse units is important.MethodsWe performed a retrospective cohort study using accurate at-risk populations to evaluate the range of benefit of admission and weekly surveillance cultures in detecting unrecognized VRE in 14 patient-care units.ResultsWe assessed 165 unit-months. The admission prevalence of VRE was 2.2%-27.2%, with admission surveillance providing 2.2-17-fold increased detection. Medical units were significantly more likely to admit VRE carriers than were surgical units. Monthly incidence was 0.8%-9.7%, with weekly surveillance providing 3.3-15.4-fold increased detection. The common practice of reporting incidence using the total number of patients, rather than patients at risk, underestimated incidence by one-third. Overall, routine surveillance prevented the misclassification of 43.0% (unit range, 0%-85.7%) of "incident" carriers on the basis of clinical cultures alone and increased VRE precaution days by 2.4-fold (unit range, 2.0-2.6-fold).ConclusionsRoutine surveillance markedly increases the detection of VRE, despite variability across patient-care units. Correct denominators prevent the substantial underestimation of incidence