Spatial interaction model for healthcare accessibility: what scale has to do with it

This manuscript develops a theoretical spatial interaction model using the entropy approach to relax the assumption of the deterministic utility function. The spatial healthcare accessibility improves as the demand for healthcare increases or the opportunity cost of traveling to and from healthcare providers decreases. The empirical application used different spatial econometric techniques and multilevel modeling to evaluate the spatial distribution of existing hospitals in Texas and their social and economic correlates. To control for spatial autocorrelation, spatial autoregressive regression models were estimated, and geographically weighted regression models examined potential spatial non-stationarity. The multilevel modeling controlled for spatial autocorrelation and also allowed local variation and spatial non-stationarity. The empirical analysis showed that healthcare accessibility was not stationary in Texas in 2015, with areas of poor accessibility in rural and peripheral areas in Texas, when using hospitals’ location and county data. The model of spatial interaction applied to healthcare accessibility can be used to evaluate policies aiming at the provision of health services, such as closures of hospitals and capacity increases.info:eu-repo/semantics/publishedVersio

Competing destinations gravity model applied to trade in intermediates

The competing-destinations formulation of the gravity model ensues from the fact that unlike the classic version, this approach explicitly acknowledges the interdependence of the flows between a set of alternative countries. This paper applies the competing-destinations gravity model to the analysis of trade in intermediate goods. The results of the model were then tested empirically with an international input-output dataset and using the PPML estimator. The empirical results suggest that the analytical model can explain trade in intermediate goods. Indeed, as predicted, import of intermediate goods is increasing in the importing country's demand for inputs, in the competitiveness of the exporting country, and decreasing in distance and competition posed by alternative countries.info:eu-repo/semantics/acceptedVersio

Patients’ out-of-pocket expenses analysis of presurgical teledermatology

Background: This study undertakes an economic analysis of presurgical teledermatology from a patient perspective, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e. costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and opportunity cost of time spent in visits. to The study quantifies the opportunity costs and direct costs of visits for adults waiting for dermatology surgery. Method: This study uses a retrospective assessment of 123 patients. Patients’ out-of-pocket expenses of presurgical teledermatology were analyzed in the setting of a public hospital over two years. The teledermatology network covering the area served by the Hospital Garcia da Horta, Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits and direct costs of visits (transport costs, and visits’ fee) of each presurgical modality (teledermatology and conventional referral), were simulated from initial primary care visit until surgical intervention. Two groups of patients, those with Squamous Cell Carcinoma and those with Basal Cell Carcinoma, were distinguished in order to compare the patients’ out-of-pocket expenses according to the dermatoses. Results: From a patient perspective, the conventional system was 2.12 times more expensive than presurgical teledermatology. Teledermatology allowed saving €0.74 per patient and per day of delay avoided. This saving was greater in patients with Squamous Cell Carcinoma than in patients with Basal Cell Carcinoma. Although, the probabilistic sensitivity analysis corroborates the results of the base case scenario, only a prospective study can substantiate these results. Conclusion: In the Portuguese public healthcare system and under specific cost hypotheses, from a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses, outperforming the conventional referral system, especially for patients with severe dermatoses.info:eu-repo/semantics/publishedVersio

Competing-destinations gravity model: an application to the geographic distribution of FDI

WOS:000267973200012 (Nº de Acesso Web of Science)The competing-destinations formulation of the gravity model ensues from the fact that unlike the classical version, this approach explicitly acknowledges the interdependence of the flows between a set of alternative locations, i.e. country-recipients are competing for Foreign Direct Investment (FDI). This article examines empirically a range of theoretical hypotheses about the determinants of FDI location in a panel data regression framework. The results of the estimation of a gravity model lend support to the proximity-concentration and internalization hypotheses. Also, the fact that FDI has been found to be decreasing in the competition posed by alternative locations is suggestive of the superiority of the competing-destinations version of the gravity equation over its classical formulation

Effect of hierarchical parish system on Portuguese housing rents

This manuscript analyzes an inter-parish housing rents gradient with respect to surrounding parishes. Using data on housing rents for 4049 Portuguese parishes in 278 municipalities, the paper explores the spatial patterns of housing rents using the geographically weighted regression (GWR) methodology. The housing rents can be explained by socio-economic factors comprising the effects of unemployment, sustainability, social diversity, elderly dependency, and population density. The proportion of overcrowded dwellings reflecting how poor living conditions affect housing rents was also included in the spatial analysis. On the structural side, characteristics of the dwellings were also included such as the area of the home and the number of other homes available in the parishes. Locational factors reflect households’ valuation for access to other parishes. In order to capture location characteristics, besides considering mobility within municipalities, the GWR allowed using distances to nearby parishes, i.e., parish hierarchy distance effect. The results suggest that the Portuguese rental housing market exhibits a heterogeneous pattern across the territory, displaying spatial variability and a hierarchical space pattern as a consequence of its locational attributes.info:eu-repo/semantics/publishedVersio

Portugal positivo: investimento directo estrangeiro e/ou plano tecnológico?

Este artigo expõe as principais teorias económicas sobre os determinantes do Investimento Directo Estrangeiro (IDE) e sobre os efeitos do IDE no crescimento económico de longo prazo e analisa empiricamente os efeitos do IDE das empresas multinacionais dos EUA e do Plano Tecnológico, no crescimento económico de longo prazo dos 15 países da União Europeia pré-alargamento. Por último, face aos resultados encontrados empiricamente, analisam-se os potenciais efeitos positivos do IDE e do Plano Tecnológico em Portugal.info:eu-repo/semantics/acceptedVersio

Substitutability between drugs, innovation, and fiscal policy in the pharmaceutical industry

A theoretical model is developed in order to examine and explain the growth and welfare effects of fiscal policies in the pharmaceutical industry. When the fiscal instrument is a tax over pharmaceutical firms' profits, R&D by firms in the pharmaceutical sector results in growth if there is a generic market. Otherwise, a subsidy over pharmaceutical firms' profits should be considered to generate innovation in medicines. In terms of policy implications, our empirical results suggest that stimulating generic competition in the pharmaceutical sector is a main instrument to contain costs and promote welfare.info:eu-repo/semantics/publishedVersio

Delaying the timing of offshoring low-skilled tasks

WOS:000281106500009 (Nº de Acesso Web of Science)This paper examines the impact of uncertainty on offshoring low-skilled tasks. The model shows that greater demand uncertainty adversely affects the expected profit and timing of offshoring. It is also shown that a home-country tax rate deduction increases the volatility of the expected profits, making offshoring appear to be more risky. One policy implication of our results is that, in order to delay relocation of MNE's production from the home country, a government should adopt tax rate deduction rather than a direct subsidy because the former is more economical and effective than the latter

Substitutability between drugs, innovation and growth in the pharmaceutical industry

This paper establishes a relationship between the elasticity of demand for pharmaceutical intermediates and the growth rate for these intermediates variety. We build a model that contains two sectors, one final good sector producing treatments, and one intermediate goods sector producing a differentiated input used in the final treatment. The effects on the medicaments varieties' growth rate of the introduction of a fiscal instrument over pharmaceutical producers' profits are discussed. When the fiscal instrument is a tax over intermediate firms' profits, R&D by firms in the pharmaceutical goods sector results in positive growth provided there is enough substitutability among intermediates assured by a patent system. Otherwise, a subsidy over pharmaceutical firms' profits should be considered to generate positive growth of innovation in medicaments.info:eu-repo/semantics/publishedVersio

Protectionism under R&D policy: innovation rate and welfare

Purpose – The purpose of this paper is to explain how eventual pressures from national lobbies may lead governments to shift from an optimal into a non‐optimal innovation policy. Design/methodology/approach – A theoretical model is developed in order to examine and explain the growth and welfare effects of optimal and non‐optimal innovation policies. The non‐optimal policy corresponds to a subsidy for national innovators that is equivalent to an optimal policy of incentives (tax cuts) to foreign investors. Since we are assessing what can nationals do with the support that could be oriented to foreign firms, we are measuring what the economy loses for not supporting foreign firms. Findings – The authors find welfare loss when supporting national R&D instead of foreign R&D and conclude that the same support given to innovation can produce strikingly different outcomes depending on who receives the support. Practical implications – The analysis allows the impact of the inefficiency caused by policies that are not sound, from a strictly economic point of view, to be measured. Originality/value – The originality of the paper is related to the assessment of the implications and to the measurement of the effects of non‐optimal R&D policies