On the Synchronization of Fiscal Policy in Selected ASEAN Countries : New Evidence from Asymmetric Modelling

The country’s fiscal deficit and debt levels are still issuing, and governments would always want to solve. Before this, it is very necessary to explore and study the types of fiscal hypotheses in various countries. The types of fiscal hypothesis are tax-spend hypothesis, spend-tax hypothesis, fiscal synchronization and lastly fiscal neutrality. This research aims to access the validity of fiscal hypothesis in five ASEAN countries, namely Malaysia, Indonesia, Philippines, Singapore and Thailand by using time series quarterly data from year 2006 to the first quarter of year 2021. The variables in this study include real gross domestic product (GDP), general government revenue (GR) and general government expenditure (GE). The methodology approach used is the asymmetric modelling approach, which includes Augmented Dickey Fuller test, Kwiatkowski-Phillips-Schmidt-Shin test, bounds test for cointegrating, Autoregressive Distributed Lag and Non-linear Autoregressive Distributed Lag models development and lastly granger causality test. The result from this research is that Malaysia and Thailand support the fiscal synchronization hypothesis, Indonesia and the Philippines support the fiscal neutrality hypothesis, and Singapore supports the spend-tax hypothesis

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely