scholarly journals Health Reform and Utilization of High-Volume Hospitals for Complex Cancer Operations

2018 ◽  
Vol 14 (1) ◽  
pp. e42-e50 ◽  
Author(s):  
Andrew P. Loehrer ◽  
David C. Chang ◽  
Zirui Song ◽  
George J. Chang
Keyword(s):  
New York ◽  
Private Insurance ◽  
Insurance Coverage ◽  
High Volume ◽  
Percentage Point Increase ◽  
Point Increase ◽  
Coverage Expansion ◽  
Incident Rate ◽  
And Control ◽  
The Impact

Purpose: Underinsured patients are less likely to receive complex cancer operations at hospitals with high surgical volumes (high-volume hospitals, or HVHs), which contributes to disparities in care. To date, the impact of insurance coverage expansion on site of complex cancer surgery remains unknown. Methods: Using the 2006 Massachusetts coverage expansion as a natural experiment, we searched the Hospital Cost and Utilization Project state inpatient databases for Massachusetts and control states (New York, New Jersey, and Florida) between 2001 and 2011 to evaluate changes in the utilization of HVHs for resections of bladder, esophageal, stomach, pancreatic, rectal, or lung cancer after the expansion of insurance coverage. We studied nonelderly, adult patients with private insurance and those with government-subsidized or self-pay (GSSP) coverage with a difference-in-differences framework. Results: We studied 11,687 patients in Massachusetts and 56,300 patients in control states. Compared with control states, the 2006 Massachusetts insurance expansion was associated with a 14% increased rate of surgical intervention for GSSP patients (incident rate ratio, 1.14; P = .015), but there was no significant change in the probability of GSSP patients undergoing surgery at an HVH (1.0 percentage-point increase; P = .710). The reform was associated with no change in the uninsured payer-mix at HVHs (0.6 percentage-point increase; P = .244) and with a 5.1 percentage-point decrease for the uninsured payer mix at low-volume hospitals ( P < .001). Conclusion: The 2006 Massachusetts insurance expansion, a model for the Affordable Care Act, was associated with increased rates of complex cancer operations and increased insurance coverage but with no change in utilization of HVH for complex cancer operations.

Shared Prosperity (or Lack Thereof) in the Sharing Economy

2022 ◽  
Author(s):  
Mohammed Alyakoob ◽  
Mohammad S. Rahman
Keyword(s):  
New York ◽  
Employment Growth ◽  
Spillover Effect ◽  
Spillover Effects ◽  
Sharing Economy ◽  
Economic Benefits ◽  
Percentage Point Increase ◽  
Point Increase ◽  
Job Growth ◽  
The Impact

This paper examines the potential economic spillover effects of a home sharing platform—Airbnb—on the growth of a complimentary local service—restaurants. By circumventing traditional land-use regulations and providing access to underutilized inventory, Airbnb attracts visitors to outlets that are not traditional tourist destinations. Although visitors generally bring significant spending power, it is unclear whether visitors use Airbnb only primarily for lodging and thus do not contribute to the adjacent economy. To evaluate this, we focus on the impact of Airbnb on restaurant employment growth across locales in New York City (NYC). Specifically, we focus on areas in NYC that did not attract a significant tourist volume prior to the emergence of a home-sharing service. Our results indicate a salient and economically significant positive spillover effect on restaurant job growth in an average NYC locality. A one-percentage-point increase in the intensity of Airbnb activity (Airbnb reviews per household) leads to approximately 1.7% restaurant employment growth. Since home-sharing visitors are lodging in areas that are not accustomed to tourists, we also investigate the demographic and market-structure-related heterogeneity of our results. Notably, restaurants in areas with a relatively high number of White residents disproportionately benefit from the economic spillover of Airbnb activity, whereas the impact in majority-Black areas is not statistically significant. Thus, policy makers must consider the heterogeneity in the potential economic benefits as they look to regulate home-sharing activities.

The Effect of Taxation and Corruption on Firm Growth: An Empirical Investigation for Vietnam

2016 ◽  
pp. 5-29
Author(s):  
Bich Le Thi Ngoc
Keyword(s):  
International Development ◽  
Firm Growth ◽  
Empirical Investigation ◽  
Manufacturing Firms ◽  
Economic Management ◽  
Tax Rate ◽  
Percentage Point Increase ◽  
Percentage Points ◽  
Point Increase ◽  
The Impact

The aim of this study is to analyze empirically the impact of taxation and corruption on the growth of manufacturing firms in Vietnam. The study employed pooled OLS estimation and then instrument variables with fixed effect for the panel data of 1377 firms in Vietnam from 2005 to 2011. These data were obtained from the survey of the Central Institute for Economic Management and the Danish International Development Agency. The results show that both taxation and corruption are negatively associated with firm growth measured by firm sales adjusted according to the GDP deflator. A one-percentage point increase in the bribery rate is linked with a reduction of 16,883 percentage points in firm revenue, over four and a half times bigger than the effect of a one-percentage point increase in the tax rate. From the findings of this research, the author recommends the Vietnam government to lessen taxation on firms and that there should be an urgent revolution in anti-corruption policies as well as bureaucratic improvement in Vietnam.

scholarly journals A Comparative UAV Forensic Analysis: Static and Live Digital Evidence Traceability Challenges

Drones ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 42
Author(s):  
Fahad E. Salamh ◽  
Umit Karabiyik ◽  
Marcus K. Rogers ◽  
Eric T. Matson
Keyword(s):  
High Volume ◽  
Forensic Analysis ◽  
Digital Evidence ◽  
Incident Response ◽  
Scientific Contribution ◽  
Response Plan ◽  
Technical Challenges ◽  
And Control ◽  
The Impact ◽  
Categorization Model

The raising accessibility of Unmanned Aerial Vehicles (UAVs), colloquially known as drones, is rapidly increasing. Recent studies have discussed challenges that may come in tow with the growing use of this technology. These studies note that in-depth examination is required, especially when addressing challenges that carry a high volume of software data between sensors, actuators, and control commands. This work underlines static and live digital evidence traceability challenges to further enhance the UAV incident response plan. To study the live UAV forensic traceability issues, we apply the `purple-teaming’ exercise on small UAVs while conducting UAV forensic examination to determine technical challenges related to data integrity and repeatability. In addition, this research highlights current static technical challenges that could pose more challenges in justifying the discovered digital evidence. Additionally, this study discusses potential drone anti-forensic techniques and their association with the type of use, environment, attack vector, and level of expertise. To this end, we propose the UAV Kill Chain and categorize the impact and complexity of all highlighted challenges based on the conducted examination and the presented scientific contribution in this work. To the best of our knowledge, there has not been any contribution that incorporates `Purple-Teaming’ tactics to evaluate UAV-related research in cybersecurity and digital forensics. This work also proposes a categorization model that classifies the discovered UAV static and live digital evidence challenges based on their complexity and impact levels

scholarly journals Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda

2020 ◽  
Vol 5 (11) ◽  
pp. e003390
Author(s):  
Nolan M Kavanagh ◽  
Elisabeth M Schaffer ◽  
Alex Ndyabakira ◽  
Kara Marson ◽  
Diane V Havlir ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Community Health ◽  
Control Group ◽  
Health Campaign ◽  
Percentage Point Increase ◽  
Percentage Points ◽  
Point Increase ◽  
Cost Planning ◽  
Testing Uptake ◽  
The Impact

IntroductionInterventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.MethodsWe randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.ResultsAmong 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI –1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI –2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8 percentage-point increase; 95% CI –2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.ConclusionThese findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.

scholarly journals Impact of the Affordable Care Act’s Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

2017 ◽  
Vol 75 (2) ◽  
pp. 131-152 ◽  
Author(s):  
Joshua Breslau ◽  
Bradley D. Stein ◽  
Bing Han ◽  
Shoshanna Shelton ◽  
Hao Yu
Keyword(s):  
Public Health ◽  
Health Status ◽  
Insurance Coverage ◽  
Health Impact ◽  
Care Utilization ◽  
The Public ◽  
Behavioral Health Treatment ◽  
Coverage Expansion ◽  
Dependent Coverage ◽  
The Impact

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

scholarly journals The impact of the 2006 Massachusetts health care reform law on spine surgery patient payer-mix status and age

2017 ◽  
Vol 27 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Nicolas W. Villelli ◽  
Hong Yan ◽  
Jian Zou ◽  
Nicholas M. Barbaro
Keyword(s):  
Health Care ◽  
New York ◽  
Health Care Reform ◽  
Health Care System ◽  
Spine Surgery ◽  
Private Insurance ◽  
New York State ◽  
Before And After ◽  
The Impact ◽  
Care System

OBJECTIVESeveral similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors’ prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US.METHODSUsing the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012. Payer-mix status was assigned as Medicare, Medicaid, private insurance, uninsured, or other, which included government-funded programs and workers’ compensation. A comparison of the payer-mix status and patient age, both before and after the policy, was performed. The New York State data were used as a control.RESULTSThe authors analyzed 81,821 spine surgeries performed in Massachusetts and 248,757 in New York. After 2008, there was a decrease in uninsured and private insurance spine surgeries, with a subsequent increase in the Medicare and “other” categories for Massachusetts. Medicaid case numbers did not change. This correlated to an increase in surgeries performed in the age group of patients 65–84 years old, with a decrease in surgeries for those 18–44 years old. New York showed an increase in all insurance categories and all adult age groups.CONCLUSIONSAfter the Massachusetts reform, spine surgery decreased in private insurance and uninsured categories, with the majority of these surgeries transitioning to Medicare. Moreover, individuals who were younger than 65 years did not show an increase in spine surgeries, despite having greater access to health insurance. In a health care system that requires insurance, the decrease in private insurance is primarily due to an increasing elderly population. The Massachusetts model continues to show that this type of policy is not causing extreme shifts in the payer mix, and suggests that spine surgery will continue to thrive in the current US health care system.

scholarly journals The impact of public coverage of newer hepatitis C medications on utilization, adherence, and costs in British Columbia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247843
Author(s):  
Harriet Ho ◽  
Naveed Z. Janjua ◽  
Kimberlyn M. McGrail ◽  
Mark Harrison ◽  
Michael R. Law ◽  
...  
Keyword(s):  
British Columbia ◽  
Hepatitis C ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Drug Coverage ◽  
Administrative Claims ◽  
Public And Private ◽  
Treatment Uptake ◽  
Private Expenditure ◽  
The Impact

Background Sofosbuvir and ledipasvir-sofosbuvir are both newer direct-acting antiviral agents for the treatment of hepatitis C. The high list prices for both drugs have led to concern about the budget impact for public drug coverage programs. Therefore, we studied the impact of public prescription drug coverage for both drugs on utilization, adherence, and public and private expenditure in British Columbia, Canada. Methods We used provincial administrative claims data from January 2014 to June 2017 for all individuals historically tested for either hepatitis C and/or human immunodeficiency virus. Using interrupted time series analysis, we examined the impact of public insurance coverage on treatment uptake, adherence (proportion of days covered), and public and private expenditures. Results Over our study period, 4,462 treatment initiations were eligible for analysis (1,131 sofosbuvir and 3,331 ledipasvir-sofosbuvir, which include 19 patients initiated on both treatments). We found the start of public coverage for sofosbuvir and ledipasvir-sofosbuvir increased treatment uptake by 154%. Adherence rates were consistently high and did not change with public coverage. Finally, public expenditure increased after the policy change, and crowded out some private expenditure. Conclusion Public coverage for high-cost drugs for hepatitis C dramatically increased use of these drugs, but did not reduce adherence. From a health policy perspective, public payers should be prepared for increased treatment uptake following the availability of public coverage. However, they should not be concerned that populations without private insurance coverage will be less adherent and not finish their treatment course.

Impact of Advertising and Public Relations on Tourism Development in Da Nang, Vietnam

2017 ◽  
pp. 1-16
Author(s):  
Xuan Tran ◽  
Minh Nguyen ◽  
Ha Kieu Tan Luu ◽  
Ny Ngo ◽  
My Tran ◽  
...  
Keyword(s):  
New York ◽  
Public Relations ◽  
Social Norms ◽  
Equation Modeling ◽  
Tourist Destinations ◽  
Structure Equation Modeling ◽  
The Social ◽  
Destination Brand ◽  
And Control ◽  
The Impact

An exploratory study was conducted to determine the impact of advertising and public relations on the visit intention of tourists in Da Nang, Vietnam. In 2015, Trip Advisor and New York Times selected Da Nang, Vietnam as one of the top Asia tourist destinations. This study sought to address the relationship between advertising or public relations and tourists' intention to visit based on the theory of planned behavior. Structure Equation Modeling was conducted to predict the impact of advertising and public relations on the visit intention of tourists in Da Nang. Findings indicate that an increased favorable attitude and control of advertising would increase tourist arrivals. Surprisingly, an increased positive attitude and control of public relations did not significantly affect tourists' intention to visit. Instead, the social norms of public relations were effective in driving the decision to visit but the social norms of advertising were not. The findings have contributed to destination brand through advertising and public relations. Implications are discussed.

scholarly journals Patterns of Coverage Gains Among Young Adult Cancer Patients Following the Affordable Care Act

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Leticia M Nogueira ◽  
Neetu Chawla ◽  
Xuesong Han ◽  
Ahmedin Jemal ◽  
K Robin Yabroff
Keyword(s):  
Young Adult ◽  
Cancer Patients ◽  
Affordable Care Act ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Temporal Patterns ◽  
Patients Âgés ◽  
The Affordable Care Act ◽  
Young Adult Cancer ◽  
The Impact

Abstract The dependent coverage expansion (DCE) and Medicaid expansions (ME) under the Affordable Care Act (ACA) may differentially affect eligibility for health insurance coverage in young adult cancer patients. Studies examining temporal patterns of coverage changes in young adults following these policies are lacking. We used data from the National Cancer Database 2003–2015 to conduct a quasi-experimental study of cancer patients ages 19–34 years, grouped as DCE-eligible (19- to 25-year-olds) and DCE-ineligible (27- to 34-year-olds). Although private insurance coverage in DCE-eligible cancer patients increased incrementally following DCE implementation (0.5 per quarter; P < .001), an immediate effect on Medicaid coverage gains was observed after ME in all young adult cancer patients (3.01 for DCE-eligible and 1.62 for DCE-ineligible, both P < .001). Therefore, DCE and ME each had statistically significant and distinct effects on insurance coverage gains. Distinct temporal patterns of ACA policies’ impact on insurance coverage gains likely affect patterns of receipt of cancer care. Temporal patterns should be considered when evaluating the impact of health policies.

Savings Groups Reduce Vulnerability, but Have Mixed Effects on Financial Inclusion

2020 ◽  
Author(s):  
Verónica Frisancho ◽  
Martín Valdivia
Keyword(s):  
Financial Inclusion ◽  
Access To Credit ◽  
Administrative Records ◽  
Labor Allocation ◽  
Percentage Point Increase ◽  
Cluster Randomized Control Trial ◽  
Point Increase ◽  
Idiosyncratic Shocks ◽  
Cluster Randomized ◽  
The Impact

This paper evaluates the impact of the introduction of savings groups on poverty, vulnerability, and financial inclusion outcomes in rural Peru. Using a cluster randomized control trial and relying on both survey and administrative records, we investigate the impact of savings groups after more than two years of exposure. We find t hat savings groups channel expensive investments such as housing improvements and reduce households' vulnerability to idiosyncratic shocks, particularly among households in poorer districts. The treatment also induces changes in households labor allocation choices: access to savings groups increases female labor market participation and, in poorer areas, it fosters greater specialization in agricultural activities. Access to savings groups also leads to a four-percentage point increase in access to credit among women, mainly driven by access to the groups loans. However, the introduction of savings groups has no impact on the likelihood of using formal financial services.On the contrary, it discourages access to loans from formal financial institutions and microfinance lenders among the unbanked.

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