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PubMed1997

Cohabiting partners' economic circumstances and marriage.

Past studies of the transition to marriage generally have relied on information about only one individual or have attempted to measure characteristics of potential spouses indirectly. Drawing on data from the two waves of the National Survey of Families and Households (NSFH), we examine the effects of economic circumstances of both partners in cohabiting unions on the transition to marriage. Focusing on both partners in a relationship affords a more direct test of the relative importance of men's versus women's economic circumstances. Our findings suggest that only the male partner's economic resources affect the transition to marriage, with positive economic situations accelerating marriage and deterring separation. Our results imply that despite trends toward egalitarian gender-role attitudes and increasing income provision among women, cohabiting men's economic circumstances carry far more weight than women's in marriage formation.

Adult↗
PubMed1997

Jobs for all, economic justice, and the challenge of welfare "reform".

Jobs for All at decent wages is not the only strategy for reducing poverty and economic inequality, but it is more desirable and more consonant with American values than a primary strategy of direct income redistribution through government benefits. To make jobs the primary strategy for people of working age, however, is not to overlook the need for certain types of income support in good times and in bad, and the important economic functions of the welfare state. Current welfare "reform" poses as a work strategy but is the very antithesis of jobs for all because it creates job seekers rather than jobs and will increase unemployment and lower wages. Economic and social benefits of full employment are identified, and criticisms of the strategy--that many current jobs are risky, boring and poorly paid--are addressed. The abiding and new obstacles to full employment are acknowledged, their seriousness assessed, and means for overcoming them proposed. The author concludes that the obstacles to jobs for all are primarily political rather than economic, and shows how the National Jobs for All Coalition is attempting to overcome them and to build a new movement for economic justice.

Employment↗
PubMed1997

[Economic assessment of low flow anesthesia with analysis of the break-even point. Experience at an underutilized operating room].

BACKGROUND: Many authors indicate the importance of economic saving obtained with the use of the inhalation rebreathing anaesthesia instead of non rebreathing anaesthesia, always referring to parameters which are the duration of anesthesia (1 hour) and the use of the operating theatre each year. It is presumed that the utilization of rebreathing system is at least a 1.000 hours/year. However it is not necessary that all the operating theatres employ 1.000 hours/year in rebreathing anesthesia. This method requires annual depreciation costs of the capital invested for the purchase of new adequate ventilators, to modificative those already existing and guarantee adequate monitoring and the maintenance of these equipment. The importance is stressed of individuating a method of economical evaluation comparing the effective savings obtained with the real utilization of rebreathing anesthesia for each operating theatre and the costs of purchasing and maintaining the equipment. From our point of view the break-even point analysis has demonstrated to be a consistent instrument for the evaluation of the real economic advantage of rebreathing system in each hospital. METHODS: It is suggested to utilize a conventional formula for the determination of the break even point, which means the minimal number of hours for year that justifies economically the adoption of rebreathing anaesthesia. RESULTS AND CONCLUSIONS: An example of this analysis has been applied for an operating theatre in the hospital of Morbegno, where the major utilization of regional anaesthesia leads to a reduced number hours/year of rebreathing anesthesia which remains anyhow economically advantageous.

Anesthesia, Inhalation↗
PubMed1997

Clinical economics and sleep disorders.

Sleep disorders have been shown to have substantial psychosocial sequelae with large economic impact. Numerous studies have examined the psychosocial aspects of sleep disorders; however, there has been little published on the associated economic implications. With increasing pressure to contain health care expenditures and provide value for the dollar, clinical economics is playing an important role in the decision-making process about alternative strategies within health care organizations. There are several strategies one may pursue to examine the economics of medical interventions. The predominant strategies include: cost identification, cost effectiveness, cost utility, and cost benefit. This review provides a basis for performing clinical economic evaluations in sleep disorders.

Costs and Cost Analysis↗
PubMed1976

The pattern of acceptance by Blacks of family planning facilities in relation to socio-economic status.

Two factors which are said to increase the acceptability of family planning in a developing country are, firstly, the ready availability of the facilities and, secondly, the raising of the socio-economic level of the community. This survey reports the effects on family planning of increasing socio-economic status on the one hand, and of urbanisation without an associated increase in the socio-economic level on the other. It is concluded that, although socio-economic status has some effect on family planning, it has a greater effect on the survival rate of children. Urbanisation, however, with family planning facilities more readily available, exerts a stronger influence upon the acceptance of family planning than socio-economic status.

Adult↗
PubMed1997

Annual economic loss caused by Taenia saginata asiatica taeniasis in three endemic areas of east Asia.

The Taenia saginata-like tapeworm in East Asia has been designed as a separate subspecies of T. saginata. It was named as T. saginata asiatica and the classical T. saginata as T. saginata saginata. In the course of conducting experimental infections and morphological studies, a large number of adult worms of T. saginata asiatica was collected. It is possible to estimate the annual economic loss caused by this infection, since the worm load and the weight of worm habored by each infected person were determined from the collection. In the mountainous areas of Taiwan, the infection rate of T. saginata asiatica taeniasis was 11.0%, the worm load was 1.6 worms/case, and the average weight of an adult worm was 20.5 g. The annual economic loss was estimated to be US$ 11,327,423. On Cheju Island of Korea, the infection rate was 6.0%, the worm load was 2 worms/case, and the average weight of an adult worm was 19.3 g. The annual economic loss was estimated to be US$ 13,641,021. On Samosir Island of Indonesia, the infection rate was 21%, the worm load was 1.8 worms/case, and the average weight of an adult worm was 22 g. The annual economic loss was estimated to be US$ 2,425,500. These figures indicate that taeniasis is not only a significant public health problem but also an important economic problem in East Asia.

Animals↗
PubMed2006

[Usability of databases in health economics].

In the health care system, there is increasing demand for health economic analyses to achieve cost reductions or increase efficiency. Apart from classical literature or study-based analyses in health economics, routinely obtained data may complement hitherto missing information for the general medical care situation. By analysing care structures and comparing applied or newly introduced technologies, results can be achieved faster and the significance for payers increased as compared to primary studies. Routinely obtained and potentially usable databases are frequently generated from surveys or from administrative data sources. In spite of clear limitations, these data are interesting in health economics based upon reflection of reality in utilization of services. They can contribute to improved understanding of general medical care and aid in identifying economically appropriate technologies and therapeutic strategies.

Cost-Benefit Analysis↗
PubMed2004

Thermodynamic accounting of ecosystem contribution to economic sectors with application to 1992 U.S. economy.

Incorporation of ecological considerations in decision-making is essential for sustainable development, but is hindered by inadequate appreciation of the role of ecosystems, and lack of scientifically rigorous techniques for including their contribution. This paper develops a novel thermodynamic accounting framework for including the contribution of natural capital via thermodynamic input-output analysis. This framework is applied to the 1992 US economy comprising 91 industry sectors, resulting in delineation of the myriad ways in which sectors of the US economy rely on ecosystem products and services. The contribution of ecosystems is represented via the concept of ecological cumulative exergy consumption (ECEC), which is related to emergy analysis but avoids any of its controversial assumptions and claims. The use of thermodynamics permits representation of all kinds of inputs and outputs in consistent units, facilitating the definition of aggregate metrics. Total ECEC requirement indicates the extent to which each economic sector relies directly and indirectly on ecological inputs. The ECEC/money ratio indicates the relative monetary versus ecological throughputs in each sector, and indicates the relationship between the thermodynamic work needed to produce a product or service and the corresponding economic activity. This ratio is found to decrease along economic supply chains, indicating industries that are higher up in the economic food chain price ecosystem contribution more than the basic infrastructure industries such as mining and manufacturing. The ratio of CEC with and without inclusion of ecosystems indicates the extent to which conventional thermoeconomic analysis underestimates the contribution of ecosystems. Such ratios, made available for the first time, provide unique insight into the importance of natural capital, and are especially useful in hybrid thermodynamic life cycle analysis of industrial systems. The approach, data compiled in this work, and the resulting insight provide a more ecologically conscious tool for environmental decision-making, and has potential applications at micro as well as macro scales.

Accounting↗
PubMed2000

The Swedish ACCES model: predicting the health economic impact of celecoxib in patients with osteoarthritis or rheumatoid arthritis.

The Arthritis Cost Consequence Evaluation System (ACCES) pharmacoeconomic model was used to evaluate the economic and health impact of the recent introduction of celecoxib for treatment of osteoarthritis (OA) and rheumatoid arthritis (RA) in Sweden. The model demonstrates that use of celecoxib can be expected to reduce the incidence of gastrointestinal adverse events, resource utilization and treatment costs. In a cost-effectiveness analysis, celecoxib demonstrated economic dominance (i.e. improved health at reduced cost) compared with the currently available alternatives for OA, and demonstrated economic dominance against a clinically relevant base-case scenario for RA. In sensitivity analyses, the results were shown to be relatively robust; celecoxib demonstrated economic dominance or favourable cost-effectiveness ratios in all analyses. Based on these data, it can be concluded that the use of celecoxib in Sweden will provide societal benefits by improving health care at reduced cost for patients with OA and RA.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2003

The use of health economic information by reimbursement authorities.

The increasing costs of health-care and the need for cost containment have resulted in a 'fourth hurdle' in the establishment of drug approval and reimbursement policies. This hurdle is the demonstration of a drug's cost-effectiveness through the process of economic evaluation. The role of models in the economic evaluation of pharmaceuticals is becoming increasingly accepted with the recent trend towards developing models with greater transparency and clinical relevance. However, health-care decisions do not, and should not, rely solely on the cost-effectiveness of a drug or intervention. Factors such as disease severity, availability of alternative treatment strategies, cost of drugs to patients, compliance with therapy and patients' satisfaction with overall treatment effectiveness should also be considered, and in some cases can be incorporated into economic evaluation. The Arthritis Cost Consequences Evaluation System (ACCES) is provided as an example of the attributes and limitations that should be considered in determining the usefulness of a model for economic evaluations with the purpose of determining reimbursement policy decisions.

Cost-Benefit Analysis↗
PubMed1991

The economic costs of marital dissolution: why do women bear a disproportionate cost?

"We review the literature on the economic consequences of marital dissolution for women. Longitudinal studies of the effects of divorce and widowhood indicate that both types of dissolutions have negative and prolonged consequences for women's economic well-being. This is not the case for men, where marital dissolution often leads to an improved economic standard of living. Following an examination of empirical studies and measurement issues in the divorce and widowhood literatures, we describe preexisting and direct sources of women's postdissolution economic insecurity." The primary geographical focus is on the United States.

Americas↗
PubMed1989

Economic well-being following marital termination: a comparison of widowed and divorced women.

Several studies of divorced and widowed women show increased odds of becoming poor following the termination of marriage. Both cross-sectional and longitudinal data suggest that the end of marriage is correlated with higher poverty rates. Less is know, however, about factors that influence economic well-being over time, and whether these factors are similar for widows and divorced women. This analysis uses data from the National Longitudinal Surveys cohort of mature women (1967-1982) to examine the probability of becoming poor after widowhood or divorce among mid-life women, and factors that seem to influence economic well-being. Findings show that 40% of widows and over 1/4 of divorced women fall into poverty for at least some time during the 1st 5 years after leaving marriage. The type of marital transition experienced by the woman is not a significant factor in economic well-being, but both age and prior economic standing have positive estimated effects.

Age Factors↗
PubMed1998

Economic organization of medicine and the Committee on the Costs of Medical Care.

Recent strategies in managed care and managed competition illustrate how health care reforms may reproduce the patterns of economic organization of their times. Such a reform approach is not a new development in the United States. The work of the 1927-1932 Committee on the Costs of Medical Care exemplifies an earlier effort that applied forms of economic organization to medical care. The committee tried to restructure medicine along lines consistent with its economic environment while attributing its models variously to science, profession, and business. Like current approaches, the committee's reports defined costs as the major problem and business models of organization as the major solution. The reports recommended expanded financial management and group medicine, which would include growth in self-supporting middle-class services such as fee clinics and middle-rate hospital units. Identifying these elements as corporate practice of medicine, the American Medical Association-based minority dissented from the final report in favor of conserving individual entrepreneurial practice. This continuum in forms of economic organization has limited structural reform strategies in medicine for the remainder of the century.

American Medical Association↗
PubMed1995

Multistage selection for maximum economic return with an application to beef cattle breeding.

Methodology for selection index updating was developed to allow multistage selection. The program determines truncation points for each stage of selection that will maximize either profit or the ratio of aggregate economic gain to cost (R = delta H/C). Either maximum profit or R may be attained by reducing the cost of performance testing in later stages of a multistage program. In order to eliminate the need for multiple integration and assure convergence, a piecewise algorithm was developed. Examples of beef bull selection compared single-stage selection at 1 yr of age, two-stage selection at birth and 1 yr, two-stage selection at 205 d and 1 yr, and three-stage selection at birth, 205 d, and 1 yr. Selection based on three traits (birth weight, gain birth to 205 d, and gain 205 to 365 d) was compared with selection based on four traits (the above three plus ultrasound fat depth) and selection based on five traits (the above four plus feed:gain ratio). Five scenarios were used that allowed variation in proportion of candidates selected for breeding, number of progeny per selected bull, and proportion of profit returned to the nucleus herd. General conclusions based on the examples were 1) multistage selection reduced aggregate economic gain relative to that attained by single-stage selection, 2) inclusion of feed conversion in the index of traits resulted in reduced profit and aggregate economic gain, 3) measurement of feed conversion could be justified when selected bulls produced a large number of progeny, and 4) three-trait selection produced greater profit in all five scenarios than did four- or five-trait selection. Use of the selection updating program described here provides a new source of information that can be used in developing economically sound performance testing and selection programs.

Aging↗
PubMed1997

Quality of life and economic evaluation.

The author examines "the place and role of quality of life in economic evaluation and welfare economics. That exercise certainly involves norms and judgments, but it is also influenced by our reading of factual possibilities, and it influences, in its turn, the nature of prescriptive possibilities we explore and the descriptive statements we choose to make. In this sense, the topic is not confined to welfare economics and involves other branches of economics as well." This essay consists of two lectures, the second of which examines how longevity, life expectancy, and gender- and race-determined mortality differences can contribute to our understanding of quality of life.

Demography↗
PubMed1996

Economic opportunity in Mexico and return migration from the United States.

I analyze the influence of the economic characteristics of origin area on trip duration for Mexican migrants in the United States. I argue that migrants from economically dynamic areas in Mexico with favorable opportunities for employment and small capital investment have a larger incentive to stay in the United States longer and to withstand the psychic costs of separation from family and friends than do migrants from economically stagnant areas in Mexico, where the productive uses of savings are severely limited. In line with this argument we should expect investment opportunities in migrants' origin areas to be associated positively with migrants' trip duration in the United States. To test this hypothesis I use individual- and household-level data on U.S. migration experience collected in 13 Mexican communities. Evidence from parametric hazards models supports the idea that economic characteristics of origin areas influence the motivations and strategies of Mexican migrants in the United States.

Adolescent↗
PubMed1985

Demographic-economic analysis in a multi-zonal region: a case study of Nordrhein-Westfalen.

"This paper develops a series of spatially-disaggregated demographic-economic models, based on an extended Leontief type input-output model. Travel between residence and place of work and residence and place of shopping is included in the models, and a detailed decomposition of a range of multipliers identified. A model explicitly involving travel to work is developed empirically for the state of Nordrhein-Westfalen in West Germany, and sets of multipliers presented which relate changes in demographic and economic variables in particular zones of the state with changes in economic output and employment-related variables in other zones."

Behavior↗
PubMed1985

Forecasting interstate migration with limited data: a demographic-economic approach.

"The limitations of available migration data preclude a time-series approach of modeling interstate migration [in the United States]. The method presented here combines aspects of the demographic and economic approaches to forecasting migration in a manner compatible with existing data. Migration rates are modeled to change in response to changes in economic conditions. When applied to resently constructed data on migration based on income tax returns and then compared to standard demographic projections, the demographic-economic approach has a 20% lower total error in forecasting net migration by state for cohorts of labor-force age."

Americas↗