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PubMed1984

Econometric models and the study of the economic effects of Social Security.

This article provides a relatively nontechnical discussion of previously published research on the use of econometric models in the study of the economic effects of social security. It illustrates the role of econometric model building by focusing on three major applications: forecasting, policy simulation, and hypothesis testing. A series of three macroeconomic examples serves to emphasize that the development and use of such models puts the focus of the analysis on the underlying economic structure. The first example presents a program-specific model of the Social Security system, the second a large-scale model of the U.S. economy, and the third a single-equation analysis of a specific issue.

Employment↗
PubMed2000

Economic impact of using mirtazapine compared to amitriptyline and fluoxetine in the treatment of moderate and severe depression in the UK.

This study modelled the economic impact of mirtazapine, compared to amitriptyline and fluoxetine, in the management of moderate and severe depression in the UK, as well as the costs related to discontinuation of antidepressant treatment. Decision models of the management of moderate and severe depression were developed from clinical trial data, resource use obtained from interviews with general practitioners and psychiatrists, and published literature, and were used to estimate the expected direct National Health Service (NHS) costs of managing a patient with moderate or severe depression. The expected cost of healthcare resource use attributable to managing a patient suffering from moderate or severe depression who discontinues antidepressant treatment, irrespective of the initial treatment, was estimated to be pounds sterling 206 (range pounds sterling 50 to pounds sterling 504) over five months. Using mirtazapine instead of amitriptyline for seven months increases the proportion of successfully treated patients by 21% (from 19.2 to 23.2%) and reduces the expected direct NHS cost by pounds sterling 35 per patient (from pounds sterling 448 to pounds sterling 413). Using mirtazapine instead of fluoxetine for six months increases the proportion of successfully treated patients by 22% (from 15.6 to 19.1%), albeit for an additional cost to the NHS of pounds sterling 27 per patient (from pounds sterling 394 to pounds sterling 420). In conclusion, this study suggests that mirtazapine is a cost-effective antidepressant compared to amitriptyline and fluoxetine in the management of moderate and severe depression in the UK.

Adolescent↗
PubMed2005

Economic efficiency versus social equality? The U.S. liberal model versus the European social model.

This article begins by challenging the widely held view in neoliberal discourse that there is a necessary trade-off between higher efficiency and lower reduction of inequalities: the article empirically shows that the liberal, U.S. model has been less efficient economically (slower economic growth, higher unemployment) than the social model in existence in the European Union and in the majority of its member states. Based on the data presented, the authors criticize the adoption of features of the liberal model (such as deregulation of their labor markets, reduction of public social expenditures) by some European governments. The second section analyzes the causes for the slowdown of economic growth and the increase of unemployment in the European Union--that is, the application of monetarist and neoliberal policies in the institutional frame of the European Union, including the Stability Pact, the objectives and modus operandi of the European Central Bank, and the very limited resources available to the European Commission for stimulating and distributive functions. The third section details the reasons for these developments, including (besides historical considerations) the enormous influence of financial capital in the E.U. institutions and the very limited democracy. Proposals for change are included.

Economics↗
PubMed2006

Economic rationality and health and lifestyle choices for people with diabetes.

Economic rationality is traditionally represented by goal-oriented, maximising behaviour, or 'instrumental rationality'. Such a consequentialist, instrumental model of choice is often implicit in a biomedical approach to health promotion and education. The research reported here assesses the relevance of a broader conceptual framework of rationality, which includes 'procedural' and 'expressive' rationality as complements to an instrumental model of rationality, in a health context. Q methodology was used to derive 'factors' underlying health and lifestyle choices, based on a factor analysis of the results of a card sorting procedure undertaken by 27 adult respondents with type 2 diabetes in Newcastle upon Tyne, UK. These factors were then compared with the rationality framework and the appropriateness of an extended model of economic rationality as a means of better understanding health and lifestyle choices was assessed. Taking a wider rational choice perspective, choices which are rendered irrational within a narrow-biomedical or strictly instrumental model, can be understood in terms of a coherent rationale, grounded in the accounts of respondents. The implications of these findings are discussed in terms of rational choice theory and diabetes management and research.

Adult↗
PubMed2006

The impact of occupational injury reduction on the U.S. economy.

BACKGROUND: Preventing occupational injuries reduces labor and fringe benefit costs to employers. The related savings filter through the economy, impacting its performance. This study is a first attempt to measure the impact of occupational injury reduction on national economic output, gross domestic product, national income, and employment by using an input-output model of the U.S. economy. METHODS: Occupational injury costs by industry for 1993 were used as a baseline for an input-output model, and the impact of the 38% injury rate reduction between 1993 and 2002 was measured. All computations are in year 2000 dollars. RESULTS: Declining occupational injury between 1993 and 2002 increased employment by an estimated 550,000 jobs. The increase in gross domestic product (GDP) was 25.5 billion US dollars or 9% of the average annual GDP increase from 1993 to 2002. CONCLUSIONS: These estimates represent the benefits of injury rate reduction but ignore associated prevention costs.

Accident Prevention↗
PubMed1996

A Framework to Assess Regional Environmental Impacts of Dedicated Energy Crop Production

Numerous studies have evaluated air quality and greenhouse gas mitigation benefits of biomass energy systems, but the potential environmental impacts associated with large-scale changes in land-use patterns needed to produce energy crops have not been quantified. This paper presents a framework to assess the potential soil, water, and biodiversity impacts that may result from the large-scale production of dedicated energy crops. The framework incorporates producer economic decision models with environmental models to assess changes in land use patterns and to quantify the consequent environmental impacts. Economic and policy issues that will affect decisions to produce energy crops are discussed. The framework is used to evaluate erosion and chemical runoff in two Tennessee regions. The analysis shows that production of dedicated energy crops in place of conventional crops will significantly reduce erosion and chemical runoff.

Journal Article↗
PubMed2006

Cost-effectiveness of the treatment and prevention of osteoporosis--a review of the literature and a reference model.

OBJECTIVE: The purpose of the paper is to update and review the latest developments related to modelling and economic evaluation of osteoporosis in the period 2002-2005 and further to present a reference model for the assessment of the cost-effectiveness of the prevention and treatment of osteoporosis. DISCUSSION: The reference model is intended to be used for fracture specific interventions affecting the risk of fracture. An interface version and an extensive description of the model is available on the internet ( http://www.healtheconomics.se ) and also accessible via the International Osteoporosis Foundation ( http://www.osteofound.org ). The purpose of the reference model is to improve the quality and comparability of cost-effectiveness analysis in the osteoporosis field and to serve as a tool for validation of present and future cost-effectiveness models. The reference model allows the cost-effectiveness analysis to be carried out from a societal perspective including intervention, morbidity and mortality costs. The model has been extensively tested and calibrated, and meets the properties of good decision analytic modelling. The model is a state transition Markov cohort model, which is characterised by a 50-year time horizon divided into one year cycle lengths. The following health states are included: "healthy", "hip fracture", "spine fracture", "wrist fracture", "other fracture", and "dead". CONCLUSION: The model is flexible and allows for the estimation of the cost-effectiveness over different ranges for a selected number of variables (e.g., age, fracture risk, cost of intervention).

Aged↗
PubMed2000

The next reinforcer: comment on Meisch (2000)

The comment herein is a response to R.A. Meisch (2000), in which he argues for a new conceptualization of reinforcer effects, vis-à-vis relative persistence. The concept is likely to be quite helpful. It is similar to some applications derived from behavioral economics.

Animals↗
PubMed2000

Culture, politics and ergonomics.

The beginning of a new century is an appropriate moment to consider the role of ergonomics in relation to the problems facing society. To help solve these serious global problems, ergonomics needs to be open to new disciplines, particularly those in the social sciences. Also, it may be difficult to generalize research on human-centred sociotechnical design without taking into account national characteristics, economics and political constraints. Currently there is more interest than ever in what ergonomics has to offer, but to deliver its promise requires a much broader approach than is usual. By adopting such new approaches one may help solve both the problems of the overdeveloped postindustrial societies and those of the societies of the Third World, where a new approach to work and economics may provide an improved chance for development given the recent changes in global economic policy.

Culture↗
PubMed1988

Selective embolization and clot dissolution with tPA in the internal carotid artery circulation of the rabbit.

We describe a model of thromboembolic stroke in rabbits that utilizes the Seldinger technique and digital arteriography. The internal carotid arteries of 14 rabbits were catheterized selectively and embolized with autologous blood clots. After embolization, eight rabbits received IV tissue plasminogen activator (tPA); the remaining six were infused with saline and served as controls. After embolization, cerebral arteriograms were obtained at 30-min intervals for 180 min. Cerebral arteriograms obtained after tPA therapy revealed partial or complete thrombus dissolution in seven (88%) of the eight treated rabbits. In the control group, none of the arteriograms of the embolized internal carotid arteries showed thrombus dissolution. In the tPA-treated group, the median time for thrombus dissolution was 60 min. This stroke model is economical, reproducible, and less traumatic to the brain than most of the previously described animal models. It also provides a means to compare the safety and efficacy of various thrombolytic agents in small animals.

Animals↗
PubMed1990

Settlement formation. Part I: a dynamic theory.

"The dynamic process of settlement formation is a fundamental issue in regional science. Our proposed model integrates the economic and migratory sectors in terms of endogenous variables in order to describe the evolution of continuous population distributions as a self-organising process.... The purpose...is to show that under strongly idealised conditions, a population consisting of different subpopulations with different economic activities will evolve into a differentiated population pattern. Each member of the subpopulations has the possibility to migrate between locations stimulated by rational economic reasons. This idea, which seems almost self-evident on the level of qualitative argumentation, [will] be cast into a mathematically self-contained quantitative dynamic model."

Behavior↗
PubMed1999

The profitability of vertical mergers between hospitals and physician practices.

We demonstrate that the existence of incentives for vertical mergers between hospitals and physician practices depends upon the relative degree of competitiveness of the two providers' markets. When the degree of competitiveness is comparable, a vertical merger enhances the bargaining position of both merging parties vis-à-vis insurers. In contrast, when one provider's market is much more competitive than the other a vertical merger may reduce the joint profits of the merged entity. Prohibiting the parties from offering their services in conjunction with outside independent entities may restore the profitability of the vertical merger even in this case.

Economic Competition↗
PubMed1999

Economic and health efficiency of education funding policy.

Public spending programmes to reduce poverty, expand primary education and improve the economic status of women are recommended priorities of aid agencies and are now gradually being reflected in third world governments' policies, in response to aid conditions imposed by the World Bank and OECD countries. However outcomes fall short of aspiration. This paper shows that donors' lending policies, especially those restricting public spending on education to the primary level, (1) perpetuate poverty, (2) minimise socio-economic impact of public health programmes and (3) prevent significant improvement in the economic status of women. These effects are the result of fundamental flaws in donors' education policy model. Evidence is presented to show that health status in developing countries will be significantly enhanced by increasing the proportion of the population which has at least post-primary education. Heads of households with just primary education have much the same probability of experiencing poverty and high mortality of their children as those with no education at all. Aid donors' policies, which require governments of developing countries to limit public funding of education to the primary level, have their roots in what is contended here to be an erroneous interpretation of human capital theory. This interpretation focuses only on the declining marginal internal rates of return on public investments in successive levels of schooling and ignores the opposite message of the increasing marginal net present values of those investments. Cars do not travel fastest in their lowest gear despite its fastest acceleration, life's long journey is not most comfortable for those with only primary schooling.

Developing Countries↗
PubMed2004

[Health economic studies in dermatology--review of the literature, evaluation and practical aspects].

BACKGROUND: Health economic studies attempt to objectivity treatment results to place them in economic. These studies summarize both physician care and other medical services to allow a more rational use of limited resources and are of great value. METHODS: The health economic studies in the literature were analyzed by the conducting countries, financing, the study period and the interval until publication. A quantitative comparison to other specialties in medicine was performed. On the basis of a checklist of basic criteria, a qualitative assessment of the studies was performed to rate the significance. RESULTS: The number of studies showed a fivefold increase. A third of the dermatological studies (n = 71) were conducted in the United States, 23.94% in Great Britain, 9.86% in Sweden and 35.23% in other countries. The interval until publication was 0 to 9 years. CONCLUSIONS: The increase in the number of studies may be explained by the growing demand for clarification of the economical situation. Reasons for the significant differences between different countries might be the financing of the studies or the nature of the dominant health care system. Whereas American studies are predominantly sponsored by pharmaceutical companies, the ones in Great Britain and Sweden are supported by public authorities. The long delays in publishing may be accounted for by long review periods and by difficulties in transferring large amounts of data in international studies. Particularly the introduction of the DRG system in Germany has increased demands for cost-effective action on the basis of well-founded and high-quality health economic studies.

Cost-Benefit Analysis↗