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Sample records for great financial burden

  1. Financial burden in recipients of allogeneic hematopoietic cell transplantation.

    Science.gov (United States)

    Khera, Nandita; Chang, Yu-hui; Hashmi, Shahrukh; Slack, James; Beebe, Timothy; Roy, Vivek; Noel, Pierre; Fauble, Veena; Sproat, Lisa; Tilburt, Jon; Leis, Jose F; Mikhael, Joseph

    2014-09-01

    Although allogeneic hematopoietic cell transplantation (HCT) is an expensive treatment for hematological disorders, little is known about the financial consequences for the patients who undergo this procedure. We analyzed factors associated with its financial burden and its impact on health behaviors of allogeneic HCT recipients. A questionnaire was retrospectively mailed to 482 patients who underwent allogeneic HCT from January 2006 to June 2012 at the Mayo Clinic, to collect information regarding current financial concerns, household income, employment, insurance, out-of-pocket expenses, and health and functional status. A multivariable logistic regression analysis identified factors associated with financial burden and treatment nonadherence. Of the 268 respondents (56% response rate), 73% reported that their sickness had hurt them financially. All patients for whom the insurance information was available (missing, n = 13) were insured. Forty-seven percent of respondents experienced financial burden, such as household income decreased by >50%, selling/mortgaging home, or withdrawing money from retirement accounts. Three percent declared bankruptcy. Younger age and poor current mental and physical functioning increased the likelihood of financial burden. Thirty-five percent of patients reported deleterious health behaviors because of financial constraints. These patients were likely to be younger, have lower education, and with a longer time since HCT. Being employed decreased the likelihood of experiencing financial burden and treatment nonadherence due to concern about costs. A significant proportion of allogeneic HCT survivors experience financial hardship despite insurance coverage. Future research should investigate potential interventions to help at-risk patients and prevent adverse financial outcomes after this life-saving procedure. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  2. Financial Burden Borne by Laparoscopic Living Kidney Donors.

    Science.gov (United States)

    Wiseman, Jennifer F; Jacobs, Cheryl L; Larson, Dawn B; Berglund, Danielle M; Garvey, Catherine A; Ibrahim, Hassan N; Matas, Arthur J

    2017-09-01

    Living kidney donors have donation-related out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs). Yet there is little information about how much of a subjective burden these constitute for the donors. From December 2003 through December 2014, we surveyed donors 6 months postdonation to determine their financial burden related to donation (on a scale of 1 to 10) and what resources were used to cover expenses. Of 1136 surveyed, 796 (70%) responded. Among respondents, mean age at donation was 43.6 ± 10.6 years, 64% were women, 96% were white, and 53% were related by blood to their recipient. Overall, 26% scored their financial burden as 5 or higher; 8% scored it as 8 or higher. Increased expenses were associated with a higher reported burden; however, significant burden was reported by some with no out-of-pocket expenses (presumably due to lost wages and continuing expenses). The burden was scored as 5 or higher by 27% of those employed outside the home (n = 660), 15% homemakers, 13% retirees, 40% students; 28% unemployed; and 26% whose occupation was unknown. Over half (51%) of those receiving a local or (means-tested) national grant still reported moderate to severe burden. Besides grants, donors used a variety of sources to help offset expenses: dipped into savings, borrowed from friends or family, took out a loan, and/or had a fundraiser. Those with the highest burden reported using the most additional sources. Donors should not have to incur costs or a financial burden to donate; the transplant community should strive to make donation financially neutral.

  3. Financial burden of medical care: a family perspective.

    Science.gov (United States)

    Cohen, Robin A; Kirzinger, Whitney K

    2014-01-01

    Data from the National Health Interview Survey, 2012. In 2012, more than one in four families experienced financial burdens of medical care. Families with incomes at or below 250% of the federal poverty level (FPL) were more likely to experience financial burdens of medical care than families with incomes above 250% of the FPL. Families with children aged 0-17 years were more likely than families without children to experience financial burdens of medical care. The presence of a family member who was uninsured increased the likelihood that a family would experience a financial burden of medical care. Recently published data from the National Health Interview Survey (NHIS) found that 1 in 5 persons was in a family having problems paying medical bills, and 1 in 10 persons was in a family with medical bills that they were unable to pay at all (1-3). NHIS defines "family" as an individual or a group of two or more related persons living together in the same housing unit. The family perspective is important to consider when examining financial risk because significant expenses for one family member may adversely affect the whole family. Health insurance coverage is one way for a family to mitigate financial risk associated with health care costs, although health insurance status may differ among family members. This report explores selected family demographic characteristics and their association with financial burdens of medical care (problems paying medical bills, paying medical bills over time, and having medical bills that cannot be paid) based on data from the 2012 NHIS. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  4. Factors associated with perceived donation-related financial burden among living kidney donors.

    Science.gov (United States)

    Ruck, Jessica M; Holscher, Courtenay M; Purnell, Tanjala S; Massie, Allan B; Henderson, Macey L; Segev, Dorry L

    2018-03-01

    The perception of living kidney donation-related financial burden affects willingness to donate and the experience of donation, yet no existing tools identify donors who are at higher risk of perceived financial burden. We sought to identify characteristics that predicted higher risk of perceived financial burden. We surveyed 51 living kidney donors (LKDs) who donated from 01/2015 to 3/2016 about socioeconomic characteristics, predonation cost concerns, and perceived financial burden. We tested associations between both self-reported and ZIP code-level characteristics and perceived burden using Fisher's exact test and bivariate modified Poisson regression. Donors who perceived donation-related financial burden were less likely to have an income above their ZIP code median (14% vs. 72%, P = .006); however, they were more likely than donors who did not perceive burden to rent their home (57% vs. 16%, P = .03), have an income donation-related cost concerns prior to donation might allow transplant centers to target financial support interventions toward potential donors at higher risk of perceiving donation-related financial burden. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. The personal financial burden of chronic rhinosinusitis: A Canadian perspective.

    Science.gov (United States)

    Yip, Jonathan; Vescan, Allan D; Witterick, Ian J; Monteiro, Eric

    2017-07-01

    Previous studies describe the financial burden of chronic rhinosinusitis (CRS) from the perspective of third-party payers, but, to our knowledge, none analyze the costs borne by patients (i.e., out-of-pocket expenses [OOPE]). Furthermore, this burden has not been previously investigated in the context of a publicly funded health care system. The purpose of this study was to characterize the financial impact of CRS on patients, specifically by evaluating its associated OOPEs and the perceived financial burden. The secondary aim was to determine the factors predictive of OOPEs and perceived burden. Patients with CRS at a tertiary care sinus center completed a self-administered questionnaire that assessed their socioeconomic characteristics, disease-specific quality of life (22-item Sino-Nasal Outcome Test [SNOT-22]), workdays missed due to CRS, perceived financial burden, and direct medical and nonmedical OOPEs over a 12-month period. Total OOPEs were calculated from the sum of direct medical and nonmedical OOPEs. Regression analyses determined factors predictive of OOPEs and the perceived burden. A total of 84 patients completed the questionnaires. After accounting for health insurance coverage and the median direct medical, direct nonmedical, and total OOPEs per patient over a 12-month period were Canadian dollars (CAD) $336.00 (2011) [U.S. $339.85], CAD $129.87 [U.S. $131.86], and CAD $607.10 [U.S. $614.06], respectively. CRS resulted in an average of 20.6 workdays missed over a 12-month period. Factors predictive of a higher financial burden included younger age, a greater number of previous sinus surgeries, financial burden and consider counseling them on strategies to offset expenses, including obtaining travel grants, using telemedicine for follow-up assessments, providing drug samples, and streamlining diagnostic testing with medical visits.

  6. Financial Burden Associated with Time to Return to Work After Living Kidney Donation.

    Science.gov (United States)

    Larson, Dawn B; Wiseman, Jennifer F; Vock, David; Bergund, Danielle M; Roman, Ashley; Ibrahim, Hassan Nimer; Matas, Arthur J

    2018-05-25

    Many living kidney donors undertake a significant financial burden in order to donate. We studied the association between time to return to work and reported financial burden. Kidney donors, who donated from 2/2005 - through 12/2015 (n=1012) were surveyed 6 months postdonation, and asked about occupation; time to return to work; and financial burden (on a 10-point Likert scale). Of 856 donors working for pay, 629 (73%) responded. After adjusting for donor characteristics, increased length of time to return to work was a significant predictor of financial burden (pfinancial burden for each week away from work (p=0.003). Older age at donation and nondirected (vs directed) donation were associated with significantly decreased financial burden. These observations provide additional information to better inform donor candidates, and further emphasize the need to develop policies so that living kidney donation can be financially neutral. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. The heterogeneity in financial and time burden of caregiving to children with chronic conditions.

    Science.gov (United States)

    Zan, Hua; Scharff, Robert L

    2015-03-01

    We examine the financial and time burdens associated with caring for children with chronic conditions, focusing on disparities across types of conditions. Using linked data from the 2003 to 2006 National Health Interview Survey and 2004-2008 Medical Expenditure Panel Survey, we created measures of financial burden (out-of-pocket healthcare costs, the ratio of out-of-pocket healthcare costs to family income, healthcare costs paid by insurance, and total healthcare costs) and time burden (missed school time due to illness or injury and the number of doctor visits) associated with 14 groups of children's chronic conditions. We used the two-part model to assess the effect of condition on financial burden and finite mixture/latent class model to analyze the time burden of caregiving. Controlling for the influences of other socio-demographic characteristics on caregiving burden, children with chronic conditions have higher financial and time burdens relative to caregiving burdens for healthy children. Levels of financial burden and burden sharing between families and insurance system also vary by type of condition. For example, children with pervasive developmental disorder or heart disease have a relatively low financial burden for families, while imposing a high cost on the insurance system. In contrast, vision difficulties are associated with a high financial burden for families relative to the costs borne by others. With respect to time burden, conditions such as cerebral palsy and heart disease impose a low time burden, while conditions such as pervasive developmental disorder are associated with a high time burden. This study demonstrates that differences exist in caregiving burden for children by type of chronic condition. Each condition has a unique profile of time and financial cost burden for families and the insurance system. These results have implications for policymakers and for families' savings and employment decisions.

  8. The impending financial healthcare burden and ethical dilemma of systemic therapy in metastatic cancer.

    Science.gov (United States)

    Riaz, Muhammad Kashif; Bal, Susan; Wise-Draper, Trisha

    2016-09-01

    Metastatic cancer remains a devastating disease that threatens to disrupt entire family structures creating economic and psychosocial stress. Fortunately, great strides have resulted in improved therapies over the years but at a huge social-economic cost. The economic burden has risen greatly and carries with it new ethical concerns when deciding treatment. Here, we discuss the financial and ethical challenges that oncologists and their patients face in the era of novel treatment strategies. J. Surg. Oncol. 2016;114:323-328. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. Perceived parent financial burden and asthma outcomes in low-income, urban children.

    Science.gov (United States)

    Patel, Minal R; Brown, Randall W; Clark, Noreen M

    2013-04-01

    The purpose of this study was to describe the demographic characteristics of low-income parents who perceive financial burden in managing their child's asthma and related associations with their children's asthma outcomes and clinical characteristics. We hypothesized that (1) identifiable differences between parents who do and do not report burden; (2) regardless of access to care, asthma outcomes would be worse for children whose parents perceive financial burden in obtaining care for their child's condition. Baseline data from a randomized trial evaluating the effect of a school-based asthma intervention were analyzed for this research. Eight hundred thirty-five parents were interviewed by telephone regarding their child's asthma management. Associations between demographic and clinical factors and perception of financial burden were examined using bivariate analysis. Multivariate regression analyses were used to examine associations between perceptions of financial burden and asthma outcomes, including emergency department visits, hospitalizations, and missed school days. Perceived financial burden was evident in 10% (n = 79) of parents. Female heads of household (χ2 (3) = 7.41; p financial burden. In models controlling for level of asthma control, income, and having a usual source of asthma care, parents who perceived financial burden were more likely to have children who had at least one emergency department visit (OR = 1.95; 95% CI = 1.15 to 3.29), hospitalization (OR = 3.99; 95% CI = 2.03 to 7.82), or missed school days due to asthma (OR = 3.26; 95% CI = 1.60 to 6.67) in the previous year. Our results supported our hypotheses. Among low-income parents of children with asthma, the majority do not perceive financial burden to obtaining care. However, among parents that do perceive burden, urgent care use and missed school days due to asthma for their child were significantly higher, regardless of family income and having a

  10. Financial burdens and mental health needs in families of children with congenital heart disease.

    Science.gov (United States)

    McClung, Nancy; Glidewell, Jill; Farr, Sherry L

    2018-04-06

    To examine the financial burdens and mental health needs of families of children with special healthcare needs (CSHCN) with congenital heart disease (CHD). Data from the 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were used to examine parent-reported financial burdens (out-of-pocket expenses, financial problems, employment impact, caregiving hours) and family members' need for mental health services in families of CSHCN with CHD. Multivariable logistic regression was used to compare financial burdens and family members' need for mental health services among CSHCN with and without CHD. Among CSHCN with CHD, multivariable logistic regression, stratified by age (0-5 and 6-17 years), was used to assess characteristics associated with the outcomes. Overall, families of 89.1% of CSHCN with CHD experienced at least one financial burden and 14.9% needed mental health services due to the child's condition. Compared with CSHCN without CHD, those with CHD had families with a higher prevalence of all financial burdens (adjusted prevalence ratio [aPR] range: 1.4-1.8) and similar family member need for mental health services (aPR = 1.3, 95% CI [1.0, 1.6]). Across both age groups, insurance type, activity limitations, and comorbidities were significantly associated with financial burdens and/or family members' need for mental health services. CSHCN with CHD, compared with those without CHD, lived in families with more financial burdens. Interventions that reduce financial burdens and improve mental health of family members are needed, especially among CSHCN with CHD who are uninsured and have comorbidities or activity limitations. © 2018 Wiley Periodicals, Inc.

  11. Financial fragility in the Great Moderation

    NARCIS (Netherlands)

    Bezemer, Dirk; Grydaki, Maria

    2014-01-01

    A nascent literature explores the measurement of financial fragility. This paper considers evidence for rising financial fragility during the 1984-2007 Great Moderation in the U.S. The literature suggests that macroeconomic stability combined with strong growth of credit to asset markets, in asset

  12. Self-reported depression and perceived financial burden among long-term rectal cancer survivors.

    Science.gov (United States)

    Chongpison, Yuda; Hornbrook, Mark C; Harris, Robin B; Herrinton, Lisa J; Gerald, Joe K; Grant, Marcia; Bulkley, Joanna E; Wendel, Christopher S; Krouse, Robert S

    2016-11-01

    Types of surgery for rectal cancer (RC), including permanent ostomy (PO) or temporary ostomy followed by anastomosis (TO) or initial anastomosis (AN), can affect psychological and financial well-being during active treatment. However, these relationships have not been well studied among long-term survivors (≥5 years post-diagnosis). A mailed survey with 576 long-term RC survivors who were members of Kaiser Permanente was conducted in 2010-2011. Prevalence of current depression was ascertained using a score of ≤45.6 on the Short Form-12 version 2 mental component summary. Perceived financial burden was assessed using a Likert scale ranging from 0 (none) to 10 (severe). Regression analyses were used to measure associations after adjustment for covariates. The overall prevalence of depression was 24% among RC survivors with the highest prevalence among those with a history of PO (31%). The adjusted odds of depression among TO and AN survivors were lower than that among PO survivors, 0.42 (CI 95% 0.20-0.89) and 0.59 (CI 95% 0.37-0.93), respectively. Twenty-two percent perceived moderate-to-high current financial burden (≥4 points). PO survivors also reported higher mean financial burden than AN survivors (2.6 vs. 1.6, respectively; p = 0.002), but perceived burden comparably to TO survivors (2.3). Self-reported depression was associated with higher perceived financial burden (p reported frequently among these long-term RC survivors, particularly among PO survivors. Depression was associated with greater perception of financial burden. Screening for depression and assessing financial well-being might improve care among long-term RC survivors.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Nipp, Ryan D; Kirchhoff, Anne C; Fair, Douglas; Rabin, Julia; Hyland, Kelly A; Kuhlthau, Karen; Perez, Giselle K; Robison, Leslie L; Armstrong, Gregory T; Nathan, Paul C; Oeffinger, Kevin C; Leisenring, Wendy M; Park, Elyse R

    2017-10-20

    Purpose Survivors of childhood cancer may experience financial burden as a result of health care costs, particularly because these patients often require long-term medical care. We sought to evaluate the prevalence of financial burden and identify associations between a higher percentage of income spent on out-of-pocket medical costs (≥ 10% of annual income) and issues related to financial burden (jeopardizing care or changing lifestyle) among survivors of childhood cancer and a sibling comparison group. Methods Between May 2011 and April 2012, we surveyed an age-stratified, random sample of survivors of childhood cancer and a sibling comparison group who were enrolled in the Childhood Cancer Survivor Study. Participants reported their household income, out-of-pocket medical costs, and issues related to financial burden (questions were adapted from national surveys on financial burden). Logistic regression identified associations between participant characteristics, a higher percentage of income spent on out-of-pocket medical costs, and financial burden, adjusting for potential confounders. Results Among 580 survivors of childhood cancer and 173 siblings, survivors of childhood cancer were more likely to have out-of-pocket medical costs ≥ 10% of annual income (10.0% v 2.9%; P report spending a higher percentage of their income on out-of-pocket medical costs, which may influence their health-seeking behavior and potentially affect health outcomes. Our findings highlight the need to address financial burden in this population with long-term health care needs.

  14. Population-based assessment of cancer survivors' financial burden and quality of life: a prospective cohort study.

    Science.gov (United States)

    Zafar, S Yousuf; McNeil, Rebecca B; Thomas, Catherine M; Lathan, Christopher S; Ayanian, John Z; Provenzale, Dawn

    2015-03-01

    The impact of financial burden among patients with cancer has not yet been measured in a way that accounts for inter-relationships between quality of life, perceived quality of care, disease status, and sociodemographic characteristics. In a national, prospective, observational, population- and health care systems-based cohort study, patients with colorectal or lung cancer were enrolled from 2003 to 2006 within 3 months of diagnosis. For this analysis, surviving patients who were either disease free or had advanced disease were resurveyed a median 7.3 years from diagnosis. Structural equation modeling was used to investigate relationships between financial burden, quality of life, perceived quality of care, and sociodemographic characteristics. Among 1,000 participants enrolled from five geographic regions, five integrated health care systems, or 15 Veterans Administration Hospitals, 89% (n = 889) were cancer free, and 11% (n = 111) had advanced cancer. Overall, 48% (n = 482) reported difficulties living on their household income, and 41% (n = 396) believed their health care to be "excellent." High financial burden was associated with lower household income (adjusted odds ratio [OR] = 0.61 per $20k per year, P financial burden was also associated with poorer quality of life (adjusted beta = -0.06 per burden category; P Financial burden is prevalent among cancer survivors and is related to patients' health-related quality of life. Future studies should consider interventions to improve patient education and engagement with regard to financial burden. Copyright © 2014 by American Society of Clinical Oncology.

  15. The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

    OpenAIRE

    Lugo-Palacios, David G; Cairns, John

    2016-01-01

    Objective. To estimate the financial and health burden of diabetic ambulatory care sensitive hospitalisations (ACSH) in Mexico during 2001-2011. Materials and methods. We identified ACSH due to diabetic complications in general hospitals run by local health ministries and estimated their financial cost using diagnostic related groups. The health burden estimation assumes that patients would not have experienced complications if they had received appropriate primary care and computes the assoc...

  16. Impact of financial burden of cancer on survivors' quality of life.

    Science.gov (United States)

    Fenn, Kathleen M; Evans, Suzanne B; McCorkle, Ruth; DiGiovanna, Michael P; Pusztai, Lajos; Sanft, Tara; Hofstatter, Erin W; Killelea, Brigid K; Knobf, M Tish; Lannin, Donald R; Abu-Khalaf, Maysa; Horowitz, Nina R; Chagpar, Anees B

    2014-09-01

    Little is known about the relationship between the financial burden of cancer and the physical and emotional health of cancer survivors. We examined the association between financial problems caused by cancer and reported quality of life in a population-based sample of patients with cancer. Data from the 2010 National Health Interview Survey (NHIS) were analyzed. A multivariable regression model was used to examine the relationship between the degree to which cancer caused financial problems and the patients' reported quality of life. Of 2,108 patients who answered the survey question, "To what degree has cancer caused financial problems for you and your family?," 8.6% reported "a lot," whereas 69.6% reported "not at all." Patients who reported "a lot" of financial problems as a result of cancer care costs were more likely to rate their physical health (18.6% v 4.3%, P financial hardship. On multivariable analysis controlling for all of the significant covariates on bivariate analysis, the degree to which cancer caused financial problems was the strongest independent predictor of quality of life. Patients who reported that cancer caused "a lot" of financial problems were four times less likely to rate their quality of life as "excellent," "very good," or "good" (odds ratio = 0.24; 95% CI, 0.14 to 0.40; P financial burden asa result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors. Copyright © 2014 by American Society of Clinical Oncology.

  17. Patient perceptions of asthma-related financial burden: public vs. private health insurance in the United States.

    Science.gov (United States)

    Patel, Minal R; Caldwell, Cleopatra H; Song, Peter X K; Wheeler, John R C

    2014-10-01

    Given the complexity of the health insurance market in the United States and the confusion that often stems from these complexities, patient perception about the value of health insurance in managing chronic disease is important to understand. To examine differences between public and private health insurance in perceptions of financial burden with managing asthma, outcomes, and factors that explain these perceptions. Secondary analysis was performed using baseline data from a randomized clinical trial that were collected through telephone interviews with 219 African American women seeking services for asthma and reporting perceptions of financial burden with asthma management. Path analysis with multigroup models and multiple variable regression analyses were used to examine associations. For public (P financial burden through different explanatory pathways. When adjusted for multiple morbidities, asthma control, income, and out-of-pocket expenses, those with private insurance used fewer inpatient (P financial burden was associated with more urgent office visits (P financial burden regardless of health insurance report more urgent health care visits and lower quality of life. Burden may be present despite having and being able to generate economic resources and health insurance. Further policy efforts are indicated and special attention should focus on type of coverage. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico.

    Science.gov (United States)

    Lugo-Palacios, David G; Cairns, John

    2016-01-01

    To estimate the financial and health burden of diabetic ambulatory care sensitive hospitalisations (ACSH) in Mexico during 2001-2011. We identified ACSH due to diabetic complications in general hospitals run by local health ministries and estimated their financial cost using diagnostic related groups. The health burden estimation assumes that patients would not have experienced complications if they had received appropriate primary care and computes the associated Disability-Adjusted Life Years (DALYs). The financial cost of diabetic ACSH increased by 125% in real terms and their health burden in 2010 accounted for 4.2% of total DALYs associated with diabetes in Mexico. Avoiding preventable hospitalisations could free resources within the health system for other health purposes. In addition, patients with ACSH suffer preventable losses of health that should be considered when assessing the performance of any primary care intervention.

  19. Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

    Science.gov (United States)

    Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

    2005-12-01

    To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. The Household Component of the 2001 Medical Expenditure Panel Survey. Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. We aggregated annual OOP expenditures for all members of 4,531 families with a child members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. A regressive gradient was noted for financial burden across income groups, with families with incomes Poverty Level (FPL) spending a mean of 119.66 US dollars OOP per 1,000 US dollars of family income and families with incomes 100-199 percent FPL spending 66.30 US dollars OOP per 1,000 US dollars, compared with 37.75 US dollars for families with incomes >400 percent FPL. For low-income families (families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage.

  20. The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

    Directory of Open Access Journals (Sweden)

    David G Lugo-Palacios

    2016-01-01

    Full Text Available Objective.To estimate the financial and health burden of diabetic ambulatory care sensitive hospitalisations (ACSH in Mexico during 2001-2011. Materials and methods. We identified ACSH due to diabetic complications in general hospitals run by local health ministries and estimated their financial cost using diagnostic related groups. The health burden estimation assumes that patients would not have experienced complications if they had received appropriate primary care and computes the associated DisabilityAdjusted Life Years (DALYs. Results. The financial cost of diabetic ACSH increased by 125% in real terms and their health burden in 2010 accounted for 4.2% of total DALYs associated with diabetes in Mexico. Conclusion. Avoiding preventable hospitalisations could free resources within the health system for other health purposes. In addition, patients with ACSH suffer preventable losses of health that should be considered when assessing the performance of any primary care intervention.

  1. Adult informal caregivers reporting financial burden in Hawaii, Kansas, and Washington: Results from the 2007 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Kusano, Claudia T; Bouldin, Erin D; Anderson, Lynda A; McGuire, Lisa C; Salvail, Florentina R; Simmons, Katrina Wynkoop; Andresen, Elena M

    2011-10-01

    Given the unpaid nature of the work, informal caregiving can create a financial burden for caregivers. Little has been done to identify specific predictors of experiencing financial burden. This study investigated demographic and health factors comparing caregivers who reported having or not having financial burden. Data are derived from adult caregivers (N = 3,317) as part of the 2007 Behavioral Risk Factor Surveillance System in Hawaii, Kansas, and Washington. The adjusted odds ratios for reporting a financial burden were estimated for demographic and other risk factors. Caregivers who reported a financial burden were younger, had lower incomes, were more likely to be current smokers, have had a stroke, and rate their health as fair or poor compared to caregivers who did not report a financial burden. Caregivers who were younger (ages 18-34), resided with care recipients, spent 20-39 hours per week providing care, and reported having a disability were at a statistically significantly higher odds of reporting a financial burden. Given the current economic difficulties faced by many Americans, further insights into the perceived financial burdens experienced by informal caregivers as well as linkages to policy and programs designed to support caregivers are critical for public health professionals to address the expanding needs in states and communities. Published by Elsevier Inc.

  2. Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia.

    Science.gov (United States)

    Morishita, Fukushi; Yadav, Rajendra-Prasad; Eang, Mao Tan; Saint, Saly; Nishikiori, Nobuyuki

    2016-01-01

    Despite free TB services available in public health facilities, TB patients often face severe financial burden due to TB. WHO set a new global target that no TB-affected families experience catastrophic costs due to TB. To monitor the progress and strategize the optimal approach to achieve the target, there is a great need to assess baseline cost data, explore potential proxy indicators for catastrophic costs, and understand what intervention mitigates financial burden. In Cambodia, nationwide active case finding (ACF) targeting household and neighbourhood contacts was implemented alongside routine passive case finding (PCF). We analyzed household cost data from ACF and PCF to determine the financial benefit of ACF, update the baseline cost data, and explore whether any dissaving patterns can be a proxy for catastrophic costs in Cambodia. In this cross-sectional comparative study, structured interviews were carried out with 108 ACF patients and 100 PCF patients. Direct and indirect costs, costs before and during treatment, costs as percentage of annual household income and dissaving patterns were compared between the two groups. The median total costs were lower by 17% in ACF than in PCF ($240.7 [IQR 65.5-594.6] vs $290.5 [IQR 113.6-813.4], p = 0.104). The median costs before treatment were significantly lower in ACF than in PCF ($5.1 [IQR 1.5-25.8] vs $22.4 [IQR 4.4-70.8], pCambodia. ACF has the great potential to mitigate the costs incurred particularly before treatment. Social protection schemes that can replace lost income are critically needed to compensate for the most devastating costs in TB. An occurrence of selling household property can be a useful proxy for catastrophic cost in Cambodia.

  3. Cost inefficiency under financial strain: a stochastic frontier analysis of hospitals in Washington State through the Great Recession.

    Science.gov (United States)

    Izón, Germán M; Pardini, Chelsea A

    2017-06-01

    The importance of increasing cost efficiency for community hospitals in the United States has been underscored by the Great Recession and the ever-changing health care reimbursement environment. Previous studies have shown mixed evidence with regards to the relationship between linking hospitals' reimbursement to quality of care and cost efficiency. Moreover, current evidence suggests that not only inherently financially disadvantaged hospitals (e.g., safety-net providers), but also more financially stable providers, experienced declines to their financial viability throughout the recession. However, little is known about how hospital cost efficiency fared throughout the Great Recession. This study contributes to the literature by using stochastic frontier analysis to analyze cost inefficiency of Washington State hospitals between 2005 and 2012, with controls for patient burden of illness, hospital process of care quality, and hospital outcome quality. The quality measures included in this study function as central measures for the determination of recently implemented pay-for-performance programs. The average estimated level of hospital cost inefficiency before the Great Recession (10.4 %) was lower than it was during the Great Recession (13.5 %) and in its aftermath (14.1 %). Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased cost inefficiency.

  4. Financial burden is associated with worse health-related quality of life in adults with multiple endocrine neoplasia type 1.

    Science.gov (United States)

    Peipert, Benjamin J; Goswami, Sneha; Helenowski, Irene; Yount, Susan E; Sturgeon, Cord

    2017-12-01

    Health-related quality of life and financial burden among patients with multiple endocrine neoplasia type 1 is poorly described. It is not known how financial burden influences health-related quality of life in this population. We hypothesized that the financial burden attributable to multiple endocrine neoplasia type 1 is associated with worse health-related quality of life. United States adults (≥18 years) with multiple endocrine neoplasia type 1 were recruited from the AMENSupport MEN online support group. Patient demographics, clinical characteristics, and financial burden were assessed via an online survey. The instrument Patient-Reported Outcomes Measurement Information System 29-item profile measure was used to assess health-related quality of life. Multivariable linear regression was used to identify significant variables in each Patient-Reported Outcomes Measurement Information System domain. Out of 1,378 members in AMENSupport, our survey link was accessed 449 times (33%). Of 153 US respondents who completed our survey, 84% reported financial burden attributable to multiple endocrine neoplasia type 1. The degree of financial burden had a linear relationship with worse health-related quality of life across all Patient-Reported Outcomes Measurement Information System domains (r = 0.36-0.55, P financial event(s). Borrowing money from friends/family (30%), unemployment (13%), and spending >$100/month out-of-pocket on prescription medications (46%) were associated consistently with impaired health-related quality of life (ß = 3.75-6.77, P times more likely to be unemployed and declare bankruptcy than the US population, respectively. This study characterizes the financial burden in patients with multiple endocrine neoplasia type 1. Individuals with multiple endocrine neoplasia type 1 report a high degree of financial burden, negative financial events, and unemployment. Each of these factors was associated with worse health-related quality of life

  5. The myth of financial innovation and the great moderation

    NARCIS (Netherlands)

    den Haan, W.; Sterk, V.

    2009-01-01

    Financial innovation is widely believed to be at least partly responsible for the recent financial crisis. At the same time, there are empirical and theoretical arguments that support the view that changes in financial markets played a role in the "great moderation". If both are true, then the price

  6. Investigating parents/caregivers financial burden of care for children with non-communicable diseases in Ghana.

    Science.gov (United States)

    Abuosi, Aaron A; Adzei, Francis A; Anarfi, John; Badasu, Delali M; Atobrah, Deborah; Yawson, Alfred

    2015-11-16

    The introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS. We conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers. The study found that over 30 % of parents/caregivers spend more than Gh¢50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40 % of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children. Even though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs

  7. Solutions to Address Diabetes-Related Financial Burden and Cost-Related Nonadherence: Results From a Pilot Study.

    Science.gov (United States)

    Patel, Minal R; Resnicow, Kenneth; Lang, Ian; Kraus, Kathleen; Heisler, Michele

    2018-02-01

    Cost-related nonadherence (CRN) to recommended self-management behaviors among adults with chronic conditions such as diabetes is prevalent. Few behavioral interventions to mitigate CRN have been tested and evaluated. We developed a financial burden resource tool and examined its acceptability and the preliminary effects on patient-centered outcomes among adults with diabetes or prediabetes seen in a clinical setting. We report a pre-post one-group design pilot study. From an endocrinology clinic, we recruited 104 adults with diabetes who reported financial burdens with their diabetes management or engaged in CRN behaviors. We offered participants the financial burden resource tool we developed, which provided tailored, low-cost resource options for diabetes management and other social needs. Acceptability and self-reported outcomes were assessed 2 months after use of the tool. Mean age of participants was 50.5 years ( SD = 15.3). Participants found the tool highly acceptable across 15 indicators (e.g., 93% "learned a lot," 98% "topics relevant" 95% "applicable to their lives," 98% "liked the information"). Significant improvements between baseline and 2-month follow-up were observed for discussion of cost concerns with nurses (19% to 29%, p financial management (33.83 to 39.62, p financial burden. A financial burden resource tool is highly acceptable to patients, is easy to administer, and can prompt behavior change. This pilot study supports the need for well-powered trials with longer follow-up to further evaluate the effectiveness of such tools in improving CRN and key outcomes.

  8. Financial burden of healthcare for cancer patients with social medical insurance: a multi-centered study in urban China

    OpenAIRE

    Mao, Wenhui; Tang, Shenglan; Zhu, Ying; Xie, Zening; Chen, Wen

    2017-01-01

    Background Cancer accounts for one-fifth of the total deaths in China and brings heavy financial burden to patients and their families. Chinese government has made strong commitment to develop three types of social medical insurance since 1997 and recently, more attempts were invested to provide better financial protection. To analyze health services utilization and financial burden of insured cancer patients, and identify the gaps of financial protection provided by insurance in urban China....

  9. Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia.

    Directory of Open Access Journals (Sweden)

    Fukushi Morishita

    Full Text Available Despite free TB services available in public health facilities, TB patients often face severe financial burden due to TB. WHO set a new global target that no TB-affected families experience catastrophic costs due to TB. To monitor the progress and strategize the optimal approach to achieve the target, there is a great need to assess baseline cost data, explore potential proxy indicators for catastrophic costs, and understand what intervention mitigates financial burden. In Cambodia, nationwide active case finding (ACF targeting household and neighbourhood contacts was implemented alongside routine passive case finding (PCF. We analyzed household cost data from ACF and PCF to determine the financial benefit of ACF, update the baseline cost data, and explore whether any dissaving patterns can be a proxy for catastrophic costs in Cambodia.In this cross-sectional comparative study, structured interviews were carried out with 108 ACF patients and 100 PCF patients. Direct and indirect costs, costs before and during treatment, costs as percentage of annual household income and dissaving patterns were compared between the two groups.The median total costs were lower by 17% in ACF than in PCF ($240.7 [IQR 65.5-594.6] vs $290.5 [IQR 113.6-813.4], p = 0.104. The median costs before treatment were significantly lower in ACF than in PCF ($5.1 [IQR 1.5-25.8] vs $22.4 [IQR 4.4-70.8], p<0.001. Indirect costs constituted the largest portion of total costs (72.3% in ACF and 61.5% in PCF. Total costs were equivalent to 11.3% and 18.6% of annual household income in ACF and PCF, respectively. ACF patients were less likely to dissave to afford TB-related expenses. Costs as percentage of annual household income were significantly associated with an occurrence of selling property (p = 0.02 for ACF, p = 0.005 for PCF.TB-affected households face severe financial hardship in Cambodia. ACF has the great potential to mitigate the costs incurred particularly before treatment

  10. State insurance parity legislation for autism services and family financial burden.

    Science.gov (United States)

    Parish, Susan; Thomas, Kathleen; Rose, Roderick; Kilany, Mona; McConville, Robert

    2012-06-01

    We examined the association between states' legislative mandates that private insurance cover autism services and the health care-related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N  =  2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.

  11. The survival of the great financial journalism

    Directory of Open Access Journals (Sweden)

    Elvira CALVO GUTIÉRREZ

    2014-07-01

    Full Text Available Traditionally, the economic international journalism has had in the Anglo-Saxon groups Dow Jones (USA and Pearson (Great Britain, publishers of The Wall Street and Financial Times respectively, his big world models. Nevertheless, the new century has brought enormous convulsions to the sector, to the newspapaers of elite and big agencies specialized in economic information as Reuters, Thomson or Bloomberg. To the battle in Internet, there add the expansion of the informative economic power and the changes of mentality of the companies and of the audiences. All this has derived in a fierce war led by the big leaders who, with more than one century of tradition someones, have been object of sales or mergers, financial indispensable operations to be able to adapt to the new times. The aim of this article is to analyze the path of the great economic journalism, with special dedication to two fronts: one, to know how these neswspapers of elite are positioned in the network; other one, the dilemma between continuing being a journalism of quality, rigorous, cosmopolitan and expensive of supporting, or to change towards an ideological, gruesome journalism or amarillista that, since in other specialities, also has spread between the financial journalism

  12. Financial Strain and Mental Health Among Older Adults During the Great Recession.

    Science.gov (United States)

    Wilkinson, Lindsay R

    2016-07-01

    The economic recession has garnered the interest of many scholars, with much attention being drawn to how the recession has affected labor force participation, household wealth, and even retirement decisions. Certainly, the Great Recession has influenced the financial well-being of older adults, but has it had discernible effects on mental health? This study draws on 5,366 respondents from the Health and Retirement Study (2006-2010) to examine objective and subjective measures of financial well-being in the period surrounding the Great Recession. Guided by cumulative inequality theory, this research investigates whether the economic downturn contributed to worsening anxiety and depressive symptoms over a 4-year period. Results from linear fixed effects models reveal that decreases in objective financial resources were associated with increased financial strain during the Great Recession. Unlike the objective indicators, however, financial strain was a strong and robust predictor of worsening mental health between 2006 and 2010. Building on prior research, this study elucidates the factors that shape financial strain and provides evidence that the Great Recession not only affected the financial well-being of older adults but also had adverse effects on mental health. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Increased financial burden among patients with chronic myelogenous leukaemia receiving imatinib in Japan: a retrospective survey

    Directory of Open Access Journals (Sweden)

    Kodama Yuko

    2012-04-01

    Full Text Available Abstract Background The financial burden of medical expenses has been increasing for cancer patients. We investigated the relationship between household income and financial burden among patients with chronic myelogenous leukaemia (CML who have been treated with imatinib. Methods A questionnaire was distributed to 1200 patients between May and August 2009. We retrospectively surveyed their household incomes, out-of-pocket medical expenses, final co-payments after refunds, and the perceived financial burden of their medical expenses in 2000, 2005 and 2008. Results A total of 577 patients completed the questionnaire. Their median age was 61 years (range, 15–94. A financial burden was felt by 41.2 % (28 of 68 of the patients treated with imatinib in 2000, 70.8 % (201 of 284 in 2005, and 75.8 % (400 of 528 in 2008. Overall, 182 patients (31.7 % considered its discontinuation because of the financial burden and 15 (2.6 % temporarily stopped their imatinib prescription. In 2000, 2005 and 2008, the patients’ median annual household incomes were 49,615 US Dollars (USD, 38,510 USD and 36,731 USD, respectively, with an average currency exchange rate of 104 Yen/USD in 2008. Their median annual out-of-pocket expenses were 11,548, 12,067 and 11,538 USD and their median final annual co-payments were 4,375, 4,327 and 3,558 USD, respectively. Older patients (OR = 0.96, 95 % CI: 0.95–0.98, p ≪ 0.0001 for 1-year increments, and patients with higher household incomes (OR = 0.92, 95 % CI: 0.85–0.99, p = 0.03 for 10,000 USD-increments were less likely to have considered discontinuing their imatinib treatment. Conversely, patients with higher annual final co-payments (OR = 2.21, 95 % CI: 1.28–4.28, p = 0.004 for 10,000 USD-increments were more likely to have considered discontinuing their imatinib treatment. Conclusions The proportion of CML patients who sensed a financial burden increased between 2000 and 2008

  14. Impact of out-of-pocket spending caps on financial burden of those with group health insurance.

    Science.gov (United States)

    Riggs, Kevin R; Buttorff, Christine; Alexander, G Caleb

    2015-05-01

    The Affordable Care Act (ACA) mandates that all private health insurance include out-of-pocket spending caps. Insurance purchased through the ACA's Health Insurance Marketplace may qualify for income-based caps, whereas group insurance will not have income-based caps. Little is known about how out-of-pocket caps impact individuals' health care financial burden. We aimed to estimate what proportion of non-elderly individuals with group insurance will benefit from out-of-pocket caps, and the effect that various cap levels would have on their financial burden. We applied the expected uniform spending caps, hypothetical reduced uniform spending caps (reduced by one-third), and hypothetical income-based spending caps (similar to the caps on Health Insurance Marketplace plans) to nationally representative data from the Medical Expenditure Panel Survey (MEPS). Participants were non-elderly individuals (aged health insurance in the 2011 and 2012 MEPS surveys (n =26,666). (1) The percentage of individuals with reduced family out-of-pocket spending as a result of the various caps; and (2) the percentage of individuals experiencing health care services financial burden (family out-of-pocket spending on health care, not including premiums, greater than 10% of total family income) under each scenario. With the uniform caps, 1.2% of individuals had lower out-of-pocket spending, compared with 3.8% with reduced uniform caps and 2.1% with income-based caps. Uniform caps led to a small reduction in percentage of individuals experiencing financial burden (from 3.3% to 3.1%), with a modestly larger reduction as a result of reduced uniform caps (2.9%) and income-based caps (2.8%). Mandated uniform out-of-pocket caps for those with group insurance will benefit very few individuals, and will not result in substantial reductions in financial burden.

  15. Household financial burden of phenylketonuria and its impact on treatment in China: a cross-sectional study.

    Science.gov (United States)

    Wang, Lin; Zou, Hui; Ye, Fang; Wang, Kundi; Li, Xiaowen; Chen, Zhihua; Chen, Jie; Han, Bingjuan; Yu, Weimin; He, Chun; Shen, Ming

    2017-05-01

    Phenylketonuria (PKU) is a rare inborn disease, which, untreated, leading to severe neurobehavioral dysfunction. Considering its complexity, the management of PKU may bring a formidable economic burden to parents and caregivers. It is still unknown what the out-of-pocket expenses are for a patient with PKU in China. This paper explores the household financial burden of classical PKU and its impact on Chinese families in a quantitative manner for the first time. A non-interventional and observational study was conducted at the China-Japan Friendship Hospital, one of the national centers for inherited metabolic disorders in China. The medical and non-medical household financial burdens were consolidated into a questionnaire to evaluate the out-of-pocket costs (OOPCs) of PKU treatment and follow-up. The total OOPCs were USD$3766.1 (0y), USD$3795.2 (1-2 ys), USD$4657.7 (3-4 ys), USD$5979.9 (5-8 ys), and USD$5588.7 (9 ys and older) for PKU patients of different age groups. The median economic burden of classical PKU was 75.0 % of total annual family income (range 1.0-779.1 %), and 94.4 % of the families exceeding the threshold considered as catastrophic expenditure. There was a negative correlation between the financial burden and the proportion of time when Phe concentrations were in the desired target range (120-250 μmol/L) in 0-4-ys group (r = -0.474, p = 0.026). The management of PKU is associated with a severe financial burden on patients' families, which may lead to insufficient treatment or variation of blood Phe concentration. The current reimbursement policies are as yet inadequate. A national reimbursement system targeting treatment practices for PKU patients and other rare diseases across China is imperative.

  16. Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors.

    Science.gov (United States)

    Kale, Hrishikesh P; Carroll, Norman V

    2016-04-15

    Cancer-related financial burden has been linked to cancer survivors (CS) forgoing/delaying medical care, skipping follow-up visits, and discontinuing medications. To the authors' knowledge, little is known regarding the effect of financial burden on the health-related quality of life of CS. The authors analyzed 2011 Medical Expenditure Panel Survey data. Financial burden was present if one of the following problems was reported: borrowed money/declared bankruptcy, worried about paying large medical bills, unable to cover the cost of medical care visits, or other financial sacrifices. The following outcomes were evaluated: Physical Component Score (PCS) and Mental Component Score (MCS) of the 12-Item Short-Form Health Survey (SF-12), depressed mood, psychological distress, and worry related to cancer recurrence. The authors also assessed the effect of the number of financial problems on these outcomes. Of the 19.6 million CS analyzed, 28.7% reported financial burden. Among them, the average PCS (42.3 vs 44.9) and MCS (48.1 vs 52.1) were lower for those with financial burden versus those without. In adjusted analyses, CS with financial burden had significantly lower PCS (β = -2.45), and MCS (β = -3.05), had increased odds of depressed mood (odds ratio, 1.95), and were more likely to worry about cancer recurrence (odds ratio, 3.54). Survivors reporting ≥ 3 financial problems reported statistically significant and clinically meaningful differences (≥3 points) in the mean PCS and MCS compared with survivors without financial problems. Cancer-related financial burden was associated with lower health-related quality of life, increased risk of depressed mood, and a higher frequency of worrying about cancer recurrence among CS. © 2015 American Cancer Society.

  17. The financial burden of cancer: Estimates from patients undergoing cancer care in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Zaidi Adnan A

    2012-10-01

    Full Text Available Abstract Introduction The emotional burden associated with the diagnosis of cancer is sometimes overshadowed by financial burden sustained by patient and the family. This is especially relevant for a developing country as there is limited state support for cancer treatment. We conducted this study to estimate the cost of cancer care for two major types of cancer and to assess the perception of patients and families regarding the burden of the cost for undergoing cancer treatment at a private tertiary care hospital. Methods This cross-sectional study was conducted at day care and radiotherapy unit of Aga Khan University, Hospital (AKUH Karachi, Pakistan. All adult patients with breast and head & neck cancers diagnosed for 3 months or more were included. Data was collected using a structured questionnaire and analysed using SPSS. Results Sixty seven patients were interviewed during the study period. The mean and median monthly income of these patients was 996.4 USD and 562.5 USD respectively. Comparatively the mean and median monthly cost of cancer care was 1093.13 USD and 946.42 USD respectively. The cost of the treatment either fully or partially was borne by the family in most cases (94%. The financial burden of cancer was perceived as significant by 28 (42% patients and unmanageable by 18 (27% patients. This perceived level of burden was associated significantly with average monthly income (p = Conclusion Our study indicates that the financial burden of cancer care is substantial and can be overwhelming. There is a desperate need for treatment support programs either by the government or other welfare organisations to support individuals and families who are already facing a difficult and challenging situation.

  18. Beyond co-pays and out-of-pocket costs: perceptions of health-related financial burden in managing asthma among African American women.

    Science.gov (United States)

    Patel, Minal R; Nelson, Belinda W; Id-Deen, Effat; Caldwell, Cleopatra H

    2014-12-01

    The purpose of this study was to define perceptions of health-related financial burden based on the views of individuals who report these perceptions through qualitative approaches. Four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview was employed by facilitators. Coded transcripts were analyzed for themes regarding dimensions of the meaning of financial burden. Major domains of financial burden identified included (1) high out-of-pocket expenses; (2) lost wages from exacerbations, inability to maintain a stable job and stress from making decisions about taking a sick day or coming to work; (3) transport costs; (4) both costs and stress of managing insurance eligibility and correcting erroneous bills. Greater awareness of factors that add to perceptions of financial burden might better equip researchers to develop interventions to help care teams manage such concerns with their patients.

  19. State Medicaid Spending and Financial Burden of Families Raising Children with Autism

    Science.gov (United States)

    Parish, Susan L.; Thomas, Kathleen C.; Rose, Roderick; Kilany, Mona; Shattuck, Paul T.

    2012-01-01

    We examined the association between state Medicaid spending for children with disabilities and the financial burden reported by families of children with autism. Child and family data were from the 2005-2006 National Survey of Children with Special Health Care Needs (n = 2,011 insured children with autism). State characteristics were from public…

  20. Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

    Science.gov (United States)

    Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

    2013-10-01

    Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

  1. Inpatient Financial Burden of Atopic Dermatitis in the United States

    DEFF Research Database (Denmark)

    Narla, Shanthi; Hsu, Derek Y; Thyssen, Jacob P

    2017-01-01

    Little is known about the inpatient burden of atopic dermatitis (AD). We sought to determine the risk factors and financial burden of hospitalizations for AD in the United States. Data were analyzed from the 2002-2012 National Inpatient Sample, including a 20% representative sample of all...... hospitalizations in the United States. Hospitalization rates for AD or eczema were highest in the northeast during the winter and south during the summer. Geometric mean cost of care (95% confidence interval) was lower for a primary diagnosis of AD or eczema versus no AD or eczema in adults ($3,502 [$3......,360-$3,651] vs. $6,849 [$6,775-$6,925]; P = 0.0004) and children ($2,716 [$2,542-$2,903] vs. $4,488 [$4,302-$4,682]; P = 0.0004). However, the high prevalence of hospitalization resulted in total inpatient costs of $8,288,083 per year for adults and $3,333,868 per year for children. In conclusion...

  2. Financial burden of survivors of medically-managed myocardial infarction and its association with selected social determinants and quality of life in a lower middle income country.

    Science.gov (United States)

    Mahesh, P K B; Gunathunga, M W; Jayasinghe, S; Arnold, S M; Mallawarachchi, D S V; Perera, S K; Wijesinghe, U A D

    2017-09-19

    Burden from ischemic heart disease is rising in Sri Lanka due to the demographic and epidemiological transitions. Documented literature is scarce on quality of life, financial burden and its determinants in relation to myocardial infarction (MI). This study was done to describe the financial burden among the survivors of MI managed only with drugs (i.e. those who did not undergo Percutaneous Coronary Intervention or Coronary Artery Bypass Graft) and its association with selected social determinants (SDHs) and quality of life (QOL). A cross sectional study was done among MI survivors in 13 hospitals in the premier province of Sri Lanka. Out of 336 participants recruited at hospital stay, 270 responded through a self-administered questionnaire at 1 month post discharge. Questionnaire included sections on financial burden, selected SDHs and on QOL measured by the EQ-5D-3 L QOL tool. Presence of financial burden was determined using an operational definition. Associations were tested with Mann-Whitney-U test, Chi square test and Spearman-correlation-coefficient at 5% significant level. Around 40% (n = 116) had to seek financial support for out-of-pocket expenditure. Nearly 5% (n = 6) of previously employed participants had lost their job. Of the employed respondents (n = 139, 51.5%), 29% (n = 85) had limited physical activity and 40% (n = 115) had limitations of employment time. Of the respondents, 15.4% had to apply for a loan, 7.8% had to sell a property, 19.1% had an income loss and 33.8% had to restrict usual expenses. Financial burden was not significantly associated with gender (p = 0.146), ethnicity (p = 0.068), highest education (p = 0.184) and area of residence (p = 0.369). Influence of income (p = 0.001), social support (p = 0.002) and the health infrastructure (p financial burden. In the group with a financial burden, the index score (p = 0.002) and VAS score (p Financial burden is common among survivors

  3. The financial burden from non-communicable diseases in low- and middle-income countries: a literature review

    Science.gov (United States)

    2013-01-01

    Non-communicable diseases (NCDs) were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both mortality and morbidity in low- and middle-income countries (LMICs), although little is known about the impact these diseases have on households in these countries. In this paper, we present a literature review on the costs imposed by NCDs on households in LMICs. We examine both the costs of obtaining medical care and the costs associated with being unable to work, while discussing the methodological issues of particular studies. The results suggest that NCDs pose a heavy financial burden on many affected households; poor households are the most financially affected when they seek care. Medicines are usually the largest component of costs and the use of originator brand medicines leads to higher than necessary expenses. In particular, in the treatment of diabetes, insulin – when required – represents an important source of spending for patients and their families. These financial costs deter many people suffering from NCDs from seeking the care they need. The limited health insurance coverage for NCDs is reflected in the low proportions of patients claiming reimbursement and the low reimbursement rates in existing insurance schemes. The costs associated with lost income-earning opportunities are also significant for many households. Therefore, NCDs impose a substantial financial burden on many households, including the poor in low-income countries. The financial costs of obtaining care also impose insurmountable barriers to access for some people, which illustrates the urgency of improving financial risk protection in health in LMIC settings and ensuring that NCDs are taken into account in these systems. In this paper, we identify areas where further research is needed to have a better view of the costs incurred by households because of NCDs; namely, the extension of the geographical scope, the

  4. Financial burden of colorectal cancer treatment among patients and their families in a middle-income country.

    Science.gov (United States)

    Azzani, Meram; Roslani, April Camilla; Su, Tin Tin

    2016-10-01

    In Malaysia, the healthcare system consists of a government-run universal healthcare system and a co-existing private healthcare system. However, with high and ever rising healthcare spending on cancer management, cancer patients and their families are likely to become vulnerable to a healthcare-related financial burden. Moreover, they may have to reduce their working hours and lose income. To better understand this issue, this study aims to assess the financial burden of colorectal cancer patients and their families in the first year following diagnosis. Data on patient costs were collected prospectively in the first year following diagnosis by using a self-administered questionnaire and telephone interviews at three time points for all four stages of colorectal cancer. The patient cost data consisted of direct out-of-pocket payments for medical-related expenses such as hospital stays, tests and treatment and for non-medical items such as travel and food associated with hospital visits. In addition, indirect cost data related to the loss of productivity of the patient and caregiver(s) was assessed. The patient's perceived level of financial difficulty and types of coping strategy were also explored. The total 1-year patient cost (both direct and indirect) increased with the stage of colorectal cancer: RM 6544.5 (USD 2045.1) for stage I, RM 7790.1 (USD 2434.4) for stage II, RM 8799.1 (USD 2749.7) for stage III and RM 8638.2 (USD 2699.4) for stage IV. The majority of patients perceived paying for their healthcare as somewhat difficult. The most frequently used financial coping strategy was a combination of current income and savings. Despite the high subsidisation in public hospitals, the management of colorectal cancer imposes a substantial financial burden on patients and their families. Moreover, the majority of patients and their families perceive healthcare payments as difficult. Therefore, it is recommended that policy- and decision-makers should further

  5. Financial innovation, macroeconomic volatility and the great moderation

    OpenAIRE

    Zaghini, Andrea; Bencivelli, Lorenzo

    2012-01-01

    In the paper we propose an assessment of the role of financial innovation in shaping US macroeconomic dynamics. We extend an existing model by Christiano, Eichenbaum and Evans which studied the transmission of monetary policy impulses to business and corporate sector financing variables just before the Great Moderation period. By investigating the properties of the model over a longer time span we show that in the later period a change in the monetary policy transmission mechanism is likely t...

  6. The financial burden of reexcising incompletely excised soft tissue sarcomas: a cost analysis.

    Science.gov (United States)

    Alamanda, Vignesh K; Delisca, Gadini O; Mathis, Shannon L; Archer, Kristin R; Ehrenfeld, Jesse M; Miller, Mark W; Homlar, Kelly C; Halpern, Jennifer L; Schwartz, Herbert S; Holt, Ginger E

    2013-09-01

    Although survival outcomes have been evaluated between those undergoing a planned primary excision and those undergoing a reexcision following an unplanned resection, the financial implications associated with a reexcision have yet to be elucidated. A query for financial data (professional, technical, indirect charges) for soft tissue sarcoma excisions from 2005 to 2008 was performed. A total of 304 patients (200 primary excisions and 104 reexcisions) were identified. Wilcoxon rank sum tests and χ2 or Fisher's exact tests were used to compare differences in demographics and tumor characteristics. Multivariable linear regression analyses were performed with bootstrapping techniques. The average professional charge for a primary excision was $9,694 and $12,896 for a reexcision (pfinancial burden nearly doubles.

  7. Why Stamp Duties are an Increasing Financial Burden on Australian Home Buyers

    OpenAIRE

    Wood, Gavin A.

    1994-01-01

    The purchaser of housing incurs stamp duty liabilities in all Australian States. These stamp duties are levied on the conveyance of residential property and mortgage sums secured. In general, stamp duties were a growing financial burden on home buyers during the period 1985-1991. This paper examines the role of house price inflation in causing increases in average rates of stamp duty, the responsiveness of average rates of stamp duty to future changes in the nominal tax base and the effective...

  8. Impact of the financial crisis on COPD burden: Greece as a case study

    Directory of Open Access Journals (Sweden)

    Ourania S. Kotsiou

    2018-01-01

    Full Text Available Poverty and low socioeconomic status have been associated with chronic obstructive pulmonary disease (COPD. The current financial crisis has forced millions back into poverty. Greece is one of the countries hit the hardest, and is in the middle of a deep ongoing collapse. There have been early reports stating the apparent effects of the Greek downturn on respiratory health. This review summarises the overall impact of the financial crisis on COPD burden throughout the period of economic downturn by analysing the case study of Greece. In all levels of the healthcare system, current economic restrictions have reduced the capacity to prevent, diagnose and treat COPD in parallel with current higher detection rates of COPD. Remarkably, expenditure on healthcare has been reduced by >25%, resulting in major healthcare equipment shortages. Lower wages (by up to 20% and higher co-payments of up to 25% of a drug's purchase price have led to patients struggling to afford inhaled medications. Treatment nonadherence has been reported, resulting in 11.5% more exacerbations and 14.1% more hospitalisations annually, while the mean cost per severe COPD exacerbation has been approximated as €2600. Greece is a noteworthy example illustrating how COPD burden, quality of care and patients' outcome can be affected by economic crisis.

  9. Solutions to Address Diabetes-Related Financial Burden and Cost-Related Nonadherence: Results from a Pilot Study

    Science.gov (United States)

    Patel, Minal R.; Resnicow, Kenneth; Lang, Ian; Kraus, Kathleen; Heisler, Michele

    2018-01-01

    Background: Cost-related nonadherence (CRN) to recommended self-management behaviors among adults with chronic conditions such as diabetes is prevalent. Few behavioral interventions to mitigate CRN have been tested and evaluated. Aims: We developed a financial burden resource tool and examined its acceptability and the preliminary effects on…

  10. The emotional, social, and financial burden of food allergies on children and their families.

    Science.gov (United States)

    Patel, Nilamben; Herbert, Linda; Green, Todd D

    2017-03-01

    As the prevalence of food allergy has risen among children and young adults, both in the United States and around the world, investigators have become increasingly aware of the daily emotional toll on patients and their families of living with food allergy. To review the literature regarding the emotional, social, and financial impact of food allergy on pediatric patients and their families, and to provide evidence-based suggestions for clinicians on how to most effectively address these issues. A literature search was performed to identify relevant articles related to the emotional, social, and financial impact of food allergy. There is a growing body of literature that demonstrates that living with food allergy adversely affects patients and families in the domains above. Food allergy can significantly impact pediatric patients and their families in all areas of their lives. Clinicians should be aware of these issues when working with these families. Implementing a multidisciplinary approach can help families cope with emotional, social, and financial burdens.

  11. "Mad or bad?": burden on caregivers of patients with personality disorders.

    Science.gov (United States)

    Bauer, Rita; Döring, Antje; Schmidt, Tanja; Spießl, Hermann

    2012-12-01

    The burden on caregivers of patients with personality disorders is often greatly underestimated or completely disregarded. Possibilities for caregiver support have rarely been assessed. Thirty interviews were conducted with caregivers of such patients to assess illness-related burden. Responses were analyzed with a mixed method of qualitative and quantitative analysis in a sequential design. Patient and caregiver data, including sociodemographic and disease-related variables, were evaluated with regression analysis and regression trees. Caregiver statements (n = 404) were summarized into 44 global statements. The most frequent global statements were worries about the burden on other family members (70.0%), poor cooperation with clinical centers and other institutions (60.0%), financial burden (56.7%), worry about the patient's future (53.3%), and dissatisfaction with the patient's treatment and rehabilitation (53.3%). Linear regression and regression tree analysis identified predictors for more burdened caregivers. Caregivers of patients with personality disorders experience a variety of burdens, some disorder specific. Yet these caregivers often receive little attention or support.

  12. The financial burden of out-of-pocket patient payments in the European Union and accession countries: Results of a systematic literature review

    NARCIS (Netherlands)

    Moser, K.; Pavlova, M.; Groot, W.

    2014-01-01

    A major issue for public health policy is to reduce the poverty and catastrophic effects of out-of-pocket payments. This paper reviews empirical studies that analyze the financial burden of out-of-pocket payments and factors that are associated with this burden for households in the EU and accession

  13. User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica.

    Science.gov (United States)

    Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

    2017-06-01

    The impact of user-fee policies on the equity of health care utilization and households' financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper-middle-income countries. This paper assesses the short- and long-term impacts of Jamaica's user-fee-removal for children in 2007. This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user-fee-removal policy on children's health care utilization and households' financial burdens, as well as the impact in the medium- to long-term. Immediately following the implementation of user-fee-removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P  = 0.018). In the short-term (2007-2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium- to long-term. The household's financial burden (health expenditure as a share of household's non-food expenditures) reduced by 6 percentage points (95% CI: -11 to -1, P  = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. User-fee-removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short-term and the medium- to long-term results have different indications: In the short-term, the policy deteriorated the equity of

  14. User–fee–removal improves equity of children’s health care utilization and reduces families’ financial burden: evidence from Jamaica

    Science.gov (United States)

    Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

    2017-01-01

    Background The impact of user–fee policies on the equity of health care utilization and households’ financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper–middle–income countries. This paper assesses the short– and long–term impacts of Jamaica’s user–fee–removal for children in 2007. Methods This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user–fee–removal policy on children’s health care utilization and households’ financial burdens, as well as the impact in the medium– to long–term. Results Immediately following the implementation of user–fee–removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P = 0.018). In the short–term (2007–2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium– to long–term. The household’s financial burden (health expenditure as a share of household’s non–food expenditures) reduced by 6 percentage points (95% CI: –11 to –1, P = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. Conclusions User–fee–removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short–term and the medium– to long

  15. Financial Burden Faced by Families due to Out-of-pocket Expenses during the Treatment of their Cancer Children: An Indian Perspective.

    Science.gov (United States)

    Sneha, Latha M; Sai, Jeyanth; Ashwini, S; Ramaswamy, Sunitha; Rajan, Mahalakshmi; Scott, Julius X

    2017-01-01

    Life-saving cancer therapy is costly and may result in financial burden for these families. Financial costs for treating childhood cancer care are traditionally assessed based on the amount spent for diagnostic tests, hospitalization, and chemotherapy. The financial costs for travel, accommodation, out-of-pocket expenses for food, phone bills, and loss of income due to reduction or termination of parental employment are hidden nonmedical expenses that are rarely accounted for. Studies on the financial implications of pediatric cancer treatment are based on the Western model of healthcare with good government/state insurance coverage and hence literature on lifestyle implications for families in developing nations with limited resources is still scarce. The aim of this study is to find out the details of out-of-pocket expenses incurred by the families during their treatment of cancer children and its implications on their quality of life. Settings and Design: This study was conducted in a tertiary care center for pediatric malignancies for over 1-year period. About seventy families whose children were diagnosed with acute leukemia and undergoing treatment at our center were asked to fill a questionnaire detailing their out-of-pocket expenses. Nonmedical expenses accounts for about 46% of their monthly household income of parents from rural areas and 22% of their household income from urban areas. On an average, a family from rural area spends four times the normal amount spent on home for their daily food expenditure. Thirty-eight percent of families have borrowed money from money lenders with an average interest rate of about 12.5% which pushes them to a state of debt for the next few years. Out-of-pocket expenses contribute a significant proportion to the financial burden of the families with childhood malignancies and these invisible expenses should be recognized and provide adequate support to lessen the burden of this economic impact.

  16. (Re)disclosing physician financial interests: rebuilding trust or making unreasonable burdens on physicians?

    Science.gov (United States)

    Sperling, Daniel

    2017-06-01

    Recent professional guidelines published by the General Medical Council instruct physicians in the UK to be honest and open in any financial agreements they have with their patients and third parties. These guidelines are in addition to a European policy addressing disclosure of physician financial interests in the industry. Similarly, In the US, a national open payments program as well as Federal regulations under the Affordable Care Act re-address the issue of disclosure of physician financial interests in America. These new professional and legal changes make us rethink the fiduciary duties of providers working under new organizational and financial schemes, specifically their clinical fidelity and their moral and professional obligations to act in the best interests of patients. The article describes the legal changes providing the background for such proposals and offers a prima facie ethical analysis of these evolving issues. It is argued that although disclosure of conflicting interest may increase trust it may not necessarily be beneficial to patients nor accord with their expectations and needs. Due to the extra burden associated with disclosure as well as its implications on the medical profession and the therapeutic relationship, it should be held that transparency of physician financial interest should not result in mandatory disclosure of such interest by physicians. It could lead, as some initiatives in Europe and the US already demonstrate, to voluntary or mandatory disclosure schemes carried out by the industry itself. Such schemes should be in addition to medical education and the address of the more general phenomenon of physician conflict of interest in ethical codes and ethical training of the parties involved.

  17. Costs on the Mind: the Influence of the Financial Burden of College on Academic Performance and Cognitive Functioning

    Science.gov (United States)

    Destin, Mesmin; Svoboda, Ryan C.

    2018-01-01

    The current studies test the hypothesis that the financial burden of college can initiate a psychological process that has a negative influence on academic performance for students at selective colleges and universities. Prior studies linking high college costs and student loans to academic outcomes have not been grounded within relevant social…

  18. The global financial crisis and the Great Recession of 2007-2009.

    Science.gov (United States)

    Dore, Mohammed H I; Singh, Rajiv G

    2010-07-01

    This paper is a re-examination of the global financial crisis that began in and was accompanied by the most severe recession since the Great Depression. It builds on our earlier paper (Dore and Singh, 2009) and expands its scope. It is divided into parts. The first part deals with the ideological backdrop in which this crisis occurred, namely the belief in the rationality and stability of all markets including the capital markets, called the 'efficient market hypothesis.' The second part is a survey of the role of income distribution and its relations to aggregate spending and the growing role played by credit in the circular flow of income. The third part examines some features of the business cycle expansion phase of to . The fourth part is a brief report on a nonlinear Vector Error Correction model spanning the period to and how this expansion came to an end. The fifth part is a brief comparison of the Great Recession with the Great Depression. Finally in the sixth part, the international impact of the Great Recession is considered briefly, followed by some conclusions.

  19. Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

    Science.gov (United States)

    Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

    2015-10-29

    Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

  20. Uncertainty and risk management after the Great Moderation: the role of risk (mis)management by financial institutions

    NARCIS (Netherlands)

    Blommestein, H.J.; Hoogduin, L.H.; Peeters, J.J.W.

    2009-01-01

    Since the early eighties volatility of GDP and inflation has been declining steadily in many countries. Financial innovation has been identified as one of the key factors driving this „Great Moderation‟. Financial innovation was considered to have improved significantly the allocation and sharing of

  1. Comparing of the Financial Ratios: A case study on United States, Great Britain, Greece Due Financial Crisis

    Directory of Open Access Journals (Sweden)

    Dr. Stamatis Kontsas

    2013-07-01

    Full Text Available The aim of this paper is to present a comparative study of the countries through the financial ratios that were analysed. This study was carried out in order to find the characteristics of each economy in comparison to the others. It would be worthy to mention that the three economies that were put under comparative study, are not of the same dynamic. The United States of America and Great Britain show some common characteristics due to the positions of power that they possess in the allocation of the global economy. However, in the case of Greece the same dynamic with the other two countries doesn’t exist, a fact that is greatly imprinted in their in-between comparison.

  2. Responses to Financial Loss During the Great Recession: An Examination of Sense of Control in Late Midlife.

    Science.gov (United States)

    Mejía, Shannon T; Settersten, Richard A; Odden, Michelle C; Hooker, Karen

    2016-07-01

    The "Great Recession" shocked the primary institutions that help individuals and families meet their needs and plan for the future. This study examines middle-aged adults' experiences of financial loss and considers how socioeconomic and interpersonal resources facilitate or hinder maintaining a sense of control in the face of economic uncertainty. Using the 2006 and 2010 waves of the Health and Retirement Study, change in income and wealth, giving help to and receiving help from others, household complexity, and sense of control were measured among middle-aged adults (n = 3,850; age = 51-60 years). Socioeconomic resources predicted both the level of and change in the engagement of interpersonal resources prior to and during the Great Recession. Experiences of financial loss were associated with increased engagement of interpersonal resources and decreased sense of control. The effect of financial loss was dampened by education. Sense of control increased with giving help and decreased with household complexity. Findings suggest that, across socioeconomic strata, proportional loss in financial resources resulted in a loss in sense of control. However, responses to financial loss differed by socioeconomic status, which differentiated the ability to maintain a sense of control following financial loss. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Affordability of cancer treatment for aging cancer patients in Singapore: an analysis of health, lifestyle, and financial burden.

    Science.gov (United States)

    Chan, Alexandre; Chiang, Yu Yan; Low, Xiu Hui; Yap, Kevin Yi-Lwern; Ng, Raymond

    2013-12-01

    With the expected rise in newly diagnosed cancer cases among the elderly in Singapore, the affordability of cancer treatments, particularly of targeted therapies, will be a growing concern for patients. This study examines the perspectives of aging cancer patients on the financial burden of their cancer treatments. A single-center, prospective study was conducted in the largest ambulatory cancer center in Singapore. Older (50 years old and above) cancer patients receiving treatment were recruited. Patients completed three sets of self-reporting tools assessing their (a) demographics and lifestyles, (b) health-related quality of life, and (c) perceptions of cancer treatment costs. The association between targeted therapy utilities and their perceived financial burden was evaluated using a multivariable logistic regression. Five hundred and sixteen patients were included in the study. The majority of the respondents (69.6 %) were between 50 and 64 years old. The majority were Singaporeans (97.7 %), belonged to the ethnic Chinese group (88.4 %), and most were female (59.1 %). The users of targeted therapies were 2.92 times more likely to perceive that the amount of cash that they spent on cancer treatment was more than expected and 2.52 times more likely to have difficulty paying for cancer treatments. Fortunately, the majority of the respondents (70.6 %) found their existing financial schemes helpful in reducing the necessary out-of-pocket expenses. Although aging cancer patients feel that the financial schemes in Singapore have helped them tremendously, the general perception is that they require further help to offset their out-of-pocket expenses. This is especially true for users of targeted therapies and those who have a poorer health status.

  4. Employment Impact and Financial Burden for Families of Children with Fragile X Syndrome: Findings from the National Fragile X Survey

    Science.gov (United States)

    Ouyang, L.; Grosse, S.; Raspa, M.; Bailey, D.

    2010-01-01

    Background: The employment impact and financial burden experienced by families of children with fragile X syndrome (FXS) has not been quantified in the USA. Method: Using a national fragile X family survey, we analysed data on 1019 families with at least one child who had a full FXS mutation. Out-of-pocket expenditures related to fragile X were…

  5. The Financial Burden of Non-Communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures

    NARCIS (Netherlands)

    Janssens, Wendy; Goedecke, Jann; de Bree, Godelieve J.; Aderibigbe, Sunday A.; Akande, Tanimola M.; Mesnard, Alice

    2016-01-01

    Better insights into health care utilization and out-of-pocket expenditures for non-communicable chronic diseases (NCCD) are needed to develop accessible health care and limit the increasing financial burden of NCCDs in Sub-Saharan Africa. A household survey was conducted in rural Kwara State,

  6. Financial Strain, Parental Smoking, and the Great Recession: An Analysis of the UK Millennium Cohort Study.

    Science.gov (United States)

    McKenna, Caoimhe S; Law, Catherine; Pearce, Anna

    2017-11-07

    During the recent "Great Recession," many families in the United Kingdom experienced increased financial strain (FS). The aim of this study was to determine if increases in FS, occurring over the period of the "Great Recession," were associated with increased risks of persistent and relapsed tobacco use among parents. We analyzed the Millennium Cohort Study, a longitudinal study of 18819 children born in the United Kingdom between 2000 and 2002. Surveys at 7 (T1, 2008) and 11 years (T2, 2012) spanned the "Great Recession." Three measures of increased FS were defined; "became income poor" (self-reported household income dropped below the "poverty line" between T1 and T2); "developed difficulty managing" (parental report of being "financially comfortable" at T1 and finding it "difficult to manage" at T2); "felt worse off" (parental report of feeling financially "worse off" at T2, compared to T1). Poisson regression was used to estimate risk ratios (RR), adjusted RRs (aRR), and 95% confidence intervals for three outcomes: "persistent tobacco use," "new reported tobacco use," and "relapsed tobacco use." Parents in households which "became income poor" over the period of the "Great Recession" were significantly more likely to report "persistent tobacco use" (aRR = 2.17 [1.83-2.57]) or "new reported tobacco use" (aRR = 1.72 [1.04-2.83]). Ninety-five percent of "new reported tobacco users" had evidence of prior tobacco use suggesting the majority were "relapsed tobacco users." Similar patterns were seen for those who "developed difficulty managing" and "felt worse off." Increased tobacco use among financially strained families has the potential to widen inequalities and undermine the public health policies that have had positive impacts on tobacco consumption in the United Kingdom. While several studies have shown that FS is associated with a higher prevalence of tobacco use, heavier smoking, and relapsed tobacco use, most of this work used cross-sectional data and none

  7. The Great Financial Crisis: How Effective is Macroeconomic Policy Response in the United Kingdom?

    Directory of Open Access Journals (Sweden)

    Clements Akinsoyinu

    2015-06-01

    Full Text Available The Great Financial Crisis has been touted to be the worst crisis since the Great Depression of 1930; its effect has profound ramifications on the global economy. The nature and the severity of the crisis provoked an unprecedented policy response from policy makers at both global and domestic levels. To address the rampaging crisis, the Bank of England implemented a number of conventional and unconventional policy measures to curtail the economic rot and to stimulate economic growth. There is a broad consensus in the empirical literature and other evidence found in this paper that a number of the policies implemented in the United Kingdom played a significant role in re-directing and stimulating the economy. This paper reviews the various policy measures adopted by the Bank of England from the inception of the financial crisis in 2008 and assesses their effectiveness in bringing back the economy from the brink of collapse. Our review shows that quantitative easing (QE policy and the expansionary fiscal policy adopted by the Bank of England were effective policy tools used in stimulating economic growth, stemming the effect and shortening the duration of the crisis in the United Kingdom

  8. Private Financial Transfers, Family Income, and the Great Recession

    Science.gov (United States)

    Gottlieb, Aaron; Pilkauskas, Natasha; Garfinkel, Irwin

    2014-01-01

    Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,701; 1998–2010), the authors studied whether the unemployment rate was associated with private financial transfers (PFTs) among urban families with young children and whether family income moderated these associations. They found that an increase in the unemployment rate was associated with greater PFT receipt and that family income moderated the association. Poor and near-poor mothers experienced increases in PFT receipt when unemployment rates were high, whereas mothers with incomes between 2 and 3 times the poverty threshold experienced decreases. Simulations estimating the impact of the Great Recession suggest that moving from 5% to 10% unemployment is associated with a 9-percentage-point increase in the predicted probability of receiving a PFT for the sample as a whole, with greater increases in predicted probabilities among poor and near poor mothers. PMID:25505802

  9. Patient-experienced burden of treatment in patients suffering from multimorbidity data

    DEFF Research Database (Denmark)

    Rosbach, Michael; Andersen, John Sahl

    2017-01-01

    the multimorbid patients. In studies conducted in the US and Australia the financial burden and the time and travel burden were found most straining to patients with deprived socioeconomic status. The burden of treatment was found to be a complex concept consisting of many different components and factors...... interacting with each other. The size of the burden was associated to the workload of demands (number of conditions, number of medications and health status), the capacity (cognitive, physical and financial resources, educational level, cultural background, age, gender and employment conditions...

  10. ANALYSIS OF TAX BURDEN PARAMETERS OF UKRAINE'S ECONOMY

    Directory of Open Access Journals (Sweden)

    I. Moyseyenko

    2017-11-01

    Full Text Available The need to solve the problems of macro-economic stabilization of the country's economy on the basis of determining the tax system efficiency led to the actuality and importance of developing methodological issues of macro-economic tax regulation. In terms of macro-financial stability for the purpose of strategic analysis, the macroeconomic category of tax burden and its fiscal efficiency in terms of direct and indirect taxation is considered. Tax burden indicators at a macro-level quantitatively measure the total level of tax payment and pumping up the budget. Based on the analysis of tax burden it is found that in Ukraine the major fiscal function is performed by consumption taxes (indirect taxes. The methodological principles of the diagnostics of tax burden influence on macro-indices of economic stabilization are as follows: selecting parameters of monitoring tax burden state and fiscal burden efficiency; the assessment of an impact on fiscal efficiency on macro-indices. To prognosticate the efficiency of fiscal burden performance in terms of indirect taxes linear and exponential trend equations are calculated. In terms of the analysis of macro-financial stability the usage of tax rates of indirect taxes as indicators of fiscal efficiency provides sufficient reasons for the conclusions regarding long-term trends of pumping the budget.

  11. Gastroesophageal reflux disease burden in Iran.

    Science.gov (United States)

    Delavari, Alireza; Moradi, Ghobad; Elahi, Elham; Moradi-Lakeh, Maziar

    2015-02-01

    Gastroesophageal reflux disease is one of the most common disorders of the gastrointestinal tract. The prevalence of this disease ranges from 5% to 20% in Asia, Europe, and North America. The aim of this study was to estimate the burden of gastroesophageal reflux disease in Iran. Burden of gastroesophageal reflux disease in Iran was estimated for one year from 21 March 2006 to 20 March 2007. The definition was adjusted with ICD-code of K21. Incident-based disability-adjusted life year (DALY) was used as the unit of analysis to quantify disease burden. A simplified disease model and DisMod II software were used for modeling. The annual incidence for total population of males and females in Iran was estimated 17.72 and 28.06 per 1000, respectively. The average duration of gastroesophageal reflux disease as a chronic condition was estimated around 10 years in both sexes. Total DALYs for an average of 59 symptomatic days per year was estimated 153,554.3 (60,330.8 for males and 93,223.5 for females).   The results of this study showed that reflux imposes high burden and high financial costs on the Iranian population. The burden of this disease in Iran is more similar to that of European countries rather than Asian countries. It is recommended to consider the disease as a public health problem and make decisions and public health plans to reduce the burden and financial costs of the disease in Iran.

  12. Financial burden of therapy in families with a child with acute lymphoblastic leukemia: report from north India.

    Science.gov (United States)

    Ghatak, Nishantadeb; Trehan, Amita; Bansal, Deepak

    2016-01-01

    In a low-income country, a child with cancer has severe financial implications for the family. Invariably, patients have to self-finance their therapy. "Out-of-pocket" expenses tend to be high. Also, parents may face loss of job or business resulting in loss of income. Our objective was to assess the financial burden in families with a child with cancer. The cost to a family with a child with acute lymphoblastic leukemia (ALL) during the first month of therapy was analyzed. Fifty families were given a cost diary in which details of expenditure (direct medical costs, living costs, transport cost) and lost income/employment were recorded. The families evaluated came from a distance of 260 ± 218 km from hospital. Most families belonged to upper lower category (62%). The medical expenditure amounted to US dollar (USD) 524 (interquartile range (IQR) 395-777). Nonmedical expenditure was USD 207 (IQR 142-293), the maximum expenditure being on food. The monthly expenses were 7.2 times the monthly per capita income of India which was Indian rupee (INR) 5729 (USD 97) in 2012-2013. Thirty-nine families got financial help (USD 800-3225) from various sources, within 6 months of application. Of the families, 72% families suffered loss of income, 34% fathers lost their jobs. Families spend up to seven times their monthly income over a period of 1 month on an unforeseen illness. Despite financial aid from various sources, nonmedical costs amount to nearly 2.5 times the average per capita income. Universal health insurance is the need of the hour.

  13. Does the cost of robotic cholecystectomy translate to a financial burden?

    Science.gov (United States)

    Rosemurgy, Alexander; Ryan, Carrie; Klein, Richard; Sukharamwala, Prashant; Wood, Thomas; Ross, Sharona

    2015-08-01

    Robotic application to cholecystectomy has dramatically increased, though its impact on cost of care and reimbursement has not been elucidated. We undertook this study to evaluate and compare cost of care and reimbursement with robotic versus laparoscopic cholecystectomy. The charges and reimbursement of all robotic and laparoscopic cholecystectomies at one hospital undertaken from June 2012 to June 2013 were determined. Operative duration is defined as time into and time out of the operating room. Data are presented as median data. Comparisons were undertaken using the Mann-Whitney U-test with significance accepted at p ≤ 0.05. Robotic cholecystectomy took longer (47 min longer) and had greater charges ($8,182.57 greater) than laparoscopic cholecystectomy (p depreciation, interest, and taxes (EBDIT), and Net Income were not impacted by approach. Relative to laparoscopic cholecystectomy, robotic cholecystectomy takes longer and has greater charges. Revenue, EBDIT, and Net Income are similar after either approach; this indicates that costs with either approach are similar. Notably, this is possible because much of hospital-based costs are determined by cost allocation and not cost accounting. Thus, the cost of longer operations and costs inherent to the robotic approach for cholecystectomy do not translate to a perceived financial burden.

  14. Patient-Centered Medical Home and Family Burden in Attention-Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Ronis, Sarah D; Baldwin, Constance D; Blumkin, Aaron; Kuhlthau, Karen; Szilagyi, Peter G

    2015-01-01

    Attention-deficit hyperactivity disorder (ADHD) can impair child health and functioning, but its effects on the family's economic burden are not well understood. The authors assessed this burden in US families of children with ADHD, and the degree to which access to a patient-centered medical home (PCMH) might reduce this burden. We conducted cross-sectional analyses of 2005-2006 and 2009-2010 National Surveys of Children with Special Health Care Needs, focusing on families of children with ADHD. They defined family economic burden as (1) family financial problems (annual expenses for the child's health care or illness-related financial problems for the family) and/or (2) family employment problems (job loss, work time loss, or failure to change jobs to avoid insurance loss). Relative risk models assessed associations between PCMH and family economic burden, adjusted for child age, sex, ethnicity, ADHD severity, poverty status, caregiver education, and insurance. In 2009, 26% of families reported financial problems because of the child's ADHD, 2.1% reported out-of-pocket expenses >5% of income, and 36% reported employment problems. Only 38% reported care that met all 5 criteria for a PCMH (similar to rates in 2005-2006). In multivariable analysis, care in a PCMH was associated with 48% lower relative risk (RR) of financial problems (RR = 0.52, p family-centered care and care coordination were more strongly associated with lower burden. The economic burdens of families with ADHD are significant but may be alleviated by family-centered care and care coordination in a medical home.

  15. Credit spread variability in U.S. business cycles: the Great Moderation versus the Great Recession

    OpenAIRE

    Hylton Hollander; Guangling Liu

    2014-01-01

    This paper establishes the prevailing financial factors that influence credit spread variability, and its impact on the U.S. business cycle over the Great Moderation and Great Recession periods. To do so, we develop a dynamic general equilibrium framework with a central role of financial intermediation and equity assets. Over the Great Moderation and Great Recession periods, we find an important role for bank market power (sticky rate adjustments and loan rate markups) on credit spread variab...

  16. Credit spread variability in U.S. business cycles: The Great Moderation versus the Great Recession

    OpenAIRE

    Hylton Hollander and Guangling Liu

    2014-01-01

    This paper establishes the prevailing financial factors that influence credit spread variability, and its impact on the U.S. business cycle over the Great Moderation and Great Recession periods. To do so, we develop a dynamic general equilibrium framework with a central role of financial intermediation and equity assets. Over the Great Moderation and Great Recession periods, we find an important role for bank market power (sticky rate adjustments and loan rate markups) on credit spread variab...

  17. Disease Burden from Hepatitis B Virus Infection in Guangdong Province, China

    Directory of Open Access Journals (Sweden)

    Jianpeng Xiao

    2015-11-01

    Full Text Available Objective: To estimate the disease burden and financial burden attributed to hepatitis B virus (HBV infection in Guangdong Province. Methods: Based on the data of incidence, mortality and healthcare cost of HBV-related diseases and other socio-economic data in Guangdong Province, we estimated deaths, disability-adjusted life-years (DALYs and economic cost for the three HBV-related diseases—hepatitis B, liver cirrhosis and liver cancer—in Guangdong following the procedures developed for the global burden of disease study. Then disease burden and economic cost attributed to HBV infection was estimated. Results: HBV infection was estimated to have caused 33,600 (95% confidence interval (CI: 29,300–37,800 premature deaths and the loss of 583,200 (95% CI: 495,200–671,100 DALYs in Guangdong in 2005. The greatest loss of deaths and DALYs were from liver cancer. The 45–59 years age group had the greatest burden attributable to HBV infection. The estimated total annual cost of HBV-related diseases in Guangdong was RMB 10.8 (95% CI: 8.7–13.0 billion,the direct and indirect cost were RMB 2.6 (95% CI: 2.1–3.2 and 8.2 (95% CI: 6.6–9.8 billion. Conclusions: HBV infection is a great medical challenge as well as a significant economic burden to Guangdong Province. The results suggest that substantial health benefits could be gained by extending effective public health and clinical interventions to reduce HBV infection in Guangdong Province.

  18. Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    McKenna, Caoimhe; Law, Catherine; Pearce, Anna

    2017-03-09

    There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the 'Great Recession' many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the 'Great Recession'. Three measures of increased FS were defined; 'became income poor' (self-reported household income dropped below the 'poverty line' between T1 and T2); 'developed difficulty managing' (parental report of being 'financially comfortable' at T1 and finding it 'difficult to manage' at T2); 'felt worse off' (parental report of feeling financially 'worse off' at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the 'Great Recession', measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. Published by the BMJ Publishing Group Limited. For

  19. Financial Intermediation, House Prices and the Welfare Effects of the U.S. Great Recession

    DEFF Research Database (Denmark)

    Menno, Dominik Francesco; Oliviero, Tommaso

    2014-01-01

    drop in consumption than savers who relatively benefit from a redistribution of housing wealth during the recession. We show that the size of this redistribution mechanism would have been significantly lower if (i) mortgage spreads would have remained at the low pre-crisis levels during the recession......This paper quantifies how the welfare costs of the U.S. Great Recession are distributed across borrowing and saving U.S. households. For this purpose, we use a calibrated dynamic general equilibrium model of housing and household debt with shocks to aggregate income and shocks to the financial...... intermediation sector. The model matches the boom-bust cycle in house prices, the dynamics of household mortgage debt, and the increase in wealth inequality observed in the U.S. between 2001-2013. We find larger welfare costs of the Great Recession for borrowers than for savers. Borrowers experience a larger...

  20. Economic and psychological burden of scheduled surgery ...

    African Journals Online (AJOL)

    Background: Cancellation of scheduled surgery creates a financial burden for hospitals, caregivers and ..... costs and disregard some of the aspects mentioned in the ..... cancellation of elective surgical procedures in a Spanish general.

  1. The impact of financial position on investment: an analysis for non-financial corporations in the euro area

    OpenAIRE

    Carmen Martínez-Carrascal; Annalisa Ferrando

    2008-01-01

    This paper analyses the impact that firms financial position has on investment decisions using panel data from a large sample of non-financial corporations(around 120,000 firms) in six euro area countries(Belgium, Germany, France, Italy, the Netherlands and Spain). The results indicate that financial position is important to explain capital expenditures, as financial pressure appears relevant in explaining investment dynamics when it is proxied by cash flow, indebtedness and debt burden. The ...

  2. Caregiver Burden in Alcohol Dependence Syndrome

    Directory of Open Access Journals (Sweden)

    Ramanujam Vaishnavi

    2017-01-01

    Full Text Available Background. Alcoholism is a major threat to the individual as well as the society and the maximum burden of the illness is borne by the family. Aim. The study is aimed at assessing the pattern of burden on the caregivers of alcohol dependent patients and at assessing the relationship between the severity of dependence and the burden on caregivers. Settings and Design. Cross-sectional descriptive study conducted in the Department of Psychiatry, Sri Ramachandra Medical College and Research Institute. Materials and Methods. A cross-sectional assessment was done in 200 patients with alcohol dependence and their caregivers. The severity of dependence and the pattern of burden on caregivers were assessed. Statistical Analysis. The data thus collected was analyzed using SPSS version 20. Results. The study demonstrates that caregivers of alcohol dependent patients reported significant objective burden and subjective burden. Furthermore, the severity of alcohol dependence and the domains of burden such as financial burden, disruption of family interaction, and disruption of family routine activities were positively correlated with high level of significance. Conclusion. The current study has illustrated that all the caregivers experienced significant amount of burden which has to be addressed for better treatment outcome of the patients.

  3. Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum disorder, developmental disability and/or mental health conditions: National Survey of CSHCN, 2009–10

    Science.gov (United States)

    Vohra, Rini; Sambamoorthi, Usha; Madhavan, S. Suresh

    2016-01-01

    Objective The purpose of this study is to examine the burdens of caregivers on one perception of the need and receipt of preventive dental care for a subset of children with special health care needs—children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009–2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers’ financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N=16,323). Results Overall, 16.3% of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0% of caregivers who reported financial burden, 20.3% who reported employment burden, and 10.8% who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1 %, 16.5%, 17.7% respectively) compared to caregivers without financial, employment, or time burdens (9.0%, 9.6%, 11.0% respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95%CI: 1.02, 1.86]) and employment burden (adjusted multinomial odds ratio, 1.45 [95%CI: 1.02, 2.06]) were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC. PMID:27465058

  4. Digging into Debt: The Financial Burden Associated with the Otolaryngology Match.

    Science.gov (United States)

    Polacco, Marc A; Lally, Jack; Walls, Andrew; Harrold, Linnea R; Malekzadeh, Sonya; Chen, Eunice Y

    2017-06-01

    Objective To quantify the cost incurred during the match process for otolaryngology applicants, determine sources of expenditures, and highlight potential methods to alleviate financial burden of the match process. Study Design Cross-sectional. Study Setting Online survey. Subjects and Methods An electronic survey was sent via email to those who applied to the otolaryngology residency programs at Dartmouth-Hitchcock Medical Center and MedStar Georgetown University Hospital during the 2016 application cycle. Questions regarding demographics and experiences with the match were multiple choice, and questions regarding cost were open answer. Data were downloaded and analyzed on Excel and Minitab software. Results Twenty-eight percent of the total 370 applicants completed the survey. The mean cost of away rotations was $2500 (95% confidence interval [CI], $2224-$2776). With application fees and the cost of interviewing, the mean total cost of applying for the 2016 otolaryngology match was $6400 (95% CI, $5710-$7090), with a total range of $1200 to $20,000. Twenty-eight percent of students did not have sufficient funds for applying and interviewing despite seeking out additional monetary resources. Conclusion In 2016, otolaryngology applicants spent a mean of $8900 (95% CI, $7935-$9865) on away rotations, applications, and interviewing. Half of the applicants obtained additional funding to cover this cost, while 28% still did not have sufficient funding. Methods of decreasing cost may include instituting a cap on application number, videoconferencing interviews, regionalizing interviews, and adjusting the interview timeline.

  5. The financial burden of national road infrastructure and the equity thereof: A South African perspective

    Directory of Open Access Journals (Sweden)

    Anton Brits

    2010-11-01

    Full Text Available Economic activities in South Africa during the past decade have caused, inter alia, road traffic congestion to accelerate annually and road infrastructure to deteriorate rapidly. Motor vehicle sales, correlated with economic trends and the economic empowerment of citizens, have and still are increasing at a faster rate than the supply of necessary infrastructure. As such, congestion, especially in the Gauteng area, has reached unacceptable levels during peak hours, necessitating the upgrading and continual maintenance of these roads and other national roads. The financial burden of upgrading and maintaining road infrastructure is enormous and, although the South African government makes contributions, an income from the road infrastructure is necessary to sustain quality infrastructure. However, a road-user paying approach, especially the structure thereof, should be acceptable to society in terms of economic efficiency and various means of equity. This article reviews the relevance of a road-user paying approach as applied in South Africa.

  6. Pilot Feasibility Study of an Oncology Financial Navigation Program.

    Science.gov (United States)

    Shankaran, Veena; Leahy, Tony; Steelquist, Jordan; Watabayashi, Kate; Linden, Hannah; Ramsey, Scott; Schwartz, Naomi; Kreizenbeck, Karma; Nelson, Judy; Balch, Alan; Singleton, Erin; Gallagher, Kathleen; Overstreet, Karen

    2018-02-01

    Few studies have reported on interventions to alleviate financial toxicity in patients with cancer. We developed a financial navigation program in collaboration with our partners, Consumer Education and Training Services (CENTS) and Patient Advocate Foundation (PAF), to improve patient knowledge about treatment costs, provide financial counseling, and to help manage out-of-pocket expenses. We conducted a pilot study to assess the feasibility and impact of this program. Patients with cancer received a financial education course followed by monthly contact with a CENTS financial counselor and a PAF case manager for 6 months. We measured program adherence, self-reported financial burden and anxiety, program satisfaction, and type of assistance provided. Thirty-four patients (median age, 60.5 years) were consented (85% white and 50% commercially insured). Debt, income declines, and loans were reported by 55%, 55%, and 30% of patients, respectively. CENTS counselors assisted most often with budgeting, retirement planning, and medical bill questions. PAF case managers assisted with applications for appropriate insurance coverage, cost of living issues (eg, housing, transportation), and disability applications. High financial burden and anxiety about costs (4 or 5 on a Likert scale) were reported at baseline by 37% and 47% of patients, respectively. Anxiety about costs decreased over time in 33% of patients, whereas self-reported financial burden did not substantially change. Implementing an oncology financial navigation program is feasible, provides concrete assistance in navigating the cost of care, and mitigates anxiety about costs in a subset of patients. Future work will focus on measuring the program's impact on financial and clinical outcomes.

  7. Psychometric Properties of the Turkish Version of Caregiver Burden Index (CBI) for Parents of Children with Allergies.

    Science.gov (United States)

    Ekim, Ayfer; Hecan, Melis; Oren, Serkan

    Childhood chronic diseases have a great impact, including physiological, social and financial burdens, on parents. The concept of "caregiver burden" is gaining importance to understand the effects of allergic diseases and plan family-centered strategies. The purpose of this study was to examine the psychometric properties of the Caregiver Burden Index (CBI) in Turkish mothers of children with allergies. The participants of this methodological study were 213 mothers of children with allergies between 6 and 12years. Construct validity was evaluated through factor analysis and reliability was evaluated through internal consistency and item-total correlation. In reliability analysis, the overall Cronbach's alpha value (0.85) demonstrated a high level of reliability. The corrected item-total correlation varied between 0.63 and 0.84. In exploratory factor analysis, it was detected that 3 factors structure explained 73.6% of the total variance. This study indicated that the CBI is a valid and reliable tool to assess the caregiver burden of mothers of Turkish children with allergies. The results of this study contribute to the development and implementation of evidence based models of care that address the caregiver burden needs of parents whose children have allergies. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Rising Prices of Targeted Oral Anticancer Medications and Associated Financial Burden on Medicare Beneficiaries.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Xu, Ying; Liu, Lei; Smieliauskas, Fabrice

    2017-08-01

    Purpose The high cost of oncology drugs threatens the affordability of cancer care. Previous research identified drivers of price growth of targeted oral anticancer medications (TOAMs) in private insurance plans and projected the impact of closing the coverage gap in Medicare Part D in 2020. This study examined trends in TOAM prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. Methods Using SEER linked to Medicare Part D, 2007 to 2012, we identified patients who take TOAMs via National Drug Codes in Part D claims. We calculated total drug costs (prices) and OOP payments per patient per month and compared their rates of inflation with general health care prices. Results The study cohort included 42,111 patients who received TOAMs between 2007 and 2012. Although the general prescription drug consumer price index grew at 3% per year over 2007 to 2012, mean TOAM prices increased by nearly 12% per year, reaching $7,719 per patient per month in 2012. Prices increased over time for newly and previously launched TOAMs. Mean patient OOP payments dropped by 4% per year over the study period, with a 40% drop among patients with a high financial burden in 2011, when the coverage gap began to close. Conclusion Rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D. Policymakers should explore methods of harnessing the surge of novel TOAMs to increase price competition for Medicare beneficiaries.

  9. "It's at a time in your life when you are most vulnerable": a qualitative exploration of the financial impact of a cancer diagnosis and implications for financial protection in health.

    Directory of Open Access Journals (Sweden)

    Aileen Timmons

    Full Text Available Although cancer patients may incur a wide range of cancer-related out-of-pocket costs and experience reduced income, the consequences of this financial burden are poorly understood. We investigated: financial adjustments needed to cope with the cancer-related financial burden; financial distress (defined as a reaction to the state of personal finances; and factors that increase risk of financial difficulties. Two sets of semi-structured face-to-face interviews were conducted with 20 patients with breast, lung and prostate cancer and 21 hospital-based oncology social workers (OSWs in Ireland, which has a mixed public-private healthcare system. Participants were asked about: strategies to cope with the cancer-related financial burden; the impact of the financial burden on the family budget, other aspects of daily life, and wellbeing. OSWs were also asked about patient groups they thought were more likely to experience financial difficulties. The two interview sets were analysed separately using a thematic approach. Financial adjustments included: using savings; borrowing money; relying on family and friends for direct and indirect financial help; and cutting back on household spending. Financial distress was common. Financial difficulties were more likely for patients who were older or younger, working at diagnosis, lacked social support, had dependent children, had low income or had few savings. These issues often interacted with one another. As has been seen in predominantly publically and predominantly privately-funded healthcare settings, a complex mixed public-private healthcare system does not always provide adequate financial protection post-cancer. Our findings highlight the need for a broader set of metrics to measure the financial impact of cancer (and to assess financial protection in health more generally; these should include: out-of-pocket direct medical and non-medical costs; changes in income; financial adjustments (including

  10. "It's at a time in your life when you are most vulnerable": a qualitative exploration of the financial impact of a cancer diagnosis and implications for financial protection in health.

    Science.gov (United States)

    Timmons, Aileen; Gooberman-Hill, Rachael; Sharp, Linda

    2013-01-01

    Although cancer patients may incur a wide range of cancer-related out-of-pocket costs and experience reduced income, the consequences of this financial burden are poorly understood. We investigated: financial adjustments needed to cope with the cancer-related financial burden; financial distress (defined as a reaction to the state of personal finances); and factors that increase risk of financial difficulties. Two sets of semi-structured face-to-face interviews were conducted with 20 patients with breast, lung and prostate cancer and 21 hospital-based oncology social workers (OSWs) in Ireland, which has a mixed public-private healthcare system. Participants were asked about: strategies to cope with the cancer-related financial burden; the impact of the financial burden on the family budget, other aspects of daily life, and wellbeing. OSWs were also asked about patient groups they thought were more likely to experience financial difficulties. The two interview sets were analysed separately using a thematic approach. Financial adjustments included: using savings; borrowing money; relying on family and friends for direct and indirect financial help; and cutting back on household spending. Financial distress was common. Financial difficulties were more likely for patients who were older or younger, working at diagnosis, lacked social support, had dependent children, had low income or had few savings. These issues often interacted with one another. As has been seen in predominantly publically and predominantly privately-funded healthcare settings, a complex mixed public-private healthcare system does not always provide adequate financial protection post-cancer. Our findings highlight the need for a broader set of metrics to measure the financial impact of cancer (and to assess financial protection in health more generally); these should include: out-of-pocket direct medical and non-medical costs; changes in income; financial adjustments (including financial coping

  11. Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?

    Science.gov (United States)

    Yu, Hao; Dick, Andrew W; Szilagyi, Peter G

    2008-10-01

    Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.

  12. Estimating the burden of rabies in Ethiopia by tracing dog bite victims

    NARCIS (Netherlands)

    Beyene, Tariku Jibat; Mourits, Monique C.M.; Kidane, Abraham Haile; Hogeveen, Henk

    2018-01-01

    In developing countries where financial resources are limited and numerous interests compete, there is a need for quantitative data on the public health burden and costs of diseases to support intervention prioritization. This study aimed at estimating the health burden and post-exposure treatment

  13. The financial burden of emergency general surgery: National estimates 2010 to 2060.

    Science.gov (United States)

    Ogola, Gerald O; Gale, Stephen C; Haider, Adil; Shafi, Shahid

    2015-09-01

    Adoption of the acute care surgery model has led to increasing volumes of emergency general surgery (EGS) patients at trauma centers. However, the financial burden of EGS services on trauma centers is unknown. This study estimates the current and future costs associated with EGS hospitalization nationwide. We applied the American Association for the Surgery of Trauma's DRG International Classification of Diseases-9th Rev. criteria for defining EGS to the 2010 National Inpatient Sample (NIS) data and identified adult EGS patients. Cost of hospitalization was obtained by converting reported charges to cost using the 2010 all-payer inpatient cost-to-charge ratio for all hospitals in the NIS database. Cost was modeled via a log-gamma model in a generalized linear mixed model to account for potential correlation in cost within states and hospitals in the NIS database. Patients' characteristics and hospital factors were included in the model as fixed effects, while state and hospital were included as random effects. The national incidence of EGS was calculated from NIS data, and the US Census Bureau population projections were used to estimate incidence for 2010 to 2060. Nationwide costs were obtained by multiplying projected incidences by estimated costs and reported in year 2010 US dollar value. Nationwide, there were 2,640,725 adult EGS hospitalizations in 2010. The national average adjusted cost per EGS hospitalization was $10,744 (95% confidence interval [CI], $10,615-$10,874); applying these cost data to the national EGS hospitalizations gave a total estimated cost of $28.37 billion (95% CI, $28.03-$28.72 billion). Older age groups accounted for greater proportions of the cost ($8.03 billion for age ≥ 75 years, compared with $1.08 billion for age 18-24 years). As the US population continues to both grow and age, EGS costs are projected to increase by 45% to $41.20 billion (95% CI, $40.70-$41.7 billion) by 2060. EGS constitutes a significant portion of US health

  14. Economic burden of disease-associated malnutrition in China.

    Science.gov (United States)

    Linthicum, Mark T; Thornton Snider, Julia; Vaithianathan, Rhema; Wu, Yanyu; LaVallee, Chris; Lakdawalla, Darius N; Benner, Jennifer E; Philipson, Tomas J

    2015-05-01

    Disease-associated malnutrition (DAM) is a well-recognized problem in many countries, but the extent of its burden on the Chinese population is unclear. This article reports the results of a burden-of-illness study on DAM in 15 diseases in China. Using data from the World Health Organization (WHO), the China Health and Nutrition Survey, and the published literature, mortality and disability-adjusted life years (DALYs) lost because of DAM were calculated; a financial value of this burden was calculated following WHO guidelines. DALYs lost annually to DAM in China varied across diseases, from a low of 2248 in malaria to a high of 1 315 276 in chronic obstructive pulmonary disease. The total burden was 6.1 million DALYs, for an economic burden of US$66 billion (Chinese ¥ 447 billion) annually. This burden is sufficiently large to warrant immediate attention from public health officials and medical providers, especially given that low-cost and effective interventions are available. © 2014 APJPH.

  15. Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia - a qualitative exploratory study.

    Science.gov (United States)

    von Kardorff, Ernst; Soltaninejad, Ali; Kamali, Mohammad; Eslami Shahrbabaki, Mahin

    2016-01-01

    Caregivers of people with mental illnesses often experience a wide range of burdens. Although many studies have confirmed burdens among family caregivers of mentally ill relatives in general, specific knowledge regarding the concrete everyday hassle and existential sorrows from the caregiverś subjective reasoning perspective is lacking. Furthermore, there is little evidence on the possible different effects of affective disorders and schizophrenia on the quality of burden; this is also true with regard to the role of cultural traditions and lay beliefs. The aim of this study was to explore the specific burdens experienced by caregivers of patients with schizophrenia and affective disorders. A qualitative study was conducted by semi-structured interviews with 45 caregivers of patients with schizophrenia and affective disorders. Data were analysed by qualitative content analysis. Eleven encumbering themes resulted from the interviews including incertitude, unawareness, emotional burden, stigma and blame, financial burden, physical burden, restriction in routine, disruption in routine, dissatisfaction with family, relatives, and acquaintances, troubles with patients' adherence to medication, and problems with health services and governmental support. Caring for a person with mental illness affects caregivers emotionally, financially, physically, and it elicits some restrictions in their routine (daily hassles). Finally, it causes conflicts in family relationships. Despite some differences regarding perceived burden among caregivers of schizophrenia and affective disorders, a common pattern of burden could be identified. Thus, authorities should provide adequate financial, educational, and psychosocial supports for caregivers of mental illnesses.

  16. The impact and financial burden of pulmonary arterial hypertension on patients and caregivers: results from a national survey.

    Science.gov (United States)

    Zhai, Zhenguo; Zhou, Xia; Zhang, Shuai; Xie, Wanmu; Wan, Jun; Kuang, Tuguang; Yang, Yuanhua; Huang, Huan; Wang, Chen

    2017-09-01

    Pulmonary arterial hypertension (PAH) is a chronic progressive devastating disease. Symptom burden might impair health-related quality of life of patients. Furthermore, treatment on this disease brings significant financial burden to patients' families. Both physiological and psychological symptoms have been reported, but limited evidence regarding the impact of PAH on patients and caregivers exists, especially the emotional issues and their association with patients' health quality. The main purpose of this study was to describe the impact of PAH on patients and their caregivers in a Chinese population.This large-scale national survey enrolled 174 participants to complete questionnaires using face-to-face semistructured interviews.PAH influenced all aspects of patients' lives including daily activities, work, emotions, and personal relationships. Both patients and caregivers reported a major impact on family finances and on their work. The majority of patients had feelings of isolation. A lack of public understanding about PAH contributes to social isolation. Most patients and caregivers would like to get information regarding PAH doctors and patient organization contacts to obtain support.This survey-based report provides information regarding the way and extent to which PAH impacts both patients and their caregivers and provides some means for comparison with non-Chinese populations. It is important for physicians and the community to offer more support and information for PAH patients and their families.

  17. Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

    Science.gov (United States)

    Sorrell, Jeanne M

    2014-03-01

    Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient. Copyright 2014, SLACK Incorporated.

  18. Measuring the burden of preventable diabetic hospitalisations in the Mexican Institute of Social Security (IMSS).

    Science.gov (United States)

    Lugo-Palacios, David G; Cairns, John; Masetto, Cynthia

    2016-08-02

    The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective primary care, a high percentage of diabetic patients have developed them imposing an important preventable burden on Mexican society and on the health system. This paper estimates the financial and health burden caused by potentially preventable hospitalisations due to diabetic complications in hospitals operated by the largest social security institution in Latin America, the Mexican Institute of Social Security (IMSS), in the period 2007-2014. Hospitalisations in IMSS hospitals whose main cause was a diabetic complication were identified. The financial burden was estimated using IMSS diagnostic-related groups. To estimate the health burden, DALYs were computed under the assumption that patients would not have experienced complications if they had received timely and effective primary care. A total of 322,977 hospitalisations due to five diabetic complications were identified during the period studied, of which hospitalisations due to kidney failure and diabetic foot represent 78 %. The financial burden increased by 8.4 % in real terms between 2007 and 2014. However, when measured as cost per IMSS affiliate, it decreased by 11.3 %. The health burden had an overall decrease of 13.6 % and the associated DALYs in 2014 reached 103,688. Resources used for the hospital treatment of diabetic complications are then not available for other health care interventions. In order to prevent these hospitalisations more resources might need to be invested in primary care; the first step could be to consider the financial burden of these hospitalisations as a potential target for switching resources from hospital care to primary care services. However, more evidence of the effectiveness of different primary care interventions is needed to know how much of the burden could

  19. Associations between neighbourhood support and financial burden with unmet needs of head and neck cancer survivors.

    Science.gov (United States)

    O'Brien, Katie M; Timmons, Aileen; Butow, Phyllis; Gooberman-Hill, Rachael; O'Sullivan, Eleanor; Balfe, Myles; Sharp, Linda

    2017-02-01

    To assess the unmet needs of head and neck cancer survivors and investigate associated factors. In particular, to explore whether social support (family/friends and neighbours) and financial burden are associated with unmet needs of head and neck cancer (HNC) survivors. This was a cross-sectional study of HNC survivors, with 583 respondents included in the analysis. Information was collected on unmet supportive care needs as measured by the Supportive Care Needs Survey (SCNS-SF34). Poisson regression with robust standard errors was used to examine factors associated with having one or more needs in each of the five domains (physical; psychological; sexuality; patient care and support; and health system and information). The mean age of respondents was 62.9years (standard deviation 11.3years) and one third of respondents were female. The top ten unmet needs was composed exclusively of items from the physical and psychological domains. Financial strain due to cancer and finding it difficult to obtain practical help from a neighbour were both associated with unmet needs in each of the five domains, in the adjusted analyses. Whilst in each domain, a minority of respondents have unmet needs, approximately half of respondents reported at least one unmet need, with the commonest unmet needs in the psychological domain. Providing services to people with these needs should be a priority for healthcare providers. We suggest that studies, which identify risk factors for unmet needs, could be used to develop screening tools or aid in the targeting of support. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Cost and economic burden of illness over 15 years in Nepal: A comparative analysis.

    Science.gov (United States)

    Swe, Khin Thet; Rahman, Md Mizanur; Rahman, Md Shafiur; Saito, Eiko; Abe, Sarah K; Gilmour, Stuart; Shibuya, Kenji

    2018-01-01

    With an increasing burden of non-communicable disease in Nepal and limited progress towards universal health coverage, country- and disease-specific estimates of financial hardship related to healthcare costs need to be evaluated to protect the population effectively from healthcare-related financial burden. To estimate the cost and economic burden of illness and to assess the inequality in the financial burden due to catastrophic health expenditure from 1995 to 2010 in Nepal. This study used nationally representative Nepal Living Standards Surveys conducted in 1995 and 2010. A Bayesian two-stage hurdle model was used to estimate average cost of illness and Bayesian logistic regression models were used to estimate the disease-specific incidence of catastrophic health payment and impoverishment. The concentration curve and index were estimated by disease category to examine inequality in healthcare-related financial hardship. Inflation-adjusted mean out-of-pocket (OOP) payments for chronic illness and injury increased by 4.6% and 7.3%, respectively, while the cost of recent acute illness declined by 1.5% between 1995 and 2010. Injury showed the highest incidence of catastrophic expenditure (30.7% in 1995 and 22.4% in 2010) followed by chronic illness (12.0% in 1995 and 9.6% in 2010) and recent acute illness (21.1% in 1995 and 7.8% in 2010). Asthma, diabetes, heart conditions, malaria, jaundice and parasitic illnesses showed increased catastrophic health expenditure over time. Impoverishment due to injury declined most (by 12% change in average annual rate) followed by recent acute illness (9.7%) and chronic illness (9.6%) in 15 years. Inequality analysis indicated that poorer populations with recent acute illness suffered more catastrophic health expenditure in both sample years, while wealthier households with injury and chronic illnesses suffered more catastrophic health expenditure in 2010. To minimize the economic burden of illness, several approaches need to be

  1. Early & Often: Designing a Comprehensive System of Financial Aid Information. A Report of the Advisory Committee on Student Financial Assistance

    Science.gov (United States)

    Advisory Committee on Student Financial Assistance, 2008

    2008-01-01

    Students and parents need ample time and accurate information to prepare for the financial burden of a college education--those who lack this knowledge base face a significant access barrier to higher education. This problem can be countered by the delivery of comprehensive, integrated financial aid information, an approach identified by the…

  2. [International financial cooperation in the fight against AIDS in Latin America and the Caribbean].

    Science.gov (United States)

    Leyva-Flores, René; Castillo, José Gabriel; Serván-Mori, Edson; Ballesteros, Maria Luisa Gontes; Rodríguez, Juan Francisco Molina

    2014-07-01

    This study analyzed the financial contribution by the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and its relationship to eligibility criteria for funding in Latin America and the Caribbean in 2002-2010. Descriptive analysis (linear regression) was conducted for the Global Fund financial contributions according to eligibility criteria (income level, burden of disease, governmental co-investment). Financial contributions totaled US$ 705 million. Lower-income countries received higher shares; there was no relationship between Global Fund contributions and burden of disease. The Global Fund's international financing complements governmental expenditure, with equity policies for financial allocation.

  3. Analysis of the economic burden of diagnosis and treatment of tuberculosis patients in rural China.

    Science.gov (United States)

    Pan, H-Q; Bele, S; Feng, Y; Qiu, S-S; Lü, J-Q; Tang, S-W; Shen, H-B; Wang, J-M; Zhu, L-M

    2013-12-01

    A county in Jiangsu Province, China. To estimate the costs of the diagnosis and treatment of tuberculosis (TB) from the patient's perspective and to identify determinants of the patient's financial burden. In a cross-sectional survey, we interviewed 316 patients diagnosed from January 2010 to May 2011 who had already completed their anti-tuberculosis treatment. The financial burden on TB patients included out-of-pocket costs and productivity losses. The average per capita total out-of-pocket cost was 3024.0 Chinese yuan (CNY), with a median cost of 1086 CNY (interquartile range [IQR] 480-2456). Mean out-of-pocket medical and non-medical costs were respectively 2565.7 CNY and 458.3 CNY. Productivity lost by patients and family members was 2615.2 CNY (median 500, IQR 250-2025). Factors associated with out-of-pocket costs and productivity losses included hospitalisation, adverse drug reactions, cost of drugs to 'protect' the liver, cost of second-line anti-tuberculosis drugs and diagnostic delay. Although the government of China has implemented a 'free TB service policy', the economic burden on patients is still heavy. More patient-centred interventions are essential to reduce the financial burden on patients.

  4. Financial Burden and Impoverishment Due to Cardiovascular Medications in Low and Middle Income Countries: An Illustration from India

    Science.gov (United States)

    Pandey, Kiran Raj; Meltzer, David O.

    2016-01-01

    Background Health expenditures are a major financial burden for many persons in low and middle-income countries, where individuals often lack health insurance. We estimate the effect of purchasing cardiovascular medicines on poverty in low and middle-income populations using rural and urban India as an example. Methods We created step-up treatment regimens for prevention of ischemic heart disease for the most common cardiovascular medications in India based on their cost and relative risk reduction. Cost was measured by Government of India mandated ceiling prices in rupees (Rs. 1 = $0·016) for essential medicines plus taxes. We calculated step-wise projected incidence and intensity of impoverishment due to medicine purchase. To do this we measured the resources available to individuals as daily per-capita expenditures from the latest National Sample Survey, subtracted daily medication costs, and compared this to 2014 poverty thresholds recommended by an expert group. Findings Analysis of cost-effectiveness resulted in five primary prevention drug regimens, created by progressive addition of Aspirin 75 mg, Hydrochlorothiazide 12.5mg, Losartan 25 mg, and Atorvastatin 10 mg or 40mg. Daily cost from steps 1 to 5 increased from Rs. 0·13, Rs. 1.16, Rs. 3.81, Rs. 10.07, to Rs. 28.85. At baseline, 31% of rural and 27% percent of urban Indian population are poor at the designated poverty thresholds. The Rs. 28.85 regimen would be unaffordable to 81% and 58% of rural and urban people. A secondary prevention regimen with aspirin, hydrochlorothiazide, atenolol and atorvastatin could be unaffordable to 81% and 57% rural and urban people respectively. According to our estimates, 17% of the rural 32% of the urban adult population could benefit with these medications, and their out of pocket purchase could impoverish 17 million rural and 10 million urban people in India and increase respective poverty gaps by 2.9%. Conclusion Medication costs for cardiovascular disease have the

  5. Financial Burden and Impoverishment Due to Cardiovascular Medications in Low and Middle Income Countries: An Illustration from India.

    Science.gov (United States)

    Pandey, Kiran Raj; Meltzer, David O

    2016-01-01

    Health expenditures are a major financial burden for many persons in low and middle-income countries, where individuals often lack health insurance. We estimate the effect of purchasing cardiovascular medicines on poverty in low and middle-income populations using rural and urban India as an example. We created step-up treatment regimens for prevention of ischemic heart disease for the most common cardiovascular medications in India based on their cost and relative risk reduction. Cost was measured by Government of India mandated ceiling prices in rupees (Rs. 1 = $0·016) for essential medicines plus taxes. We calculated step-wise projected incidence and intensity of impoverishment due to medicine purchase. To do this we measured the resources available to individuals as daily per-capita expenditures from the latest National Sample Survey, subtracted daily medication costs, and compared this to 2014 poverty thresholds recommended by an expert group. Analysis of cost-effectiveness resulted in five primary prevention drug regimens, created by progressive addition of Aspirin 75 mg, Hydrochlorothiazide 12.5mg, Losartan 25 mg, and Atorvastatin 10 mg or 40mg. Daily cost from steps 1 to 5 increased from Rs. 0·13, Rs. 1.16, Rs. 3.81, Rs. 10.07, to Rs. 28.85. At baseline, 31% of rural and 27% percent of urban Indian population are poor at the designated poverty thresholds. The Rs. 28.85 regimen would be unaffordable to 81% and 58% of rural and urban people. A secondary prevention regimen with aspirin, hydrochlorothiazide, atenolol and atorvastatin could be unaffordable to 81% and 57% rural and urban people respectively. According to our estimates, 17% of the rural 32% of the urban adult population could benefit with these medications, and their out of pocket purchase could impoverish 17 million rural and 10 million urban people in India and increase respective poverty gaps by 2.9%. Medication costs for cardiovascular disease have the potential to cause financial burden to

  6. Action to address the household economic burden of non-communicable diseases.

    Science.gov (United States)

    Jan, Stephen; Laba, Tracey-Lea; Essue, Beverley M; Gheorghe, Adrian; Muhunthan, Janani; Engelgau, Michael; Mahal, Ajay; Griffiths, Ulla; McIntyre, Diane; Meng, Qingyue; Nugent, Rachel; Atun, Rifat

    2018-05-19

    The economic burden on households of non-communicable diseases (NCDs), including cardiovascular diseases, cancer, respiratory diseases, and diabetes, poses major challenges to global poverty alleviation efforts. For patients with NCDs, being uninsured is associated with 2-7-fold higher odds of catastrophic levels of out-of-pocket costs; however, the protection offered by health insurance is often incomplete. To enable coverage of the predictable and long-term costs of treatment, national programmes to extend financial protection should be based on schemes that entail compulsory enrolment or be financed through taxation. Priority should be given to eliminating financial barriers to the uptake of and adherence to interventions that are cost-effective and are designed to help the poor. In concert with programmes to strengthen national health systems and governance arrangements, comprehensive financial protection against the growing burden of NCDs is crucial in meeting the UN's Sustainable Development Goals. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Caregiver burden and nonachievement of healthy lifestyle behaviors among family caregivers of cardiovascular disease patients.

    Science.gov (United States)

    Mochari-Greenberger, Heidi; Mosca, Lori

    2012-01-01

    To determine whether caregiver burdens are associated with lifestyle behaviors 1 year following the hospitalization of a family member with cardiovascular disease (CVD). Prospective follow-up study of National Heart Lung and Blood Institute sponsored Family Intervention Trial for Heart Health participants. Hospital-based recruitment/baseline visit with 1-year follow-up. Family members of hospitalized CVD patients (N  =  423; 67% female; 36% racial/ethnic minority; mean age 49 years). Systematic evaluation at 1 year to determine heart-healthy diet (defined as caregiver burdens (five domains: employment, financial, physical, social, and time; Caregiver Strain Questionnaire). Logistic regression adjusted for covariates. Heart-healthy diet was less frequent among caregivers citing feeling overwhelmed (odds ratio [OR]  =  .50; 95% confidence interval [CI]  =  .26-.97), sleep disturbance (OR  =  .51; 95% CI  =  .27-.96), financial strain (OR  =  .41; 95% CI  =  .20-.86), upsetting behavior (OR  =  .48; 95% CI  =  .25-.92), and/or time demands (OR  =  .47; 95% CI  =  .26-.85) as burdens. Physical activity was less frequent among caregivers reporting financial strain (OR  =  .32; 95% CI  =  .13-.81) or upsetting patient behavior (OR  =  .33; 95% CI  =  .15-.76) as burdens. The most commonly cited caregiver burdens included changes in personal plans (39%), time demands (38%), and sleep disturbance (30%). Caregiver burdens were associated with nonachievement of heart-healthy diet and physical activity behaviors among family caregivers 1 year after patient discharge. When developing heart-health promotion interventions, caregiver burden should be considered as a possible barrier to prevention among family members of CVD patients.

  8. Setting the stage for universal financial distress screening in routine cancer care.

    Science.gov (United States)

    Khera, Nandita; Holland, Jimmie C; Griffin, Joan M

    2017-11-01

    Financial burden from cancer treatment is increasingly being recognized as a threat to optimal access, quality, and outcomes of cancer care for patients. Although research in the area is moving at a fast pace, multiple questions remain unanswered, such as how to practically integrate the assessment and management of financial burden into routine health care delivery for patients with cancer. Although psychological distress screening for patients undergoing cancer treatment now is commonplace, the authors raise the provocative idea of universal screening for financial distress to identify and assist vulnerable groups of patients. Herein, the authors outline the arguments to support screening for financial burden in addition to psychological distress, examining it as an independent patient-reported outcome for all patients with cancer at various time points during their treatment. The authors describe the proximal and downstream impact of such a strategy and reflect on some challenges and potential solutions to help integrate this concept into routine cancer care delivery. Cancer 2017;123:4092-4096. © 2017 American Cancer Society. © 2017 American Cancer Society.

  9. Trends in Outcomes, Financial Burden, and Mortality for Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) in the United States from 2002 to 2010.

    Science.gov (United States)

    Jinjuvadia, Chetna; Jinjuvadia, Raxitkumar; Mandapakala, Chaitanya; Durairajan, Navin; Liangpunsakul, Suthat; Soubani, Ayman O

    2017-02-01

    Chronic obstructive pulmonary disease (COPD) is the cause of substantial economic and social burden. We evaluated the temporal trends of hospitalizations from acute exacerbation of COPD and determined its outcome and financial impact using the National (Nationwide) Inpatient Sample (NIS) databases (2002-2010). Individuals aged ≥ 18 years were included. Subjects who were hospitalized with primary diagnosis of COPD exacerbation and those who were admitted for other causes but had underlying acute exacerbation of COPD (secondary diagnosis) were captured by International Classification of Diseases-Ninth Revision (ICD-9) codes. The hospital outcomes and length of stay were determined. Multivariate logistic regression was used to identify the independent predictors of inpatient mortality. Overall acute exacerbation of COPD-related hospitalizations accounted for nearly 3.31% of all hospitalizations in the year 2002. This did not change significantly to year 2010 (3.43%, p = 0.608). However, there was an increase in hospitalization with secondary diagnosis of COPD. Elderly white patients accounted for most of the hospitalizations. Medicare was the primary payer source for most of the hospitalizations (73-75%). There was a significant decrease in inpatient mortality from 4.8% in 2002 to 3.9% in 2010 (slope -0.096, p < 0.001). Similarly, there was a significant decrease in average length of stay from 6.4 days in 2002 to 6.0 days in 2010 (slope -0.042, p < 0.001). Despite this, the hospitalization cost was increased substantially from $22,187 in 2002 to $38,455 in 2010. However, financial burden has increased over the years.

  10. Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH surveys

    Directory of Open Access Journals (Sweden)

    Maria Carmen Viana

    2013-06-01

    Full Text Available Objective: To assess prevalence and correlates of family caregiver burdens associated with mental and physical conditions worldwide. Methods: Cross-sectional community surveys asked 43,732 adults residing in 19 countries of the WHO World Mental Health (WMH Surveys about chronic physical and mental health conditions of first-degree relatives and associated objective (time, financial and subjective (distress, embarrassment burdens. Magnitudes and associations of burden are examined by kinship status and family health problem; population-level estimates are provided. Results: Among the 18.9-40.3% of respondents in high, upper-middle, and low/lower-middle income countries with first-degree relatives having serious health problems, 39.0-39.6% reported burden. Among those, 22.9-31.1% devoted time, 10.6-18.8% had financial burden, 23.3-27.1% reported psychological distress, and 6.0-17.2% embarrassment. Mean caregiving hours/week was 12.9-16.5 (83.7-147.9 hours/week/100 people aged 18+. Mean financial burden was 15.1% of median family income in high, 32.2% in upper-middle, and 44.1% in low/lower-middle income countries. A higher burden was reported by women than men, and for care of parents, spouses, and children than siblings. Conclusions: The uncompensated labor of family caregivers is associated with substantial objective and subjective burden worldwide. Given the growing public health importance of the family caregiving system, it is vital to develop effective interventions that support family caregivers.

  11. Financialisation, oil and the Great Recession

    International Nuclear Information System (INIS)

    Gkanoutas-Leventis, Angelos; Nesvetailova, Anastasia

    2015-01-01

    This article addresses the role of world oil price hike of 2007–08 in serving to transform the financial and banking crisis into what is commonly referred to the Great Recession. Existing literature on the global crisis of 2007–09 tends to view it as a financial or banking phenomenon, with analyses focusing mainly on state policies, governance mechanisms and market dynamics in transforming the banking crisis of 2007–08 into the economic recession of 2008-12/13 Although often attributing the global meltdown to wider phenomenon of financialisation, rarely do existing perspectives delve into the role of the commodity sector in the global credit crunch. In this paper, we aim to fill this gap, by inquiring into the role played by oil as a financial asset class in the political economy of the global crisis. - Highlights: • We study the oil price and its effects on the Great Recession. • We approach oil as a financial asset class. • We observe the transformation of oil through deregulation.

  12. CAREGIVER BURDEN AMONG PEOPLE CARING FOR PATIENTS WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Shivani Bansal

    2017-04-01

    Full Text Available BACKGROUND Caregivers of patients suffering from mental illness report burden in different areas including effects on family functioning, psychological problems, financial problems and health. The aim of the study is to determine the sociodemographic profile and caregiver burden among caregivers of persons with schizophrenia and to study the effect of patients’ psychopathology on caregiver burden scale. MATERIALS AND METHODS The present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 34 was taken who were primary caregivers (preferably parents or spouse of schizophrenia patients diagnosed using ICD10. Measures included caregiver’s demographic variables and caregiver’s burden using the Zarit burden interview and PANSS scale in patients. Statistical Analysis- Data was analysed using SPSS software version 21. RESULTS The mean age of the caregiver was 42 SD (12.16 years. The majority of the caregivers were parents, married and employed. The mean average score of the responses to Zarit burden interview was (SD=59.52 ± 20.92. Majority of the caregivers experienced severe burden (52.9%, 9 (26.4% caregivers had reported moderate burden and 6 (17.6% had reported mild burden. The mean duration of illness was 6.89 (SD=5.03 years. The level of burden experienced was significantly associated with total PANSS score, negative symptoms, positive symptoms, general psychopathology score and duration of schizophrenia illness (p=0.00. CONCLUSION There is need for psychological assistance and social support for the vulnerable caregivers to help them reduce the burden levels and employ positive coping strategies.

  13. Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

    Science.gov (United States)

    Wilks, Scott E; Vonk, M Elizabeth

    2008-01-01

    This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

  14. CERN comes under fresh financial pressure

    CERN Multimedia

    Dickson, D

    1996-01-01

    Germany's decision to effect a 10% cut in its annual subscription to the Large Hadron Collider (LHC) in 1997 has added to the financial problems of the European Laboratory for Particle Physics (CERN), Geneva, Switzerland. Reduced European contributions will have a crucial impact on the planned construction and completion of LHC. Proposals for non-European membership to reduce the financial burden on CERN members is doubtful in the current political context. The German move hints at a reappraisal of the funding projections for LHC.

  15. Socioeconomic variation in the financial consequences of ill health for older people with chronic diseases: a systematic review.

    Science.gov (United States)

    Valtorta, Nicole K; Hanratty, Barbara

    2013-04-01

    Chronic disease has financial consequences for older adults, but it is unclear how this varies between conditions with different disease trajectories. The aim of this study was to review evidence on the financial burden associated with cancer, heart failure or stroke in older people, to identify those most at risk of financial adversity. We systematically searched nine databases for studies with data on the illness-related financial burden (objective), or on the perception of financial hardship (subjective), of older patients and/or their informal caregivers in high-income countries. We identified thirty-eight papers published in English between 1984 and 2012. Studies fell into three categories: those reporting direct, out of pocket, costs (medical and/or non-medical); studies of the indirect costs associated with illness (such as wage or income loss); and papers reporting general financial or economic burdens secondary to illness. Three out of four studies focused on people with cancer. More affluent people had greater out of pocket costs, but were less financially burdened by illness, compared with older adults from lower socioeconomic backgrounds. Disadvantaged patients and families were more likely to report experiences of financial hardship, and spend a higher proportion of their income on all expenses related to their diagnoses. This review illustrates how little is known about the financial adversity experienced by patients with some common chronic conditions. It raises the possibility that higher expenditure by more affluent older people may be creating inequalities in how chronic illness is experienced. The development of effective strategies for financial protection at older ages will require more information on who is affected and at which point in their illness trajectory. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. State plans to force companies to eliminate environmental burdens

    International Nuclear Information System (INIS)

    Marcan, P.

    2004-01-01

    The Ministry of Environment is preparing legislation aimed at forcing the state and especially private enterprises to map and eliminate tips, refuse from company premises and farmyards, and manure heaps. It is expected that the main burden will fall on private enterprises. The department is still working on the wording of this new Act on environmental burdens and so it is not yet clear whether it will be of assistance in the elimination of environmental burdens. The Ministry is aware that economic aspects must also be taken into account when exercising pressure on the companies. Closing down a company that cannot meet environmental criteria would result in redundancies and so the time schedule for the elimination of environmental burdens will be adjusted to fit the financial situation of the company involved. The ministry plans to first find companies responsible for environmental debts and then set a deadline for the preparation of a project to eliminate the environmental burden. The project would have to contain a description of elimination methods, in addition to a time schedule and cost assessment. If a private company does not report an environmental burden, the competent public authority will have the power to request access to the premises to undertake an inspection. (author)

  17. Impact of Helmet Use on Injury and Financial Burden of Motorcycle and Moped Crashes in Hawai‘i: Analysis of a Linked Statewide Database

    Science.gov (United States)

    Castel, Nikki A; Wong, Linda L; Steinemann, Susan

    2016-01-01

    Helmet use reduces injury severity, disability, hospital length of stay, and hospital charges in motorcycle riders. The public absorbs billions of dollars annually in hospital charges for unhelmeted, uninsured motorcycle riders. We sought to quantify, on a statewide level, the healthcare burden of unhelmeted motorcycle and moped riders. We examined 1,965 emergency medical service (EMS) reports from motorcycle and moped crashes in Hawai‘i between 2007–2009. EMS records were linked to hospital medical records to assess associations between vehicle type, helmet use, medical charges, diagnoses, and final disposition. Unhelmeted riders of either type of vehicle suffered more head injuries, especially skull fractures (adjusted odds ratio (OR) of 4.48, P motorcycle and moped riders, with a significant (P = .006) difference between helmeted ($27,176) and unhelmeted ($40,217) motorcycle riders. Unhelmeted riders were twice as likely to self-pay (19.3%, versus 9.8% of helmeted riders), and more likely to have Medicaid or a similar income-qualifying insurance plan (13.5% versus 5.0%, respectively). Protective associations with helmet use are stronger among motorcyclists than moped riders, suggesting the protective effect is augmented in higher speed crashes. The public financial burden is higher from unhelmeted riders who sustain more severe injuries and are less likely to be insured. PMID:27980882

  18. A cross-country perspective on the causes of the global financial crisis

    NARCIS (Netherlands)

    Claessens, S.; Dell'Ariccia, G.; Igan, D.; Laeven, L.; Caprio, G.; Beck, T.; Claessens, S.; Schmukler, S.L.

    2013-01-01

    The global financial crisis is rooted in a combination of factors common to previous financial crises and some new factors. The four features in common with other crises are (1) asset price increases that turned out to be unsustainable, (2) credit booms that led to excessive debt burdens, (3)

  19. Can measures of the consumer debt burden reliably predict an economic slowdown?

    OpenAIRE

    C. Alan Garner

    1996-01-01

    Some analysts and business executives are becoming concerned that recent increases in the consumer debt burden may foreshadow an economic slowdown. Higher debt increases the risk that a household may experience financial distress in the event of an adverse economic shock, such as the loss of a job or large uninsured medical expenses. As the risk of financial distress rises, households may become less willing to spend on consumer goods, particularly big ticket items such as automobiles and hom...

  20. Bulgaria : Country Financial Accountability Assessment

    OpenAIRE

    World Bank

    2003-01-01

    Bulgaria's ambitious program of reforms in several areas, including public financial management (PFM), focuses greatly on its entry into the European Union (EU). Thus, the country has a well developed system, and structure of financial management, that relies heavily on information technology (such as in the area of cash management), and has independent external audits, and parliamentary o...

  1. The direct costs of intensive care management and risk factors for financial burden of patients with severe sepsis and septic shock.

    Science.gov (United States)

    Khwannimit, Bodin; Bhurayanontachai, Rungsun

    2015-10-01

    The costs of severe sepsis care from middle-income countries are lacking. This study investigated direct intensive care unit (ICU) costs and factors that could affect the financial outcomes. A prospective cohort study was conducted in the medical ICU of a tertiary referral university teaching hospital in Thailand. A total of 897 patients were enrolled in the study, with 683 (76.1%) having septic shock. Community-, nosocomial, and ICU-acquired infections were documented in 574, 282, and 41 patients, respectively. The median ICU costs per patient were $2716.5 ($1296.1-$5367.6) and $599.9 ($414.3-$948.6) per day. The ICU costs accounted for 64.7% of the hospital costs. In 2008 to 2011, the ICU costs significantly decreased by 40% from $3542.5 to $2124.9, whereas, the daily ICU costs decreased only 3.3% from $609.7 to $589.7. By multivariate logistic regression analysis, age, nosocomial or ICU infection, admission from the emergency department, number of organ failures, ICU length of stay, and fluid balance the first 72 hours were independently associated with ICU costs. The ICU costs of severe sepsis management significantly declined in our study. However, the ICU costs were a financial burden accounting for two thirds of the hospital costs. It is essential for intensivists to contribute a high standard of care within a restricted budget. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Financial Considerations for Health and Safety in the Australian Dairy Industry.

    Science.gov (United States)

    Lower, Tony; Pollock, Kirrily

    2017-01-01

    This study aimed to quantify the burden of fatal and workers' compensation-related injuries on the dairy sector in Australia and to assess current financial inputs for work health and safety actions. The first and second phases entailed a review of the financial costs associated with fatal (2001-2013) and workers' compensation cases (2008-2009 to 2012-2013). The third element was a case-study approach focusing on actual production and cost data from a small sample of dairy farms (n = 6) to ascertain an estimate for current financial inputs to work health and safety. The estimated financial impact was approximately AUD$12.4 million each year, comprising AUD$6.8 million for fatalities and AUD$5.6 million for compensable injuries. All sample businesses were investing in health and safety initiatives; however, this was modest and on average represented 0.4% of total expenditure (AUD$4,472) or financial case to increase strategic investments into work health and safety by dairy farmers in Australia. Increased investment has the potential to not only minimize the burden of injury and costs to dairy farmers, but will also significantly reduce the devastating impacts that these incidents have on individuals, their families and communities.

  3. RATIONAL FINANCIAL BEHAVIOR OF POPULATION AS A PROSPERITY FACTOR OF FINANCIAL SECTOR

    Directory of Open Access Journals (Sweden)

    Sushko E. Yu.

    2014-12-01

    Full Text Available The rapid sophistication of the Russian financial system inevitably leads not only to the emergence of great opportunities for the development of the financial sector, as expressed in the opening of the new financial institutions or new financial products and services, but also a huge financial risks for companies of this sector, as expressed in the increase of population’s debts and the decline of trust in the financial sector. That is why special tools used in making management decisions about the development of the financial sector in a particular region acquires greater significance. On the basis of statistical data over the Volgograd region the author developed the model of initial attractiveness estimation of an area for business entities, reflecting the level of financial literacy and using the data from open sources of information. The article provides a brief introduction to the development of the methodology: from a theoretical substantiation of the original list of variables for analysis up to determine the regression equation. Obtained regression model can be used by entrepreneurs in case of expansion of their financial business to new areas and by regional governance whose aim is to increase the level of financial literacy.

  4. Weathering the financial storm

    DEFF Research Database (Denmark)

    Ólafsson, Tjörvi; Pétursson, Thórarinn G.

    2011-01-01

    The recent global financial tsunami has had economic consequences that have not been witnessed since the Great Depression. But while some countries suffered a particularly large contraction in economic activity on top of a system-wide banking collapse, others came off relatively lightly. In this ......The recent global financial tsunami has had economic consequences that have not been witnessed since the Great Depression. But while some countries suffered a particularly large contraction in economic activity on top of a system-wide banking collapse, others came off relatively lightly...... pegs outside EMU were hit particularly hard, while inflation targeting seemed to mitigate the crisis. Finally, we find some evidence suggesting a role for international real linkages and institutional credibility. Our key results are robust to various alterations in the empirical setup and we are able...

  5. Parental depressive symptoms and childhood cancer: the importance of financial difficulties.

    Science.gov (United States)

    Creswell, Paul D; Wisk, Lauren E; Litzelman, Kristin; Allchin, Adelyn; Witt, Whitney P

    2014-02-01

    Research suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer. Data are from 215 parents of children diagnosed with cancer or brain tumors (n = 75) and a comparison group of parents of healthy children (n = 140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms. Caring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR = 4.93; 95 % CI 1.97-12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR = 4.89; 95 % CI 1.26-18.96). Caring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents.

  6. Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions.

    Science.gov (United States)

    Tran, Viet-Thi; Barnes, Caroline; Montori, Victor M; Falissard, Bruno; Ravaud, Philippe

    2015-05-14

    Management strategies for patients with chronic conditions are becoming increasingly complex, which may result in a burden of treatment for patients. To develop a Minimally Disruptive Medicine designed to reduce the burden of treatment, clinicians need to understand which healthcare tasks and aggravating factors may be responsible for this burden. The objective of the present study was to describe and classify the components of the burden of treatment for patients with chronic conditions from the patient's perspective. We performed a multi-country qualitative study using an online survey and a purposive sampling strategy to select English-, French-, and Spanish-speaking participants with different chronic conditions. Participants were recruited by physicians, patients' associations, advertisement on social media, and 'snowballing'. The answers were analyzed by i) manual content analysis with a grounded theory approach, coded by two researchers, and ii) automatic textual analysis by Reinert's method. Between 2013 and 2014, 1,053 participants from 34 different countries completed the online survey using 408,625 words. Results from both analyses were synthesized in a taxonomy of the burden of treatment, which described i) the tasks imposed on patients by their diseases and by their healthcare system (e.g., medication management, lifestyle changes, follow-up, etc.); ii) the structural (e.g., access to healthcare resources, coordination between care providers), personal, situational, and financial factors that aggravated the burden of treatment; and iii) patient-reported consequences of the burden (e.g., poor adherence to treatments, financial burden, impact on professional, family, and social life, etc.). Our findings may not be applicable to patients with chronic conditions who differ from those who responded to our survey. Our taxonomy of the burden of treatment, provided by patients with chronic conditions from different countries and settings, supports the

  7. Debt burden of the Kingdom of Yugoslavia at times of great depression

    Directory of Open Access Journals (Sweden)

    Gnjatović Dragana

    2016-01-01

    Full Text Available It is customary to look for the causes of widespread problems of public debt service at times of the Great Depression on the side of a sharp drop of foreign exchange earnings of the debtor country, in conditions of severe contraction of international trade and the introduction of a series of foreign trade restrictions. In the case of the Kingdom of Yugoslavia, in addition to these causes, which were generated by the Great Depression, there were some specific reasons on the side of public expenditures that were not related to the crisis, which led the country to sovereign debt default in 1932. Analysing these reasons is the subject matter of this paper. The aim of this paper is to indicate, on the basis of relevant macroeconomic indicators and economic-historical facts, how much the Kingdom of Yugoslavia was indebted and why it was not possible to avoid the accumulation of public debt in the years of Great Depression.

  8. Unmeasured costs of a child's death: perceived financial burden, work disruptions, and economic coping strategies used by American and Australian families who lost children to cancer.

    Science.gov (United States)

    Dussel, Veronica; Bona, Kira; Heath, John A; Hilden, Joanne M; Weeks, Jane C; Wolfe, Joanne

    2011-03-10

    Financial concerns represent a major stressor for families of children with cancer but remain poorly understood among those with terminally ill children. We describe the financial hardship, work disruptions, income loss, and coping strategies of families who lost children to cancer. Retrospective cross-sectional survey of 141 American and 89 Australian bereaved parents whose children died between 1990 and 1999 and 1996 to 2004, respectively, at three tertiary-care pediatric hospitals (two American, one Australian). Response rate: 63%. Thirty-four (24%) of 141 families from US centers and 34 (39%) of 88 families from the Australian center reported a great deal of financial hardship resulting from their children's illness. Work disruptions were substantial (84% in the United States, 88% in Australia). Australian families were more likely to report quitting a job (49% in Australia v 35% in the United States; P = .037). Sixty percent of families lost more than 10% of their annual income as a result of work disruptions. Australians were more likely to lose more than 40% of their income (34% in Australia v 19% in the United States; P = .035). Poor families experienced the greatest income loss. After accounting for income loss, 16% of American and 22% of Australian families dropped below the poverty line. Financial hardship was associated with poverty and income loss in all centers. Fundraising was the most common financial coping strategy (52% in the United States v 33% in Australia), followed by reduced spending. In these US and Australian centers, significant household-level financial effects of a child's death as a result of cancer were observed, especially for poor families. Interventions aimed at reducing the effects of income loss may ease financial distress.

  9. Parental perspectives on the financial impact of caring for a child with CKD.

    Science.gov (United States)

    Medway, Meredith; Tong, Allison; Craig, Jonathan C; Kim, Siah; Mackie, Fiona; McTaggart, Steven; Walker, Amanda; Wong, Germaine

    2015-03-01

    The economic consequences of chronic kidney disease (CKD) are severe for adult patients and their households, but the out-of-pocket expenses and economic burden of CKD and how this affects the caregivers of children with kidney disease are unclear. This study aims to describe parental perspectives on the financial impact of caring for a child with CKD. Face-to-face semistructured interviews. Parents of children with CKD from 3 pediatric nephrology centers in Australia. Transcripts were analyzed thematically. 27 parents of 26 children participated. We identified 5 themes: loss of freedom and control (prioritizing care, limiting occupational opportunities, and appreciating socioeconomic advantage), burden of sole responsibility (inability to rely on others, lack of respite, increased separation of family roles, and self-reliance), adapting for survival (vigilant budgeting, redefining normality and expectations, rechanneling resources to basic needs, and negotiating work flexibility), instability of circumstances (depleted capacity to work, unpredictability of child's health, burden of travel-related costs, imposition of debt, and domestic upheaval), and struggle in seeking support ("falling through the cracks" and unmet information needs). Few participants were fathers (n=5), and results may not be transferable to non-English-speaking caregivers because these participants were excluded. Parents focused their resources and attention on meeting the complex needs of their child. Inability to sustain employment due to focus on their child's care and both medical and nonmedical expenses were major contributors to the financial impact, with financial stress compounded by difficulties accessing government support. As a result, parents experienced profound financial and social instability and physical and psychological fatigue and exercised extreme financial vigilance. Increased access to respite and domestic support and financial and psychosocial interventions are suggested

  10. Identifying Self-Efficacy and Financial Behaviors as Predictors of Undergraduate College Students' Financial Literacy at a Land Grant University in North Carolina

    Science.gov (United States)

    Hucul, Donna T.

    2015-01-01

    Financial literacy has become a serious concern in the wake of the Great Recession of 2008. This study explored the financial literacy of undergraduate college students, who as a group constitute a distinct cohort of learners, emerging adults. The college student population represents a financially at-risk group facing mounting student loan debt.…

  11. The application of financial management in enterprise management

    Institute of Scientific and Technical Information of China (English)

    刘国晴

    2017-01-01

    Nowadays, financial management plays a vital role in the process of enterprise operation. To improve the level and ability offinancial management of enterprises is of great significance to the realization of the modernization of enterprises and the sustainable development ofscience. In this paper, the financial management status would be first proposed, and suggestions would be made to improve the financial managementin enterprises.

  12. State-level income inequality and family burden of U.S. families raising children with special health care needs.

    Science.gov (United States)

    Parish, Susan L; Rose, Roderick A; Dababnah, Sarah; Yoo, Joan; Cassiman, Shawn A

    2012-02-01

    Growing evidence supports the hypothesis that income inequality within a nation influences health outcomes net of the effect of any given household's absolute income. We tested the hypothesis that state-level income inequality in the United States is associated with increased family burden for care and health-related expenditures for low-income families of children with special health care needs. We analyzed the 2005-06 wave of the National Survey of Children with Special Health Care Needs, a probability sample of approximately 750 children with special health care needs in each state and the District of Columbia in the US Our measure of state-level income inequality was the Gini coefficient. Dependent measures of family caregiving burden included whether the parent received help arranging or coordinating the child's care and whether the parent stopped working due to the child's health. Dependent measures of family financial burden included absolute burden (spending in past 12 months for child's health care needs) and relative burden (spending as a proportion of total family income). After controlling for a host of child, family, and state factors, including family income and measures of the severity of a child's impairments, state-level income inequality has a significant and independent association with family burden related to the health care of their children with special health care needs. Families of children with special health care needs living in states with greater levels of income inequality report higher rates of absolute and relative financial burden. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. The Recent Financial Bubble: an Overview

    Directory of Open Access Journals (Sweden)

    Thalassinos E.

    2009-12-01

    Full Text Available The main aim of this paper is to analyse the recent financial crisis and to make recommendations how to handle it in the best possible way. Financial bubbles, since the great depression, have been analysed and some recommendations have been made taking into account the internationalization of the world economy which behaves like a domino. The recent financial crisis in the sub-prime mortgage market creates new problems in the world market with unforeseen continuances. Deflation has been referred to as a possible continuance after a financial bubble because often but not always deflation follows. Deflation often results in financial and economic crises. Financial and economic crises affect the architecture of the monetary system, while a change in the system may affect the role of the dollar, the euro and the yen.

  14. Firm Financial Performance: An Empirical Investigation on Romanian SMEs

    OpenAIRE

    Ionescu Alexandra; Horga Maria-Gabriela; Nancu Dorinela

    2013-01-01

    Firm's financial performance is reflected by its profit and loss account. Still, all financial statements are needed in order to have a complete view on a firm's financial performance. As a general rule, several financial indicators are calculated in this sense. Hence, it would be of great interest to reduce the number of financial indicators into fewer, more synthetic ones. However, the new indicators should reflect the same information as the first ones. Statistics offers this possibility t...

  15. Oil Price Rise and the Great Recession of 2008

    Directory of Open Access Journals (Sweden)

    Mehdi Siamak MONADJEMI

    2017-02-01

    Full Text Available The financial crises of 2007-2008, caused wide-spread falling output and unemployment, in the affected countries and also globally. The severity of the recession was such that it was called the “Great Recession”. As a result of an increase in demand from China and India, at the same time, oil prices rose significantly. The empirical results from this study show that oil price changes negatively affected global growth rate in the 1970s but not in the 1990s and 2000s. These results suggest that the Great Recession in 2008 that initiated by the financial crises, was independent of a significant rise in oil prices.

  16. Early & Often: Designing a Comprehensive System of Financial Aid Information. Abridged Report of the Advisory Committee on Student Financial Assistance

    Science.gov (United States)

    Advisory Committee on Student Financial Assistance, 2008

    2008-01-01

    Students and parents need ample time and accurate information to prepare for the financial burden of a college education--those who lack this knowledge base face a significant access barrier to higher education. The early intervention community is calling for a method of delivering age-appropriate information in a timely manner as one means of…

  17. The Financial Crisis: Lessons from History

    Directory of Open Access Journals (Sweden)

    Brian Grinder

    2016-01-01

    Full Text Available Financial crises have regularly afflicted economies throughout history and the United States has been no exception.  This paper examines the Panic of 1907, the Crash of 1929 and the Great Depression and the Great Recession of 2007-08 and discusses the responses of the government and regulators.  The short version of the story is that the while the government response has varied in terms of monetary and fiscal policy, the regulatory response has remained essentially the same.  The typical reactive regulation sounds good and gives the appearance of accomplishing something but, in fact, only serves to sow the seeds of future crises. The ineffective implementation of existing regulation has had a similar result. Indeed, several authors note that most financial innovation in recent years has its origins in circumventing new regulations. Likewise, government monetary and fiscal responses may or may not help the economy and often give the appearance of great arbitrariness.  Our conclusion is that there will be unforeseen financial crises in the future, sweeping regulation and promises of recent politicians notwithstanding.  Serious study of the unanticipated consequences of this regulation and the development of more robust risk management systems will help us mitigate the effects of future crises but will be of little assistance when it comes to avoiding them. Developing the analyses and risk management systems requires a detailed study of financial history keep both successes and failures fresh in our collective memory.

  18. The Financial Crisis: Lessons from History

    Directory of Open Access Journals (Sweden)

    Brian Grinder

    2015-02-01

    Full Text Available Financial crises have regularly afflicted economies throughout history and the United States has been no exception.  This paper examines the Panic of 1907, the Crash of 1929 and the Great Depression and the Great Recession of 2007-08 and discusses the responses of the government and regulators.  The short version of the story is that the while the government response has varied in terms of monetary and fiscal policy, the regulatory response has remained essentially the same.  The typical reactive regulation sounds good and gives the appearance of accomplishing something but, in fact, only serves to sow the seeds of future crises. The ineffective implementation of existing regulation has had a similar result. Indeed, several authors note that most financial innovation in recent years has its origins in circumventing new regulations. Likewise, government monetary and fiscal responses may or may not help the economy and often give the appearance of great arbitrariness.  Our conclusion is that there will be unforeseen financial crises in the future, sweeping regulation and promises of recent politicians notwithstanding.  Serious study of the unanticipated consequences of this regulation and the development of more robust risk management systems will help us mitigate the effects of future crises but will be of little assistance when it comes to avoiding them. Developing the analyses and risk management systems requires a detailed study of financial history keep both successes and failures fresh in our collective memory.

  19. COMPARATIVE STUDY ON THE BURDEN OF BIPOLAR AFFECTIVE DISORDER AND SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    C. Jayakrishnaveni

    2018-01-01

    Full Text Available BACKGROUND Mental and behavioural disorders have a large impact on individuals, family and communities. There is a paucity of studies on burden and cost of illness of Bipolar Affective Disorder both internationally and in India. Such studies are important for clinical management and policy decisions. Aim of the study - The aim of the present study is to assess the magnitude of the cost of illness and family burden of Bipolar Affective Disorder and Schizophrenia and to find out the difference in the burden of the caregivers for both the groups. MATERIALS AND METHODS The study was conducted in the outpatient department of Institute of Mental Health, Chennai. Sixty patients in each group were included by stratified sampling. Caregivers living with patients for atleast one year are included in the study, and those with any comorbid illness, were excluded from the study. ICD -10 diagnostic and research criteria were used for diagnosis of BPAD and Schizophrenia, Questionnaire for Assessment of Cost of Illness was used to assess cost of illness and Family Burden Interview Schedule was used to assess burden of caregivers. RESULTS Schizophrenia patients are mostly from urban, nuclear family. The illness characters & sociodemographic profile of caregivers are comparable. Lifetime costs and loss of income over lifetime was more in schizophrenia. Loss of income in the past year was similar. The burden was comparable for caregivers of both groups in disruption of family routine, interaction with family members, effect on mental health. CONCLUSION Burden of both diseases were comparable except schizophrenics experience more financial burden.

  20. Trends in State Financial Aid: Actions from the 2013 and 2014 Legislative Sessions. Financial Aid: Trends in the States

    Science.gov (United States)

    Pingel, Sarah

    2014-01-01

    The outcomes states gain from investing in postsecondary financial aid programs remain hotly debated, leading to great interest in developing programs that are both cost-effective and productive in helping states meet goals. In the 2012-13 academic year, states collectively provided approximately $11.2 billion in financial aid to students enrolled…

  1. Financial and Time Burdens for Medical Students Interviewing for Residency.

    Science.gov (United States)

    Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan

    2017-02-01

    Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.

  2. The 2008 Financial Crisis and Taxation Policy

    OpenAIRE

    Thomas Hemmelgarn; Gaetan Nicodeme

    2010-01-01

    The 2008 financial crisis is the worst economic crisis since the Great Depression of 1929. It has been characterised by a housing bubble in a context of rapid credit expansion, high risk-taking and exacerbated financial leverage, ending into deleveraging and credit crunch when the bubble burst. This paper discusses the interactions between tax policy and the financial crisis. In particular, it reviews the existing evidence on the links between taxes and many characteristics of the crisis. Fin...

  3. Financial gerontology and the rehabilitation nurse.

    Science.gov (United States)

    Mauk, Kristen L; Mauk, James M

    2006-01-01

    Rehabilitation nurses, particularly those who work in geriatrics, recognize that the elderly have become increasingly heterogeneous, with many remaining active well into their 80s and beyond. As the baby boomers enter older adulthood, the senior healthcare market will be greatly affected. The areas of finance, economics, and marketing are seeing new trends that combine the expertise of financial planners with healthcare advisors and advocates for seniors. One emerging specialty area is financial gerontology. This article defines financial gerontology, presents emerging trends and certifications related to the field, and discusses implications for the rehabilitation nurse.

  4. Financial, vocational, and interpersonal impact of living liver donation.

    Science.gov (United States)

    Holtzman, Susan; Adcock, Lesley; Dubay, Derek A; Therapondos, George; Kashfi, Arash; Greenwood, Sarah; Renner, Eberhard L; Grant, David R; Levy, Gary A; Abbey, Susan E

    2009-11-01

    The ability to inform prospective donors of the psychosocial risks of living liver donation is currently limited by the scant empirical literature. The present study was designed to examine donor perceptions of the impact of donation on financial, vocational, and interpersonal life domains and identify demographic and clinical factors related to longer recovery times and greater life interference. A total of 143 donors completed a retrospective questionnaire that included a standardized measure of life interference [Illness Intrusiveness Rating Scale (IIRS)] and additional questions regarding the perceived impact of donation. Donor IIRS scores suggested that donors experience a relatively low level of life interference due to donation [1.60 +/- 0.72, with a possible range of 1 ("not very much" interference) to 7 ("very much" interference)]. However, approximately 1 in 5 donors reported that donating was a significant financial burden. Logistic regression analysis revealed that donors with a psychiatric diagnosis at or prior to donation took longer to return to their self-reported predonation level of functioning (odds ratio = 3.78, P = 0.016). Medical complications were unrelated to self-reported recovery time. Multiple regression analysis revealed 4 independent predictors of greater life interference: less time since donation (b = 0.11, P financial burden of donation.

  5. The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

    Directory of Open Access Journals (Sweden)

    Katherine E Baird

    2016-01-01

    Full Text Available Background: This article compares the burden that medical cost-sharing requirements place on households in the United States and Canada. It estimates the probability that individuals with similar demographic features in the two countries have large medical expenses relative to income. Method: The study uses 2010 nationally representative household survey data harmonized for cross-national comparisons to identify individuals with high medical expenses relative to income. Using logistic regression, it estimates the probability of high expenses occurring among 10 different demographic groups in the two countries. Results: The results show the risk of large medical expenses in the United States is 1.5–4 times higher than it is in Canada, depending on the demographic group and spending threshold used. The United States compares least favorably when evaluating poorer citizens and when using a higher spending threshold. Conclusion: Recent health care reforms can be expected to reduce Americans’ catastrophic health expenses, but it will take very large reductions in out-of-pocket expenditures—larger than can be expected—if poorer and middle-class families are to have the financial protection from high health care costs that their counterparts in Canada have.

  6. Factors associated with the caregiver burden among family caregivers of patients with heart failure in southwest China.

    Science.gov (United States)

    Hu, Xiaolin; Dolansky, Mary A; Hu, Xiuying; Zhang, Fengying; Qu, Moying

    2016-03-01

    We investigated the status of caregiver burden and identified the factors related to caregiver burden among family caregivers of patients with heart failure in southwest China. A cross-sectional descriptive design with a convenience sample was adopted. Patient and family caregiver dyads (n = 226) in four hospitals in Chengdu, China were recruited from June 2013 to July 2014. The instruments used in this study included the Social Support Rating Scale, the Zarit Burden Interview, and the General Self-Efficacy Scale. Multivariate analysis was used to identify the factors associated with caregiver burden. Forty-four percent of the variance of the caregiver burden was explained by the payment type for treatment, monthly family income, relationship to the patient, caregivers' self-efficacy, and social support. The caregiver burden in southwest China was higher than studies conducted in developed areas. Specific to southwest China, the financial burden and insufficient resources are the main factors associated with caregiver burden. The results suggest that self-efficacy and social support in underdeveloped areas are potential areas for future intervention. © 2016 John Wiley & Sons Australia, Ltd.

  7. Analysing correlations after the financial crisis of 2008 and ...

    Indian Academy of Sciences (India)

    2015-02-06

    Feb 6, 2015 ... It deals with the statistics of eigen- values and ... 2008 is the worst financial crisis since the great depression of 1930s. The global financial .... The positive components (Egypt, India, Indonesia, Malaysia, South Korea,. Taiwan ...

  8. Commands for financial data management and portfolio optimization

    OpenAIRE

    C. Alberto Dorantes

    2013-01-01

    Several econometric software offer portfolio management tools for practitioners and researchers. For example, MatLab and R offer a great variety of tools for the simulation, optimization, and analysis of financial time series. Stata, together with Mata, offers powerful programming tools for the simulation, optimization, and analysis of financial data. However, related user commands are scarce. In this presentation, commands for online market data collection, data manipulation, and financial a...

  9. Post-crisis financial intermediation

    Directory of Open Access Journals (Sweden)

    Ilie MIHAI

    2015-09-01

    Full Text Available The recent financial crisis that begun in 2007 in the US, which then swept around the world, has left deep scars on the already wrinkled face of the global economy. Some national and regional economies, which had money for expensive makeup, or created money[1], managed to blur or hide the scars left by the crisis, others are still facing difficulties in overcoming the effects of this. The rapacity of banks, their greed and risk ignorance, were the origin of the outbreak of the last major economic and financial crisis but unfortunately those who were responsible or, rather, irresponsible, paid little or nothing at all for the burden of their bad loan portfolio. This cost has been supported by the population, either directly by paying high interest and fees [Mihai I., 2007], or indirectly, through the use of public budgets to cover the losses of banks, most of which had private capital. In this context, we intend to examine the state of financial intermediation in Romania in the post-crisis period, and to primarily follow: (i The structure and evolution of the banking system; (ii Non-government credit situation; (iii The level of savings; (iiii Loan-deposit ratio; (v The degree of financial intermediation and disintegration phenomenon etc., and to articulate some conclusions and suggestions on the matters that have been explored.

  10. The household-level economic burden of heart disease in India.

    Science.gov (United States)

    Karan, Anup; Engelgau, Michael; Mahal, Ajay

    2014-05-01

    To estimate healthcare use and financial burden associated with heart disease among Indian households. Data from the 2004 round household survey of the National Sample Survey in India were used to assess the implications of heart disease for out-of-pocket health spending, spending on items other than health care, employment and healthcare financing patterns, by matching households with a member self-reporting heart disease (cardiovascular disease (CVD)-affected households) to (control) households with similar socio-economic and demographic characteristics. Propensity score matching methods were used. Compared with control households, CVD-affected households had more outpatient visits and inpatient stays, spent an extra INT$ (International Dollars) 232 (P expenditure that was 16.5% higher (P < 0.01) and relied more on borrowing and asset sales to finance inpatient care (32.7% vs. 12.8%, P < 0.01). Members of CVD-affected households had lower employment rates than members of control households (43.6% vs. 46.4%, P < 0.01), and elderly members experienced larger declines in employment than younger adults. CVD-affected households with lower socio-economic status were at heightened financial risk. Non-communicable conditions such as CVD can impose a serious economic burden on Indian households. © 2014 John Wiley & Sons Ltd.

  11. 75 FR 4558 - Notice of Inquiry Regarding Passenger Vessel Financial Responsibility

    Science.gov (United States)

    2010-01-28

    ..., credit and financial companies, sureties, guarantors, insurers, travel agents, cruise passengers and... Maritime Commission is issuing this Inquiry to solicit information and comments concerning the benefits and... that will assist in assessing comprehensively the benefits or burdens that the Nonperformance Coverage...

  12. The Burden Endured by Caregivers of Patients With Morquio A Syndrome

    Directory of Open Access Journals (Sweden)

    Christian J. Hendriksz MD

    2014-07-01

    Full Text Available This international survey performed by direct personal interview or mail evaluated the global burden among primary caregivers of patients with Morquio A syndrome. Collected outcomes included self-reported time spent on caregiving, proportion of daily activities (from the Mucopolysaccharidosis Health Assessment Questionnaire requiring caregiver assistance, and how the patient’s age and wheelchair use affect these. In addition, the impact of caregiving on the caregivers’ relationship with family and friends, physical and mental health, and employment status and income was evaluated. Caregiver burden increased with disease progression. Adult patients always using a wheelchair required substantially more caregiving time and complete assistance with a larger proportion of daily activities than more mobile patients. In children, this was less apparent. Caregivers suffered physically and emotionally and their family and social life and financial situation were considerably impacted. Improvements in patient mobility may substantially reduce the level of caregiver support and the burden of caregiving.

  13. Analysis of the debt burden in Russian economy sectors

    Directory of Open Access Journals (Sweden)

    Svetlana Popova

    2017-12-01

    Full Text Available This paper provides an analysis of the debt burden of Russian companies and raises the issue of debt-level heterogeneity across economic sectors. To identify the causes of this heterogeneity, it estimates a regression model that includes both fundamental explanatory variables of companies and industry fixed effects. The results of the analysis demonstrate that standard variables, such as profitability, company size, asset turnover, and fixed-asset turnover ratio have a strong statistical significance. However, these do not fully explain the variation in the debt levels of companies in different sectors. According to model estimation, there are other industry specific factors that produce an imbalance between fundamental factors and companies’ debt levels. An understanding of the formation process and structure of debt burden in individual industries is extremely important for the financial stability of companies and for an effective monetary policy.

  14. The burden of deliberate self-harm on the critical care unit of a peri ...

    African Journals Online (AJOL)

    It also examined the financial burden that DSH exerts on public-sector critical care. Methods. DSH cases admitted to CMH's CCU between January 2006 and December 2010 were retrospectively reviewed. Patients under 13 years of age were excluded. Age, gender, admission duration, agent used, outcome and toxicology ...

  15. SMEs Financial Reporting in European Union: Steps towards a More Harmonized Reporting

    OpenAIRE

    Buculescu (Costicã) Maria Mãdãlina; Stoica Anamaria

    2014-01-01

    Recognizing the increasingly importance of SMEs in the economy, European Commission attempts to develop an “economic friendly” environment for SMEs business and further to create a harmonized accounting framework for SMEs financial reporting. Therefore, in 2013, European Commission issued a new Accounting Directive 2013/34/EU, to which the member states have to comply until July 2015, representing an important effort undertaken to reduce the administrative burden of SMEs financial reporting, ...

  16. Financial Crisis Management in Higher Education: Responses by 20 Private Colleges and Universities to the 2007-2009 Financial Crisis

    Science.gov (United States)

    Dorantes, Andrew R.; Low, Justin R.

    2016-01-01

    As a result of the Great Recession, higher education in the United States suffered from the most significant financial crisis since the Great Depression (Breneman 2008; Zumeta 2010). This crisis affected all institutions of higher education since it challenged three major revenue sources: net tuition income, endowment income, and gift income…

  17. Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia.

    Science.gov (United States)

    Lee, Way Seah; Poo, Muhammad Izzuddin; Nagaraj, Shyamala

    2007-12-01

    To estimate the cost of an episode of inpatient care and the economic burden of hospitalisation for childhood rotavirus gastroenteritis (GE) in Malaysia. A 12-month prospective, hospital-based study on children less than 14 years of age with rotavirus GE, admitted to University of Malaya Medical Centre, Kuala Lumpur, was conducted in 2002. Data on human resource expenditure, costs of investigations, treatment and consumables were collected. Published estimates on rotavirus disease incidence in Malaysia were searched. Economic burden of hospital care for rotavirus GE in Malaysia was estimated by multiplying the cost of each episode of hospital admission for rotavirus GE with national rotavirus incidence in Malaysia. In 2002, the per capita health expenditure by Malaysian Government was US$71.47. Rotavirus was positive in 85 (22%) of the 393 patients with acute GE admitted during the study period. The median cost of providing inpatient care for an episode of rotavirus GE was US$211.91 (range US$68.50-880.60). The estimated average cases of children hospitalised for rotavirus GE in Malaysia (1999-2000) was 8571 annually. The financial burden of providing inpatient care for rotavirus GE in Malaysian children was estimated to be US$1.8 million (range US$0.6 million-7.5 million) annually. The cost of providing inpatient care for childhood rotavirus GE in Malaysia was estimated to be US$1.8 million annually. The financial burden of rotavirus disease would be higher if cost of outpatient visits, non-medical and societal costs are included.

  18. ANDRA - Management report and financial statements 2011

    International Nuclear Information System (INIS)

    2012-07-01

    The first part of this ANDRA report (French National Agency for radioactive waste management) comments the global financial balance and the evolution of the personnel. It briefly presents the CIGEO project, the FA-VL project (low activity and long life). It presents the various industrial activities such as surface storage centres, nuclear activities outside the electronuclear sector (waste collection, polluted sites, national inventory of radioactive wastes). It evokes public subsidies, investments, and the international activity. It discusses the securing of the future nuclear burden financing. It briefly indicates the main objectives for 2012. The second part contains the different tables of the financial statements. These accounts are discussed and commented in appendix

  19. Financial Derivatives (Based on Two Supports Evaluation

    Directory of Open Access Journals (Sweden)

    Tiberiu Socaciu

    2016-07-01

    Full Text Available In this paper we build a PDE like Black-Scholes equation in hypothesis of a financial derivative that is dependent on two supports (usual is dependent only on one support, like amoption based on gold, when national currency has a great float.Keywords: Financial derivatives, derivatives evaluation, derivatives based on two supports, extended Itō like lemma.

  20. The double-edged sword: financial source of household healthcare expenditure in Ghana

    Directory of Open Access Journals (Sweden)

    Henry Armah Tagoe

    2012-08-01

    Full Text Available In many regions, some of the most formidable enemies of health are joining forces with the allies of poverty to impose a double burden of disease, disability and premature death. This paper looks at the main financial sources households use to finance healthcare in Ghana. It examines the spatial and socio-economic dynamics and the challenges these pose to health and development. Analysis of the 2003 Ghana World Health Survey data indicates that approximately 41% of households depend on more than one financial source with 88% depending on household income to finance healthcare expenditure. The high dependency on household income will erode gains in the economic and health sector in the midst of the recent global economic recession. Comprehensive national health insurance programs that cover emerging disease conditions will mitigate the double burden of disease on households in emerging economies.

  1. Tax Mechanism of Influence on the Financial Component of Russians’ Living Standards

    Directory of Open Access Journals (Sweden)

    Leyla Akifovna Mytareva

    2016-12-01

    Full Text Available In a socially-oriented country the development standard is determined by the living standards of population. The article is devoted to a comprehensive presentation of tax mechanism influencing the quality of Russians’ life, based on the interdependence of tax revenue and spending. The article comprehensively presented and explained variable combination of tax techniques and tools, influencing the financial component of the living standard of the population (individuals not engaged in entrepreneurial activities, including: the type and level of tax required and elective elements of the tax, tax residency, tax audits and combating tax evasion. The author presents the elements of tax mechanism of influence on the financial component of the living standards of Russians. As the main indicator for evaluating the impact of the tax mechanism on the living standards, the author proposed the indicator of tax burden, calculated both as the total size and as a structure: the objects of taxation (income, property and indirect taxation and tax levels (Federal, regional and local. The author points to a slight increase in tax burden of the Russians since 2006 and 2015, against a significant growth of the amount of tax paid by them and the amount of cash income; predominance of income and Federal taxes in the structure of tax burden; a slight change in the structure of the tax burden on taxable items and tax rates.

  2. Financial Technology: The Promise of Blockchain

    OpenAIRE

    Demary, Markus; Demary, Vera

    2017-01-01

    Digitization affects all sectors of the economy. A new and possibly disruptive digital technology is the blockchain, a decentralized ledger, which seems to offer great promise for many financial and business applications.

  3. The business of death: a qualitative study of financial concerns of widowed older women.

    Science.gov (United States)

    DiGiacomo, Michelle; Lewis, Joanne; Phillips, Jane; Nolan, Marie; Davidson, Patricia M

    2015-04-18

    The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death. Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.

  4. The disease burden of human cystic echinococcosis based on HDRs from 2001 to 2014 in Italy.

    Directory of Open Access Journals (Sweden)

    Toni Piseddu

    2017-07-01

    Full Text Available Cystic echinococcosis (CE is an important neglected zoonotic parasitic infection belonging to the subgroup of seven Neglected Zoonotic Disease (NZDs included in the World Health Organization's official list of 18 Neglected Tropical Diseases (NTDs. CE causes serious global human health concerns and leads to significant economic losses arising from the costs of medical treatment, morbidity, life impairments and fatality rates in human cases. Moreover, CE is endemic in several Italian Regions. The aim of this study is to perform a detailed analysis of the economic burden of hospitalization and treatment costs and to estimate the Disability Adjusted Life Years (DALYs of CE in Italy.In the period from 2001 to 2014, the direct costs of 21,050 Hospital Discharge Records (HDRs belonging to 12,619 patients with at least one CE-related diagnosis codes were analyzed in order to quantify the economic burden of CE. CE cases average per annum are 901 (min-max = 480-1,583. Direct costs include expenses for hospitalizations, medical and surgical treatment incurred by public and private hospitals and were computed on an individual basis according to Italian Health Ministry legislation. Moreover, we estimated the DALYs for each patient. The Italian financial burden of CE is around € 53 million; the national average economic burden per annum is around € 4 million; the DALYs of the population from 2001 to 2014 are 223.35 annually and 5.26 DALYs per 105 inhabitants.In Italy, human CE is responsible for significant economic losses in the public health sector. In humans, costs associated with CE have been shown to have a great impact on affected individuals, their families and the community as a whole. This study could be used as a tool to prioritize and make decisions with regard to a surveillance system for this largely preventable yet neglected disease. It demonstrates the need of implementing a CE control program aimed at preventing the considerable economic

  5. "You Pay Your Share, We'll Pay Our Share": The College Cost Burden and the Role of Race, Income, and College Assets

    Science.gov (United States)

    Elliott, William; Friedline, Terri

    2013-01-01

    Changes in financial aid policies raise questions about students being asked to pay too much for college and whether parents' college savings for their children helps reduce the burden on students to pay for college. Using trivariate probit analysis with predicted probabilities, in this exploratory study we find recent changes in the financial aid…

  6. Burden and depression in primary caregivers of persons with visual impairment

    Directory of Open Access Journals (Sweden)

    Shubhank Khare

    2016-01-01

    regression, burden predicted depression (r = 0.557; P < 0.001. Conclusions: Caregivers merit community support, financial benefit, interventions to diagnose and treat depression, and training in coping. Centers that provide disability certification could offer counseling.

  7. Anticipated debt and financial stress in medical students.

    Science.gov (United States)

    Morra, Dante J; Regehr, Glenn; Ginsburg, Shiphra

    2008-01-01

    While medical student debt is increasing, the effect of debt on student well-being and performance remains unclear. As a part of a larger study examining medical student views of their future profession, data were collected to examine the role that current and anticipated debt has in predicting stress among medical students. A survey was administered to medical students in all four years at the University of Toronto. Of the 804 potential respondents across the four years of training, 549 surveys had sufficient data for inclusion in this analysis, for a response rate of 68%. Through multiple regression analysis, we evaluated the correlation between current and anticipated debt and financial stress. Although perceived financial stress correlates with both current and anticipated debt levels, anticipated debt was able to account for an additional 11.5% of variance in reported stress when compared to current debt levels alone. This study demonstrates a relationship between perceived financial stress and debt levels, and suggests that anticipated debt levels might be a more robust metric to capture financial burden, as it standardizes for year of training and captures future financial liabilities (future tuition and other future expenses).

  8. Elementary Schools, Teaching, and Social Studies in Texas: Facing the Great Depression

    Science.gov (United States)

    Bellows, M. Elizabeth; Baumi, Michelle; Field, Sherry L.

    2013-01-01

    Across the United States, the Great Depression was a period of tremendous upheaval. Economic, family, political, and educational institutions shook mightily as the tremors of widespread financial downturn were felt. Public schools faced increasing hardships, which included financial problems such as a weakened tax base due to the non-payment of…

  9. Exploring caregiver burden experienced by family caregivers of patients with End-Stage Renal Disease in Nigeria

    Directory of Open Access Journals (Sweden)

    Yemisi Okikiade Oyegbile

    Full Text Available Background: Family caregivers in many African countries bear the burden of caregiving alone, with the paucity of research, especially for caregivers of End-Stage Renal Disease patients, having concealed their needs. Aim: To explore the caregiver burden of family caregivers of End-Stage Renal Disease (ESRD patients in South-West Nigeria. Design: Following a complementary mixed method data collection strategy, the quantitative data was collected using the Zarit Burden Interview questionnaire to measure the burden of caregiving. Qualitative data was thereafter obtained through in-depth, individual interviews and was analysed using content analysis. Settings: The three research settings consisted of two state hospitals and one private hospital that provide renal care in South-West Nigeria. Result: The mean burden of caregiving for the sample was 50.18 thus indicating that family caregivers experienced moderate to severe burden, which is high compared to the other studies. The participants’ experiences of caregiving revealed the following categories: total dependence, acceptance of caregiving role, competing responsibilities, financial sacrifice and “not making mistakes”. Conclusion: Understanding the extent of caregiver burden, what constitutes burden to family caregivers in low/middle-income countries, and the difficulties associated with caregiving for care-recipients with ESRD, allows appropriate strategies and interventions to be developed. Keywords: End Stage Renal Disease, Family caregivers, Caregiver burden, Complementary mixed methods, Nigeria

  10. The financial burden of morbidity in HIV-infected adults on antiretroviral therapy in Cote d'Ivoire.

    Directory of Open Access Journals (Sweden)

    Arnousse Beaulière

    Full Text Available BACKGROUND: Large HIV care programs frequently subsidize antiretroviral (ARV drugs and CD4 tests, but patients must often pay for other health-related drugs and services. We estimated the financial burden of health care for households with HIV-infected adults taking antiretroviral therapy (ART in Côte d'Ivoire. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cross-sectional survey. After obtaining informed consent, we interviewed HIV-infected adults taking ART who had consecutively attended one of 18 HIV care facilities in Abidjan. We collected information on socioeconomic and medical characteristics. The main economic indicators were household capacity-to-pay (overall expenses minus food expenses, and health care expenditures. The primary outcome was the percentage of households confronted with catastrophic health expenditures (health expenditures were defined as catastrophic if they were greater than or equal to 40% of the capacity-to-pay. We recruited 1,190 adults. Median CD4 count was 187/mm(3, median time on ART was 14 months, and 72% of subjects were women. Mean household capacity-to-pay was $213.7/month, mean health expenditures were $24.3/month, and 12.3% of households faced catastrophic health expenditures. Of the health expenditures, 75.3% were for the study subject (ARV drugs and CD4 tests, 24.6%; morbidity events diagnosis and treatment, 50.1%; transportation to HIV care centres, 25.3% and 24.7% were for other household members. When we stratified by most recent CD4 count, morbidity events related expenses were significantly lower when subjects had higher CD4 counts. CONCLUSIONS/SIGNIFICANCE: Many households in Côte d'Ivoire face catastrophic health expenditures that are not attributable to ARV drugs or routine follow-up tests. Innovative schemes should be developed to help HIV-infected patients on ART face the cost of morbidity events.

  11. 40 CFR 305.33 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 305.33 Section 305.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Hearing Procedure § 305.33 Burden of presentation; burden of persuasion. The Requestor has the burden of... justified. Accordingly, the Requestor bears the burdens of presentation and persuasion. Following the...

  12. Economic burden of underweight and overweight among adults in the Asia-Pacific region: a systematic review.

    Science.gov (United States)

    Hoque, Mohammad Enamul; Mannan, Munim; Long, Kurt Z; Al Mamun, Abdullah

    2016-04-01

    To assess the economic burden of underweight and overweight among adults in the Asia-Pacific region. Systematic review of articles published until March 2015. Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5-9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5-3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7-9.8% and more, and extra healthcare costs for obese individuals of 17-22.3% and higher. Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia-Pacific region. © 2016 John Wiley & Sons Ltd.

  13. ECONOMICS OF ALEXANDER THE GREAT (15 vols + 4 cdroms) by Gregory Zorzos

    OpenAIRE

    Gregory Zorzos

    2002-01-01

    Research contains many ancient texts (Ancient Greek, Hebrews, Hieroglyphs, Assyrian, Sumerian, Babylonian, Latin, etc.). 1. (MICRO-MACRO ECONOMICS OF ALEXANDER THE GREAT (5 vols + cdrom). Microeconomics and macroeconomics of Alexander the Great. Economic theories, feasibilities, economic plannings, general description of the campaign's business plan etc. 2. BANKS OF ALEXANDER THE GREAT (2 vols + cdrom) Describes banking system, economists, financiers, investors, accountants, bookkeepers, etc,...

  14. 45 CFR 672.17 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Burden of presentation; burden of persuasion. 672.17 Section 672.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.17 Burden of presentation; burden of persuasion. The...

  15. One world health: socioeconomic burden and parasitic disease control priorities.

    Science.gov (United States)

    Torgerson, Paul R

    2013-08-01

    Parasitic diseases present a considerable socio-economic impact to society. Zoonotic parasites can result in a considerable burden of disease in people and substantive economic losses to livestock populations. Ameliorating the effects of these diseases may consist of attempts at eradicating specific diseases at a global level, eliminating them at a national or local level or controlling them to minimise incidence. Alternatively with some parasitic zoonoses it may only be possible to treat human and animal cases as they arise. The choice of approach will be determined by the potential effectiveness of a disease control programme, its cost and the cost effectiveness or cost benefit of undertaking the intervention. Furthermore human disease burden is being increasingly measured by egalitarian non-financial measures which are difficult to apply to livestock. This adds additional challenges to the assessment of socio-economic burdens of zoonotic diseases. Using examples from the group of neglected zoonotic diseases, information regarding the socio-economic effects is reviewed together with how this information is used in decision making with regard to disease control and treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Health spending, illicit financial flows and tax incentives in Malawi ...

    African Journals Online (AJOL)

    Health spending, illicit financial flows and tax incentives in Malawi. B O'Hare, M Curtis. Abstract. This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax ...

  17. A Comparison of Global Financial Market Recovery after the 2008 Global Financial Crisis

    Directory of Open Access Journals (Sweden)

    Foo Jennifer

    2017-06-01

    Full Text Available The Financial Crisis of 2007-2009 plunged countries into a Great Recession and focused the world’s attention on the global stock markets. The global contagion has a major impact on global stock markets, with the U.S. DJIA falling to 6,547.05 on March 9, 2009 from a high of 14,164.53 on October 9, 2007, with a loss of more than 54%. Other stock markets also had a precipitous drop during the financial crisis. However, some equity markets have recovered while others have not. This paper looks at how global markets compared in their recovery. This paper also investigates the advanced countries’ recovery relative to the emerging and developing countries in the aftermath of the financial crisis and their ability to climb back to the pre-financial crisis levels. Analysis is provided for 31 stock indexes from January 2005 to March 2013. In 2013 the majority of analysed stock markets recovered from the crises regardless of if they belong to the group of developed or emerging markets.

  18. Trajectories of caregiver burden in families of adult cystic fibrosis patients.

    Science.gov (United States)

    Wojtaszczyk, Ann; Glajchen, Myra; Portenoy, Russell K; Berdella, Maria; Walker, Patricia; Barrett, Malcolm; Chen, Jack; Plachta, Amy; Balzano, Julie; Fresenius, Ashley; Wilder, Kenya; Langfelder-Schwind, Elinor; Dhingra, Lara

    2017-10-17

    Little is known about the experience of family caregivers of adults with cystic fibrosis (CF). This information is important for the identification of caregivers at risk for burden. This was a longitudinal analysis of survey data obtained from caregivers of adult CF patients participating in an early intervention palliative care trial. Caregivers completed the validated Brief Assessment Scale for Caregivers (BASC) repeatedly over a 28-month period. Mixed-effects modeling evaluated multivariate associations with positive and negative caregiver perceptions over time. Of the 54 caregivers, 47.9% were spouses. The mean age was 50.9 years (SD = 13.2); 72.2% were women; 75.9% were married; and 63.0% were employed. At baseline, the BASC revealed large variations in positive and negative perceptions of caregiving. Although average scores over time were unchanging, variation was greater across caregivers than within caregivers (0.49 vs. 0.27, respectively). At baseline, the positive impact of caregiving in the sample was higher than the negative impact. Multivariate analysis revealed that patients' baseline pulmonary function and their full-time employment status predicted caregiver burden over time. Caregivers of CF patients varied in their positive and negative caregiving experiences, although burden levels in individual caregivers were stable over time. When the disease was advanced, caregivers of CF patients experienced more overall burden but also more positive impact. This suggests that the role of caregivers may become more meaningful as disease severity worsens. In addition, full-time patient employment was associated with lower caregiver burden regardless of disease severity. This suggests that burden in CF caregivers may be predicted by financial strain or benefits conferred by patient employment. These associations require further investigation to determine whether highly burdened caregivers can be identified and assisted using tailored interventions.

  19. Review: Burden on Family Caregivers Caring for Patients with Schizophrenia and Its Related Factors

    Directory of Open Access Journals (Sweden)

    Imas Rafiyah

    2011-01-01

    Full Text Available Background: Family caregiver is the most important person who cares for patient with schizophrenia. However when care is provided for long time, he/she may experiences the burden.Purpose: The purpose was to review concept and factors related to burden on family caregivers caring for patients with schizophrenia.Method: A literatures were searched from databases: Pubmed, CINAHL, and Science Direct. Key words used to retrieve literature include caregiver burden and schizophrenia. Searching was limited in English language, full text, and the year of publication from 2000 to 2009 was used.Results: Twenty two studies were reviewed in this paper. The result showed that the caregivers caring for patients with schizophrenia experience burden. Burden was defined as a negative impact of caring for the impaired person experienced by caregiver on their activity (objective burden or feeling (subjective burden that involves emotional, physical health, social life, and financial status. Factors related to burden on family caregiver were grouped into: 1 caregiver‟s factors included age, gender, educational level, income, health status, and spent time per day, knowledge of schizophrenia, culture, and coping; 2 patient‟s factors included age, clinical symptoms, and disability in daily life; 3 environmental factors included mental health service and social support.Conclusion: Definition of burden have quite same meaning and mostly factors focus on the patient‟s symptoms, demographic factors of caregiver, and time spent per day. Most of studies cannot be generalized due to small sample used in the study and that too conducted in western countries. For further research, the correlation between burden and resources of family caregiver should be investigated particularly in eastern country.Key words: burden on family caregiver, caring, schizophrenia.

  20. The economic burden of angina on households in South Asia

    Science.gov (United States)

    2014-01-01

    Background Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. Methods We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Results Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p angina-affected households relative to matched controls in India (9.60%, p Angina-affected households significantly relied on borrowing or selling assets to finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Conclusions Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD. PMID:24548585

  1. The economic burden of angina on households in South Asia.

    Science.gov (United States)

    Alam, Khurshid; Mahal, Ajay

    2014-02-19

    Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p < 0.01) and Sri Lanka (7.80%, p = 0.01). However, impoverishment, non-medical consumption expenditure and employment status of the angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD.

  2. Health disparities from economic burden of diabetes in middle-income countries: evidence from México.

    Directory of Open Access Journals (Sweden)

    Armando Arredondo

    Full Text Available The rapid growth of diabetes in middle-income countries is generating disparities in global health. In this context we conducted a study to quantify the health disparities from the economic burden of diabetes in México. Evaluative research based on a longitudinal design, using cost methodology by instrumentation. For the estimation of epidemiological changes during the 2010-2012 period, several probabilistic models were developed using the Box-Jenkins technique. The financial requirements were obtained from expected case management costs by disease and the application of an econometric adjustment factor to control the effects of inflation. Comparing the economic impact in 2010 versus 2012 (p<0.05, there was a 33% increase in financial requirements. The total amount for diabetes in 2011 (US dollars was $7.7 billion. It includes $3.4 billion in direct costs and $4.3 in indirect costs. The total direct costs were $.4 billion to the Ministry of Health (SSA, serving the uninsured population; $1.2 to the institutions serving the insured population (Mexican Institute for Social Security-IMSS-, and Institute for Social Security and Services for State Workers-ISSSTE-; $1.8 to users; and $.1 to Private Health Insurance (PHI. If the risk factors and the different health care models remain as they currently are in the analyzed institutions, health disparities in terms of financial implications will have the greatest impact on users' pockets. In middle-income countries, health disparities generated by the economic burden of diabetes is one of the main reasons for catastrophic health expenditure. Health disparities generated by the economic burden of diabetes suggests the need to design and review the current organization of health systems and the relevance of moving from biomedical models and curative health care to preventive and socio-medical models to meet expected challenges from diseases like diabetes in middle-income countries.

  3. A comparison of critical care research funding and the financial burden of critical illness in the United States.

    Science.gov (United States)

    Coopersmith, Craig M; Wunsch, Hannah; Fink, Mitchell P; Linde-Zwirble, Walter T; Olsen, Keith M; Sommers, Marilyn S; Anand, Kanwaljeet J S; Tchorz, Kathryn M; Angus, Derek C; Deutschman, Clifford S

    2012-04-01

    To estimate federal dollars spent on critical care research, the cost of providing critical care, and to determine whether the percentage of federal research dollars spent on critical care research is commensurate with the financial burden of critical care. The National Institutes of Health Computer Retrieval of Information on Scientific Projects database was queried to identify funded grants whose title or abstract contained a key word potentially related to critical care. Each grant identified was analyzed by two reviewers (three if the analysis was discordant) to subjectively determine whether it was definitely, possibly, or definitely not related to critical care. Hospital and total costs of critical care were estimated from the Premier Database, state discharge data, and Medicare data. To estimate healthcare expenditures associated with caring for critically ill patients, total costs were calculated as the combination of hospitalization costs that included critical illness as well as additional costs in the year after hospital discharge. Of 19,257 grants funded by the National Institutes of Health, 332 (1.7%) were definitely related to critical care and a maximum of 1212 (6.3%) grants were possibly related to critical care. Between 17.4% and 39.0% of total hospital costs were spent on critical care, and a total of between $121 and $263 billion was estimated to be spent on patients who required intensive care. This represents 5.2% to 11.2%, respectively, of total U.S. healthcare spending. The proportion of research dollars spent on critical care is lower than the percentage of healthcare expenditures related to critical illness.

  4. A Review of Financial Accounting Fraud Detection based on Data Mining Techniques

    Science.gov (United States)

    Sharma, Anuj; Kumar Panigrahi, Prabin

    2012-02-01

    With an upsurge in financial accounting fraud in the current economic scenario experienced, financial accounting fraud detection (FAFD) has become an emerging topic of great importance for academic, research and industries. The failure of internal auditing system of the organization in identifying the accounting frauds has lead to use of specialized procedures to detect financial accounting fraud, collective known as forensic accounting. Data mining techniques are providing great aid in financial accounting fraud detection, since dealing with the large data volumes and complexities of financial data are big challenges for forensic accounting. This paper presents a comprehensive review of the literature on the application of data mining techniques for the detection of financial accounting fraud and proposes a framework for data mining techniques based accounting fraud detection. The systematic and comprehensive literature review of the data mining techniques applicable to financial accounting fraud detection may provide a foundation to future research in this field. The findings of this review show that data mining techniques like logistic models, neural networks, Bayesian belief network, and decision trees have been applied most extensively to provide primary solutions to the problems inherent in the detection and classification of fraudulent data.

  5. Estimating the burden of rabies in Ethiopia by tracing dog bite victims.

    Directory of Open Access Journals (Sweden)

    Tariku Jibat Beyene

    Full Text Available In developing countries where financial resources are limited and numerous interests compete, there is a need for quantitative data on the public health burden and costs of diseases to support intervention prioritization. This study aimed at estimating the health burden and post-exposure treatment (PET costs of canine rabies in Ethiopia by an investigation of exposed human cases. Data on registered animal bite victims during the period of one year were collected from health centers in three districts, i.e. Bishoftu, Lemuna-bilbilo and Yabelo, to account for variation in urban highland and lowland areas. This data collection was followed by an extensive case search for unregistered victims in the same districts as the registered cases. Victims were visited and questioned on their use of PET, incurred treatment costs and the behavioral manifestations of the animal that had bitten them. Based on the collected data PET costs were evaluated by financial accounting and the health burden was estimated in Disability-Adjusted Life Years (DALYs. In total 655 animal bite cases were traced of which 96.5% was caused by dog bites. 73.6% of the biting dogs were suspected to be potentially rabid dog. Annual suspected rabid dog exposures were estimated per evaluated urban, rural highland and rural lowland district at, respectively, 135, 101 and 86 bites, which led, respectively, to about 1, 4 and 3 deaths per 100,000 population. In the same district order average costs per completed PET equaled to 23, 31 and 40 USD, which was significantly higher in rural districts. Extrapolation of the district results to the national level indicated an annual estimate of approximately 3,000 human deaths resulting in about 194,000 DALYs per year and 97,000 exposed persons requiring on average 2 million USD treatment costs per year countrywide. These estimations of the burden of rabies to the Ethiopian society provide decision makers insights into the potential benefits of

  6. Estimating the burden of rabies in Ethiopia by tracing dog bite victims.

    Science.gov (United States)

    Beyene, Tariku Jibat; Mourits, Monique C M; Kidane, Abraham Haile; Hogeveen, Henk

    2018-01-01

    In developing countries where financial resources are limited and numerous interests compete, there is a need for quantitative data on the public health burden and costs of diseases to support intervention prioritization. This study aimed at estimating the health burden and post-exposure treatment (PET) costs of canine rabies in Ethiopia by an investigation of exposed human cases. Data on registered animal bite victims during the period of one year were collected from health centers in three districts, i.e. Bishoftu, Lemuna-bilbilo and Yabelo, to account for variation in urban highland and lowland areas. This data collection was followed by an extensive case search for unregistered victims in the same districts as the registered cases. Victims were visited and questioned on their use of PET, incurred treatment costs and the behavioral manifestations of the animal that had bitten them. Based on the collected data PET costs were evaluated by financial accounting and the health burden was estimated in Disability-Adjusted Life Years (DALYs). In total 655 animal bite cases were traced of which 96.5% was caused by dog bites. 73.6% of the biting dogs were suspected to be potentially rabid dog. Annual suspected rabid dog exposures were estimated per evaluated urban, rural highland and rural lowland district at, respectively, 135, 101 and 86 bites, which led, respectively, to about 1, 4 and 3 deaths per 100,000 population. In the same district order average costs per completed PET equaled to 23, 31 and 40 USD, which was significantly higher in rural districts. Extrapolation of the district results to the national level indicated an annual estimate of approximately 3,000 human deaths resulting in about 194,000 DALYs per year and 97,000 exposed persons requiring on average 2 million USD treatment costs per year countrywide. These estimations of the burden of rabies to the Ethiopian society provide decision makers insights into the potential benefits of implementing effective

  7. Schizophrenia: management and family burden.

    Science.gov (United States)

    Sebit, M B

    2007-01-01

    To explore schizophrenia with respect to its management, causes, risk factors as well as the impact it has in families regarding the burden and social networks support. Desk literature reviews. The findings are that patients with schizophrenia typically have great difficulty following a medication regimen, but they also have the greatest potential for benefiting from adherence. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services, enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. Finally, this paper is not exhaustive, but a pointer for further readings.

  8. Burden on family carers and difficulty in covering costs of care at the end of life: a cross-national retrospective study via representative networks of general practitioners.

    NARCIS (Netherlands)

    Pivodic, L.; Block, L. van den; Pardon, K.; Miccinesi, G.; Vega, T.; Boffin, N.; Donker, G.; Cancian, M.; Lopéz-Maside, A.; Onwuteaka-Philipsen, B.D.; Deliens, L.

    2013-01-01

    Background: Given a growing number of people with long disease trajectories and a preference for home death, need for family care is expected to increase. However, populationbased data on the prevalence of burden in family carers of people at the end of life and of care-related financial burden are

  9. Stroke management: Informal caregivers' burdens and strians of caring for stroke survivors.

    Science.gov (United States)

    Gbiri, Caleb Ademola; Olawale, Olajide Ayinla; Isaac, Sarah Oghenekewe

    2015-04-01

    Stroke survivors live with varied degrees of disabilities and cares are provided largely by the informal caregivers. This study investigated informal caregivers' burden and strains of caring for stroke patients. This study involved 157 (81 males and 76 females) informal caregivers of stroke survivors receiving care in all secondary and tertiary health institutions with physiotherapy services in Lagos State, Nigeria. Information was collected through self-administered questionnaire during clinic-hours. Data was analyzed using Spearman's Rank Correlation Coefficient. The patients' age ranged between 20 and 79 (mean=59.6 ± 14.6 years). Sixty-one had haemorrhagic stroke while 96 had ischaemic stroke. The informal caregivers' age was 39.2 ± 12.8 years (range: 17-36 years). More (60.8%) participants reported moderate objective while 79.2% had mild subjective burdens. The following factors significantly increased (Pfinancial well-beings of the informal caregivers. Caring for stroke survivors put social, emotional, health and financial burdens and strains on the informal caregivers. These burdens and strains increase with duration of stroke, intimacy, smaller number of caregivers and length of daily caregiving. Therefore, informal caregivers should be involved in the rehabilitation plan for stroke patients and their well-being should also be given adequate attention. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. The mediating effect of caregiver burden on the caregivers' quality of life.

    Science.gov (United States)

    Jeong, Yeon-Gyu; Jeong, Yeon-Jae; Kim, Won-Cheol; Kim, Jeong-Soo

    2015-05-01

    [Purpose] Quality of life (QoL) can be closely related to caregiver burden, which may be a potential mediating effect on the relationships among stroke patient caregivers. This study investigated the predictors of caregiver's QoL based on patient and caregiver characteristics, with caregiver burden as a mediator. [Methods] This study was conducted using surveys, a literature review, and interviews. Survey data were collected from 238 subjects, who were diagnosed with stroke, and their family caregivers from October 2013 to April 2014. [Results] Caregiver health status, income, spouses caring for patients, and duration of hospitalization were identified as significant predictors of caregivers' QoL with a mediating effect of caregiver burden. The time spent on caregiving per day and patient education level were the only direct predictors of caregivers' QoL. [Conclusion] The responsibility of caring for patients with stroke, in particular for a spouse, must be administered by means of a holistic family-centered rehabilitation program. In addition, financial support and availability of various health and social service programs must be comprehensively provided in order to maintain caregivers' well-being.

  11. A Knowledge-Based Consultant for Financial Marketing

    OpenAIRE

    Kastner, John; Apte, Chidanand; Griesmer, James

    1986-01-01

    This article describes an effort to develop a knowledge-based financial marketing consultant system. Financial marketing is an excellent vehicle for both research and application in artificial intelligence (AI). This domain differs from the great majority of previous expert system domains in that there are no well-defined answers (in traditional sense); the goal here is to obtain satisfactory arguments to support the conclusions made. A large OPS5-based system was implemented as an initial pr...

  12. Fairness of Financial Contribution in Iranian Health System: Trend Analysis of National Household Income and Expenditure, 2003-2010.

    Science.gov (United States)

    Fazaeli, Amir Abbas; Seyedin, Hesam; Vosoogh Moghaddam, Abbas; Delavari, Alireza; Salimzadeh, H; Varmazyar, Hasan; Fazaeli, Ali Akbar

    2015-03-18

    Social systems are dealing with the challenge of achieving fairness in the distribution of financial burden and protecting the risk of financial loss. The purpose of this paper is to present a trend analysis for the indicators related to fairness in healthcare's financial burden in rural and urban population of Iran during the eight years period of 2003 to 2010. We used the information gathered by statistical center of Iran through sampling processes for the household income and expenditures. The indicators of fairness in financial contribution of healthcare were calculated based on the WHO recommended methodology. The indices trend analysis of eight-year period for the rural, urban areas and the country level were computed. This study shows that in Iran the fairness of financial contribution index during the eight-year period has been decreased from 0.841 in 2003 to above 0.827 in 2010 and The percentage of people with catastrophic health expenditures has been increased from 2.3% to above 3.1%. The ratio of total treatment costs to the household overall capacity to pay has been increased from 0.055 to 0.068 and from 0.072 to 0.0818 in urban and rural areas respectively. There is a decline in fairness of financial contribution index during the study period. While, a trend stability of the proportion of households who suffered catastrophic health expenditures was found.

  13. Impact of Economic Hardship and Financial Threat on Suicide Ideation and Confusion.

    Science.gov (United States)

    Fiksenbaum, Lisa; Marjanovic, Zdravko; Greenglass, Esther; Garcia-Santos, Francisco

    2017-07-04

    The present study tested the extent to which perceived economic hardship is associated with psychological distress (suicide ideation and confusion) after controlling for personal characteristics. It also explored whether perceived financial threat (i.e., fearful anxious-uncertainty about the stability and security of one's personal financial situation) mediates the relationship between economic hardship and psychological distress outcomes. The theoretical model was tested in a sample of Canadian students (n = 211) and was validated in a community sample of employed Portuguese adults (n = 161). In both samples, the fit of the model was good. Parameter estimates indicated that greater experience of economic hardship increased with financial threat, which in turn increased with levels of suicide ideation and confusion. We discuss the practical implications of these results, such as for programs aimed at alleviating the burden of financial hardship, in our concluding remarks.

  14. Challenges on the epidemiological and economic burden of diabetes and hypertension in Mexico.

    Science.gov (United States)

    Arredondo, Armando; Orozco, Emanuel; Alcalde-Rabanal, Jaqueline; Navarro, Juan; Azar, Alejandra

    2018-01-01

    OBJECTIVE To analyze the epidemiological and economic burden of the health services demand due to diabetes and hypertension in Mexico. METHODS Evaluation study based on a time series study that had as a universe of study the assured and uninsured population that demands health services from the three main institutions of the Health System in Mexico: The Health Department, the Mexican Institute of Social Security, and Institute of Services and Social Security for State Workers. The financing method was based on instrumentation and consensus techniques for medium case management. In order to estimate the epidemiological changes and financial requirements, a time series of observed cases for diabetes and hypertension 1994-2013 was integrated. Probabilistic models were developed based on the Box-Jenkins technique for the period of 2013-2018 with 95% confidence intervals and p < 0.05. RESULTS Comparing results from 2013 versus 2018, in the five regions, different incremental trends of 14%-17% in epidemiological changes and 58%-66% in the economic burden for both diseases were observed. CONCLUSIONS If the risk factors and the different models of care remained as they currently are in the three institutions analyzed, the financial consequences would be of greater impact for the Mexican Institute of Social Security, following in order of importance the Institute of Services and Social Security for State Workers and lastly the Health Department. The financial needs for both diseases will represent approximately 13%-15% of the total budget allocated to the uninsured population and 15%-17% for the population insured depending on the region.

  15. Achieving a Financially Secure Retirement: A Retirement Community Case Study

    Science.gov (United States)

    Dong, Francis Henry

    2014-01-01

    In the wake of recent events, especially the Great Recession of 2007-2009, affecting the economy, resulting in job losses, personal financial distress, and gloomy perceptions of their future well-being, many Americans are concerned about their financial quality of life in retirement. The media is replete with a plethora of advertisements for…

  16. The burden of illness of osteoporosis in Canada.

    Science.gov (United States)

    Tarride, J-E; Hopkins, R B; Leslie, W D; Morin, S; Adachi, J D; Papaioannou, A; Bessette, L; Brown, J P; Goeree, R

    2012-11-01

    To update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at $2.3 billion in Canada or 1.3% of Canada's healthcare expenditures. Prevention of fractures in high-risk individuals is key to decrease the financial burden of osteoporosis. Since the 1996 publication of the burden of osteoporosis in 1993 in Canada, the population has aged and the management of osteoporosis has changed. The study purpose was to estimate the current burden of illness due to osteoporosis in Canadians aged 50 and over. Analyses were conducted using five national administrative databases from the Canadian Institute for Health Information for the fiscal-year ending March 31 2008 (FY 2007/2008). Gaps in national data were supplemented by provincial and community data extrapolated to national levels. Osteoporosis-related fractures were identified using a combination of most responsible diagnosis at discharge and intervention codes. Fractures associated with severe trauma codes were excluded. Costs, expressed in 2010 dollars, were calculated for osteoporosis-related hospitalizations, emergency care, same day surgeries, rehabilitation, continuing care, homecare, long-term care, prescription drugs, physician visits, and productivity losses. Sensitivity analyses were conducted to measure the impact on the results of key assumptions. Osteoporosis-related fractures were responsible for 57,413 acute care admissions and 832,594 hospitalized days in FY 2007/2008. Acute care costs were estimated at $1.2 billion. When outpatient care, prescription drugs, and indirect costs were added, the overall yearly cost of osteoporosis was over $2.3 billion for the base case analysis and as much as $3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities due to osteoporosis. Osteoporosis is a chronic disease that affects a large segment of the adult population and results in a

  17. Risk adjusted financial costs of photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Szabo, Sandor; Jaeger-Waldau, Arnulf [Joint Research Centre, Institute for Energy, Via E. Fermi 2749, I-21020 Ispra (Italy); Szabo, Laszlo [Joint Research Centre, Institute for Prospective Technological Studies C. Inca Garcilaso, 3. E-41092 Sevilla (Spain)

    2010-07-15

    Recent research shows significant differences in the levelised photovoltaics (PV) electricity cost calculations. The present paper points out that no unique or absolute cost figure can be justified, the correct solution is to use a range of cost figures that is determined in a dynamic power portfolio interaction within the financial scheme, support mechanism and industry cost reduction. The paper draws attention to the increasing role of financial investors in the PV segment of the renewable energy market and the importance they attribute to the risks of all options in the power generation portfolio. Based on these trends, a former version of a financing model is adapted to project the energy mix changes in the EU electricity market due to investors behaviour with different risk tolerance/aversion. The dynamic process of translating these risks into the return expectation in the financial appraisal and investment decision making is also introduced. By doing so, the paper sets up a potential electricity market trend with the associated risk perception and classification. The necessary risk mitigation tasks for all stakeholders in the PV market are summarised which aims to avoid the burden of excessive risk premiums in this market segment. (author)

  18. Risk adjusted financial costs of photovoltaics

    International Nuclear Information System (INIS)

    Szabo, Sandor; Jaeger-Waldau, Arnulf; Szabo, Laszlo

    2010-01-01

    Recent research shows significant differences in the levelised photovoltaics (PV) electricity cost calculations. The present paper points out that no unique or absolute cost figure can be justified, the correct solution is to use a range of cost figures that is determined in a dynamic power portfolio interaction within the financial scheme, support mechanism and industry cost reduction. The paper draws attention to the increasing role of financial investors in the PV segment of the renewable energy market and the importance they attribute to the risks of all options in the power generation portfolio. Based on these trends, a former version of a financing model is adapted to project the energy mix changes in the EU electricity market due to investors behaviour with different risk tolerance/aversion. The dynamic process of translating these risks into the return expectation in the financial appraisal and investment decision making is also introduced. By doing so, the paper sets up a potential electricity market trend with the associated risk perception and classification. The necessary risk mitigation tasks for all stakeholders in the PV market are summarised which aims to avoid the burden of excessive risk premiums in this market segment.

  19. Burden of tuberculosis in indigenous peoples globally: a systematic review.

    Science.gov (United States)

    Tollefson, D; Bloss, E; Fanning, A; Redd, J T; Barker, K; McCray, E

    2013-09-01

    The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown. To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control. A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide. Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of indigenous groups. Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.

  20. The Burden of Dysphagia on Family Caregivers of the Elderly: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Ashwini M. Namasivayam-MacDonald

    2018-06-01

    Full Text Available With the rapid increase in the elderly population, there is a simultaneous increased need for care provided by family caregivers. Research in the field of head and neck cancer has indicated that caring for patients with dysphagia can impact a caregiver’s quality of life. Given that many older adults present with dysphagia, one can assume that their caregivers are equally, if not more greatly, affected. The purpose of this systematic review was to examine all relevant literature regarding the caregiver burden in caregivers of community-dwelling older adults with dysphagia. A review of relevant studies published through April 2018 was conducted using search terms related to dysphagia, caregiver burden, and older adults. The search yielded 2331 unique abstracts. Of the 176 abstracts that underwent full review, four were accepted. All reported an increase in caregiver burden due to presence of dysphagia in care recipients. Worsening feeding-related behaviors were associated with burden, and the use of feeding tubes was more frequently associated with “heavy burden”. The presence of dysphagia in community-dwelling older adults is a factor leading to an increased burden among caregivers. Although aspects of dysphagia play a role in the caregiver burden, the specific reasons for the increased burden are unknown. Clinicians should be aware of dysphagia as a source of the burden, and future studies should further define the relationship between dysphagia and the caregiver burden in order to develop comprehensive approaches to care.

  1. The Financial Communication and the Accounting - Audit - Valuation Trinomial

    Directory of Open Access Journals (Sweden)

    Bogdan Cosmin Gomoi

    2015-01-01

    Full Text Available At this time, financial communication faces various obstacles concerning the homogenization of communication types. Moreover, due to globalization, communication on capital markets confronts with a very visible changing process. Thus, people from different parts of the world managed to pass over language barriers but still face the ones in the financial communication field. It is well known that most financial decisions are based on the information from the financial statements. But, both the form and the conceptual language used in order to elaborate these financial statements present numerous conflict marks. In order to attenuate these conflict marks, the IASB, having as main target the financial reporting homogenization, elaborated the IFRS. At this time, Romania also faces economic, politic, social and cultural irreversible processes, of great interest for accounting: the growth of number and economic power of multinational companies; the economic globalization, especially of the financial markets; the growth of capitalization and the appearance and development of new financial products.

  2. Correlation of financial markets in times of crisis

    Science.gov (United States)

    Sandoval, Leonidas; Franca, Italo De Paula

    2012-01-01

    Using the eigenvalues and eigenvectors of correlations matrices of some of the main financial market indices in the world, we show that high volatility of markets is directly linked with strong correlations between them. This means that markets tend to behave as one during great crashes. In order to do so, we investigate financial market crises that occurred in the years 1987 (Black Monday), 1998 (Russian crisis), 2001 (Burst of the dot-com bubble and September 11), and 2008 (Subprime Mortgage Crisis), which mark some of the largest downturns of financial markets in the last three decades.

  3. Social and Economic Burden of Human Leishmaniasis.

    Science.gov (United States)

    Okwor, Ifeoma; Uzonna, Jude

    2016-03-01

    Leishmaniasis continues to pose a major public health problem worldwide. With new epidemics occurring in endemic areas and the spread of the disease to previously free areas because of migration, tourism, and military activities, there is a great need for the development of an effective vaccine. Leishmaniasis is a disease of the poor, occurring mostly in remote rural villages with poor housing and little or no access to modern health-care facilities. In endemic areas, diagnosis of any form of leishmaniasis puts a huge financial strain on an already meagre financial resource at both the individual and community levels. Most often families need to sell their assets (land and livestock) or take loans from informal financial outfits with heavy interest rates to pay for the diagnosis and treatment of leishmaniasis. Here, we discuss the disease with special emphasis on its socioeconomic impact on the affected individual and community. In addition, we highlight the reasons why continued research aimed at developing an effective Leishmania vaccine is necessary. © The American Society of Tropical Medicine and Hygiene.

  4. The burden of allergic rhinitis.

    Science.gov (United States)

    Nathan, Robert A

    2007-01-01

    Although formerly regarded as a nuisance disease, allergic rhinitis (AR) has a considerable effect on quality of life and can have significant consequences if left untreated. The total burden of this disease lies not only in impaired physical and social functioning but also in a financial burden made greater when considering evidence that AR is a possible causal factor in comorbid diseases such as asthma or sinusitis. Compared with matched controls, patients with AR have an approximate twofold increase in medication costs and 1.8-fold the number of visits to health practitioners. Hidden direct costs include the treatment of comorbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyposis. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. In the United States, AR results in 3.5 million lost workdays and 2 million lost schooldays annually. Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects. Ironically, health care providers overestimate patient satisfaction with therapy. Therefore, improvement in patient-practitioner communication may enhance patient adherence with prescribed regimens.

  5. Stable financial inclusion: Recovering the Salvadoran Rurality

    OpenAIRE

    Héctor David Córdova

    2013-01-01

    This article approaches a topic of great significance for the Salvadorian financial sector, as well as for the whole population, especially that in the rural areas of this country.  This article refers, in terms of their institutional evolution, the stages the Federation of Cooperative Associations of Savings and Credit of El Salvador FEDECACES DE R.L has lived through in its development.  In this work an analysis of the process of financial inclusion that has been undertaken by FEDEC...

  6. Humanistic burden of disease for patients with advanced melanoma in Canada.

    Science.gov (United States)

    Cheung, Winson Y; Bayliss, Martha S; White, Michelle K; Stroupe, Angela; Lovley, Andrew; King-Kallimanis, Bellinda L; Lasch, Kathryn

    2018-06-01

    Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach. Many patients' journeys began with the startling diagnosis of an invasive disease and a vastly shortened life expectancy. By the time they reached an advanced stage of melanoma, these patients' overall functioning and quality of life had been greatly diminished by this quickly progressing cancer. The impact was described in terms of physical pain and disability, emotional distress, diminished interactions with friends and family, and burden on caregivers. Our findings provide evidence of signs, symptoms, and functional impacts of advanced melanoma. Signs and symptoms reported (physical, mental, and social) confirm and expand on those reported in the existing clinical literature. Primary care physicians should be better trained to identify melanomas early. Oncology care teams can improve on their current approaches for helping patients navigate treatment options, with information about ancillary services to mitigate disease impacts on HRQL, such as mental health and social supports, as well as employment or financial support services.

  7. The ties that bind: the relationship between caregiver burden and the neuropsychological functioning of TBI survivors.

    Science.gov (United States)

    Lehan, Tara; Arango-Lasprilla, Juan Carlos; de los Reyes, Carlos José; Quijano, María Cristina

    2012-01-01

    Advances in medical and assistive technology have increased the likelihood of survival following a traumatic brain injury (TBI). Consequently, families frequently must provide care to individuals with TBI. Because they are rarely prepared for the associated demanding medical needs and financial burden, family caregivers are at risk for physical and emotional problems, which can negatively influence their individual and family functioning. Whereas scholars have examined the influence of survivor functioning on caregiver burden, few have explicitly recognized that caregiver burden also influences survivor functioning. Results of a multivariate linear regression suggest that, in a sample of 51 pairs of TBI survivors and their caregivers living in Colombia, survivors receiving care from a family member who reported a higher level of burden had poorer objective neuropsychological functioning than those receiving care from a family member who reported a lower level of burden, after controlling for survivor education and history of occupational therapy. Therefore, a family-focused approach might maximize intervention effectiveness, especially for Latin American and Hispanic families, which tend to be characterized by a strong sense of familism. The emphasis on family can create problems in a healthcare system that views the individual as the primary unit.

  8. Financial reporting by small and medium enterprises in Thailand

    OpenAIRE

    Ploybut, Sutthirat

    2012-01-01

    The increasing complexity of financial reporting requirements, especially accounting standards, leads many countries to consider moving to simpler reporting requirements for small and medium enterprises (SMEs) in order to reduce reporting burdens. In response to such concern, the International Accounting Standards Board (IASB) also released the IFRS for SMEs, an international accounting standard intended for SMEs worldwide. In Thailand, SMEs are required by law to prepare and publish general ...

  9. The Great Cross-Border Bank Deleveraging; Supply Constraints and Intra-Group Frictions

    OpenAIRE

    Eugenio M Cerutti; Stijn Claessens

    2014-01-01

    International banks greatly reduced their direct cross-border and local affiliates’ lending as the global financial crisis strained balance sheets, lowered borrower demand, and changed government policies. Using bilateral, lender-borrower countrydata and controlling for credit demand, we show that reductions largely varied in line with markets’ prior assessments of banks’ vulnerabilities, with banks’ financial statement variables and lender-borrower country characteristics playing minor roles...

  10. Measuring Burden of Diseases in a Rapidly Developing Economy: State of Qatar

    Science.gov (United States)

    Bener, Abdulbari; Zirie, Mahmoud A.; Kim, Eun-Jung; Buz, Rama Al; Zaza, Mouayyad; Al-Nufal, Mohammed; Basha, Basma; Hillhouse, Edward W; Riboli, Elio

    2013-01-01

    Background: The Global Burden of Disease (GBD) study has provided a conceptual and methodological framework to quantify and compare the health of populations. Aim: The objective of the study was to assess the national burden of disease in the population of Qatar using the disability-adjusted life year (DALYs) as a measure of disability. Methods: We adapted the methodology described by the World Health Organization for conducting burden of disease to calculate years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability adjusted life years (DALYs). The study was conducted during the period from November 2011 to October 2012. Results:: The study findings revealed that ischemic heart disease (11.8%) and road traffic accidents (10.3%) were the two leading causes of burden of diseases in Qatar in 2010. The burden of diseases among men (222.04) was found three times more than of women's (71.85). Of the total DALYs, 72.7% was due to non fatal health outcomes and 27.3% was due to premature death. For men, chronic diseases like ischemic heart disease (15.7%) and road traffic accidents (13.7%) accounted great burden and an important source of lost years of healthy life. For women, birth asphyxia and birth trauma (12.6%) and abortion (4.6%) were the two leading causes of disease burden. Conclusion:: The results of the study have shown that the national health priority areas should cover cardiovascular diseases, road traffic accidents and mental health. The burden of diseases among men was three times of women's. PMID:23445701

  11. "Financial Innovation and Risk Management: The Cross-Guarantee Solution"

    OpenAIRE

    Bert Ely

    1995-01-01

    The cross-guarantee concept, which is summarized below, will eliminate the regulatory moral hazard that electronic technology has greatly exacerbated in recent years. The paper concludes by outlining the many benefits cross-guarantees will bring to the financial system as well as the structural and international implications of using cross-guarantees to bring market-driven regulation to the financial services sector of the American economy.

  12. EFFECTS OF THE GLOBAL FINANCIAL CRISIS IN THE BANKING SYSTEM OF KOSOVO

    OpenAIRE

    Myrvete Badivuku-Pantina; Anera Alishani

    2012-01-01

    Financial crises are phenomena that happened before and continue to happen even nowadays. There were many financial crises in the last century, starting with the Great Depression of 1929 and continuing with other financial crisis, and it was believed that people would learn from their previous experiences and would not allow the crisis to happen again. But the financial crisis of 2007, created the impression that no one wanted to learn for the real causes of their occurrence and consequences,...

  13. Modeling The Economic Burden Of Adult Vaccine-Preventable Diseases In The United States.

    Science.gov (United States)

    Ozawa, Sachiko; Portnoy, Allison; Getaneh, Hiwote; Clark, Samantha; Knoll, Maria; Bishai, David; Yang, H Keri; Patwardhan, Pallavi D

    2016-11-01

    Vaccines save thousands of lives in the United States every year, but many adults remain unvaccinated. Low rates of vaccine uptake lead to costs to individuals and society in terms of deaths and disabilities, which are avoidable, and they create economic losses from doctor visits, hospitalizations, and lost income. To identify the magnitude of this problem, we calculated the current economic burden that is attributable to vaccine-preventable diseases among US adults. We estimated the total remaining economic burden at approximately $9 billion (plausibility range: $4.7-$15.2 billion) in a single year, 2015, from vaccine-preventable diseases related to ten vaccines recommended for adults ages nineteen and older. Unvaccinated individuals are responsible for almost 80 percent, or $7.1 billion, of the financial burden. These results not only indicate the potential economic benefit of increasing adult immunization uptake but also highlight the value of vaccines. Policies should focus on minimizing the negative externalities or spillover effects from the choice not to be vaccinated, while preserving patient autonomy. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Taxing of financial sector as possible own resource of EU budget

    Directory of Open Access Journals (Sweden)

    Danuše Nerudová

    2013-01-01

    Full Text Available The discussion about the possible taxation of the financial sector has started in the European Union as a result of the financial crisis which has spread to the Europe from the United States in 2008. European Commission concluded that EU should lead the efforts to introduce system of levies or taxies on financial institutions. EU member states individually committed to support the financial sector for a total about EUR 4.6 trillion (i.e. 39% of EU-27 GDP in 2009. Those public interventions have significant budgetary consequences (strongly felt in Greece, Spain or Italy and imposes a heavy burden on the present and future generations. Therefore there is a strong consensus not only on the level of the European Union but also internationally, that financial sector should contribute to the public finance more fairly. As a reaction on costs of the financial crisis which was paid out from the public money, some of the countries immediately introduced temporary measures in order to collect back paid out money. The aim of the paper is to research the possibility of financial sector taxation, to discuss the proposal of the European Union on the introduction of financial transaction tax on EU level and through the multi-criteria analysis to research, whether this type of the tax is suitable as an own resource of EU budget.

  15. Fairness of Financial Contribution in Iranian Health System: Trend Analysis of National Household Income and Expenditure, 2003-2010

    Science.gov (United States)

    Fazaeli, Amir Abbas; Seyedin, Hesam; Moghaddam, Abbas Vosoogh; Delavari, Alireza; Salimzadeh, H.; Varmazyar, Hasan; Fazaeli, Ali Akbar

    2015-01-01

    Background: Social systems are dealing with the challenge of achieving fairness in the distribution of financial burden and protecting the risk of financial loss. The purpose of this paper is to present a trend analysis for the indicators related to fairness in healthcare’s financial burden in rural and urban population of Iran during the eight years period of 2003 to 2010. Methods: We used the information gathered by statistical center of Iran through sampling processes for the household income and expenditures. The indicators of fairness in financial contribution of healthcare were calculated based on the WHO recommended methodology. The indices trend analysis of eight-year period for the rural, urban areas and the country level were computed. Results: This study shows that in Iran the fairness of financial contribution index during the eight-year period has been decreased from 0.841 in 2003 to above 0.827 in 2010 and The percentage of people with catastrophic health expenditures has been increased from 2.3% to above 3.1%. The ratio of total treatment costs to the household overall capacity to pay has been increased from 0.055 to 0.068 and from 0.072 to 0.0818 in urban and rural areas respectively. Conclusion: There is a decline in fairness of financial contribution index during the study period. While, a trend stability of the proportion of households who suffered catastrophic health expenditures was found. PMID:26156920

  16. Offshore Financial Centers in Global Capital Flow

    Directory of Open Access Journals (Sweden)

    Lutsyshyn Zoriana

    2017-12-01

    integral parts concertedly working under increasingly unified rules. The world financial centers are establishing new criteria for economic activity, modifying its motivation and priorities. Basically, these changes are aimed at shortening the activities timing and advancing profitability over all other criteria. As a result, substantial portion of funds is directed not to production, but to purely financial transactions. The matter is not only that with significant financial resources available, the volume of competitive production facilities according to international standards is limited and often burdened with increased political risk. The financial sector itself is artificially creating particularly favorable conditions for itself, at the same time generating risks to be mitigated and securitized.

  17. Annual Report 2008 -- Office of the Chief Financial Officer (OCFO)

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, Jeffrey

    2008-12-22

    It is with great pleasure that I present to you the 2008 Chief Financial Officer's Annual Report. The data included in this report has been compiled from the Budget Office, the Controller, Procurement and Property Management and the Sponsored Projects Office. Also included are some financial comparisons with other DOE Laboratories and a glossary of commonly used acronyms.

  18. How the Economy Influences Pedagogy: The Great Recession's Influence on Elementary Teaching Practices

    Science.gov (United States)

    Sawyer, Amanda G.

    2017-01-01

    From 2007 to 2009, the United States experienced one of the greatest economic declines reported in the previous decades, known as the Great Recession (Bureau of Labor Statistics, 2012). While a great deal of media attention focused on the immediate financial effects of the recession, little discussion was made about the influence of this crisis…

  19. Development of a financial literacy course for patients with newly diagnosed cancer.

    Science.gov (United States)

    Shankaran, Veena; Linden, Hannah; Steelquist, Jordan; Watabayashi, Kate; Kreizenbeck, Karma; Leahy, Tony; Overstreet, Karen

    2017-03-01

    Although patients with cancer often face serious financial hardships, few studies have reported on strategies to mitigate this burden. Improving literacy about the financial aspects of cancer care may decrease the negative financial impact of cancer diagnosis and treatment. We obtained input from patient stakeholders on the perceived value and optimal design of a financial literacy program in the advanced cancer setting. Prospective cohort survey.  A series of semi-structured interviews were conducted, during which patients with either colorectal or breast cancer were asked to describe the impact of cancer on their finances and employment, to state their preferences about discussing costs with their providers, and to give input on development of a financial literacy course. Twenty-one patients (76% Caucasian) completed interviews, the majority of whom had Medicare or commercial insurance (71%). Lost income from early retirement or disability was the most financially burdensome experience for 67% of patients. The majority of patients (76%) reported that a financial literacy course would be helpful in navigating the cost of cancer care. Most preferred the course be administered at diagnosis in a live group format. Feedback from patients with cancer supported the development of a group financial literacy course that addresses barriers to discussing cost concerns, employment changes during cancer, and available resources for financial assistance.

  20. Mediating effects of burden on quality of life for caregivers of first-time stroke patients discharged from the hospital within one year.

    Science.gov (United States)

    Tsai, Yu-Hsia; Lou, Meei-Fang; Feng, Tsui-Hsia; Chu, Tsung-Lan; Chen, Ying-Jen; Liu, Hsueh-Erh

    2018-04-25

    early stage. Caregivers' financial factors affected caregiver QoL directly. Caregivers' poor self-rated health and lower education level negatively affected caregiver QoL indirectly through caregiver burden as a mediator. Interventions to make appropriate policies for financial subsidies, to enhance caregivers' health and to provide tailored stroke-related education through multidisciplinary cooperation may effectively promote caregiver QoL.

  1. The Great Depression and the Great Recession: A Comparative Analysis of their Analogies

    Directory of Open Access Journals (Sweden)

    Cristina Peicuti

    2014-06-01

    Full Text Available The decades preceding the Great Depression and the U.S. subprime mortgage crisis have close similarities. Both decades were characterized by rapid growth without major contractions, by an increase in liquidity, a lack of inflation, and a generalized decrease in risk premiums. Additional similarities included significant changes in the financing of real estate by commercial banks along with a consolidation of the banking sector and high hopes that the efficiency of monetary policy would prevent financial crises. These decades were also characterized by the consolidation of the powers of young central banks (the Federal Reserve System in the 1920s and the European Central Bank in the 2000s, by unsuccessful attempts to control market speculation, by their international dimensions, and by the eruption of crises after the failure of a major American financial institution that could have been avoided. Understanding these analogies help us better identify the causes of the subprime mortgage crisis and prevent history from repeating itself to the extentof such large-scale devastating consequences.

  2. Family functioning in severe brain injuries: correlations with caregivers' burden, perceived social support and quality of life.

    Science.gov (United States)

    Tramonti, Francesco; Bonfiglio, Luca; Di Bernardo, Carolina; Ulivi, Chiara; Virgillito, Alessandra; Rossi, Bruno; Carboncini, Maria Chiara

    2015-01-01

    Severe brain injuries have long-term consequences on functional status and psychosocial functioning. Family life can be greatly influenced as well, and features of high caregiver burden can emerge. Although the data on caregivers' distress are constantly increasing, less information is available about the role of family functioning. Thirty caregivers of hospitalised patients with severe brain injuries received questionnaires for the evaluation of caregiver burden, family functioning and perceived social support. A semi-structured interview was performed for the evaluation of quality of life. Family cohesion and adaptability positively correlated with caregivers' quality of life and perceived social support. Partner caregivers' scores were significantly higher on the time-dependent burden than those of sons and daughters, whereas the latter scored higher on the emotional burden.

  3. Family caregiver burden: the burden of caring for lung cancer patients according to the cancer stage and patient quality of life

    Directory of Open Access Journals (Sweden)

    Eliana Lourenço Borges

    Full Text Available ABSTRACT Objective: Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL of lung cancer patients have on caregiver burden. Methods: This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36. Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50. Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. Results: We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. Conclusions: Caregiver burden is more affected by patient QoL than by lung cancer stage.

  4. FINANCIAL RISK COVERAGE IN THE CONTEXT OF GLOBALIZATION FINANCIAL MARKETS

    Directory of Open Access Journals (Sweden)

    María Esperanza González-del Foyo

    2016-01-01

    Full Text Available In a globalized environment, the increase of risks that assume the international commerce makes necessary the to articulate the instruments of covering. The enterprise activity and the country in matter will condition in a great measure the type of covering that be needed to contract, the principal consist in: knowing the risks, evaluate its incidence, decide to cover it or assume it and in both cases the right choise most be the aplication of the strategy thatt be more efective. The States put under disposition of the enterprises a series of public mechanismes to help them to promote its internationalitation . One of the pillars where this politics rest is the use of mechanismes of riskes cover in the internacional commerce. In correspondence with the previous, to reflect on the aplications of the financial risk and the formulation of strategies to cover them in conditions of globalization of the financial markets, constitute the objetive of this article. 

  5. 76 FR 4993 - Agency Information Collection; Activity Under OMB Review; Report of Financial and Operating...

    Science.gov (United States)

    2011-01-27

    ... for Small Aircraft Operators AGENCY: Bureau of Transportation Statistics (BTS), DOT. ACTION: Notice... continuing need for and usefulness of BTS collecting financial, traffic and operating statistics from small... address whether BTS accurately estimated the reporting burden and if there are other ways to enhance the...

  6. Caregiver burden in Alzheimer's disease patients in Spain.

    Science.gov (United States)

    Peña-Longobardo, Luz María; Oliva-Moreno, Juan

    2015-01-01

    Alzheimer's disease constitutes one of the leading causes of burden of disease, and it is the third leading disease in terms of economic and social costs. To analyze the burden and problems borne by informal caregivers of patients who suffer from Alzheimer's disease in Spain. We used the Survey on Disabilities, Autonomy and Dependency to obtain information on the characteristics of disabled people with Alzheimer's disease and the individuals who provide them with personal care. Additionally, statistical multivariate analyses using probit models were performed to analyze the burden placed on caregivers in terms of health, professional, and leisure/social aspects. 46% of informal caregivers suffered from health-related problems as a result of providing care, 90% had leisure-related problems, and 75% of caregivers under 65 years old admitted to suffering from problems related to their professional lives. The probability of a problem arising for an informal caregiver was positively associated with the degree of dependency of the person cared for. In the case of caring for a greatly dependent person, the probability of suffering from health-related problems was 22% higher, the probability of professional problems was 18% higher, and there was a 10% greater probability of suffering from leisure-related problems compared to non-dependents. The results show a part of the large hidden cost for society in terms of problems related to the burden lessened by the caregivers. This information should be a useful tool for designing policies focused toward supporting caregivers and improving their welfare.

  7. 40 CFR 179.91 - Burden of going forward; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 179.91 Section 179.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...; burden of persuasion. (a) The party whose request for an evidentiary hearing was granted has the burden... FFDCA has the burden of persuasion in the hearing on that issue, whether the proceeding concerns the...

  8. Burden of Sexual Dysfunction.

    Science.gov (United States)

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  9. Inappropriately Timed Pediatric Orthopaedic Referrals From the Emergency Department Result in Unnecessary Appointments and Financial Burden for Patients.

    Science.gov (United States)

    Jackson, Taylor J; Blumberg, Todd J; Shah, Apurva S; Sankar, Wudbhav N

    2018-03-01

    Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system. We performed a retrospective review of pediatric patients with acute musculoskeletal injuries referred from our ED (without a formal orthopaedic consult) to our outpatient clinic. Patients were retrospectively reviewed in a consecutive fashion. The appropriateness of the recommended follow-up time interval was determined for each patient, and the direct and indirect cost of the inappropriate services were calculated utilizing a combination of traditional cost accounting techniques and time-driven activity-based costing. The characteristics of patients with appropriate and untimely follow-up referrals were compared. Two hundred consecutive referrals from the ED were reviewed. Overall, 96.5% of the follow-up visits recommended by the ED were premature, which led 106 (53%) patients to require a second visit to complete their clinical care. Patients who required a second visit were significantly younger (P=0.005), more likely to be male (P=0.042), more likely to have a fracture (Pcost of $342.93 per patient. Untimely referrals for follow-up of acute pediatric musculoskeletal conditions are very common and represent a significant financial burden to patients, families, and the health care system. Over 40% of unnecessary visits resulted from just 3 diagnoses. Improved orthopaedic follow-up guidelines, particularly for these readily recognizable conditions, and feedback to referring providers may reduce poorly timed clinic visits and decrease costs in

  10. ACCOUNTING AND FINANCIAL WEB REPORTING IN ALBANIA

    Directory of Open Access Journals (Sweden)

    DEMIRAJ Rezart

    2013-12-01

    Full Text Available Recent technological changes have had a great impact on the accounting and financial environment. As other countries Albania has also been affected by developments such as the evolution towards using accounting information packages, financial web reporting, XBRL and cloud computing. Throughout this paper we try to analyze the current situation of accounting and financial reporting in Albania and the impact that the web reporting has had on the simplification of the accounting procedures. We present how tools such as cloud computing and XBRL have impacted the use of the accounting systems and also other reporting institutions in Albania. Describing the current development of cloud services we give information on the part of software vendors in Albania. We find that cloud computing has been used extensively not only by the private companies offering accounting infomations systems, but also by other companies in the public sector (i.e. education. On the other hand we find that XBRL, even though a promising technology, has not been gained great recognition in Albania and is currently not used by any on the institutions or companies, neither by institutions whose mission is to create extensive databases (such as the Registrar of the Companies and which might benefit the most from this technology.

  11. Impact of trained oncology financial navigators on patient out-of-pocket spending.

    Science.gov (United States)

    Yezefski, Todd; Steelquist, Jordan; Watabayashi, Kate; Sherman, Dan; Shankaran, Veena

    2018-03-01

    Patients with cancer often face financial hardships, including loss of productivity, high out-of-pocket (OOP) costs, depletion of savings, and bankruptcy. By providing financial guidance and assistance through specially trained navigators, hospitals and cancer care clinics may be able mitigate the financial burdens to patients and also minimize financial losses for the treating institutions. Financial navigators at 4 hospitals were trained through The NaVectis Group, an organization that provides training to healthcare staff to increase patient access to care and assist with OOP expenses. Data regarding financial assistance and hospital revenue were collected after instituting these programs. Amount and type of assistance (free medication, new insurance enrollment, premium/co-pay assistance) were determined annually for all qualifying patients at the participating hospitals. Of 11,186 new patients with cancer seen across the 4 participating hospitals between 2012 and 2016, 3572 (32%) qualified for financial assistance. They obtained $39 million in total financial assistance, averaging $3.5 million per year in the 11 years under observation. Patients saved an average of $33,265 annually on medication, $12,256 through enrollment in insurance plans, $35,294 with premium assistance, and $3076 with co-pay assistance. The 4 hospitals were able to avoid write-offs and save on charity care by an average of $2.1 million per year. Providing financial navigation training to staff at hospitals and cancer centers can significantly benefit patients through decreased OOP expenditures and also mitigate financial losses for healthcare institutions.

  12. [Burden of relatives and their expectations towards psychiatric institutions. A review of the literature and own results].

    Science.gov (United States)

    Schmid, R; Spiessl, H; Vukovich, A; Cording, C

    2003-03-01

    This article aimed to provide an overview regarding the burden of relatives of mentally ill patients and their expectations towards psychiatric institutions. The literature was selected from Medline covering the years 1996 - 2002. 342 articles were reviewed, 145 of which were described in this review. The burden of relatives are manifold and can be classified into the following categories: time spent on caring, financial difficulties, occupational restrictions, detrimental effects on relatives own physical and psychological well-being, reduction in leisure activities, negative effects on social relationships, experiences of discrimination and refusal, deficiencies in information about illness, feelings of not being taken seriously, insufficient service support, long distance to mental health service, emotional burdens of caregivers and difficulties with the patients behaviour. The expectations of the relatives mainly refer to the categories "relationship between staff and relatives", "information about illness" and "establishing of institutions required". The various burdens of relatives and their expectations towards psychiatric services point to necessary improvements of mental health services in the sense of a consumer-oriented psychiatric care.

  13. What accounting leaves out of hospital financial management.

    Science.gov (United States)

    Boles, K E; Glenn, J K

    1986-01-01

    As PPS and other fixed-price initiatives replace cost-based reimbursement in the hospital industry, the burden of assuming the risk for business success or failure shifts from the payor to the hospital. As a consequence, theories of risk to the business firm which have found application in other industries now deserve attention by hospital management. Incorporating such risk concepts into hospital strategies and actions requires a view of financial management that goes beyond the generally accepted accounting principles of managing and assigning costs for maximum revenue and profitability. This article examines the financial theory of risk in business firms, illustrates the various components of risk as they apply to a hospital business, and discusses how the hospital management strategies of cost-reduction, marketing, diversification, and multiorganizational affiliation can alter the risk characteristics of a hospital business.

  14. Show Me the Money Resources: Financial Literacy for 21st-Century Learners

    Science.gov (United States)

    Gavigan, Karen

    2010-01-01

    Some economists have called the current U.S. economic environment the worst financial crisis since the Great Depression. Many educators and parents believe it is more important than ever for students to master financial literacy skills. To become successful and responsible 21st century citizens, students need to graduate globally competitive for…

  15. Financial history and financial economics

    OpenAIRE

    Turner, John D.

    2014-01-01

    This essay looks at the bidirectional relationship between financial history and financial economics. It begins by giving a brief history of financial economics by outlining the main topics of interest to financial economists. It then documents and explains the increasing influence of financial economics upon financial history, and warns of the dangers of applying financial economics unthinkingly to the study of financial history. The essay proceeds to highlight the many insights that financi...

  16. Financial constraints and Islamic finance: Lesson learned from external financing perspective

    Directory of Open Access Journals (Sweden)

    Achmad Tohirin

    2016-10-01

    Full Text Available This study examines the presence of financial constraints and explores the role of profit-loss sharing (PLS in mitigating the problem of the financial constraints stemmed from the capital market imperfections. Using Malaysian listed companies’ data, this study finds that the financial constraints are present in the capital market. This finding implies the imperfect capital market. In Islamic PLS framework, there are two options of financing contracts that may be enforced in the capital market as financing mechanisms, i.e. al-musharakah and al-mudharabah. These schemes promote sharing of information and mutual trust between financiers and ‘borrowers’. In these contracts, there are strict terms and conditions to be adhered to by both parties so that the contracts pursue to be valid. Besides, PLS mechanism may reduce the cost of capital since the profit and loss are shared rather than be burdened only on one shoulder. In this regard, the imperfect market problems namely asymmetric information, agency problem and transaction cost can be reduced if not be overcome.

  17. Reducing financial barriers to vaccinating children and adolescents in the USA.

    Science.gov (United States)

    Bednarczyk, Robert A; Birkhead, Guthrie S

    2011-02-01

    To increase awareness of the financial barriers to childhood and adolescent vaccination, recent steps taken to mitigate these barriers, and remaining gaps following passage of Federal healthcare reform legislation. Financial barriers to vaccination remain, even with the safety net of the Vaccines for Children Program. Newly recommended vaccines have substantially increased the cost to fully vaccinate a child up to age 18 years, and the combination of these cost burdens and inadequate reimbursement, in both the private and public sectors, has led some physicians to seriously consider stopping vaccination services. Up to 20% of privately insured children or adolescents have coverage that does not fully cover all costs of immunization, potentially leading to fragmented and inadequate preventive care. Federal healthcare reform legislation, as currently constituted, may not fully address all financing gaps, and the extent to which financial barriers to immunization services remain will need to be evaluated as the legislation is implemented. Recent National Vaccine Advisory Committee recommendations need to be considered to address financial barriers to immunization.

  18. Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study.

    Science.gov (United States)

    Eton, David T; Ramalho de Oliveira, Djenane; Egginton, Jason S; Ridgeway, Jennifer L; Odell, Laura; May, Carl R; Montori, Victor M

    2012-01-01

    Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure. We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes. Thirty-two patients (20 female, 12 male, age 26-85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles. We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment.

  19. Teen financial literacy evaluated to develop outreach materials

    OpenAIRE

    Varcoe, Karen; Peterson, Shirley; Go, Charles; Johns, Margaret; René-Fitch, Paula; Powell, Carol; Costello, Connie

    2002-01-01

    Teenagers have access to and spend a great deal of money each year, yet research indicates that their financial literacy is low. Many curricula for teaching money management exist, but we do not know if we are teaching teens what they want to know in a way that they want to learn. This study, conducted by the Money 2000+ for Teens Workgroup of the UC Division of Agriculture and Natural Resources, sought to find out what teens want to know about financial management. Questionnaires were admini...

  20. Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria

    Science.gov (United States)

    Akpan-Idiok, Paulina Ackley; Anarado, Agnes Nonye

    2014-01-01

    Introduction Cancer care is devastating to families. This research studied the informal caregivers’ perceptions of burden of caregiving to cancer patients attending University of Calabar Teaching Hospital, Calabar. Methods The research adopted a cross-sectioned descriptive design and 210 caregivers providing care to advanced cancer patients were purposively selected. Data were collected using a researcher developed questionnaire and standardized Zarit Burden Interview scale (ZBIS). Data collected were analysed using descriptive and chi-square statistics with the help of SPSS 18.0 and PAS 19.0 softwares. Results The results indicated that the caregivers were in their youthful and active economic age, dominated by females, Christians, spouses, partners and parents. The burden levels experienced by the caregivers were as follows: severe (46.2%), moderate (36.2%) and trivial of no burden (17.6%). The forms of burden experienced were physical (43.4%), psychological (43.3%), financial (41.1%) and social (46.7%), quite frequently and nearly always. Psychological and social forms of burden had the highest weighted score of 228 in terms of magnitude of burden. The result further showed that there was a significant (P = 0.001) and inverse association between caregivers’ burden and the care receivers’ functional ability. The level of burden also increased significantly (P = 0.000) with the duration of care, while there was also a significant (P = 0.01) relationship between caregivers’ experience of burden and their desire to continue caregiving. Conclusion Caregiving role can be enhanced by provision of interventions such as formal education programme on cancer caregiving, oncology, home services along side with transmural care. PMID:25419297

  1. Engaging Student Borrowers: Results of a Survey of Financial Aid Professionals. Research Report

    Science.gov (United States)

    Webster, Jeff; Fernandez, Chris; Fletcher, Carla; Klepfer, Kasey

    2017-01-01

    The rising cost of attending college creates a financial challenge for most students, many of whom must take out student loans to pursue their education goals. Whether or not they earn a degree, these students will leave school with the burden of managing student debt. How well they manage this complex process may shape their personal finances for…

  2. Financial sector taxation: Financial activities tax or financial transaction tax?

    Directory of Open Access Journals (Sweden)

    Danuše Nerudová

    2011-01-01

    Full Text Available The recent financial crises has revealed the need to improve and ensure the stability of the financial sector to reduce negative externalities, to ensure fair and substantial contribution of the financial sector to the public finances and the need to consolidate public finance. All those needs represent substantial arguments for the discussion about the introduction of financial sector taxation. There are discussed in the paper two possible schemes of financial sector taxation – financial transaction tax and financial activities tax. The aim of the paper is to research the possibility of the introduction of financial sector taxation, to discuss the pros and cons of two major candidates on financial sector taxation – financial transaction tax and financial activities tax and to suggest the possible candidate suitable for the implementation on the EU level. Financial transaction tax represents the tool suitable mainly on global level, for only in that case enables generate sufficient financial resources. From EU point of view is considered as less suitable, for it bears the risk of reallocation. Therefore the introduction of financial activities tax on EU level is considered as a better solution for the financial sector taxation in the EU, for financial sector is exempted from value added tax. With respect to the fact, that the implementation would represent the innovative approach to the financial sector taxation, there are no empirical proves and therefore this could be the subject of further research.

  3. The socio-economic burden of human African trypanosomiasis and the coping strategies of households in the South Western Kenya foci.

    Directory of Open Access Journals (Sweden)

    Salome A Bukachi

    2017-10-01

    Full Text Available Human African Trypanosomiasis (HAT, a disease caused by protozoan parasites transmitted by tsetse flies, is an important neglected tropical disease endemic in remote regions of sub-Saharan Africa. Although the determination of the burden of HAT has been based on incidence, mortality and morbidity rates, the true burden of HAT goes beyond these metrics. This study sought to establish the socio-economic burden that households with HAT faced and the coping strategies they employed to deal with the increased burden.A mixed methods approach was used and data were obtained through: review of hospital records; structured interviews (152; key informant interviews (11; case narratives (12 and focus group discussions (15 with participants drawn from sleeping sickness patients in the south western HAT foci in Kenya. Quantitative data were analysed using descriptive statistics while qualitative data was analysed based on emerging themes.Socio-economic impacts included, disruption of daily activities, food insecurity, neglect of homestead, poor academic performance/school drop-outs and death. Delayed diagnosis of HAT caused 93% of the affected households to experience an increase in financial expenditure (ranging from US$ 60-170 in seeking treatment. Out of these, 81.5% experienced difficulties in raising money for treatment resorting to various ways of raising it. The coping strategies employed to deal with the increased financial expenditure included: sale of agricultural produce (64%; seeking assistance from family and friends (54%; sale/lease of family assets (22%; seeking credit (22% and use of personal savings (17%.Coping strategies outlined in this study impacted negatively on the affected households leading to further food insecurity and impoverishment. Calculation of the true burden of disease needs to go beyond incidence, mortality and morbidity rates to capture socio-economic variables entailed in seeking treatment and coping strategies of HAT

  4. Analysis of Informationization Construction of Business Financial Management under the Network Economy

    Science.gov (United States)

    Dong, Yahui; Zhang, Pengwei; Li, Wei

    To strengthen the informationization construction of the financial management has great significance to the achievement of business management informationization, and under the network economic environment, it is an important task of the financial management that how to conduct informationization construction of traditional financial management to provide true, reliable and complete financial information system for the business managers. This paper thoroughly researches the problem of financial information orientation management (FIOM) by taking the method of combining theory with practice. This paper puts forward the thinking method of financial information management, makes the new contents of E-finance. At last, this paper rebuilds the system of finance internal control from four aspects such as control of organization and management, system development control and safety control of network system.

  5. Financialization and financial profit

    Directory of Open Access Journals (Sweden)

    Arturo Guillén

    2014-09-01

    Full Text Available This article starts from the critical review of the concept of financial capital. I consider it is necessary not to confuse this category with of financialization, which has acquired a certificate of naturalization from the rise of neoliberalism. Although financial monopoly-financial capital is the hegemonic segment of the bourgeoisie in the major capitalist countries, their dominance does not imply, a fortiori, financialization of economic activity, since it depends of the conditions of the process reproduction of capital. The emergence of joint stock companies modified the formation of the average rate of profit. The "promoter profit" becomes one of the main forms of income of monopoly-financial capital. It is postulated that financial profit is a kind of "extraordinary surplus-value" which is appropriated by monopoly-financial capital by means of the monopolistic control it exerts on the issue and circulation of fictitious capital.

  6. Fiscal Policy Problems Under Conditions Of Financial Liberalization

    Directory of Open Access Journals (Sweden)

    Valentina Urazayeva

    2014-01-01

    Full Text Available The article under the title deals with the difficulties in pursuing national fiscal policy in conditions of international financial liberalization. The author analyzes the nature of liberalization of international capital flows and its positive and negative consequences for the economies of the countries which participate in global capital movement. The author especially highlights the fact that international financial liberalization often leads to economic crises and what is even more important to their rapid spread between countries due to their growing financial interdependence. The author distinguishes two groups of fiscal policy problems in conditions of international financial liberalization. The first group includes problems arising due to quick spread of the crises due to eliminating restrictions on crossborder capital flows. These are reduction in taxes and at the same time increase in budget spending, which often happens unexpectedly and substantially impedes fiscal policy. To illustrate these points the author refers to the statistics on Spain, the USA and the OECD as a whole. Moreover countries face another range of problems regardless of the business cycle phase. In the short term it is the necessity of large scale structural economic reforms to achieve the required level of financial liberalization, which often is a heavy burden on the state budget. In the long term the attention is paid to the problem of tax competition between countries, which affects the instruments of fiscal policy. The author notes that the negative consequences of global financial liberalization are relevant not only for recipient countries but for donor countries as well and emphasizes such a burning issue as "capital flight".

  7. FISCAL POLICY PROBLEMS UNDER CONDITIONS OF FINANCIAL LIBERALIZATION

    Directory of Open Access Journals (Sweden)

    Valentina Urazayeva

    2014-01-01

    Full Text Available The article under the title deals with the difficulties in pursuing national fiscal policy in conditions of international financial liberalization. The author analyzes the nature of liberalization of international capital flows and its positive and negative consequences for the economies of the countries which participate in global capital movement. The author especially highlights the fact that international financial liberalization often leads to economic crises and what is even more important to their rapid spread between countries due to their growing financial interdependence. The author distinguishes two groups of fiscal policy problems in conditions of international financial liberalization. The first group includes problems arising due to quick spread of the crises due to eliminating restrictions on crossborder capital flows. These are reduction in taxes and at the same time increase in budget spending, which often happens unexpectedly and substantially impedes fiscal policy. To illustrate these points the author refers to the statistics on Spain, the USA and the OECD as a whole. Moreover countries face another range of problems regardless of the business cycle phase. In the short term it is the necessity of large scale structural economic reforms to achieve the required level of financial liberalization, which often is a heavy burden on the state budget. In the long term the attention is paid to the problem of tax competition between countries, which affects the instruments of fiscal policy. The author notes that the negative consequences of global financial liberalization are relevant not only for recipient countries but for donor countries as well and emphasizes such a burning issue as "capital flight".

  8. Corporate governance structure and firm’ financial performance: Evidences from Egypt

    Directory of Open Access Journals (Sweden)

    Mohammed M. Soliman

    2014-01-01

    Full Text Available Recent financial international scandals have generated hyped interest in the area of corporate governance as a mean to mitigate financial problems faced in developing nations. The purpose of this study is to examine the link between corporate governance structure and firm’ financial performance in Egypt. The data for analysis are gathered from manual review of the financial statements and websites of the thirty enterprises that make up the (EGX 30 covering the four years period 2007-2010. Results from the study indicate that board size; the presence of audit committee; and audit quality significantly have relationship with firm’ financial performance measured by ROA and ROE. The results also, indicate that board independence; and institutional ownership have no significant correlation with firm’ financial performance. For CEO duality, the results indicate that CEO duality has a positive impact upon companies’ financial performance measured by ROE, at the same time, is not correlated with the ROA measure of financial performance. This study is important because it offers evidence on the impact of corporate governance structure on firm financial performance. In addition, it provides useful information that is of great value to policy makers, academics and other stakeholders.

  9. Benefits Access for College Completion: Innovative Approaches to Meet the Financial Needs of Low-Income Students

    Science.gov (United States)

    Center for Postsecondary and Economic Success, 2014

    2014-01-01

    Benefits Access for College Completion (BACC) was designed to help colleges develop new policies that increase low-income students' access to public benefits, easing their financial burden to allow them to finish school and earn postsecondary credentials. Colleges participating in BACC have developed and institutionalized scalable, sustainable…

  10. An agent-based approach to financial stylized facts

    Science.gov (United States)

    Shimokawa, Tetsuya; Suzuki, Kyoko; Misawa, Tadanobu

    2007-06-01

    An important challenge of the financial theory in recent years is to construct more sophisticated models which have consistencies with as many financial stylized facts that cannot be explained by traditional models. Recently, psychological studies on decision making under uncertainty which originate in Kahneman and Tversky's research attract a lot of interest as key factors which figure out the financial stylized facts. These psychological results have been applied to the theory of investor's decision making and financial equilibrium modeling. This paper, following these behavioral financial studies, would like to propose an agent-based equilibrium model with prospect theoretical features of investors. Our goal is to point out a possibility that loss-averse feature of investors explains vast number of financial stylized facts and plays a crucial role in price formations of financial markets. Price process which is endogenously generated through our model has consistencies with, not only the equity premium puzzle and the volatility puzzle, but great kurtosis, asymmetry of return distribution, auto-correlation of return volatility, cross-correlation between return volatility and trading volume. Moreover, by using agent-based simulations, the paper also provides a rigorous explanation from the viewpoint of a lack of market liquidity to the size effect, which means that small-sized stocks enjoy excess returns compared to large-sized stocks.

  11. Economic burden of gastrointestinal cancer under the protection of the New Rural Cooperative Medical Scheme in a region of rural China with high incidence of oesophageal cancer: cross-sectional survey.

    Science.gov (United States)

    Li, Xiang; Cai, Hong; Wang, Chaoyi; Guo, Chuanhai; He, Zhonghu; Ke, Yang

    2016-07-01

    To evaluate the financial burden of oesophageal cancer under the protection of the new Rural Cooperative Medical Scheme (NCMS) and to provide evidence and suggestions to policymakers in a high-incidence region in China. We analysed inpatient claim data for oesophageal cancer, gastric cancer and colorectal cancer from 1 January to 31 December 2013. The data were extracted from the NCMS management system of Hua County, Henan Province, a typical high-risk region for oesophageal cancer in China. Cancer-specific health economic indicators were calculated to evaluate the financial burden under the protection of the local NCMS. The total cost of oesophageal cancer was 2.7-3.6 times higher than that of gastric cancer and colorectal cancer, respectively, due to high incidence of oesophageal cancer. For each hospitalisation to treat oesophageal cancer, the average total cost and out-of-pocket expenses after reimbursement equalled an entire year's gross domestic product per capita and per capita disposable income, respectively, for the local area. The average total cost per hospitalisation for oesophageal cancer increased monotonically with hospital level for surgical hospitalisations, and it increased more rapidly for non-surgical hospitalisations (from $301 to $2589, 860%) than for gastric cancer (from $289 to $1453, 503%) and colorectal cancer (from $359 to $1610, 448%). Vulnerable groups with less access to high-level hospitals were found in different gender and age groups. Oesophageal cancer imposes serious financial burdens on communities and patients' households in this high-incidence region, and no preferential policy from the local NCMS has been designed to address this issue. A special supportive policy should be developed on the basis of local disease profiles and population characteristics to alleviate the financial burden of populations at high risk for certain high-cost diseases. © 2016 John Wiley & Sons Ltd.

  12. Financial Bubbles, Real Estate Bubbles, Derivative Bubbles, and the Financial and Economic Crisis

    Science.gov (United States)

    Sornette, Didier; Woodard, Ryan

    The financial crisis of 2008, which started with an initially well-defined epicenter focused on mortgage backed securities (MBS), has been cascading into a global economic recession, whose increasing severity and uncertain duration has led and is continuing to lead to massive losses and damage for billions of people. Heavy central bank interventions and government spending programs have been launched worldwide and especially in the USA and Europe, with the hope to unfreeze credit and bolster consumption. Here, we present evidence and articulate a general framework that allows one to diagnose the fundamental cause of the unfolding financial and economic crisis: the accumulation of several bubbles and their interplay and mutual reinforcement have led to an illusion of a "perpetual money machine" allowing financial institutions to extract wealth from an unsustainable artificial process. Taking stock of this diagnostic, we conclude that many of the interventions to address the so-called liquidity crisis and to encourage more consumption are ill-advised and even dangerous, given that precautionary reserves were not accumulated in the "good times" but that huge liabilities were. The most "interesting" present times constitute unique opportunities but also great challenges, for which we offer a few recommendations.

  13. THE IMPACT OF THE GLOBAL FINANCIAL CRISIS ON ALGERIAN ECONOMY

    Directory of Open Access Journals (Sweden)

    Zeyneb GUELLIL

    2015-04-01

    Full Text Available The Global Economic Crisis and 2008 financial crisis, is considered by many economists the worst financial crisis since the Great Depression of the 1930s , The financial crisis, brewing for a while, really started to show its effects in the middle of 2007 and into 2008. It is a situation where macro indicator like economic growth rate fall in most countries across the world. “Although economists largely failed to predict this global economic seismic shock, they have since made up for their oversight by generating a large and growing literature explaining the crisis.” In this discussion paper explores what happened and what issues arise from the Global Financial Crisis on the global economy and the Algerian economic in particular.

  14. The Effects of Financial Education on Impulsive Decision Making.

    Directory of Open Access Journals (Sweden)

    William B DeHart

    Full Text Available Delay discounting, as a behavioral measure of impulsive choice, is strongly related to substance abuse and other risky behaviors. Therefore, effective techniques that alter delay discounting are of great interest. We explored the ability of a semester long financial education course to change delay discounting. Participants were recruited from a financial education course (n = 237 and an abnormal psychology course (n = 80. Both groups completed a delay-discounting task for $100 during the first two weeks (Time 1 of the semester as well as during the last two weeks (Time 2 of the semester. Participants also completed a personality inventory and financial risk tolerance scale both times and a delay-discounting task for $1,000 during Time 2. Delay discounting decreased in the financial education group at the end of the semester whereas there was no change in delay discounting in the abnormal psychology group. Financial education may be an effective method for reducing delay discounting.

  15. The Effects of Financial Education on Impulsive Decision Making.

    Science.gov (United States)

    DeHart, William B; Friedel, Jonathan E; Lown, Jean M; Odum, Amy L

    2016-01-01

    Delay discounting, as a behavioral measure of impulsive choice, is strongly related to substance abuse and other risky behaviors. Therefore, effective techniques that alter delay discounting are of great interest. We explored the ability of a semester long financial education course to change delay discounting. Participants were recruited from a financial education course (n = 237) and an abnormal psychology course (n = 80). Both groups completed a delay-discounting task for $100 during the first two weeks (Time 1) of the semester as well as during the last two weeks (Time 2) of the semester. Participants also completed a personality inventory and financial risk tolerance scale both times and a delay-discounting task for $1,000 during Time 2. Delay discounting decreased in the financial education group at the end of the semester whereas there was no change in delay discounting in the abnormal psychology group. Financial education may be an effective method for reducing delay discounting.

  16. Weathering the financial storm: The importance of fundamentals and flexibility

    DEFF Research Database (Denmark)

    Ólafsson, Tjörvi; Pétursson, Thórarinn G.

    The recent global financial tsunami has had economic consequences that have not been witnessed since the Great Depression. But while some countries suffered a particularly large contraction in economic activity on top of a system-wide banking and currency collapse, others came off relatively ligh...... in determining the economic impact of the crisis and, in particular, that countries with sound fundamentals and flexible economic frameworks were better able to weather the financial storm....

  17. Evaluation of risk management and financial performance of BMW Group

    OpenAIRE

    Mysina, Amira

    2017-01-01

    Effective risk and financial management possess a great challenge for the multinational companies operating globally. Despite the increasing development of diverse hedging strategies against foreign exchange risk, global firms cannot fully foresee and measure the degree of the impact of foreign currency fluctuations. This paper aims to evaluate the exchange risk management and financial performance of the BMW Group from the year 2005 to 2016. Moreover, this paper is devoted to provide explana...

  18. Public hospitals in financial distress: Is privatization a strategic choice?

    Science.gov (United States)

    Ramamonjiarivelo, Zo; Weech-Maldonado, Robert; Hearld, Larry; Menachemi, Nir; Epané, Josué Patien; O'Connor, Stephen

    2015-01-01

    As safety net providers, public hospitals operate in more challenging environments than private hospitals. Such environments put public hospitals at greater risk of financial distress, which may result in privatization and deterioration of the safety net. The purpose of this study was to investigate whether financial distress is associated with privatization among public hospitals. We used panel data merged from the American Hospital Association Annual Survey, Medicare Cost Reports, Area Resource File, and Local Area Unemployment Statistics. Our study population consisted of all U.S. nonfederal acute care public hospitals in 1997 tracked through 2009, resulting in 6,426 hospital-year observations. The dependent variable "privatization" was defined as conversion from public status to either private not-for-profit or private for-profit status. The main independent variable, "financial distress," was based on the Altman Z-score methodology. Control variables included market and organizational factors. Two random-effects logistic regression models with state and year fixed-effects were constructed. The independent and control variables were lagged by 1 year and 2 years for Models 1 and 2, respectively. Public hospitals in financial distress had greater odds of being privatized than public hospitals not in financial distress: (OR = 4.53, p resources and may provide financial relief to government entities from the burden of continuously funding a hospital operating at a loss, which in turn may help keep the hospital open and preserve access to care for the community. Privatizing a financially distressed public hospital may be a better strategic alternative than closure. The Altman Z-score could be used as a managerial tool to monitor hospitals' financial condition and take corrective actions.

  19. Breaking Bad Habits: Navigating the Financial Crisis

    Science.gov (United States)

    Jones, Dennis; Wellman, Jane

    2010-01-01

    The "Great Recession" of 2009 has brought an unprecedented level of financial chaos to public higher education in America. Programs are being reduced, furloughs and layoffs are widespread, class sizes are increasing, sections are being cut, and students can't get into classes needed for graduation. Reports of budget cuts in public…

  20. RESEARCH OF PROCESS OF FINANCIAL MONITORING ORGANIZING IN BANKS

    Directory of Open Access Journals (Sweden)

    Viktoriia Kovalenko

    2017-03-01

    Full Text Available The article aims to study methods and tools for financial monitoring by banks. It is proved that one of the main global financial problems in recent years is increasing number of cases of banks participating in the money laundering. It causes banks huge losses, undermines the credibility of honest depositors, in addition, circulation of funds like these hurts the national economy. The article is to develop recommendations to improve the effectiveness of financial monitoring in banks. It is proved that the current model of the national financial monitoring system includes the following elements: the purpose of macroeconomic and microeconomic levels; principles; function; facilities; subjects; types of financial monitoring; methods of implementation and regulatory prevue regulation. It is proved that the major problems related to the financial monitoring of banks are the following: lack of legislatively established quality requirements of customer information; persons engaged in legalization of illegal incomes are highly qualified, which greatly facilitates them through the bank of suspicious transactions; the process of settlement bank failure in the conduct of questionable transactions. Keywords: financial monitoring, suspicious transactions, bank, money laundering, financing of terrorism.

  1. EVALUATION OF FINANCIAL PERFORMANCE OF UNIVERSITY HOSPITALS BY RATIO ANALYSIS METHOD

    Directory of Open Access Journals (Sweden)

    Ferda BÜLÜÇ

    2017-09-01

    Full Text Available This study aims to evaluate the financial performances of public university hospitals in Turkey; make contribution to the related literature in accordance with the findings and develop recommendations for the decision makers. Within the scope of the study, financial statements of revolving fund of the 43 public university hospitals for the years of 2013, 2014 and 2015 were obtained from the Ministry of Finance General Directorate of Public Accounts. Financial statements were evaluated by ratio analysis method. After analysing, it has been reached that the burden of debt of the hospitals were high,  they have been experiencing the problem of paying short term debts, stock turnover rates and turnover rates were low and the incomes of the hospitals can not cover their expenses. It is recomended that hospitals should use resources more efficiently and decision makers should consider education and research activities in budget allocation to university hospitals.

  2. Burden control by artificial intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Saxen, H.; Nikus, M. [Aabo Akademi, Turku (Finland). Heat Engineering Lab.

    1998-07-01

    The burden distribution plays an important role for the fuel economy of the blast furnace. By an appropriate burden distribution, the operation of the furnace is smooth and the gas is utilized well, the burden descends steadily and the wear of the lining is minimal. Since it is very difficult to obtain reliable information about the burden distribution in operating blast furnaces, this research project developed methods for interpretation of burden and gas distribution in the shaft mainly based on temperature measurements from above-burden probes.

  3. The Financial Burden of Non-Communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures.

    Science.gov (United States)

    Janssens, Wendy; Goedecke, Jann; de Bree, Godelieve J; Aderibigbe, Sunday A; Akande, Tanimola M; Mesnard, Alice

    2016-01-01

    Better insights into health care utilization and out-of-pocket expenditures for non-communicable chronic diseases (NCCD) are needed to develop accessible health care and limit the increasing financial burden of NCCDs in Sub-Saharan Africa. A household survey was conducted in rural Kwara State, Nigeria, among 5,761 individuals. Data were obtained using biomedical and socio-economic questionnaires. Health care utilization, NCCD-related health expenditures and distances to health care providers were compared by sex and by wealth quintile, and a Heckman regression model was used to estimate health expenditures taking selection bias in health care utilization into account. The prevalence of NCCDs in our sample was 6.2%. NCCD-affected individuals from the wealthiest quintile utilized formal health care nearly twice as often as those from the lowest quintile (87.8% vs 46.2%, p = 0.002). Women reported foregone formal care more often than men (43.5% vs. 27.0%, p = 0.058). Health expenditures relative to annual consumption of the poorest quintile exceeded those of the highest quintile 2.2-fold, and the poorest quintile exhibited a higher rate of catastrophic health spending (10.8% among NCCD-affected households) than the three upper quintiles (4.2% to 6.7%). Long travel distances to the nearest provider, highest for the poorest quintile, were a significant deterrent to seeking care. Using distance to the nearest facility as instrument to account for selection into health care utilization, we estimated out-of-pocket health care expenditures for NCCDs to be significantly higher in the lowest wealth quintile compared to the three upper quintiles. Facing potentially high health care costs and poor accessibility of health care facilities, many individuals suffering from NCCDs-particularly women and the poor-forego formal care, thereby increasing the risk of more severe illness in the future. When seeking care, the poor spend less on treatment than the rich, suggestive of lower

  4. The Great Cross-Border Bank Deleveraging: Supply Constraints and Intra-Group Frictions

    NARCIS (Netherlands)

    Cerutti, E.; Claessens, S.

    2014-01-01

    International banks greatly reduced their direct cross-border and local affiliates’ lending as the global financial crisis strained balance sheets, lowered borrower demand, and changed government policies. Using bilateral, lender-borrower countrydata and controlling for credit demand, we show that

  5. The Impact of the Great Recession on Midlife and Older parents of Individuals With a Mental Health Problem or a Developmental Disability.

    Science.gov (United States)

    Song, Jieun; Mailick, Marsha R; Greenberg, Jan S

    2017-03-13

    Parents of sons and daughters with disabilities have ongoing financial burdens and vulnerability due to the demands of caregiving responsibilities and their related direct and indirect costs. This study aims to investigate whether midlife and older parents of individuals with a mental health problem or a developmental disability were particularly vulnerable to the impact of the recession. The data were drawn from Midlife in the United States (MIDUS), a longitudinal survey of a national probability sample in the United States, Waves II (2004-2006) and III (2013-2014; 84 parents of individuals with a mental health problem, 98 parents of individuals with a developmental disability, and 2,029 parents of individuals without any conditions as a comparison group). The findings suggest that the midlife and older parents whose son or daughter had a mental health problem experienced more recession impacts than comparison parents, even after controlling prerecession financial status and sociodemographic characteristics. The results indicate the need for policies that provide effective financial support and reduce restrictions on health service access in order to relieve the financial burden experienced by midlife and older parents of individuals with a mental health problem. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Stable financial inclusion: Recovering the Salvadoran Rurality

    Directory of Open Access Journals (Sweden)

    Héctor David Córdova

    2013-06-01

    Full Text Available This article approaches a topic of great significance for the Salvadorian financial sector, as well as for the whole population, especially that in the rural areas of this country.  This article refers, in terms of their institutional evolution, the stages the Federation of Cooperative Associations of Savings and Credit of El Salvador FEDECACES DE R.L has lived through in its development.  In this work an analysis of the process of financial inclusion that has been undertaken by FEDECACES is shown, as well as the impact achieved in the country, specially in the rural areas, which lacked financial entities able to offer this type of service with the stability and guarantee that the cooperatives affiliated to the Federation bring today.  The work carried out is sustained on an analysis of the main financial variables of base cooperatives as well as of the sustained membership increase in these entities. This demonstrates the quality of the services they offer, shown by the level of satisfaction of the population, to whom they are addressed.

  7. A Study of the BRICS Bank from the Perspective of Global Financial Governance

    Directory of Open Access Journals (Sweden)

    Bo Peng

    2014-12-01

    Full Text Available The transition of the global financial governance system is a history of the rise and fall of the Western advanced countries in the post-war international political and economic system. Since the end of the Second World War, the International Monetary Foundation and the World Bank have always taken the dominant role in the field of global financial governance. However, after the beginning of the global financial crisis in 2008, many drawbacks have become apparent concerning these two significant institutions, such as the lack of representatives, the slow and ineffective response to the crisis, etc. Following a strong appeal from the developing countries (with the emerging powers as their representatives, the global financial governance system has experienced several rounds of reforms which have yet to yield acceptable results. Therefore, it is highly necessary to create a new institution which can play a complementary role in the existing financial governance system rather than overthrow it. Complying with the tide of history, the official establishment of the BRICS Bank can be of great significance to the reform of current global financial governance systems such as diversifying the global financial governance bodies, representing the interests of developing countries in a better way, enhancing the status and improving the importance of emerging economies in the international political and economic order. Admittedly, the BRICS Bank also faces great challenges and limits such as the lack of a core leadership and the absence of a unified currency, etc.

  8. An exploration of caregiver burden for children with nodding syndrome (lucluc) in Northern Uganda.

    Science.gov (United States)

    Nakigudde, Janet; Mutamba, Byamah Brian; Bazeyo, William; Musisi, Seggane; James, Okello

    2016-07-22

    Caregivers of patients with chronic illnesses are often uncompensated for work that is physically demanding, time consuming and emotionally and economically draining. This is particularly true for caregivers of children with nodding syndrome, an emergent neurological disorder of unknown etiology in resource poor settings in Africa. We aimed to explore perceptions of caregivers regarding challenges that a typical caregiver faces when caring for a child with nodding syndrome. We used a qualitative exploratory study design with focus group discussions and in-depth interviews to collect data. We analyzed data using the qualitative analysis software package of NVivo and thematic query building. Emergent themes centered on burden of care with emotional agony as the most prominent. Subthemes reflecting the burden of care giving included child and caregiver safety concerns, burnout, social isolation and rejection, and homicidal ideation. Caregivers also complained of physical and financial constraints associated with the care of children with nodding syndrome. The findings point to a high burden of care for caregivers of children with nodding syndrome and suggests the need to incorporate community-based psychosocial and mental health care services for the caregivers of affected children into the national health system response.

  9. Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia.

    Directory of Open Access Journals (Sweden)

    Felix Masiye

    Full Text Available Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities.Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE experienced by households.Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence.Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of

  10. Approaches to Refining Estimates of Global Burden and Economics of Dengue

    Science.gov (United States)

    Shepard, Donald S.; Undurraga, Eduardo A.; Betancourt-Cravioto, Miguel; Guzmán, María G.; Halstead, Scott B.; Harris, Eva; Mudin, Rose Nani; Murray, Kristy O.; Tapia-Conyer, Roberto; Gubler, Duane J.

    2014-01-01

    Dengue presents a formidable and growing global economic and disease burden, with around half the world's population estimated to be at risk of infection. There is wide variation and substantial uncertainty in current estimates of dengue disease burden and, consequently, on economic burden estimates. Dengue disease varies across time, geography and persons affected. Variations in the transmission of four different viruses and interactions among vector density and host's immune status, age, pre-existing medical conditions, all contribute to the disease's complexity. This systematic review aims to identify and examine estimates of dengue disease burden and costs, discuss major sources of uncertainty, and suggest next steps to improve estimates. Economic analysis of dengue is mainly concerned with costs of illness, particularly in estimating total episodes of symptomatic dengue. However, national dengue disease reporting systems show a great diversity in design and implementation, hindering accurate global estimates of dengue episodes and country comparisons. A combination of immediate, short-, and long-term strategies could substantially improve estimates of disease and, consequently, of economic burden of dengue. Suggestions for immediate implementation include refining analysis of currently available data to adjust reported episodes and expanding data collection in empirical studies, such as documenting the number of ambulatory visits before and after hospitalization and including breakdowns by age. Short-term recommendations include merging multiple data sources, such as cohort and surveillance data to evaluate the accuracy of reporting rates (by health sector, treatment, severity, etc.), and using covariates to extrapolate dengue incidence to locations with no or limited reporting. Long-term efforts aim at strengthening capacity to document dengue transmission using serological methods to systematically analyze and relate to epidemiologic data. As promising tools

  11. Evolution of tolerance by magpies to brood parasitism by great spotted cuckoos.

    Science.gov (United States)

    Soler, J J; Martín-Gálvez, D; Martínez, J G; Soler, M; Canestrari, D; Abad-Gómez, J M; Møller, A P

    2011-07-07

    Hosts may use two different strategies to ameliorate negative effects of a given parasite burden: resistance or tolerance. Although both resistance and tolerance of parasitism should evolve as a consequence of selection pressures owing to parasitism, the study of evolutionary patterns of tolerance has traditionally been neglected by animal biologists. Here, we explore geographical covariation between tolerance of magpies (Pica pica) and brood parasitism by the great spotted cuckoo (Clamator glandarius) in nine different sympatric populations. We estimated tolerance as the slope of the regression of number of magpie fledglings (i.e. host fitness) on number of cuckoo eggs laid in non-depredated nests (which broadly equals parasite burden). We also estimated prevalence of parasitism and level of host resistance (i.e. rejection rates of mimetic model eggs) in these nine populations. In accordance with the hypothetical role of tolerance in the coevolutionary process between magpies and cuckoos we found geographical variation in tolerance estimates that positively covaried with prevalence of parasitism. Levels of resistance and tolerance were not associated, possibly suggesting the lack of a trade-off between the two kinds of defences against great spotted cuckoo parasitism for magpies. We discuss the results in the framework of a mosaic of coevolutionary interactions along the geographical distribution of magpies and great spotted cuckoos for which we found evidence that tolerance plays a major role.

  12. Setting priorities for the health care sector in Zimbabwe using cost-effectiveness analysis and estimates of the burden of disease

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Chapman, Glyn

    2008-01-01

    Background: This study aimed at providing information for priority setting in the health care sector of Zimbabwe as well as assessing the efficiency of resource use. A general approach proposed by the World Bank involving the estimation of the burden of disease measured in Disability-Adjusted Life...... a combination of step-down and micro-costing was applied. Effectiveness of health interventions was estimated based on published information on the efficacy adjusted for factors such as coverage and compliance. Results: Very cost-effective interventions were available for the major health problems. Using...... estimates of the burden of disease, the present paper developed packages of health interventions using the estimated cost-effectiveness ratios. These packages could avert a quarter of the burden of disease at total costs corresponding to one tenth of the public health budget in the financial year 1997...

  13. Financial markets theory equilibrium, efficiency and information

    CERN Document Server

    Barucci, Emilio

    2017-01-01

    This work, now in a thoroughly revised second edition, presents the economic foundations of financial markets theory from a mathematically rigorous standpoint and offers a self-contained critical discussion based on empirical results. It is the only textbook on the subject to include more than two hundred exercises, with detailed solutions to selected exercises. Financial Markets Theory covers classical asset pricing theory in great detail, including utility theory, equilibrium theory, portfolio selection, mean-variance portfolio theory, CAPM, CCAPM, APT, and the Modigliani-Miller theorem. Starting from an analysis of the empirical evidence on the theory, the authors provide a discussion of the relevant literature, pointing out the main advances in classical asset pricing theory and the new approaches designed to address asset pricing puzzles and open problems (e.g., behavioral finance). Later chapters in the book contain more advanced material, including on the role of information in financial markets, non-c...

  14. Patients Undergoing Radiation Therapy Are at Risk of Financial Toxicity: A Patient-based Prospective Survey Study.

    Science.gov (United States)

    Palmer, Joshua D; Patel, Tejash T; Eldredge-Hindy, Harriet; Keith, Scott W; Patel, Tapas; Malatesta, Theresa; DiNome, Jessie; Lowther, Anne; Ferguson, Linda; Wagenborg, Sally; Smyles, John; Babaria, Usha; Stabile, Richard; Gressen, Eric; Rudoler, Shari; Fisher, Scot A

    2018-06-01

    Little is known about the financial burden experienced by patients receiving radiation therapy. Furthermore, currently, no financial toxicity screening tools have been validated for use in radiation oncology. Physician surveys were used to gauge provider understanding of treatment costs and their willingness to adopt the use of financial toxicity screening tools. Post-treatment patient surveys were used to investigate the covariates of treatment-induced financial risk. Of the 210 radiation oncologists who completed our survey, 53% reported being "very concerned" with treatment-related costs negatively affecting their patients, and 80% believed that a financial toxicity screening tool would be useful in practice. An analysis of patient surveys using logistic regression found age and cancer site to be the most important variables associated with financial toxicity. Thirty-four patients (22%) experienced financial toxicity related to treatment. The financial toxicities experienced were loss of job (28%), loss of income (24%), difficulty paying their rent or mortgage (20%), difficulty paying for transportation (15%), and difficulty paying for meals (13%). Financial toxicity is an important measure for patients and providers and is experienced by approximately one quarter of patients. Further studies to improve models to predict financial toxicity and how financial toxicity is related to patient outcomes and quality of life are warranted. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. The Financial Coaching Advice Model: An Exploration into how it Satisfies Expectations of Quality Advice

    Directory of Open Access Journals (Sweden)

    Julie Knutsen

    2012-11-01

    Full Text Available For 20 years, the financial planning sector in Australia has been transitioning from a sales-orientated force to aprofession of qualified and skilled practitioners. Today, the potential for professional financial planning adviceto benefit Australians financially, economically and psychologically is recognised by government. Financially,these benefits include increased savings, less interest expense through faster debt reduction, higher investmentreturns and appropriate levels of insurance. Economically, a more financially literate society has the potentialfor less reliance on an already burdened social security system. Psychologically, the benefits include the peaceof mind that comes from an individual being confident in financial matters. However, despite this level ofrecognition and development, national surveys have reported that only a small percentage of the populationactually seek professional financial advice. The factors attributing to these low percentages included the gapsin financial literacy limiting an individual’s engagement in financial matters and consumer’s current mistrust ofthe financial advice business models that remain dominated by commission-driven product sales. Thesedeficiencies have led some financial planning firms to break from financial product sales as the primary advicemodel and focus on financial coaching. Exploratory interviews with the practitioners and clients of a selectedfinancial planning firm have generated insightful discussion into how a financial coaching advice model isachieving the financial, economic and psychological benefits recognised by government as the potentialoutcomes of professional financial advice. The aim of this paper is to present the findings from that discussionand demonstrate the opportunities embedded within a financial coaching advice model. It is argued that thisdiscussion offers a foundation for future research direction in an area currently under researched in

  16. CONSIDERATIONS REGARDING FINANCIAL STABILITY

    Directory of Open Access Journals (Sweden)

    MERCEA PATRICIA AMALIA

    2018-02-01

    target digital coin concepts, use in distributed real-time payment systems of blockchain technologology, artificial intelligence, and information security. However, a large number of economists admit that the current crisis has emphasized the overcoming of the limits of (mainstream economics and its implications in the field of financial regulation and the sphere of monetary policy that should focus not only on price stability, but also on financial stability. In other words, the banks, the financial institutions must be obliged to hold a minimal countercyclical capital and mandatory reserves that should be large enough to cope with the turmoil generated by the decrease of the asset prices and the liquidity risk. In macroprudential policy, the “shadow banking system” (investment banks, hedge funds, private equity funds must also be included.Last but not least, the central banks have to cooperate with the other categories of systemic risk managers: Financial Stability Oversight Council-FSOC (USA, European Systemic Risk Board-ESRB (EU, Financial Policy Committee-FPC (Great Britain, National Committee for Financial Stability-CNSF (Romania.

  17. MONETARY POLICY ADJUSTMENT AT THE GLOBAL FINANCIAL CRISIS CONSTRAINTS

    Directory of Open Access Journals (Sweden)

    Adina Criste

    2014-12-01

    Full Text Available The global financial crisis marked a border for central banks, as it raised challenges which constrained them both to extend the range of monetary policy instruments and to redefine their role in the financial system. The present paper aims to identify features of conducting the monetary policy of some central banks, during and after the global financial crisis outbreak. For that purpose, we apply to a comparative analysis between some central banks of European Union (EU, namely Czech National Bank (CNB, National Bank of Hungary (NBH, National Bank of Poland (NBP and National Bank of Romania (NBR. We also assume that the monetary policy could be characterised through both the challenges faced by the central banks and the type of measures adopted, as a reaction to these challenges. Analysis shows that central banks have different levels of burden, according to domestic condition, and also different ”pattern” of monetary policy adjustments, using more or less unconventional or macro-prudential measures. An important conclusion raised from this article refers to the increasing role of these special measures for central banks, which requires defining a new monetary policy framework in the near future.

  18. Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh.

    Science.gov (United States)

    Alfonso, Natalia Y; Alonge, Olakunle; Hoque, Dewan Md Emdadul; Baset, Kamran Ul; Hyder, Adnan A; Bishai, David

    2017-04-29

    This study provides a comprehensive review of the care-seeking patterns and direct economic burden of injuries from the victims' perspective in rural Bangladesh using a 2013 household survey covering 1.17 million people. Descriptive statistics and bivariate analyses were used to derive rates and test the association between variables. An analytic model was used to estimate total injury out-of-pocket (OOP) payments and a multivariate probit regression model assessed the relationship between financial distress and injury type. Results show non-fatal injuries occur to 1 in 5 people in our sample per year. With average household size of 4.5 in Bangladesh--every household has an injury every year. Most non-fatally injured patients sought healthcare from drug sellers. Less than half of fatal injuries sought healthcare and half of those with care were hospitalized. Average OOP payments varied significantly (range: $8-$830) by injury type and outcome (fatal vs. non-fatal). Total injury OOP expenditure was $$355,795 and $5000 for non-fatal and fatal injuries, respectively, per 100,000 people. The majority of household heads with injuries reported financial distress. This study can inform injury prevention advocates on disparities in healthcare usage, OOP costs and financial distress. Reallocation of resources to the most at risk populations can accelerate reduction of preventable injuries and prevent injury related catastrophic payments and impoverishment.

  19. Financial Literacy, Financial Education, and Economic Outcomes

    Science.gov (United States)

    Hastings, Justine S.; Madrian, Brigitte C.; Skimmyhorn, William L.

    2013-01-01

    In this article, we review the literature on financial literacy, financial education, and consumer financial outcomes. We consider how financial literacy is measured in the current literature and examine how well the existing literature addresses whether financial education improves financial literacy or personal financial outcomes. We discuss the…

  20. The Burden of Caring for Children with Emotional or Conduct Disorders

    OpenAIRE

    Meltzer, Howard; Ford, Tamsin; Goodman, Robert; Vostanis, Panos

    2011-01-01

    Introduction. There is a paucity of evidence from epidemiological studies on the burden of children's emotional and conduct disorders on their parents. The main purpose of this study is to describe the problems experienced by parents of children with conduct and emotional disorders using data from a large national study on the mental health of children and young people in Great Britain. Materials and Methods. The Development and Well-Being Assessment and sections of the Child and Adolescent B...

  1. Trend Analysis of Betel Nut-associated Oral Cancer 
and Health Burden in China.

    Science.gov (United States)

    Hu, Yan Jia; Chen, Jie; Zhong, Wai Sheng; Ling, Tian You; Jian, Xin Chun; Lu, Ruo Huang; Tang, Zhan Gui; Tao, Lin

    To forecast the future trend of betel nut-associated oral cancer and the resulting burden on health based on historical oral cancer patient data in Hunan province, China. Oral cancer patient data in five hospitals in Changsha (the capital city of Hunan province) were collected for the past 12 years. Three methods were used to analyse the data; Microsoft Excel Forecast Sheet, Excel Trendline, and the Logistic growth model. A combination of these three methods was used to forecast the future trend of betel nut-associated oral cancer and the resulting burden on health. Betel nut-associated oral cancer cases have been increasing rapidly in the past 12  years in Changsha. As of 2016, betel nuts had caused 8,222 cases of oral cancer in Changsha and close to 25,000 cases in Hunan, resulting in about ¥5 billion in accumulated financial loss. The combined trend analysis predicts that by 2030, betel nuts will cause more than 100,000 cases of oral cancer in Changsha and more than 300,000 cases in Hunan, and more than ¥64 billion in accumulated financial loss in medical expenses. The trend analysis of oral cancer patient data predicts that the growing betel nut industry in Hunan province will cause a humanitarian catastrophe with massive loss of human life and national resources. To prevent this catastrophe, China should ban betel nuts and provide early oral cancer screening for betel nut consumers as soon as possible.

  2. Financial cost of amyotrophic lateral sclerosis: a case study.

    Science.gov (United States)

    Obermann, M; Lyon, M

    2015-03-01

    There are only a few recently published reports of the cost of amyotrophic lateral sclerosis (ALS) care in the United States. Our objectives were to: 1) report annual and disease-duration costs; 2) provide costs related to specific care and services; 3) present costs by payor; and 4) identify strategies and resources that can be offered to patients to assist with the financial burden of ALS. Over a 10-year period (2001-2010), all expenses related to the cost of care for an individual patient were collected concurrently and then analyzed in 2012. Results showed that total disease-duration costs were $1,433,992 (85% paid by insurance, 9% paid by family, 6% paid by charities). The highest costs were for in-home caregivers ($669,150), ventilation ($212,430) and hospital care ($114,558). In conclusion, this case study illustrates costs of care for ALS as a burden for patients that may impact treatment decisions. Charity organizations and insurance case-managers provide services to patients that can help reduce this burden. Costs for specific services as well as resources identified by this study offer physicians and other healthcare providers data-based cost of care information and strategies to share with their patients.

  3. Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income.

    Science.gov (United States)

    Bennett, Kevin J; Dismuke, Clara E

    2010-05-01

    High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden. The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics. Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios. Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.

  4. The household economic burden for acute coronary syndrome survivors in Australia

    Directory of Open Access Journals (Sweden)

    Karice K. Hyun

    2016-11-01

    Full Text Available Abstract Background Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. Methods Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship. Results Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614 in Australian dollars was A$258.06 (median: A$126.50 per month. The average spending for medical services was A$120.18 (SD: A$310.35 and medications was A$66.25 (SD: A$80.78. In total, 350 (51 % of patients reported experiencing economic hardship, 78 (12 % were unable to pay for medical services and 81 (12 % could not pay for medication. Younger age (18–59 vs ≥80 years (OR: 1.89, no private health insurance (OR: 2.04, pensioner concession card (OR: 1.80, residing in more disadvantaged area (group 1 vs 5 (OR: 1.77, history of CVD (OR: 1.47 and higher out-of-pocket expenses (group 4 vs 1 (OR: 4.57 were more likely to experience hardship. Conclusion Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients.

  5. The Impact of Financial Crisis in Coronary Artery Disease Burden in Greece.

    Science.gov (United States)

    Sanidas, Elias A; Papaioannou, Theodoros G; Papadopoulos, Dimitrios P; Tatsi, Konstantina; Velliou, Maria; Dalianis, Nikolaos; Paizis, Ioannis; Anastasiadis, George; Kelepesis, Glaukos; Bonou, Maria; Tsioufis, Kontantinos; Barbetseas, John

    2018-03-27

    Economic crisis poses an immense threat to public health worldwide and has been linked to cardiovascular morbidity and mortality. Greece is facing a distinctive recession over the recent years. However, the exact impact on coronary artery disease (CAD) burden has not been adequately addressed. Demographic, clinical and angiographic data of 3895 hospitalized patients were retrospectively studied. Patients were classified in those before crisis (2006-2007, n=1228) and those during crisis (2011-2015, n=2667). All data before and during crisis were compared. During crisis, patients presented with less acute coronary syndromes (ACS - 45.5% vs 39.9%, pcrisis was partially affected. Even though the incidence of ACS was decreased, more women and more patients with no or single vessel disease were led for cardiac catheterization. In addition, the prevalence of traditional risk factors for CAD did not increase except obesity confirming the "obesity paradox". It seems that the impact of traditional risk factors for CAD is not an immediate process and is somewhat related to living conditions or other exogenous and social factors. Copyright © 2018 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  6. Fluctuation behaviors of financial return volatility duration

    Science.gov (United States)

    Niu, Hongli; Wang, Jun; Lu, Yunfan

    2016-04-01

    It is of significantly crucial to understand the return volatility of financial markets because it helps to quantify the investment risk, optimize the portfolio, and provide a key input of option pricing models. The characteristics of isolated high volatility events above certain threshold in price fluctuations and the distributions of return intervals between these events arouse great interest in financial research. In the present work, we introduce a new concept of daily return volatility duration, which is defined as the shortest passage time when the future volatility intensity is above or below the current volatility intensity (without predefining a threshold). The statistical properties of the daily return volatility durations for seven representative stock indices from the world financial markets are investigated. Some useful and interesting empirical results of these volatility duration series about the probability distributions, memory effects and multifractal properties are obtained. These results also show that the proposed stock volatility series analysis is a meaningful and beneficial trial.

  7. Understanding the Great Depression: Lessons for Current Policy

    OpenAIRE

    Stephen G. Cecchetti

    1997-01-01

    Over the four years beginning in the summer of 1929, financial markets, labor markets and goods markets all virtually ceased to function. Throughout this, the government policymaking apparatus seemed helpless. Since the end of the Great Depression, macroeconomists have labored diligently in an effort to understand the circumstances that led to the wholesale collapse of the economy. What lessons can we draw from our study of these events? In this essay, I argue that the Federal Reserve played ...

  8. Cultural differences are reflected in variables associated with carer burden in FTD: a comparison study between India and Australia

    Science.gov (United States)

    Mekala, Shailaja; Alladi, Suvarna; Chandrasekar, Kammammettu; Fathima, Safiya; M.O.'Connor, Claire; McKinnon, Colleen; Hornberger, Michael; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

    2013-01-01

    There is great need to understand variables behind carer burden, especially in FTD. Carer burden is a complex construct, and its factors are likely to vary depending on the type of dementia, carer characteristics and cultural background. OBJECTIVE The present study aimed to compare profiles and severity of carer burden, depression, anxiety and stress in carers of FTD patients in India in comparison to Australia; to investigate which carer variables are associated with carer burden in each country. METHODS Data of 138 participants (69 dyads of carers-patients) from India and Australia (India, n=31; Australia, n=38). Carer burden was assessed with the short Zarit Burden Inventory; carer depression, anxiety and stress were measured with the Depression, Anxiety and Stress-21. Dementia severity was determined with the Frontotemporal Dementia Rating Scale (FTD-FRS), and a range of demographic variables regarding the carer and patient were also obtained. RESULTS Overall, levels of carer burden were not significantly different across India and Australia, despite more hours delivering care and higher dementia severity in India. Variables associated with burden, however, differed between countries, with carer depression, anxiety and stress strongly associated with burden in India. By contrast, depression, stress, and dementia severity were associated with burden in Australia. CONCLUSION This study demonstrated that variables associated with carer burden in FTD differ between cultures. Consequently, cultural considerations should be taken into account when planning for interventions to reduce burden. This study suggests that addressing carers' skills and coping mechanisms are likely to result in more efficacious outcomes than targeting patient symptoms alone. PMID:29213826

  9. A Study of the Impact of Underground Economy on Integral Tax Burden in the Proportional Growth Model under Uncertainty

    Directory of Open Access Journals (Sweden)

    Akif Musayev

    2018-01-01

    Full Text Available Economic processes are naturally characterized by imprecise and uncertain relevant information. One of the main reasons is existence of an underground economy. However, in existing works, real-world imprecision and uncertainty of economic conditions are not taken into account. In this paper we consider a problem of calculation of a taxation base to assess tax burden for proportionally growing economy under uncertainty. In order to account for imprecision and uncertainty of economic processes, we use the theory of fuzzy sets. A fuzzy integral equation is used to identify an integral tax burden taking into account the contribution of the underground economy for a certain financial (tax year. It is also assumed that dynamics of gross domestic product are modeled by fuzzy linear differential equation. An optimal value of tax burden is determined as a solution to the considered fuzzy integral equation. An example is provided to illustrate validity of the proposed study.

  10. BURDEN AND QUALITY OF LIFE– A COMPARISON OF THOSE CARING FOR PSYCHIATRICALLY ILL AND MEDICALLY ILL

    Directory of Open Access Journals (Sweden)

    Shweta Rupendu

    2018-02-01

    Full Text Available BACKGROUND Despite epidemiological transitions, communicable diseases are widely prevalent world over, concomitantly non-communicable diseases are also on the rise. Mental and behavioural disorders account for 12% of the global burden of disease. Caregiving for both groups of patients, rests with an identified primary caregiver. Caregiving lays a great deal of burden on the caregiver, adversely affecting his quality of life. These factors influence the quality of caregiving, and thereby the long-term well-being of the patient. Differences between the two groups of caregivers has not been studied, more so in the Indian context. MATERIALS AND METHODS 60 caregivers of psychiatrically ill and 63 caregivers of the medically ill were studied. Burden of care was assessed using Elmstahl burden scale, and quality of life (QOL using WHOQOL BREF. RESULTS The socio demographic profile of both groups was similar. All subjects experienced a burden of care, with those caring for the psychiatrically ill experiencing a greater burden. QOL was poorer in the care givers of the psychiatrically ill, especially in those married, employed, and in a lower income group. The female care giver, mostly the spouse, experienced a greater burden of care and a poorer QOL. CONCLUSION Chronicity, stigma, poor insight and disabling dependence of the psychiatrically ill, are probably contributory. A higher caregiver burden and a lower QOL will influence quality of caregiving, and have an adverse effect on the course and prognosis of the illness. There is thus a need for routine assessment of the caregiver, and planned intervention for the same.

  11. Chest physician-reported, work-related, long-latency respiratory disease in Great Britain.

    Science.gov (United States)

    Carder, Melanie; Darnton, Andrew; Gittins, Matthew; Stocks, S Jill; Ross, David; Barber, Chris M; Agius, Raymond M

    2017-12-01

    Much of the current burden of long-latency respiratory disease (LLRD) in Great Britain is attributed to historical asbestos exposure. However, continuing exposure to other agents, notably silica, also contributes to disease burden. The aim of this study was to investigate the incidence of work-related LLRD reported by chest physicians in Great Britain, including variations by age, gender, occupation and suspected agent.LLRD incidence and incidence rate ratios by occupation were estimated (1996-2014). Mesothelioma cases by occupation were compared with proportional mortality ratios.Cases were predominantly in men (95%) and 92% of all cases were attributed to asbestos. Annual average incidence rates (males) per 100 000 were: benign pleural disease, 7.1 (95% CI 6.0-8.2); mesothelioma, 5.4 (4.8-6.0); pneumoconiosis, 1.9 (1.7-2.2); lung cancer, 0.8 (0.6-1.0); chronic obstructive pulmonary disease (COPD), 0.3 (0.2-0.4). Occupations with a particularly high incidence of LLRD were miners and quarrymen (COPD), plumbers and gas fitters (asbestosis), and shipyard and dock workers (all other categories). There was a clear concordance between cases of SWORD mesothelioma and proportional mortality ratios by occupation.Occupationally caused LLRD continues to contribute to a significant disease burden. Many cases are attributable to past exposure to agents such as asbestos and silica, but the potential for occupational exposures persists. Copyright ©ERS 2017.

  12. The role of credit in the Great Moderation : A multivariate GARCH approach

    NARCIS (Netherlands)

    Grydaki, Maria; Bezemer, Dirk

    During the Great Moderation, financial innovation in the US increased the size and scope of credit flows supporting the growth of wealth. We hypothesize that spending out of wealth came to finance a wider range of GDP components such that it smoothed GDP. Both these trends combined would be

  13. Estimation of Influence of the Level of Financial Literacy on the Investment Attractiveness of the Territory

    Directory of Open Access Journals (Sweden)

    Ekaterina Yuryevna Sushko

    2016-03-01

    Full Text Available The article presents a regression model that reflects rational financial behavior of households and allowing to reveal regions with low/high level of financial literacy, which is one of the indicators of financial sector development. Model construction is based on a regression of financial literacy surveys data and a statistical panel data concerning socio-economic situation of 38 Volgograd region’s municipalities during three-year period. The author shows that the level of financial literacy (which used as an indicator of the situation in the financial sector of a particular municipality is not unpredictable. This level depends on objective factors: the level of demographic and social burden on the state and municipalities, the income growth of municipal budgets, the number of financial institutions, material wealth of the population, its business activity, readiness to self-help housing and interest in increasing their knowledge. Therefore, the level of financial literacy can be predicted and even adjusted by the authorities and business representatives using credit, finance, social policy, etc. Financial literacy level is useful for investment attractiveness assessment. In the given paper a ranking of territories’ attractiveness is constructed on the basis of regression model. It is created to help in developing of effective management decisions by business (opening of new branches, launching new financial products and services, etc. and by regional/municipal authorities (whose aim is to improve the quality of life and the level of financial welfare.

  14. Financial integration and financial development in transition economies: What happens during financial crises?

    Directory of Open Access Journals (Sweden)

    Igor Masten

    2011-12-01

    Full Text Available

    This paper provides an empirical analysis of the role of financial development and financial integration in the growth dynamics of transition countries. We focus on the role of financial integration in determining the impact of financial development on growth, distinguishing “normal times” from periods of financial crises. In addition to confirming the significant positive effect on growth exerted by financial development and financial integration, our estimates show that a higher degree of financial openness tends to reduce the contractionary effect of financial crises, by cushioning the effect on the domestic supply of credit. Consequently, the high reliance on international capital flows by transition countries does not necessarily increase their financial fragility. This implies that financial protectionism is a self-defeating policy, at least for transition countries.

  15. ANALYSIS OF THE MAIN STRUCTURAL CHARACTERISTICS OF THE ROMANIAN FINANCIAL SYSTEM

    Directory of Open Access Journals (Sweden)

    Marius Constantin Apostoaie

    2011-12-01

    Full Text Available To know and to understand the factors within a financial system that significantly influences the institutions behaviour and the market responses to the central bank actions is of great importance for the monetary authorities and for the achievement of their monetary policy objectives. In Romania, the National Bank must pay special attention to financial institutions given their significant role in the process of financial intermediation (bank-based system. This study aims to conduct an investigation of the main coordinates of the Romanian financial system that are relevant for the study of the monetary policy transmission mechanism. The study focuses on the following features of the Romanian financial system: financial deepening, the existence of a bank-based system, the concentration degree of the Romanian banking sector, the balance sheet structure of monetary financial institutions and the soundness of the banking system. The study also considers the effects of the recent financial market turmoil on the financial system. The span of the empirical study covers the period after 2000 but brings to the forefront the period before and after October 2008. We believe that this research provides useful information for a future analysis of the Romanian monetary policy transmission mechanism.

  16. The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.

    Science.gov (United States)

    van Randeraad-van der Zee, Carlijn H; Beurskens, Anna J H M; Swinkels, Raymond A H M; Pool, Jan J M; Batterham, Roy W; Osborne, Richard H; de Vet, Henrica C W

    2016-05-01

    To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

  17. Economic Efficiency of Selected Financial System Institutions of Local Government

    Directory of Open Access Journals (Sweden)

    Urszula Rabiej

    2014-03-01

    Full Text Available Functioning of local government units, as for as the economic sphere is concerned, is based on the financial law regulations. Those regulations aim at solving economic and social problems. The analysis of economic efficiency concerning implemented regulations is of particular importance for changing the EU’s attitude towards the influence, which EU has on functioning of the local governments. Implementing the local budgets, based on regulations which economic efficiency hasn’t been evaluated on the stage of legislation, may have a negative impact on local community and the economic situation of the country. Frequent changes of financial law cause actions, which financial effects cannot be predicted. What is more, those unstable regulations make it impossible to plan essential parts of a budget in a right way. That has a great importance in terms of correctness of long-term financial perspectives of the local government units.

  18. Out-of-pocket Cost Burden in Pediatric Inflammatory Bowel Disease: A Cross-sectional Cohort Analysis.

    Science.gov (United States)

    Sin, Aaron T; Damman, Jennifer L; Ziring, David A; Gleghorn, Elizabeth E; Garcia-Careaga, Manuel G; Gugig, Roberto R; Hunter, Anna K; Burgis, Jennifer C; Bass, Dorsey M; Park, K T

    2015-06-01

    Pediatric inflammatory bowel disease (IBD), consisting of Crohn's disease (CD) and ulcerative colitis (UC), can result in significant morbidity requiring frequent health care utilization. Although it is known that the overall financial impact of pediatric IBD is significant, the direct out-of-pocket (OOP) cost burden on the parents of children with IBD has not been explored. We hypothesized that affected children with a more relapsing disease course and families in lower income strata, ineligible for need-based assistance programs, disparately absorb ongoing financial stress. We completed a cross-sectional analysis among parents of children with IBD residing in California using an online HIPAA-secure Qualtrics survey. Multicenter recruitment occurred between December 4, 2013 and September 18, 2014 at the point-of-care from site investigators, informational flyers distributed at regional CCFA conferences, and social media campaigns equally targeting Northern, Central, and Southern California. IBD-, patient-, and family-specific information were collected from the parents of pediatric patients with IBD patients younger than 18 years of age at time of study, carry a confirmed diagnosis of CD or UC, reside in and receive pediatric gastroenterology care in California, and do not have other chronic diseases requiring ongoing medical care. We collected 150 unique surveys from parents of children with IBD (67 CD; 83 UC). The median patient age was 14 years for both CD and UC, with an overall 3.7 years (SD 2.8 yr) difference between survey completion and time of IBD diagnosis. Annually, 63.6%, 28.6%, and 5.3% of families had an OOP cost burden >$500, >$1000, and >5000, respectively. Approximately one-third (36.0%) of patients had emergency department (ED) visits over the past year, with 59.2% of these patients spending >$500 on emergency department copays, including 11.1% who spent >$5000. Although 43.3% contributed $2000 in the past year. Families with household income

  19. Haskell financial data modeling and predictive analytics

    CERN Document Server

    Ryzhov, Pavel

    2013-01-01

    This book is a hands-on guide that teaches readers how to use Haskell's tools and libraries to analyze data from real-world sources in an easy-to-understand manner.This book is great for developers who are new to financial data modeling using Haskell. A basic knowledge of functional programming is not required but will be useful. An interest in high frequency finance is essential.

  20. Financial Village Standing in Indonesian Financial System

    Directory of Open Access Journals (Sweden)

    Herry Purnomo

    2015-12-01

    Full Text Available Financial resources of the village that are sourced from a country or a Regional Finance Financial based Law Number 6 Year 2014 of The Village is the mandate of the law that must be allocated to the village. The interconnectedness of the financial position of the village in the financial system of the country or Region concerned the Financial administrative and territorial relations, and there is no setting directly regarding the finances of the village as part of the financial system of the country or the financial area. In respect of the elements of the crime of corruption deeds against financial irregularities of the village there are still disagreements on the interpretation of the law in trapping the perpetrators of corruption on the village chief that implies not satisfy the principle of legality and legal certainty in the ruling of the matter of financial irregularities. In fact, many of the village chief or Councilor caught the criminal offence of corruption over the use of financial irregularities. This research analyzes How the financial position of the village in the financial system of the country or region, as well as whether the financial resources of the village is derived from the state budget or region budget managed in village budget belongs to the category of village finances and whether tort against the financial management of the village can be categorized as a criminal act corruption. How To Cite: Purnomo, H. (2015. Financial Village Standing in Indonesian Financial System. Rechtsidee, 2(2, 121-140. doi:http://dx.doi.org/10.21070/jihr.v2i2.81

  1. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    J.D. Stanaway (Jeffrey D.); D.S. Shepard (Donald); E.A. Undurraga (Eduardo); Halasa, Y.A. (Yara A); L.E. Coffeng (Luc); Brady, O.J. (Oliver J); Hay, S.I. (Simon I); Bedi, N. (Neeraj); I.M. Bensenor (Isabela M.); C.A. Castañeda-Orjuela (Carlos A); T.-W. Chuang (Ting-Wu); K.B. Gibney (Katherine B); Z.A. Memish (Ziad); A. Rafay (Anwar); K.N. Ukwaja (Kingsley N); N. Yonemoto (Naohiro); C.J.L. Murray (Christopher)

    2016-01-01

    textabstractBackground Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and

  2. The humanistic and economic burden of Dravet syndrome on caregivers and families: Implications for future research.

    Science.gov (United States)

    Jensen, Mark P; Brunklaus, Andreas; Dorris, Liam; Zuberi, Sameer M; Knupp, Kelly G; Galer, Bradley S; Gammaitoni, Arnold R

    2017-05-01

    We reviewed the current literature with respect to the humanistic and financial burdens of Dravet Syndrome (DS) on the caregivers of children with DS, in order to (1) identify key unanswered questions or gaps in knowledge that need to be addressed and then, based on these knowledge gaps, (2) propose a research agenda for the scientific community to address in the coming decade. The findings support the conclusion that caring for a child with DS is associated with significant humanistic burden and direct costs. However, due in part to the paucity of studies, as well as the lack of measures of specific burden domains, there remains much that is not known regarding the burden of caregiving for children with DS. To address the significant knowledge gaps in this area, research is needed that will: (1) identify the specific domains of caregivers' lives that are impacted by caring for a child with DS; (2) identify or, if needed, develop measures of caregiving impact in this area; (3) identify the factors that influence DS caregiving burden; (4) develop and evaluate the efficacy of treatments for reducing the negative impact of DS and its comorbidities on DS caregivers; (5) quantify the direct medical costs associated with DS and DS comorbidities and identify the factors that influence these costs; and (6) quantify and fully explore the indirect costs of DS. Research that addresses these goals will provide the empirical foundation needed for improving the quality of life of children with DS and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Household wealth inequality, entrepreneurs’ financial constraints, and the great recession: evidence from the Kauffman Firm Survey

    NARCIS (Netherlands)

    Braggion, F. (Fabio); Dwarkasing, M. (Mintra); S. Ongena (Steven)

    2017-01-01

    textabstractWe empirically test if household wealth inequality affects borrowing constraints of young entrepreneurs. We construct a measure of wealth inequality at the US county level based on the distribution of financial rents in 2004. We find that in more unequal areas, entrepreneurs are less

  4. How great is Latvia's success story? The economic, social and political consequences of the recent financial crisis in Latvia

    OpenAIRE

    Austers, Aldis

    2014-01-01

    The current state of Latvia can be best described in medical terms: the patient is pale, but alive. The financial woes have been successfully resolved, but economic, social and political challenges remain. The crisis is continuing to affect the fabric of social and political life in Latvia. This paper looks at the economic, social and political consequences of the recent financial crisis and the ensuing economic collapse in Latvia and suggests some remedial actions.

  5. FINANCIAL INSTABILITY, FINANCIAL DEVELOPMENT AND POVERTY

    Directory of Open Access Journals (Sweden)

    Ionescu Cristian

    2012-12-01

    Full Text Available There is a positive relationship between financial development and economic growth in short-run and long-run. Financial development is beneficial to the reduction of poverty. But the financial instability which accompanies financial development is is costly for the poor and reduces the positive effect of financial development on the reduction of poverty. The paper aims to analyze in detail the relationship and the (direct and indirect effects between these variables, taking into account their economic and social importance. It is also highlighted the correlation between the financial economy and the real economy, emphasizing the impact on social welfare involved by the interaction of the above mentioned variables.

  6. Some Characteristics Of the Financial Data Series

    Directory of Open Access Journals (Sweden)

    Gheorghe Săvoiu

    2013-05-01

    Full Text Available This paper attempts to delineate from a theoretical of view the financial data series relative to other statistical data, starting from the financial econometrics’ models and from the resulting features of the specific descriptive statistics’ analysis of these characteristic series. From the analysis of these financial data during either very short and short or medium periods of time or from the information provided by the website of the Bucharest Stock Exchange (BVB, the trend of great values of kurtosis or eccentricity and skewness or asymmetry of series appears as a characteristic tendency. During a long period of time, between 1920 and 2008, this tendency seems to be more relevant, being confirmed by an excerpt from the author’s earlier paper written in 2009, concerning the statistical Dow Jones Industrial Average Index (DJIA Index. The skewness, kurtosis and normality of data distribution analysis, using Jarque Bera test, along with the identification of residual autocorrelation or serial correlation in the presence of significant residual values and heteroskedasticity are the major evaluated aspects. Finally, the author investigates the optimal way to ensure statistical comparability inflationary and deflationary method for financial series of data, and offers a solution to the selection of the appropriate indicator from the categories of the absolute values, absolute variation of the absolute values and the relative variation of the absolute values, expressed by percentages, with the finding of the latter alternative as the best alternative in the world of financial modelling of the economic and financial processes and phenomena.

  7. 40 CFR 22.24 - Burden of presentation; burden of persuasion; preponderance of the evidence standard.

    Science.gov (United States)

    2010-07-01

    ... persuasion; preponderance of the evidence standard. 22.24 Section 22.24 Protection of Environment... Burden of presentation; burden of persuasion; preponderance of the evidence standard. (a) The complainant has the burdens of presentation and persuasion that the violation occurred as set forth in the...

  8. Factors of caregiver burden and family functioning among Taiwanese family caregivers living with schizophrenia.

    Science.gov (United States)

    Hsiao, Chiu-Yueh; Tsai, Yun-Fang

    2015-06-01

    To assess the degree of caregiver burden and family functioning among Taiwanese primary family caregivers of people with schizophrenia and to test its association with demographic characteristics, family demands, sense of coherence and family hardiness. Family caregiving is a great concern in mental illness. Yet, the correlates of caregiver burden and family functioning in primary family caregivers of individuals with schizophrenia still remain unclear. A cross-sectional descriptive study. A convenience sample of 137 primary family caregivers was recruited from two psychiatric outpatient clinics in Taiwan. Measures included a demographic information sheet and the Chinese versions of the Family Stressors Index, Family Strains Index, 13-item Sense of Coherence Scale, 18-item Caregiver Burden Scale, Family Hardiness Index and Family Adaptability, Partnership, Growth, Affection, and Resolve Index. Data analysis included descriptive statistics, Pearson's product-moment correlation coefficients, t-test, one-way analysis of variance and a stepwise multiple linear regression. Female caregivers, additional dependent relatives, increased family demands and decreased sense of coherence significantly increased caregiver burden, whereas siblings as caregivers reported lower degrees of burden than parental caregivers. Family caregivers with lower family demands, increased family hardiness and higher educational level had significantly enhanced family functioning. Sense of coherence was significantly correlated with family hardiness. Our findings highlighted the importance of sense of coherence and family hardiness in individual and family adaptation. Special attention needs to focus on therapeutic interventions that enhance sense of coherence and family hardiness, thereby improving the perception of burden of care and family functioning. Given the nature of family caregiving in schizophrenia, understanding of correlates of caregiver burden and family functioning would help

  9. The Role of Urban Financial Centers within the Economy of Global Cities

    Directory of Open Access Journals (Sweden)

    Oana Mionel

    2014-06-01

    Full Text Available Nowadays, there is no doubt that state economy refers to city economy. In other words, the most part of a state‘s GDP is given by the urban environment, especially by capitals, which are often the economic engine of this environment. There are also cities having great economic importance abroad, beyond the state and even continental borders. These are the so-called global cities where the financial activities play an important role. There are a few cities (New York, London, Hong Kong etc. centering financial activities which are influential for large geographic areas. This research highlights the importance of the financial sector within urban economy and, subsequently, how it consolidates the status of global city. These cities are the engine of the international financial system as they host the headquarters of the most important and famous international stock exchange markets, financial supervision institutions, law firms and consulting companies.

  10. Social class related inequalities in household health expenditure and economic burden: evidence from Kerala, south India

    Directory of Open Access Journals (Sweden)

    Narayana Delampady

    2011-01-01

    Full Text Available Abstract Background In the Indian context, a household's caste characteristics are most relevant for identifying its poverty and vulnerability status. Inadequate provision of public health care, the near-absence of health insurance and increasing dependence on the private health sector have impoverished the poor and the marginalised, especially the scheduled tribe population. This study examines caste-based inequalities in households' out-of-pocket health expenditure in the south Indian state of Kerala and provides evidence on the consequent financial burden inflicted upon households in different caste groups. Methods Using data from a 2003-2004 panel survey in Kottathara Panchayat that collected detailed information on health care consumption from 543 households, we analysed inequality in per capita out-of-pocket health expenditure across castes by considering households' health care needs and types of care utilised. We used multivariate regression to measure the caste-based inequality in health expenditure. To assess health expenditure burden, we analysed households incurring high health expenses and their sources of finance for meeting health expenses. Results The per capita health expenditures reported by four caste groups accord with their status in the caste hierarchy. This was confirmed by multivariate analysis after controlling for health care needs and influential confounders. Households with high health care needs are more disadvantaged in terms of spending on health care. Households with high health care needs are generally at higher risk of spending heavily on health care. Hospitalisation expenditure was found to have the most impoverishing impacts, especially on backward caste households. Conclusion Caste-based inequality in household health expenditure reflects unequal access to quality health care by different caste groups. Households with high health care needs and chronic health care needs are most affected by this inequality

  11. Financial Literacy and Financial Behaviour

    NARCIS (Netherlands)

    Sayinzoga, Aussi; Bulte, Erwin H.; Lensink, Robert

    2016-01-01

    We organise a field experiment with smallholder farmers in Rwanda to measure the impact of financial literacy training on financial knowledge and behaviour. The training increased financial literacy of participants, changed their savings and borrowing behaviour and had a positive effect on the

  12. Burden of Surgical Conditions in Uganda: A Cross-sectional Nationwide Household Survey.

    Science.gov (United States)

    Tran, Tu M; Fuller, Anthony T; Butler, Elissa K; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Ssennono, Vincent F; Chipman, Jeffrey G; Galukande, Moses; Haglund, Michael M

    2017-08-01

    To quantify the burden of surgical conditions in Uganda. Data on the burden of disease have long served as a cornerstone to health policymaking, planning, and resource allocation. Population-based data are the gold standard, but no data on surgical burden at a national scale exist; therefore, we adapted the Surgeons OverSeas Assessment of Surgical Need survey and conducted a nation-wide, cross-sectional survey of Uganda to quantify the burden of surgically treatable conditions. The 2-stage cluster sample included 105 enumeration areas, representing 74 districts and Kampala Capital City Authority. Enumeration occurred from August 20 to September 12, 2014. In each enumeration area, 24 households were randomly selected; the head of the household provided details regarding any household deaths within the previous 12 months. Two household members were randomly selected for a head-to-toe verbal interview to determine existing untreated and treated surgical conditions. In 2315 households, we surveyed 4248 individuals: 461 (10.6%) reported 1 or more conditions requiring at least surgical consultation [95% confidence interval (CI) 8.9%-12.4%]. The most frequent barrier to surgical care was the lack of financial resources for the direct cost of care. Of the 153 household deaths recalled, 53 deaths (34.2%; 95% CI 22.1%-46.3%) were associated with surgically treatable signs/symptoms. Shortage of time was the most frequently cited reason (25.8%) among the 11.6% household deaths that should have, but did not, receive surgical care (95% CI 6.4%-16.8%). Unmet surgical need is prevalent in Uganda. There is an urgent need to expand the surgical care delivery system starting with the district-level hospitals. Routine surgical data collection at both the health facility and household level should be implemented.

  13. Open Access to Content and Financial Innovation

    Directory of Open Access Journals (Sweden)

    Wesley Mendes-Da-Silva

    2015-08-01

    Full Text Available Over the last twenty years the world has experienced significant growth in the supply of knowledge as a result of the advent of the Internet and there has been a drastic reduction in the cost of acquiring or constructing relevant information. This has meant that various industries, like banks, commerce and even the public management sector have undergone a reconfiguration process. Similarly, universities and the publishers of scientific periodicals need to reflect on their future. After all, who is prepared to pay for content that can be freely accessed? In the wake of the change in the technological paradigm that characterizes communication, and driven by financial crises, we find the topic of Financial Innovation (Lerner, 2006. But this topic was already on the agenda even before the Internet appeared on the scene (Miller, 1986. At the beginning of May 2013, when we started putting together the Journal of Financial Innovation (JoFI an article entitled “Free-for-all”, which was published in the important British publication, The Economist, discussed the growth of open access scientific journals. At the time the British magazine stressed the practice adopted in the UK, which established open access journals as being the destination for research results. In essence, what is intended is to constitute a quality publication route without readers or authors being burdened with high costs, an area that is still responsible for large portions of the billionaire publishing market around the world. 

  14. FINANCIAL DEPTH AND FINANCIAL ACCESS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Sigit Setiawan

    2015-05-01

    Full Text Available This study is intended to analyze the current levels of financial depth and financial access in Indonesia and to analyze the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relatively better than its financial depth, especially for financial markets, in which Indonesia ranks in the lower average group. From literature reviews, it can be inferred that the main factor driving the poor financial depth in Indonesia is non-competitiveness of the institutions; whereas the driving force of poor financial access in Indonesia are geographical constraints, poverty, a high income gap, and a less than effective national financial development policy.

  15. Past and future regulation to prevent a systemic financial crisis

    Directory of Open Access Journals (Sweden)

    Mario Sarcinelli

    2010-01-01

    Full Text Available The article is a revised and updated version of that published on the March 2010 issues of Moneta e Credito. It was there claimed that, up to now, the G20 has supervised the process to revitalize the real economy affected by the Great Recession through fiscal stimuli and a very easy monetary policy, and to rescue the battered financial system by injecting capital into giant banks and firms. The G20 is now turning its attention to financial regulation, with the FSB as its main operational arm. The ideas that are being proposed stress the need for disincentives toward too much risk taking (more capital, higher liquidity, limits to remunerations and bonuses, etc., particularly by big and complex financial institutions that are likely to entail systemic risks. The paper maintains that, as the disincentive approach is insufficient to deter financial managers looking for power, some kind of segmentation needs to be introduced, as suggested by Paul Volcker.

  16. Financial analysis as a financial management instrument

    Directory of Open Access Journals (Sweden)

    Stehlíková Beáta

    2001-12-01

    Full Text Available The financial market is one of the elements of the market-oriented economy. The financial analysis is a fundamental element of the financial controlling business. The purpose of this article is to inform briefly about horizontal and vertical financial statements analysis as the source of competitive advantage of the firm. The article is divided into two parts. First describes financial analysis and financial statements generally. Second, it presents a practical contribution of the horizontal and vertical financial statements analysis at the controlled businesses as financial management tools, which identify the financial position, market behaviour, correlations between the net profit and the prohibitively cost and operating profit, the financial activities profit, the income tax etc.Business, which the analysed firm operates in asks a provable claim on the high value of fixed assets. The capital composition of the firm is call to typify for the state-owned enterprise that was transformed to private joint-stock companies. Analysis is specially pleading for the needs considering the price of the borrowed capital in the capital structure rating. Fault factor ø value talks about needs for the cost regulation. Stair-step conception used for counting of the net profit in the accountant period indicates the financial profit, alternatively loss, as the distinguished pre-tax profit element. Picture about firm’s financial results can be completed with the information about the income tax value. Form of financial analyses presented in the article entablature the accents on the necessity to compare several accounting period and on the necessity of complex understanding of statements accounting slide “en bloc”.Financial analyse makes the decision makers possible to screen potential partners before the cooperation starts. On the other side, it makes a possibility to influence the production process, sales and financial management during the accounting

  17. National Studies as a Component of the World Health Organization Initiative to Estimate the Global and Regional Burden of Foodborne Disease.

    Directory of Open Access Journals (Sweden)

    Robin J Lake

    Full Text Available The World Health Organization (WHO initiative to estimate the global burden of foodborne diseases established the Foodborne Diseases Burden Epidemiology Reference Group (FERG in 2007. In addition to global and regional estimates, the initiative sought to promote actions at a national level. This involved capacity building through national foodborne disease burden studies, and encouragement of the use of burden information in setting evidence-informed policies. To address these objectives a FERG Country Studies Task Force was established and has developed a suite of tools and resources to facilitate national burden of foodborne disease studies. This paper describes the process and lessons learned during the conduct of pilot country studies under the WHO FERG initiative.Pilot country studies were initiated in Albania, Japan and Thailand in 2011 and in Uganda in 2012. A brief description of each study is provided. The major scientific issue is a lack of data, particularly in relation to disease etiology, and attribution of disease burden to foodborne transmission. Situation analysis, knowledge translation, and risk communication to achieve evidence-informed policies require specialist expertise and resources.The FERG global and regional burden estimates will greatly enhance the ability of individual countries to fill data gaps and generate national estimates to support efforts to reduce the burden of foodborne disease.

  18. EAMJ Jan. Burden.indd

    African Journals Online (AJOL)

    2009-01-01

    Jan 1, 2009 ... developed world where the burden of disease is accurately determined. ... Projections indicate an expected yearly incidence of 15 to 20 million new .... of global mortality and burden of diseases from 2002 to 2030. Plos. Med.

  19. EFFECTIVE CRISIS MANAGEMENT FOR ISLAMIC FINANCIAL INDUSTRY AND THE INSTITUTION OF HISBAH: LESSONS FROM GLOBAL FINANCIAL CRISIS

    Directory of Open Access Journals (Sweden)

    Najeeb Zada

    2016-06-01

    Full Text Available The recent financial crisis resulted destructive effects on finance industry. Islamic financial industry (IFI is still naïve and largely untested in the face of a major financial turmoil. Major issues and uncertainties of the insolvency of IFI include the issue of moral hazard, government bailouts, excessive risk taking and deposit insurance. This paper addresses the issue of crisis management in IFI from the perspective of al-Siyasah al-Shar’iyyah and attempts to derive public policy guidelines that are useful in developing a timely and efficient crises management framework for Islamic finance industry. By using qualitative methods, the study found that the global financial crisis resulted in great destruction of financial institution. Although Islamic finance was quite immune to the global crisis as compared to its conventional peer, concerns still exist. It is time that Islamic finance industry learns from the financial woes of the rest of the world. =========================================== Krisis keuangan baru-baru ini mengakibatkan efek destruktif pada industri keuangan. Industri keuangan Islam (IKI masih naif dan sebagian besar belum teruji dalam menghadapi gejolak keuangan besar. Isu utama dan ketidakpastian dari kebangkrutan IKI meliputi moral hazard, dana talangan pemerintah, pengambilan risiko yang berlebihan dan asuransi deposito. Makalah ini membahas isu manajemen krisis dalam IKI dari perspektif al-Siyasah al-Shar'iyyah dan berusaha mendapatkan pedoman kebijakan publik yang bermanfaat dalam mengembangkan kerangka kerja manajemen krisis yang tepat waktu dan efisien bagi IKI. Dengan menggunakan metode kualitatif, studi ini menemukan bahwa krisis keuangan global mengakibatkan kehancuran besar bagi industri keuangan. Meskipun keuangan Islam cukup kebal terhadap krisis global dibandingkan dengan keuangan konvensional, kekhawatiran masih ada. Sudah saatnya industri keuangan Islam belajar dari krisis keuangan dari seluruh dunia.

  20. Financial satisfaction and financial stressors in marital satisfaction.

    Science.gov (United States)

    Archuleta, Kristy L; Britt, Sonya L; Tonn, Teresa J; Grable, John E

    2011-04-01

    Using a sample of 310 married respondents from one U.S. Midwestern state, a test was conducted to examine the association of financial satisfaction and financial stressors in a spouse's decision to stay married to the same person or leave the relationship. The role of demographic and socioeconomic variables, religiosity, psychological constructs, financial satisfaction, and financial stressors as factors influencing marital satisfaction was tested. Financial stressors were measured using a list of financial stressors adapted from the literature. Financial satisfaction was measured with a one-item scale. The Kansas Marital Satisfaction Scale was used as a validation tool to assess whether individuals would marry or not marry again. Religiosity and financial satisfaction were positively associated with marital satisfaction. A negative interaction between financial satisfaction and financial stressors was also noted. Findings suggest that respondents who are financially satisfied tend to be more stable in their marriages.

  1. Linkages between financial development, financial instability, financial liberalisation and economic growth in Africa

    OpenAIRE

    Enowbi Batuo, M.; Mlambo, Kupukile; Asongu, Simplice

    2017-01-01

    In the aftermath of the 2008 global financial crisis, the implications of financial liberalisation for stability and economic growth has come under increased scrutiny. One strand of literature posits a positive relationship between financial liberalisation and economic growth and development. However, others emphasise the link between financial liberalisation is intrinsically associated with financial instability which may be harmful to economic growth and development. This study assesses ...

  2. Impact of Unbalanced Development of Economy on Financial Sector Stability

    Directory of Open Access Journals (Sweden)

    Kozlov Vladislav I.

    2013-11-01

    Full Text Available The article is devoted to the study of c connection between the stability of development of the financial sector and its share in the aggregate volume of production. The article conducts a comparative study of the countries that suffered the large-scale financial and economic crisis in 2007 (USA and Great Britain and countries economies of which turned out to be more stable (Czech Republic, Poland and Finland. In the course of the study the article marks out indicators that allow characterisation of the degree of balancing of economic development. The developed approach is applied for analysis of the Ukrainian economy in the pre-crisis period. Results of the study allow assertion that excessive growth of the financial sector increases the risk of realisation of financial and economic crises independent on the level of economic development of a country. The article develops an approach to assessment of the role of the financial sector in economy. It underlines important aspects of its application for analysing economies of developing countries. The article leaves a vast expanse for further studies and focuses on importance of monitoring of the state and development of the financial sector with consideration of the direction and rates of development of other sectors of economy. The obtained results justify the necessity of use of indicators that characterise structure of the national economy by financial sector control bodies.

  3. Approaches to capturing the financial cost of family care-giving within a palliative care context: a systematic review.

    Science.gov (United States)

    Gardiner, Clare; Brereton, Louise; Frey, Rosemary; Wilkinson-Meyers, Laura; Gott, Merryn

    2016-09-01

    The economic burden faced by family caregivers of people at the end of life is well recognised. Financial burden has a significant impact on the provision of family care-giving in the community setting, but has seen limited research attention. A systematic review with realist review synthesis and thematic analysis was undertaken to identify literature relating to the financial costs and impact of family care-giving at the end of life. This paper reports findings relating to previously developed approaches which capture the financial costs and implications of caring for family members receiving palliative/end-of-life care. Seven electronic databases were searched from inception to April 2012, for original research studies relating to the financial impact of care-giving at the end of life. Studies were independently screened to identify those which met the study inclusion criteria, and the methodological quality of included studies was appraised using realist review criteria of relevance and rigour. A descriptive thematic approach was used to synthesise data. Twelve articles met the inclusion criteria for the review. Various approaches to capturing data on the financial costs of care-giving at the end of life were noted; however, no single tool was identified with the sole purpose of exploring these costs. The majority of approaches used structured questionnaires and were administered by personal interview, with most studies using longitudinal designs. Calculation of costs was most often based on recall by patients and family caregivers, in some studies combined with objective measures of resource use. While the studies in this review provide useful data on approaches to capturing costs of care-giving, more work is needed to develop methods which accurately and sensitively capture the financial costs of caring at the end of life. Methodological considerations include study design and method of administration, contextual and cultural relevance, and accuracy of cost

  4. The Global Cancer Burden

    Centers for Disease Control (CDC) Podcasts

    2012-02-02

    This podcast describes the global burden of cancer and efforts by CDC and others to reduce that burden.  Created: 2/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2012.

  5. Financial Literacy and Financial Planning in France

    Directory of Open Access Journals (Sweden)

    Luc Arrondel

    2013-07-01

    Full Text Available We study financial literacy in France using the PATER survey and following the Lusardi and Mitchell (2011c approach. We find that some subpopulations are less financially literate than others: women, young and old people as well as less-educated people are more likely to face difficulties when dealing with fundamental financial concepts such as risk diversification and inflation and interest compounding. We also find some differences in financial knowledge depending on the political opinion of the respondents. Finally we show that these differences in financial knowledge are correlated with differences in the propensity to plan: people who score higher on the financial literacy questions are more likely to be engaged in the preparation of a clearly defined financial plan.

  6. Major trauma: the unseen financial burden to trauma centres, a descriptive multicentre analysis.

    Science.gov (United States)

    Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Dickson, Cara; McDonnell, Karon

    2014-02-01

    This research examines the existing funding model for in-hospital trauma patient episodes in New South Wales (NSW), Australia and identifies factors that cause above-average treatment costs. Accurate information on the treatment costs of injury is needed to guide health-funding strategy and prevent inadvertent underfunding of specialist trauma centres, which treat a high trauma casemix. Admitted trauma patient data provided by 12 trauma centres were linked with financial data for 2008-09. Actual costs incurred by each hospital were compared with state-wide Australian Refined Diagnostic Related Groups (AR-DRG) average costs. Patient episodes where actual cost was higher than AR-DRG cost allocation were examined. There were 16693 patients at a total cost of AU$178.7million. The total costs incurred by trauma centres were $14.7million above the NSW peer-group average cost estimates. There were 10 AR-DRG where the total cost variance was greater than $500000. The AR-DRG with the largest proportion of patients were the upper limb injury categories, many of whom had multiple body regions injured and/or a traumatic brain injury (P<0.001). AR-DRG classifications do not adequately describe the trauma patient episode and are not commensurate with the expense of trauma treatment. A revision of AR-DRG used for trauma is needed. WHAT IS KNOWN ABOUT THIS TOPIC? Severely injured trauma patients often have multiple injuries, in more than one body region and the determination of appropriate AR-DRG can be difficult. Pilot research suggests that the AR-DRG do not accurately represent the care that is required for these patients. WHAT DOES THIS PAPER ADD? This is the first multicentre analysis of treatment costs and coding variance for major trauma in Australia. This research identifies the limitations of the current AR-DRGS and those that are particularly problematic. The value of linking trauma registry and financial data within each trauma centre is demonstrated. WHAT ARE THE

  7. Corporate Investments in Asian Emerging Markets: Financial Conditions, Financial Development, and Financial Constraints

    OpenAIRE

    Wang, Jianxin; Gochoco-Bautista, Maria Socorro; Sotocinal, Noli

    2013-01-01

    Motivated by the literature on the finance–growth nexus, this paper explores the mechanisms through which finance affects corporate investments and capital accumulation. We separate the effects of financial conditions from those of financial development. Based on a sample of firms from five Asian emerging economies, we find that (1) financial conditions and financial development affect corporate investments through different channels. Financial conditions affect firms' growth opportunities an...

  8. On Rural Financial and Accounting Work under the Background of Rapid Agricultural Economic Development

    OpenAIRE

    Tang, Yaozheng

    2013-01-01

    Under the background of rapid agricultural economic development, rural financial and accounting work is of great significance. From rural accounting management system, rural accountant allocation and rural accounting training, this paper analyzes current situations of rural accounting work in China. In rural financial and accounting work, there are following problems. (1) Accounting behavior is not standard, and basic accounting work is to be further strengthened; (2) Internal control is not ...

  9. How Should the Financial Crisis Change How We Teach Economics?

    Science.gov (United States)

    Shiller, Robert J.

    2010-01-01

    Student dissatisfaction with teaching of economics--particularly with macroeconomics--during the current financial crisis mirrors dissatisfaction that was expressed during the last big crisis, the Great Depression. Then and now, a good number of students have felt that their lectures bear little relation to the economic crisis raging outside the…

  10. Understanding Financial Statements. Financial Matters. Board Basics.

    Science.gov (United States)

    McCarthy, John H.; Turner, Robert M.

    1998-01-01

    This booklet for trustees of higher education institutions offers guidelines to help trustees understand the institution's financial statements. Individual sections describe the three major financial statements and cover topics such as: (1) standards of the Financial Accounting Standards Board; (2) the "statement of financial position,"…

  11. Patients' self-perceived burden, caregivers' burden and quality of life for amyotrophic lateral sclerosis patients: a cross-sectional study.

    Science.gov (United States)

    Geng, Dan; Ou, RuWei; Miao, XiaoHui; Zhao, LiHong; Wei, QianQian; Chen, XuePing; Liang, Yan; Shang, HuiFang; Yang, Rong

    2017-10-01

    This study surveys the quality of life of amyotrophic lateral sclerosis patients and the factors associated with amyotrophic lateral sclerosis patients' self-perceived burden and their caregivers' burden. Burdens of patients with amyotrophic lateral sclerosis and their caregivers in Chinese population are largely unknown. A cross-sectional study was conducted among 81 pairs of amyotrophic lateral sclerosis patients and their caregivers. Amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden were assessed by the Self-Perceived Burden Scale and Zarit-Burden Interview, respectively. Quality of life of amyotrophic lateral sclerosis patients was measured using the World Health Organization Quality of Life-Bref. The amyotrophic lateral sclerosis Functional Rating Scale-Revised questionnaire was used to estimate patients' physical function. Both patients and caregivers reported a mild to moderate burden. The World Health Organization quality of life-Bref scores were decreased in respondents with lower amyotrophic lateral sclerosis Functional Rating Scale-Revised, higher Self-Perceived Burden Scale and higher Zarit-Burden Interview scores. Self-Perceived Burden Scale scores were associated with patients' knowledge of amyotrophic lateral sclerosis, respiratory function and female sex. Zarit-Burden Interview scores were associated with caregivers' age, patients' motor function and out-of-pocket payment. With increase in amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden, quality of life of amyotrophic lateral sclerosis patients decreased. Female patients, who had known more about the disease, and those with severe respiratory dysfunction were subject to higher self-perceived burden. Older caregivers and caregivers of patients with severe motor dysfunction and more out-of-pocket payment experienced more care burdens. Our study suggests that paying more attention to female amyotrophic lateral sclerosis patients

  12. The Burden of Craft in Arthroscopic Rotator Cuff Repair: Where Have We Been and Where We Are Going.

    Science.gov (United States)

    Burkhart, Stephen S

    2015-08-01

    The rather turbulent history of arthroscopic rotator cuff repair went through stages of innovation, conflict, disruption, assimilation, and transformation that might be anticipated when a new and advanced technology (arthroscopic cuff repair) displaces an entrenched but outdated discipline (open cuff repair). The transition from open to arthroscopic rotator cuff repair has been a major paradigm shift that has greatly benefited patients. However, this technical evolution/revolution has also imposed a higher "burden of craft" on the practitioners of arthroscopic rotator cuff repair. Technological advancements in surgery demand that surgeons accept this burden of craft and master the advanced technology for the benefit of their patients. This article outlines the author's involvement in the development of arthroscopic rotator cuff repair, and it also explores the surgeon's obligation to accept the burden of craft that is imposed by this discipline.

  13. Does financial literacy improve financial inclusion? Cross country evidence

    OpenAIRE

    Grohmann, Antonia; Klühs, Theres; Menkhoff, Lukas

    2017-01-01

    While financial inclusion is typically addressed by improving the financial infrastructure we show that financial literacy, representing the demand-side of financial markets, also has a beneficial effect. We study this effect at the cross-country level, which allows to consider institutional variation. Regarding "access to finance", financial infrastructure and financial literacy are mainly substitutes. However, regarding the "use of financial services", the effect of higher financial literac...

  14. ECB’S MONETARY MEASURES DURING THE FINANCIAL CRISIS

    Directory of Open Access Journals (Sweden)

    Magdalena RADULESCU

    2015-06-01

    Full Text Available This paper presents the main developments of the eurozone during the crisis period and the measures adopted by ECB in this context. The paper especially aims the countries that were the most affected by the crisis, namely: Greece, Cyprus, Ireland, Portugal, Spain and Italy. The public debt of those countries increased greatly and they faced many pressures on the international financial markets.

  15. A study of the stressor, family environment and family burden in dissociative (conversion disorder patients

    Directory of Open Access Journals (Sweden)

    Kamal K Verma

    2017-01-01

    Full Text Available Background: Dissociative disorder is a stress-related disorder usually present in adolescent and younger age group. It is also accompanied with significant impairment in activity of daily living and family relationship. Family environment plays important role in initiation and maintenance of symptoms and this put significant burden on family. Aim and Objective: To study presence of stressor, family environment, and assessment of family burden in dissociative disorder patients. Material and Method: This was a cross-sectional observational study in which 100 dissociatives disorder patients were included after fulfilling inclusion criteria from both inpatients and outpatient department of psychiatry. Results: In our study major part of the sample were women 60 (60%, among them most of were housewife and educated up to primary school. According to a stressor, 63 (63% patients had family stress/problem and out of them, 35 (58.4 were women. Seventy-four (74% patients had dissociative convulsion and out of them, 45 (75% were women. The dissociative disorder patients cause a considerable degree of burden over other family members in both men and women. There is a significant difference found in the family environment in term of personal growth dimension, relationship dimension in both men and women. Conclusion: Present study concludes that dissociative disorder patients cause a considerable degree of burden over other family members in term of leisure, physical, mental, financial, and routines family interrelationship domains. The family environment in term of personal growth dimension, relationship dimension has a casual effect on symptoms of dissociative disorder patients.

  16. Nexus between Information and Communication Technology, Financial Intermediation, and Household Investment: A Review

    Directory of Open Access Journals (Sweden)

    Richard M. Kiai

    2017-06-01

    Full Text Available Financial inclusion has been recognized as a poverty reduction tool, and many economies have taken it up as a national agenda. To achieve the expected levels of financial inclusion, governments have worked with financial intermediaries to reach the expected target group, the unbanked poor. As per the financial intermediation theory, the role of financial intermediaries is to minimize the information asymmetry in the financial system. To enhance financial inclusion, many countries and financial institutions have embraced information and communication technology (ICT. ICT has been recognized as a tool that has worked greatly toward enhancing sharing of information at a low cost and that has thus helped in improving financial inclusion. Though many countries have achieved high levels of financial inclusion through ICT, the levels of poverty have not declined. It was thus important to establish the relationship between ICT, financial intermediation, and household investment. This study methodology was a review of the literature on financial inclusion, financial intermediation, ICT, and household investment. From this study, it was noted that ICT is helping in financial intermediation and thus more people can access financial services. Unfortunately, the levels of ICT capability among the poor are low, and in that case, the poor are not able to utilize financial services offered through ICT platforms to undertake household investment. This is the reason as to why, despite the high levels of financial inclusion, the poor still remain poor. This study recommends that the government should ensure that the levels of ICT among the populace are high. Financial institutions on the other hand should provide financial services with more user-friendly platforms.

  17. Quality of Financial Policies and Financial System Stress

    OpenAIRE

    Udaibir S Das; Plamen Yossifov; Richard Podpiera; Dmitriy L Rozhkov

    2005-01-01

    In this paper, we develop multi-country indices of financial system stress and quality of financial policies and use them in regression analysis of the determinants of financial stress. We find that countries with higher quality of financial policies are better able to contain the effects of macroeconomic pressures on the overall level of stress in the financial system. They are also in a better position to ensure sustainable development of the financial system.

  18. Why Financial Advice Cannot Substitute for Financial Literacy?

    OpenAIRE

    M. Debbich

    2015-01-01

    This paper examines the ability of financial advice provided by sellers of financial services to substitute for financial literacy of customers. I set up a simple theoretical model in which an informed financial advisor communicates with a less informed customer of financial services. Given the existence of a conflict of interest from the advisor's perspective, the model predicts that only well financially sophisticated customers receive relevant information from the advisor. This fact tends ...

  19. Factors affecting caregiver burden of terminally ill adults in the home setting - A systematic review.

    Science.gov (United States)

    He Leow, Mabel Qi; Wai Chi Chan, Sally

    from the JBI-MAStARI (Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument). Quantitative data were extracted from included papers using standardised data extraction tools from the JBI-MAStARI. Findings were presented in narrative form, as statistical pooling was not possible. Seven studies were included in the review. All the studies used a cross-sectional descriptive survey for the collection of data. Four main factors that influenced caregivers' perception of caregiving burden were identified: 1. Caregiver characteristics, 2. Patient characteristics, 3. Social support, and 4. Caregivers' personal protective resources. Caregiver characteristics, patient characteristics, social support, and attitude of caregiver towards the caregiving situation, were found to influence caregivers' perceived caregiving burden. Additional support is required for caregivers who are employed, known to have financial difficulties, caring for patient indicating symptom distress, and caring for a patient at the terminal stage (Level III). Future studies may attempt to develop a framework to identify factors that impact on caregiver burden. More studies on caregiver burden in males, caregiver burden of patients who were at the terminal stages of the various chronic illnesses should be explored.

  20. The economic burden of infant formula on families with young children in the Philippines.

    Science.gov (United States)

    Sobel, Howard L; Iellamo, Alessandro D; Raya, Rene R; Padilla, Alexander A; Sta Ana, Filomeno S; Nyunt-U, Soe

    2012-05-01

    Infant formula usage places children at risk for illness and death. Studies in the United States demonstrated high economic burden, health care costs, and absenteeism of caregivers associated with formula usage. Despite high formula usage in developing countries, no economic studies were found. This study examines the financial burden of purchasing infant formula and increased health care expenditure in the Philippines, a developing country with a per capita income of $3930. The average exchange rate of the peso to the US dollar for 2003 was $1 to P52, according to Bangko Sentral ng Pilipinas (BSP). This is a secondary analysis of the 2003 Family Income and Expenditure Survey, a national cross-sectional multistage cluster survey of 42 094 households. Almost half of Philippine families with a young child and one-third of families living on less than $2 per day purchase formula. Nationally, $260 million was spent on infant formula in 2003. Formula-buying families with young children had spent an aggregate of $143.9 million on medical care compared to $56.6 million by non-formula-buying families. After adjusting for income and nonmilk family expenditures, the average formula-purchasing Philippine family spent an additional $0.30 (95% CI: 0.24 - 0.36; r(2) = 0.08) on medical expenditure for every $1 spent on formula. The economic burden from infant formula purchase and out-of-pocket medical expenditure exceeded $400 million in 2003. This cost was aside from other costs, such as absenteeism and the risk of childhood death and illness. These expenses caused an unnecessary burden on Filipino families and could instead have been invested in education and other social services.

  1. Financial System of Malaysia: the Concept of Financial Dispute

    Directory of Open Access Journals (Sweden)

    Evgenia E. Frolova

    2017-01-01

    Full Text Available Purpose: the article examines the main problems associated the new regulatory acts of Malaysia – the Financial Services Act of 2013 and the Islamic Financial Services Act of 2013; The characteristics of the legal status of the "Ombudsman for financial services" are listed, types of financial disputes subject to settlement under the "financial ombudsman scheme" are listed, parties to the financial dispute are identified. To achieve this goal, the article must solve the following tasks: to determine whether there are institutions in Malaysia that provide services for resolving financial disputes; to investigate the main problems associated with the definition of the concept and types of financial dispute, the conditions for the transfer of a financial dispute to the competent authority. Methods: this article is based on an interdisciplinary concept of research, which allowed to distinguish the distinctive features of the legal regulation of the settlement of financial disputes in Malaysia. Results: according to the provisions of the new laws of Malaysia, namely the Financial Services Act of 2013 and the Islamic Financial Services Act of 2013, a financial dispute should be understood as a dispute, to which the parties are a financial consumer and a financial service provider provider. Financial disputes include disputes in the field of insurance and Islamic insurance, as well as disputes over bank cards, bank accounts, ATMs, Internet banking, mobile banking, and others. The main body for the settlement of financial disputes is the Financial Ombudsman. The competence of the financial ombudsman is limited by the amount of the claim of 250,000 ringgit (about 4.5 million rubles, under insurance claims – 10,000 ringgit, in the field of unauthorized transactions – 25,000 ringgit. The procedure for resolving a financial dispute, which in Malaysia is referred to as the "scheme of a financial ombudsman", is established by the Central Bank of Malaysia

  2. Which Clinical and Patient Factors Influence the National Economic Burden of Hospital Readmissions After Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-12-01

    The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. We classified the reasons for readmissions as either procedure- or medical-related. Cost-to-charge ratios supplied with the Nationwide Readmissions Database were used to compute the individual per-patient cost of 90-day readmissions as a continuous variable in separate general linear models for THA and TKA. Payer, patient, clinical, and hospital factors were treated as covariates. We estimated the national burden of readmissions by payer and by the reason for readmission. The national rates of 30- and 90-day readmissions after THA were 4% (95% confidence interval [CI], 4.2%-4.5%) and 8% (95% CI, 7.5%-8.1%), respectively. The national rates of 30- and 90-day readmissions after primary TKA were 4% (95% CI, 3.8%-4.0%) and 7% (95% CI, 6.8%-7.2%), respectively. The five most important variables responsible for the cost of 90-day THA readmissions (in rank order, based

  3. Providing Coverage for the Unique Lifelong Health Care Needs of Living Kidney Donors Within the Framework of Financial Neutrality.

    Science.gov (United States)

    Gill, J S; Delmonico, F; Klarenbach, S; Capron, A M

    2017-05-01

    Organ donation should neither enrich donors nor impose financial burdens on them. We described the scope of health care required for all living kidney donors, reflecting contemporary understanding of long-term donor health outcomes; proposed an approach to identify donor health conditions that should be covered within the framework of financial neutrality; and proposed strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are donation related or that may compromise postdonation kidney function. Amendment of Medicare regulations is needed to clarify that surveillance and treatment of conditions that may compromise postdonation kidney function following donor nephrectomy will be covered without expense to the donor. In other countries lacking health insurance for all residents, sufficient data exist to allow the creation of a compensation fund or donor insurance policies to ensure appropriate care. Providing coverage for donation-related sequelae as well as care to preserve postdonation kidney function ensures protection against the financial burdens of health care encountered by donors throughout their lives. Providing coverage for this care should thus be cost-effective, even without considering the health care cost savings that occur for living donor transplant recipients. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. ANALYSIS OF THE INFLUENCE OF A COMPANY’S INDEBTEDNESS ON THE FINANCIAL RISK

    Directory of Open Access Journals (Sweden)

    LĂPĂDUȘI MIHAELA LOREDANA

    2015-06-01

    Full Text Available Awareness of indebtedness and financial risk represents a great importance not only for the management of the company but also for creditors, investors, institutional investors, rating agencies, etc. An indebtedness analysis implies its effect on financial risk through financial lever coefficient or the financial lever. A financial lever is a notion originating in physics and it is the force that is applied in order to give a boost of a process or a phenomenon. However, in economics that notion was adapted and can be regarded as the strenght of different financial categories, financial instruments used in order to give a boost in a certain sense to various economic processes or activities in order to achieve the established objectives. More specifically we can say that the financial lever or the financial leverage expresses the impact of the financial structure over the company’s profitability. The research aims at analysing indebtedness and its influence over the financial risk and all the aspects underlined in the present article will prove the assumption that a company's performance and its capacity to produce profit depends mainly on the management and the use of financial resources. The purpose of present article is to highlight the impact of indebtedness over financial risk through the financial lever. The main objectives of the article set out to achieve this purpose are: the theoretical approach of a company's overall indebtedness, the analysis of the financial levers, and the analysis of the positive and negative leverage effects.

  5. Global burden of oral diseases: emerging concepts, management and interplay with systemic health.

    Science.gov (United States)

    Jin, L J; Lamster, I B; Greenspan, J S; Pitts, N B; Scully, C; Warnakulasuriya, S

    2016-10-01

    This study presents the global burden of major oral diseases with an exegetical commentary on their current profiles, the critical issues in oral healthcare and future perspectives. A narrative overview of current literature was undertaken to synthesise the contexts with critical elaboration and commentary. Oral disease is one of the most common public health issues worldwide with significant socio-economic impacts, and yet it is frequently neglected in public health policy. The oral data extracted from the Global Burden of Disease Study in 2010 (Murray et al, 2012) show that caries, periodontal disease, edentulism, oral cancer and cleft lip/palate collectively accounted for 18 814 000 disability-adjusted life-years; and the global burden of periodontal disease, oral cancer and caries increased markedly by an average of 45.6% from 1990 to 2010 in parallel with the major non-communicable diseases like diabetes by 69.0%. Oral diseases and non-communicable diseases are closely interlinked through sharing common risk factors (e.g. excess sugar consumption and tobacco use) and underlying infection/inflammatory pathways. Oral disease remains a major public health burden worldwide. It is of great importance to integrate oral health into global health agenda via the common risk factor approach. The long-term sustainable strategy for global oral health should focus on health promotion and disease prevention through effective multidisciplinary teamwork. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The Usefulness of Financial Statements in Making Financial Diagnosis

    Directory of Open Access Journals (Sweden)

    Mitica Pepi

    2016-01-01

    Full Text Available Our research aims to develop an analysis of the usefulness of financial statements and financial investment in making the diagnosis. Financial analysis is by definition an activity that performance condition is diagnosed entity of the financial year. Financial analysis shall be determined by strengths and weaknesses of financial management based on which will underpin future strategy of the entity to maintain and develop it into a competitive environment. Results of financial analysis depends on the quality, accuracy, relevance and effectiveness of economic information collected and processed. The primary sources of information for financial analysis are the financial statements, which are considered as raw material in the analysis.

  7. [Financial burden of hepatitis B-related diseases and factors influencing the costs in Shenzhen, China].

    Science.gov (United States)

    Liang, Sen; Zhang, Shun-xiang; Ma, Qi-shan; Xiao, He-wei; Lü, Qiu-ying; Xie, Xu; Mei, Shu-jiang; Hu, Dong-sheng; Zhou, Bo-ping; Li, Bing; Chen, Jing-fang; Cui, Fu-qiang; Wang, Fu-zhen; Liang, Xiao-feng

    2010-12-01

    To investigate the direct, indirect and intangible costs due to hepatitis B-related diseases and to explore main factors associated with the costs in Shenzhen. Cluster sampling for cases collected consecutively during the study period was administrated. Subjects were selected from eligible hepatitis B-related patients. By pre-trained professional investigators, health economics-related information was collected, using a structured questionnaire. Hospitalization expenses were obtained through hospital records after the patients were discharged from hospital. Total economic burden of hepatitis B-related patients would involve direct, indirect and intangible costs. Direct costs were further divided into direct medical costs and direct nonmedical costs. Human Capital Approach was employed to measure the indirect costs both on patients and the caregivers in 1-year time span. Willing to pay method was used to estimate the intangible costs. Multiple linear stepwise regression models were conducted to determine the factors linked to the economic burden. On average, the total annual cost of per patient with hepatitis B-related diseases was 81 590.23 RMB Yuan. Among which, direct, indirect and intangible costs were 30 914.79 Yuan (account for 37.9%), 15 258.01 Yuan (18.7%), 35 417.43 Yuan (43.4%), respectively. The total annual costs per patient for hepatocellular carcinoma, severe hepatitis B, decompensated cirrhosis, compensated cirrhosis, chronic hepatitis B and acute hepatitis B were 194 858.40 Yuan, 144 549.20 Yuan, 120 333.60 Yuan, 79 528.81 Yuan, 66 282.46 Yuan and 39 286.81 Yuan, respectively. The ratio of direct to indirect costs based on the base-case estimation foot add to 2.0:1, increased from hepato-cellular carcinoma (0.7:1) to compensated cirrhosis (3.5:1), followed by acute hepatitis B (3.3:1), severe hepatitis B (2.8:1), decompensate cirrhosis (2.3:1) and chronic hepatitis B (2.2:1). Direct medical costs were more than direct nonmedical. Ratio between the

  8. The transmission of fluctuant patterns of the forex burden based on international crude oil prices

    International Nuclear Information System (INIS)

    Gao, Xiangyun; An, Haizhong; Fang, Wei; Li, Huajiao

    2014-01-01

    For a country that imports crude oil, the forex burden is always fluctuant due to the fluctuation of international crude oil prices and exchange rates over time. The gap discovered between international crude oil prices and the crude oil price based on exchange rates may indicate the fluctuation of the forex burden. There exist different fluctuant patterns in the fluctuation process of the forex burden in different periods. Hence, we proposed an approach combining econometrics and complex network theory to explore the transmission mechanism of these fluctuant patterns. In this study, we defined the forex burden and the fluctuant patterns by normalization, sliding windows of data and econometric models. And then we set the fluctuant patterns as nodes and the transformation between patterns as edges; in this way, the transmission complex network is constructed. The results show that different major fluctuant patterns with different probabilities appear in different scales. The fluctuant patterns transferred into each other conveniently. And the transmission medium can help to identify the transitional periods in the process of the transmission. The contribution of this study to the energy policy decision-making is that the formulations of related policies under different period lengths require different reference standards. - Highlights: • Small “gap” between crude oil price and exchange rate can make great forex fluctuation. • We defined the fluctuant patterns of forex burden through data sliding windows. • We constructed the transmission network models of fluctuant patterns of forex burden. • The transitional periods can be identified by media capabilities of fluctuant patterns. • Energy policies making for different lengths of period should reference different scales standards

  9. The transmission of fluctuant patterns of the forex burden based on international crude oil prices

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Xiangyun [School of Humanities and Economic Management, China University of Geosciences, Beijing 100083 (China); Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Land and Resources (Chinese Academy of Land and Resource Economics, China University of Geosciences Beijing), Beijing 100083 (China); Lab of Resources and Environmental Management, China University of Geosciences, Beijing 100083 (China); Department of Earth and Environmental Sciences, University of Waterloo, ON N2L 3G1 (Canada); An, Haizhong [School of Humanities and Economic Management, China University of Geosciences, Beijing 100083 (China); Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Land and Resources (Chinese Academy of Land and Resource Economics, China University of Geosciences Beijing), Beijing 100083 (China); Lab of Resources and Environmental Management, China University of Geosciences, Beijing 100083 (China); Fang, Wei [School of Humanities and Economic Management, China University of Geosciences, Beijing 100083 (China); Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Land and Resources (Chinese Academy of Land and Resource Economics, China University of Geosciences Beijing), Beijing 100083 (China); Lab of Resources and Environmental Management, China University of Geosciences, Beijing 100083 (China); Li, Huajiao [School of Humanities and Economic Management, China University of Geosciences, Beijing 100083 (China); Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Land and Resources (Chinese Academy of Land and Resource Economics, China University of Geosciences Beijing), Beijing 100083 (China); Lab of Resources and Environmental Management, China University of Geosciences, Beijing 100083 (China); others, and

    2014-08-14

    For a country that imports crude oil, the forex burden is always fluctuant due to the fluctuation of international crude oil prices and exchange rates over time. The gap discovered between international crude oil prices and the crude oil price based on exchange rates may indicate the fluctuation of the forex burden. There exist different fluctuant patterns in the fluctuation process of the forex burden in different periods. Hence, we proposed an approach combining econometrics and complex network theory to explore the transmission mechanism of these fluctuant patterns. In this study, we defined the forex burden and the fluctuant patterns by normalization, sliding windows of data and econometric models. And then we set the fluctuant patterns as nodes and the transformation between patterns as edges; in this way, the transmission complex network is constructed. The results show that different major fluctuant patterns with different probabilities appear in different scales. The fluctuant patterns transferred into each other conveniently. And the transmission medium can help to identify the transitional periods in the process of the transmission. The contribution of this study to the energy policy decision-making is that the formulations of related policies under different period lengths require different reference standards. - Highlights: • Small “gap” between crude oil price and exchange rate can make great forex fluctuation. • We defined the fluctuant patterns of forex burden through data sliding windows. • We constructed the transmission network models of fluctuant patterns of forex burden. • The transitional periods can be identified by media capabilities of fluctuant patterns. • Energy policies making for different lengths of period should reference different scales standards.

  10. Does financial education impact financial literacy and financial behavior, and if so, when?

    OpenAIRE

    Kaiser, Tim; Menkhoff, Lukas

    2017-01-01

    A meta-analysis of 126 impact evaluation studies finds that financial education significantly impacts financial behavior and, to an even larger extent, financial literacy. These results also hold for the subsample of randomized experiments (RCTs). However, intervention impacts are highly heterogeneous: financial education is less effective for low-income clients as well as in low- and lowe...

  11. Measuring financial performance: an overview of financial statements.

    Science.gov (United States)

    Dalsted, N L

    1995-07-01

    Financial management has emerged as a critical component in the long-term viability of today's ranches and farms. Proper and timely financial reporting and analysis of financial statements are valuable tools that agricultural producers can use to monitor, coordinate, and plan their operational production and marketing schemes and strategies. A side note to preparation of financial statements. With the concerns over lender liability issues associated with statements either assisted with or prepared by a lending officer, agricultural producers will be responsible for preparing their own statements. The lending institutions may prepare their own statements in their assessment of the financial condition of a business and or individual, but, ultimately, the responsibility of financial statements is the borrower's. Some of the material presented in this article provides important input for use in such analytical programs as the National Cattlemen's Association, Integrated Resource Committees, and Standard Performance Analysis (SPA). SPA techniques and associated software have been or currently are under development for cow-calf, stocker, seedstock, and sheep enterprises. Critical to the analysis is having complete and correct financial statements. These analytical programs build on the financial statements. These analytical programs build on the financial statements as recommended by the FFSTF. Proper financial reporting is critical not only to a SPA assessment but also to the overall financial management of today's farms and ranches. Recognizing the importance of financial management in production agriculture is not enough, taking a proactive stance in one's financial plan is paramount to success. Failure to do so will only enhance the exit rates of producers from production agriculture.

  12. Financial Stress Indices and Financial Crises

    NARCIS (Netherlands)

    Vermeulen, Robert; Hoeberichts, Marco; Vasicek, Borek; Zigraiova, Diana; Smidkova, Katerina; de Haan, Jakob

    This paper develops a Financial Stress Index (FSI) for 28 OECD countries and examines its relationship to crises using a novel database for financial crises. A stress index measures the current state of stress in the financial system and summarizes it in a single statistic. Our results suggest that

  13. Financial Analysis of the Financial Institutions Sector in Kosovo

    Directory of Open Access Journals (Sweden)

    Vlora Prenaj

    2015-12-01

    Full Text Available Paper work “Financial analysis of the financial institutions sector in Kosovo” treats financial sector in Kosovo. Paper work contains the current position of the economy, economic prospects and macroeconomic projections for the financial sector in Kosovo, future potential and possibilities of financial sector in Kosovo. The main goal of this research is financial analysis of Kosovo financial institutions sector - overview of key indicators. This research evaluates the performances of commercial bank’s profitability, which have operated in the market during the period 2006-2012. This research is conducted through financial analysis coefficients: Return on Equity, Return on assets and Cost to Income. Test t-Student is used to analyze the profitability for the period 2006/2007 before the financial crisis and the period 2011/2012 after financial crisis.

  14. Tax management in strengthening financial independence of local government

    Directory of Open Access Journals (Sweden)

    Badida M.P.

    2017-05-01

    Full Text Available The article analyses the directions of tax management in the context of budgetary decentralization. The paper aims to research tax management in the system of forming local budgets in the conditions of financial resources decentralization and analyze the current tools of tax management on the local level. In spite of a great number of researches, the issue of tax management in strengthening financial independence of local budgets is not enough studied; therefore, to reach financial independence of local communities it is necessary to adopt new normative and legal acts concerning decentralization of financial resources taking into account tax potential of each territorial community. The lack of financial resources causes the problem of optimal redistribution of power among central and local authorities. The author proposes the new mechanisms of solving the current problems on the example of local budget of the city of Uzgorod to contribute budgetary decentralization. The principal idea while conducting the reform of the budgetary process must be the adoption of certain changes in budgetary legislation which have to shift the mechanisms of budgetary financing and equating local budgets. The author concludes that the progressive vector of well-being increasing completely depends on the developed concept of regional economic policy. The article pays attention to the importance of taking into account the tax potential of a territory and characterizes the directions of strengthening financial independence of local government.

  15. Taxing the Financially Integrated Multinational Firm

    DEFF Research Database (Denmark)

    Johannesen, Niels

    partly fall on investment and thus workers in the former country. This tax exporting mechanism introduces a scope for corporate taxes, which is not present in standard models of international taxation. Accounting for the internal capital markets of multinational firms thus represents a way to resolve......This paper develops a theoretical model of corporate taxation in the presence of financially integrated multinational firms. Under the assumption that multinational firms at least partly use internal loans to finance foreign investment, we find that the optimal corporate tax rate is positive from...... the perspective of a small, open economy. This finding contrasts the standard result that the optimal source based capital tax is zero. Intuitively, to the extent that multinational firms finance investment in country i with loans from affiliates in country j, the burden of corporate taxes in the latter country...

  16. Financial Economy and Financial System: Basis of Structural Interconnection

    Directory of Open Access Journals (Sweden)

    Khorosheva Olena I.

    2014-02-01

    Full Text Available The goal of the article lies in identification of grounds of interconnection of the financial economy and financial system. The study was conducted with consideration of main provisions of the theory of finance and concept of financial economy, which is a set of means used in the process of reproduction of finance by their owner for formation and / or maintenance of the own system of values in the viable state. For the first time ever the structure of the financial system is identified as an aggregate of financial economies and financial market. The article justifies a necessity of expansion of boundaries of perception of the state financial economy, which is offered to include public financial economy of the state level and the set of financial economies of the state as a subject of economic activity. Such an approach forms a base for justification of the synthesis of participation of the state in financial relations as the owner and as the basic macro-economic regulator. Prospects of further study in this direction are: development of classification of financial economies; revelation of specific features of impact of shadow finance on development of the national financial economy; and assessment of possibilities of inclusion of structured financial products into the system of values of financial economies in Ukraine.

  17. East Asian Financial Cycles: Asian vs. Global Financial Crises

    OpenAIRE

    Akira Kohsaka; Jun-ichi Shinkai

    2014-01-01

    We examine the role of financial shocks in business cycles in general and in financial crises in particular in East Asia (Indonesia, Korea, Malaysia and Thailand) since the 1990s. Estimating a Financial Conditions Index, we found that financial shocks explain most of business downturns in all the economies in the Asian Financial Crisis (AFC) in 1997-98, but that the effects of financial shocks are diverse across economies in the Global Financial Crisis (GFC) in 2008-09. In the GFC, the financ...

  18. Corporate financial restructuring in Asia: implications for financial stability

    OpenAIRE

    Michael Pomerleano

    2007-01-01

    Corporate financial fragility preceding the Asian financial crisis heightened vulnerabilities. Many countries in the region undertook significant corporate financial restructuring after the crisis, with some countries bouncing back much faster than others. These sounder corporate financial practices bode well for financial stability.

  19. FINANCIAL INFORMATION, EFFECTS OF FINANCIAL INFORMATION ON ECONOMIC DECISION

    Directory of Open Access Journals (Sweden)

    TAK ISA

    2010-12-01

    Full Text Available Financial information has, indisputably, an important effect in economics. To form an effective capital market, financial information must be reliable and accurate. Misleading financial information always has a negative impact on economic decision taken by users. It is known that financial information as the cornerstone of financial markets, can improve economic performance in several ways. Nowadays we are facing economic crisis due to irregularities of presentation of financial statements to users. Misunderstandings cause economic recession. Detection of fraudulent financial information, is an important issue facing the auditing profession. Currently, bankruptcy of companies around the world, leaves millions of people without jobs, this is caused by financial information which is manipulated by companies. The purpose of this paper is to analyze the effects of errors and manipulation committed in the financial information sector on the real economy. Also one of the purposes of this paper is to analyze error and fraud in financial statements how it effects the real economy and the reasons for committing fraud in financial statements. Also, several suggestions are included in this study about actions that can be taken to prevent errors and manipulation in financial information.

  20. Financial Liberalization and Financial Fragility

    OpenAIRE

    Enrica Detragiache; Asli Demirgüç-Kunt

    1998-01-01

    The authors study the empirical relationship between banking crises and financial liberalization using a panel of data for 53 countries for 1980-95. They find that banking crises are more likely to occur in liberalized financial systems. But financial liberalization's impact on a fragile banking sector is weaker where the institutional environment is strong--especially where there is respect for the rule of law, a low level of corruption, and good contract enforcement. They examine evidence o...

  1. The Study of Airline Merger and Acquisition in the Great China Area

    Science.gov (United States)

    Shon, Zhengyi

    2003-01-01

    The Asian financial crisis in the late 20 th century has some long lasting effect on the air transportation industry in Asia, especially in the Great China Area. Starting from 1998, airlines in both China and Taiwan suffered some serious financial losses due to the diminishing travel demand caused by the economic recession. Airlines were forced to cut price to attract passengers and hence crashed the market discipline. A number of airline mergers and acquisitions were then driven by the markets and the governments. After China and Taiwan have both entered the World Trade Organization, some mega-merging cases were finalized in late 2002 for better fitting the world's aviation competitions. This paper reviews the nine merging and acquiring cases in the Great China Area in the past 5 years. Almost all the airlines in the area were involved. The new groups of airlines and the survival airlines are introduced. Market response to the airline mergers will also be examined. A general look over the performance of the new airlines will be discussed. And the future of the market will also be analyzed. Finally, the practices and the impacts of current inter-state mergers in the Great China Area will be examined. The study has expected a highly concentrated domestic market in both China and Taiwan. Each of the market will be dominated by three major airline groups of their own. Cross-holding equity within these 6 leading aviation groups would also be possible after further deregulations.

  2. A Question of Trust : the Pursuit of Consumer Trust in the Financial Sector by Means of EU Legislation

    NARCIS (Netherlands)

    de Jager, C.E.

    2017-01-01

    The decrease in consumer trust in the financial sector and the attempts to restore it are receiving a great deal of interest, especially since the financial crisis at the end of 2008. EU legislation is one of the ways that attempts have been made to regain the trust of investors. In Section 2, the

  3. Warner Bros. and Its First Two Great Depression Musicals:Changing the Form and Reflecting the Times

    OpenAIRE

    Cohen, Harvey

    2013-01-01

    This working paper analyses the production, content, public reaction and significance of the first two Warner Bros. Great Depression Musicals (this term was created by later scholars). "42nd Street" and "Gold Diggers of 1933," both released in the first half of 1933 during some of the direst months of the Great Depression, artistically and financially rejuvenated the previously failing genre of the film musical. They both featured extravagant highly cinematic dance numbers created by Busby Be...

  4. The Burden of Schizophrenia on Caregivers

    Directory of Open Access Journals (Sweden)

    Filiz Adana

    2011-06-01

    Full Text Available Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family such as the patients disturbing behaviors, economic difficulties, and loss of income, restricted social activities, distressed household atmosphere, and undesirable influences on physical and mental health of the family members. The subjective burden refers to the extent of emotional distress caused by the objective burden. The data in the pertinent literature suggest an association between caregivers’ burden and sex, ethnicity, culture, caregivers’ health and quality of life, social support, and the symptomatology as presented by the patient. In order to promote mental health of schizophrenia patients along with their caregivers, the mental health workers should strive to find the means of supporting, informing, and cooperating with the family members. Psychosocial interventions designed for families and psychosocial rehabilitations programs designed for schizophrenia patients are effective means of easing caregivers’ burden.

  5. Disclosure of Non-Financial Information: Relevant to Financial Analysts?

    OpenAIRE

    ORENS, Raf; LYBAERT, Nadine

    2013-01-01

    The decline in the relevance of financial statement information to value firms leads to calls from organizational stakeholders to convey non-financial information in order to be able to judge firms' financial performance and value. This literature review aims to report extant literature findings on the use of corporate non-financial information by sell-side financial analysts, the information intermediaries between corporate management and investors. Prior studies highlight that financial ana...

  6. Financial globalisation uncertainty/instability is good for financial development

    OpenAIRE

    Asongu, Simplice A.; Koomson, Isaac; Tchamyou, Vanessa S.

    2015-01-01

    Purpose – This study assesses the effect of time-dynamic financial globalisation uncertainty on financial development in 53 African countries for the period 2000-2011. Design/methodology/approach – Financial globalisation uncertainty is estimated as time-dynamic to capture business cycle disturbances while all dimensions identified by the Financial Development and Structure Database of the World Bank are employed, namely: financial depth (money supply and liquid liabilities), financial sy...

  7. Regional resilience across Europe : on urbanization and the initial impact of the Great Recession

    NARCIS (Netherlands)

    Brakman, S.; van Marrewijk, J.G.M.; Partridge, Mark

    2015-01-01

    Using a novel data set for 207 European regions from 22 different countries, we analyse the relevance of urbanisation for the short-term resilience to a major shock. We take the Great Recession, the economic and financial crisis that started in 2008, as our shock and analyse how the European NUTS 2

  8. Financial liquidity of farms in the European Union Płynność finansowa gospodarstw rolnych w Unii Europejskiej

    Directory of Open Access Journals (Sweden)

    Anna Bieniasz

    2008-09-01

    Full Text Available In the article diversifying the level of financial liquidity of farm in UE was presented. The research showed that a higher financial liquidity than non-agricultural sectors characterized farming. This state is a result of relatively smaller participation of short-term capital in total capital. In the EU countries the highest financial liquidity is met in farms of Belgium, Spain and Slovenia, however lowest in farms of Great Britain, the Czech Republic and Netherlands. The financial liquidity is also strongly diversified according to the economic size, the type of farms and conditions of agricultural production.

  9. College Students and Financial Distress: Exploring Debt, Financial Satisfaction, and Financial Anxiety

    Science.gov (United States)

    Archuleta, Kristy L.; Dale, Anita; Spann, Scott M.

    2013-01-01

    The impact of financial concerns on overall mental health has become a popular topic among researchers and practitioners. In this exploratory study, possible associations of financial anxiety were explored using a sample of 180 college students who sought services at a university peer financial counseling center in a Midwestern state. Of…

  10. The Annual Economic Burden of Syphilis: An Estimation of Direct, Productivity, and Intangible Costs for Syphilis in Guangdong Initiative for Comprehensive Control of Syphilis Sites.

    Science.gov (United States)

    Zou, Yaming; Liao, Yu; Liu, Fengying; Chen, Lei; Shen, Hongcheng; Huang, Shujie; Zheng, Heping; Yang, Bin; Hao, Yuantao

    2017-11-01

    Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective. Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method. Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54. Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.

  11. Evaluating a Financial Assessment Tool: The Financial Checkup

    OpenAIRE

    Johnson, Alena C.

    2001-01-01

    The purpose of this study was to evaluate The Financial Checkup program. The program consisted of a booklet called The Financial Checkup and a 1-1 y, hour workshop explaining the booklet. The booklet helps individuals evaluate their financial situation on an annual basis. It includes a net worth statement, an income and expense statement, financial ratios, a revolving savings worksheet, a retirement worksheet, a life insurance worksheet, a financial goals worksheet, and a budget worksheet. Th...

  12. Patient-oncologist cost communication, financial distress, and medication adherence.

    Science.gov (United States)

    Bestvina, Christine M; Zullig, Leah L; Rushing, Christel; Chino, Fumiko; Samsa, Gregory P; Altomare, Ivy; Tulsky, James; Ubel, Peter; Schrag, Deborah; Nicolla, Jon; Abernethy, Amy P; Peppercorn, Jeffrey; Zafar, S Yousuf

    2014-05-01

    Little is known about the association between patient-oncologist discussion of cancer treatment out-of-pocket (OOP) cost and medication adherence, a critical component of quality cancer care. We surveyed insured adults receiving anticancer therapy. Patients were asked if they had discussed OOP cost with their oncologist. Medication nonadherence was defined as skipping doses or taking less medication than prescribed to make prescriptions last longer, or not filling prescriptions because of cost. Multivariable analysis assessed the association between nonadherence and cost discussions. Among 300 respondents (86% response), 16% (n = 49) reported high or overwhelming financial distress. Nineteen percent (n = 56) reported talking to their oncologist about cost. Twenty-seven percent (n = 77) reported medication nonadherence. To make a prescription last longer, 14% (n = 42) skipped medication doses, and 11% (n = 33) took less medication than prescribed; 22% (n = 66) did not fill a prescription because of cost. Five percent (n = 14) reported chemotherapy nonadherence. To make a prescription last longer, 1% (n = 3) skipped chemotherapy doses, and 2% (n = 5) took less chemotherapy; 3% (n = 10) did not fill a chemotherapy prescription because of cost. In adjusted analyses, cost discussion (odds ratio [OR] = 2.58; 95% CI, 1.14 to 5.85; P = .02), financial distress (OR = 1.64, 95% CI, 1.38 to 1.96; P financial burden than expected (OR = 2.89; 95% CI, 1.41 to 5.89; P financial distress were associated with medication nonadherence, suggesting that cost discussions are important for patients forced to make cost-related behavior alterations. Future research should examine the timing, content, and quality of cost-discussions. Copyright © 2014 by American Society of Clinical Oncology.

  13. Assessing the burden of medical impoverishment by cause: a systematic breakdown by disease in Ethiopia.

    Science.gov (United States)

    Verguet, Stéphane; Memirie, Solomon Tessema; Norheim, Ole Frithjof

    2016-10-21

    Out-of-pocket (OOP) medical expenses often lead to catastrophic expenditure and impoverishment in low- and middle-income countries. Yet, there has been no systematic examination of which specific diseases and conditions (e.g., tuberculosis, cardiovascular disease) drive medical impoverishment, defined as OOP direct medical costs pushing households into poverty. We used a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia, i.e., the number of households crossing a poverty line due to excessive OOP direct medical expenses. We utilized disease-specific mortality estimates from the Global Burden of Disease study, epidemiological and cost inputs from surveys, and secondary data from the literature to produce a count of poverty cases due to OOP direct medical costs per specific condition. In Ethiopia, in 2013, and among 20 leading causes of mortality, we estimated the burden of impoverishment due to OOP direct medical costs to be of about 350,000 poverty cases. The top three causes of medical impoverishment were diarrhea, lower respiratory infections, and road injury, accounting for 75 % of all poverty cases. We present a preliminary attempt for the estimation of the burden of medical impoverishment by cause for high mortality conditions. In Ethiopia, medical impoverishment was notably associated with illness occurrence and health services utilization. Although currently used estimates are sensitive to health services utilization, a systematic breakdown of impoverishment due to OOP direct medical costs by cause can provide important information for the promotion of financial risk protection and equity, and subsequent design of health policies toward universal health coverage, reduction of direct OOP payments, and poverty alleviation.

  14. How did the Global Financial Crisis Influence the Automobile Industry: Comparison between the US and Japanese Auto Industry

    OpenAIRE

    SUN, YAN

    2013-01-01

    The 2008 global financial crisis was the worst one in seventy-five years and had great negative impact on the economy worldwide. Automobile industry, the pillar to the economic development, was hit most by the recession among the sectors. The purpose of this study is to analyze the financial crisis impacts on the automobile industry and find out strategies to decrease the occurrence rate and the loss if a similar crisis occurs. The study, firstly, describes the impact of financial crisis...

  15. Financial Coaching's Potential for Enhancing Family Financial Security

    Science.gov (United States)

    Collins, J. Michael; Olive, Peggy; O'Rourke, Collin M.

    2013-01-01

    Financial coaching is an emerging complement to financial education and counseling. As defined in this article, financial coaching is a process whereby participants set goals, commit to taking certain actions by specific dates, and are then held accountable by the coach. In this way, financial coaching is designed to help participants bridge the…

  16. FINANCIAL DEPTH AND FINANCIAL ACCESS IN INDONESIA

    OpenAIRE

    Sigit Setiawan

    2015-01-01

    This study is intended to analyze the current levels of financial depth and financial access in Indonesia and to analyze the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relativel...

  17. Materiality from financial towards non-financial reporting

    OpenAIRE

    Chiara Mio

    2013-01-01

    The article aims at discussing the evolution of the concept of materiality in financial and, more specifically, non-financial reporting. Materiality will play a central role in the next years in order for reports to reach conciseness, which is at present one of the main goals both financial and non-financial reporting (in particular Integrated Reporting) aims to achieve. The article reviews the most relevant materiality frameworks and definitions and provides further insights for the advancem...

  18. Late Financial Distress Process Stages and Financial Ratios

    DEFF Research Database (Denmark)

    Sormunen, Nina; Laitinen, Teija

    2012-01-01

    stage affects the classification ability of single financial ratios and financial distress prediction models in short-term financial distress prediction. The study shows that the auditor's GC task could be supported by paying attention to the financial distress process stage. The implications...... of these findings for auditors and every stakeholder of business firms are considered....

  19. Implementing the Fundamental Principle of Islamic Finance PLS in Order to Reduce Moral Hazard on the Financial Services Market

    OpenAIRE

    Dariusz Piotrowski

    2014-01-01

    Moral hazard is a situation where agent takes a risky actions, knowing that potential costs will be born by principal. In finance, moral hazard arises when advisers take risky decisions come to believe that they will not have to carry the full burden of potential loses. Implementing the fundamental principle of Islamic finance PLS could reduce moral hazard on financial services market.

  20. Global Financial and Economic Crisis and the EU Economic Governance Failure – Evidence From Spain

    Directory of Open Access Journals (Sweden)

    Iulia Monica Oehler-Șincai

    2012-10-01

    Full Text Available The process of public sector restructuring, known in the economic literature as the New Public Management (NPM, came to a deadlock as the global financial and economic crisis broke out in 2008. The expansion of cheap credit, market dereglementation and asset securitization, speculative bubbles, the mixture of euphoria, greed and even naivety and ignorance of the economic players outlined an international financial system which was not subordinated any more to the real economy, but to the own principles, similar to Ponzi schemes or casino rules (Posner, 2011, Kindleberger and Aliber, 2011, Rajan, 2010, Stiglitz, 2010, Roubini and Mihm, 2010. All these generated, at global level, the deepest recession after the Great Depression. The anti-crisis measures came without delay, but they did not produce the expected results. At the Euro Zone level, an almost immediate and direct effect of the crisis and the accompanying countercyclical fiscal measures was that of enhancing the fiscal burden for governments. The levels of fiscal deficit and the public debt as percentages of GDP substantially increased and, gradually, another crisis broke out: the Euro Zone sovereign debt crisis. As a result, at the level of the EU governance, in order for the authorities to be able to improve it, there were adopted distinct strategies, programs and instruments. In spite of the converging efforts at the EU as well as national levels, the majority of the countries in the Euro Zone were not able to find the right formula of restarting economic growth. The present analysis brings to the forefront Spain’s experience, which represents a clear example of governance (and NPM failure, as neither the countercyclical measures adopted for the recovery, in accordance with the keynesyan principles, nor the austerity packages that followed them were not able to induce the economic growth, so essential for diminishing unemployment.

  1. FINANCIAL DEPTH AND FINANCIAL ACCESS IN INDONESIA

    OpenAIRE

    Sigit Setiawan

    2015-01-01

    This study is intended to analyse the current levels of financial depth and financial access in Indonesia and to analyse the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relativel...

  2. Financial Depth and Financial Access in Indonesia

    OpenAIRE

    Setiawan, Sigit

    2015-01-01

    This study is intended to analyse the current levels of financial depth and financial access in Indonesia and to analyse the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relativel...

  3. Adolescents' Financial Literacy: The Role of Financial Socialization Agents, Financial Experiences, and Money Attitudes in Shaping Financial Literacy among South Korean Youth

    Science.gov (United States)

    Sohn, Sang-Hee; Joo, So-Hyun; Grable, John E.; Lee, Seonglim; Kim, Minjeung

    2012-01-01

    The purpose of this study was to test the relationships between financial socialization agents, financial experiences, money attitudes, demographic characteristics, and the financial literacy of Korean adolescents. Using the 2006 Korean National Financial Literacy Test Survey for Adolescents (N = 1185), a series of regression analyses were…

  4. TAXATION OF FINANCIAL SECTOR AFTER THE CRISIS IN THE EUROPEAN UNION

    Directory of Open Access Journals (Sweden)

    Mara Eugenia-Ramona

    2012-12-01

    Full Text Available Taxation of financial sector is an important issue of the actual fiscal policy, especially after the economic crisis impact. By taxing the financial sector, it is intended taxation of financial transactions, and financial activities. European Union supports the taxation of the financial system and makes proposals in this regard. This paper tries to reveal the major aspects concerning the taxation of financial sector, both theoretical and empirical aspects. It will analyze the reasons which justify the application of such taxes, but also difficulties involved in practice. Another major objective of this paper is to examine the role of taxation in the financial sector as important regulatory instrument. This subject is debated in European Commission papers and by many economists. There are underlined the necessity of such tax, the impact and the economic efficiency. Our purpose is to identify if this kind of tax is good for our economy and what can be the impact from budgetary point of view. For finding this answers the paper realize a complex analysis of the types of taxes applied on financial sector in countries which already adopted this kind of taxes, like United Kingdom, Austria, Hungary, Cyprus. We believe that the financial sector should be charged, because was responsible in great measure the economic crisis impact. A potential tax applied to financial sector is considered as an important source of budget revenues. This article tries to explore the possible tax measures for financial sector according to the major principle of public finance –equity and efficiency. Special attention will be given to the need to implement financial sector taxation in Romania. In the years before the crisis banks and entire financial sector in Romania recorded significant profits. For this reason such tax is justified given that this sector is exempt from VAT. Applying such a tax would reduce the budget deficit and on the long term will

  5. Collaborating with congregations: opportunities for financial services in the inner city.

    Science.gov (United States)

    Fondation, L; Tufano, P; Walker, P

    1999-01-01

    In all economies, financial systems perform a basic set of functions, which include the need to pool resources, to save and borrow, to make payments, and to collect information. And yet, in rich and poor communities, the ways in which those needs are met differ greatly. In part, this is because traditional financial service firms have found it too expensive to serve poor neighborhoods. But it is possible to work with less traditional institutions to meet those needs. According to the authors, inner cities face two core impediments to financial services: lack of economies of scale and lack of good information. An inner-city investor with $500, for instance, does not warrant much attention from financial service firms. But 20,000 parishioners investing $500 apiece can collectively wield $10 million. By partnering with strong social organizations such as churches, financial institutions can benefit both themselves and investors. A lack of good information concerning credit histories--a common problem in poor communities--also makes low-income customers much less appealing to financial institutions. Churches can help close such information gaps by vouching for parishioners' reliability. There are certainly problems that come with mixing business and religion, as the authors concede. Ethical issues, trust issues, and issues of experience all come to mind. But understanding that functions need to dictate the structure of the financial service sector may be the first step toward achieving inner-city prosperity.

  6. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.

    Directory of Open Access Journals (Sweden)

    Alize J Ferrari

    2013-11-01

    Full Text Available Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.Burden was calculated for major depressive disorder (MDD and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs and disability adjusted life years (DALYs. Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8% of global YLDs and dysthymia for 1.4% (0.9%-2.0%. Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2% of global DALYs and dysthymia for 0.5% (0.3%-0.6%. There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8% to 3.8% (3.0%-4.7% of global DALYs.GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing

  7. FINANCIAL DISCIPLINE IN REPUBLIC MACEDONIAWAY OF MORE EFFICIENT MODE FOR ENTERPRISES’ ACTIVITIES

    Directory of Open Access Journals (Sweden)

    EMILIJA MATESKA

    2015-04-01

    Full Text Available The severe economic crisis that occupied the world economy can be felt in the Republic of Macedonia, too. The low solvency and the decreased buying faculties of the population and firms are a major problem in the economics in general. A great capability and power is necessary in order to survive in these difficult economic conditions, as well as a constant alertness by the firms as instigators of the economic activity in every country. Enitieis in the Economy are realizing different tipes of transactions making financial obligations that, ussualy can not be fullfiled. As a result there is a problem with financial recovery that disrupts their liquidity, and at the end point, their activity in the economy is worsens. Because of that, the Law for Financial Discipline was voted, for the first time in Republic of Macedonia in December 2013. This Law is regulation for payments on time for all financial activities made between private entities, also for financial activities made between entities among public and private sector preventing failure of the financial obligations on agreed terms. In this article we would like to determine the reasons and needs for finding the way which will be regulatory instead of punishment for successful financial discipline of the entities, that will improve their liquidity and, of course, to ensure better activities in the economy as a whole.

  8. Financial Ratios and Perceived Household Financial Satisfaction

    Directory of Open Access Journals (Sweden)

    Scott Garrett

    2013-08-01

    Full Text Available This paper tests the relative strength of three objective measures of financial health (using the solvency, liquidity, and investment asset ratio in predicting a household’s subjective feeling of current financial satisfaction. Using a sample of 6,923 respondents in the 2008 Health and Retirement Study this paper presents evidence of two main findings: 1 the solvency ratio is most strongly associated with financial satisfaction levels based on a cross-sectional design and 2 changes in the investment asset ratio are most strongly associated with changes in financial satisfaction over time.

  9. Development and validation of the Patient Experience with Treatment and Self-management (PETS): a patient-reported measure of treatment burden.

    Science.gov (United States)

    Eton, David T; Yost, Kathleen J; Lai, Jin-Shei; Ridgeway, Jennifer L; Egginton, Jason S; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T

    2017-02-01

    The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden-the Patient Experience with Treatment and Self-management (PETS). A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (α range 0.79-0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps < 0.01). A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine.

  10. The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Ciobanu, Liliana G; Ferrari, Alize J; Erskine, Holly E; Santomauro, Damian F; Charlson, Fiona J; Leung, Janni; Amare, Azmeraw T; Olagunju, Andrew T; Whiteford, Harvey A; Baune, Bernhard T

    2018-05-01

    Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

  11. Demographic and Socio-Economic Determinants of Local Financial Autonomy in Romania

    Directory of Open Access Journals (Sweden)

    Dănuţ Vasile JEMNA

    2013-06-01

    Full Text Available Local autonomy is a rarely explored concept in the literature, still holding an increasing importance in the current context of Romania’s development in the European Union. In this paper we attempt to provide an overall survey on the financial dimension of local autonomy, assuming that local autonomy cannot be implemented, unless local authorities have adequate financial resources. In this study we also analyze the possibility to measure the local revenue autonomy and to identify the variables which represent the determinants of the local revenue autonomy. Using empirical evidence from Romanian counties, we analyze the regional distributions for own revenues and for the significant determinants of local revenue autonomy. By means of econometric modeling we will highlight the variables which are statistically significant and explain the variation of the local revenues of Romanian counties, as well as the order of importance of the determinants of local financial autonomy. The empirical results show us that, although, theoretically, the counties have a great administrative and financial autonomy, practically this autonomy is very reduced (an average of under 40% for local revenue. The modeling results show that the degree of local financial autonomy can be increased by increasing economic development, urbanization, the average living area per person and fertility. Unemployment and a high level of demographic dependency contribute to the decrease of local financial autonomy.

  12. THE FINANCIAL SECTOR IN THE FINANCIAL SYSTEM ECONOMY: THEORETICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    Yu. Kovalenko

    2015-06-01

    Full Text Available Broad and narrow approaches of the financial system are obtained. The difference between the financial system and the financial sector (the fi-nancial corporations sector is shown. Organizational and institutional matrix of the financial system of the economy is proposed. Key positions of institutional sectors classification of Ukraine’s economy are analyzed, as well as the System of National Accounts with respect to the financial sec-tor of corporations. The structure of the sector of financial corporations in Ukraine is defined.

  13. FINANCIAL LITERACYOF UNDERGRADUATE STUDENTS–A CASESTUDY OF A PUBLIC UNIVERSITY IN SOUTH AFRICA

    Directory of Open Access Journals (Sweden)

    Gumani Ramavhea

    2017-07-01

    Full Text Available Lowfinancial literacylevels of students are receivingworldwideattention due tothe impact it has on financialdecision-makingduring the adult years. In line withthis international trendon lowfinancial literacy,South African studentsdemonstrate low levels of financial literacy, which is of great concern if one takesinto consideration that they are the future participants of an economy that ison theverge of arecession.Therefore, the aim of this study was to determineundergraduatestudents’financial literacyat a public university in South Africa. A cross-sectional studywas conducted of a sample of 300 undergraduate students.The findings of the study enabled a more in-depth understanding of thefinancialliteracyof undergraduate students, which holds important implications forfinancial literacy training.The participants’ knowledgeregardingthe issuesrelating to generalfinancial literacywasobserved to be low. They also performedpoorly in terms of banking and taxation andfinancial planning, interest rates andgeneral inflation.Itwasalso reported that thereis asignificantdifference betweenmany groupswithinthe biographical data.The research confirmed thatthere isa need for financial literacy trainingamongstudents. Thisshould focus on content areas where they lackfinancial literacy, in order to ensure that students experience financial well-beingduringtheadultyears.Better informed adults would make better financial decisions.

  14. Strengthening financial management, providing financial safeguard mechanism

    International Nuclear Information System (INIS)

    Sun Wumei

    2010-01-01

    This article reviewed the history of Zhong He Shanxi Uranium Enrichment Company, summarizing an efficient and systematical financial management method during both construction period and operational period of the company. It related to fundamental financial management structure building, integrated budgeting, fund management, cost management, asset management, tax planning and HR management. of financial staffs. (author)

  15. Financial Stress, Financial Literacy, Counselling and the Risk of Homelessness

    Directory of Open Access Journals (Sweden)

    Adam Steen

    2013-09-01

    Full Text Available Poor financial literacy may lead to poor life choices. These life choices can create or contribute to financial stress with adverse consequences - not the least of which may be homelessness. These issues are relatively well understood, but there is limited research on the link between financial stress, financial literacy and counselling, and homelessness. Specifically, there has been little research on how improved financial literacy and appropriate financial counselling might help to prevent homelessness. This paper synthesises existing literature on this topic and considers these issues using the ABCX family stress model of Hill (1958 using data from an Australian program aimed at alleviating family homelessness, the Home Advice Program. We provide evidence that suggests that case management and support which incorporates financial counselling and financial literacy can assist in moderating the impact of financial stress and help those at risk of homelessness. The findings have implications for public policy in the areas of financial education, consumer finance, and social services provision.

  16. Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study

    Directory of Open Access Journals (Sweden)

    Eton DT

    2012-08-01

    Full Text Available David T Eton,1 Djenane Ramalho de Oliveira,2,3 Jason S Egginton,1 Jennifer L Ridgeway,1 Laura Odell,4 Carl R May,5 Victor M Montori1,61Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; 3Medication Therapy Management Program, Fairview Pharmacy Services LLC, Minneapolis, MN, USA; 4Pharmacy Services, Mayo Clinic, Rochester, MN, USA; 5Faculty of Health Sciences, University of Southampton, Southampton, UK; 6Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USABackground: Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure.Methods: We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy, and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes.Results: Thirty-two patients (20 female, 12 male, age 26–85 years were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles

  17. Are survivors who report cancer-related financial problems more likely to forgo or delay medical care?

    Science.gov (United States)

    Kent, Erin E; Forsythe, Laura P; Yabroff, K Robin; Weaver, Kathryn E; de Moor, Janet S; Rodriguez, Juan L; Rowland, Julia H

    2013-10-15

    Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. The authors identified cancer survivors diagnosed as adults (n=1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. Copyright © 2013 American Cancer Society.

  18. Are Survivors Who Report Cancer-Related Financial Problems More Likely to Forgo or Delay Medical Care?

    Science.gov (United States)

    Kent, Erin E.; Forsythe, Laura P.; Yabroff, K. Robin; Weaver, Kathryn E.; de Moor, Janet S.; Rodriguez, Juan L.; Rowland, Julia H.

    2015-01-01

    BACKGROUND Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. METHODS The authors identified cancer survivors diagnosed as adults (n = 1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. RESULTS Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%–34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. PMID:23907958

  19. ANALYSIS OF INTERCOMMUNICATION OF FINANCIAL RESULTS OF ACTIVITY AND INDEXES OF ESTIMATION OF THE FINANCIAL STATE OF A COMMERCIAL ORGANIZATION

    OpenAIRE

    Prudnikov A. G.; Zhurova O. I.

    2016-01-01

    The system of indicators characterizing the financial condition of a commercial organization, the major thing is profitability of its operations as the ratio of profit on sales and revenues, the ratio of profit before tax and the average annual value of total assets, the ratio of net profit and the average value of all assets, net income and average equity. Great practical importance for the efficient management of resources economic entity is marginal analysis, but it requires, in our opinio...

  20. Remittances, financial development and economic growth: Empirical evidence from Lesotho

    Directory of Open Access Journals (Sweden)

    Athenia Bongani Sibindi

    2014-11-01

    Full Text Available Increasingly remittances now constitute a great source of foreign currency inflows for many developing countries. In some instances remittances have outpaced the growth of foreign direct investment (FDI. Amongst others, remittances can be used as a vehicle of savings mobilisation as well as fostering the supply of credit by providing liquidity to the market. In this article we investigate the causal relationship between the remittances, financial development and economic growth in Lesotho for the period 1975 to 2010. We make use of per capita remittances, real per capita broad money supply and real per capita growth domestic product as the proxies for remittances, financial development and economic growth respectively. We then test for cointegration amongst the variables by applying the Johansen procedure and then test for Granger causality based on the vector error correction model (VECM. Our results confirm the existence of at least one cointegrating relationship and also indicate that the direction of causality runs from remittances to the economy without feedback. The results also suggest that financial development Granger causes economic growth without feedback which is consistent with ‘supply-leading’ growth hypothesis. The results also confirm a causal relationship running from financial development to remittances without feedback. The results also lend credence to the “complementarity’ hypothesis in that, remittances complement rather than substitute financial development in bringing about economic growth.

  1. Tobacco expenditure, smoking-induced deprivation and financial stress: results from the International Tobacco Control (ITC) Four-Country Survey.

    Science.gov (United States)

    Siahpush, Mohammad; Borland, Ron; Yong, Hua-Hie; Cummings, K Michael; Fong, Geoffrey T

    2012-07-01

    While higher tobacco prices lead to a reduction in smoking prevalence, there is a concern that paying more for cigarettes can lead to excess financial burden. Our primary aim was to examine the association of daily cigarette expenditure with smoking-induced deprivation (SID) and financial stress (FS). We used data from wave 7 (2008-2009) of the International Tobacco Control (ITC) Four-Country Survey which is a survey of smokers in Canada, the USA, the UK and Australia (n = 5887). Logistic regressions were used to assess the association of daily cigarette expenditure with SID and FS. In multivariate analyses, a one standard deviation increase in daily cigarette expenditure was associated with an increase of 24% (P = 0.004) in the probability of experiencing SID. While we found no association between daily cigarette expenditure and FS, we found that SID is a strong predictor of FS (odds ratio 6.25; P < 0.001). This suggests that cigarette expenditure indirectly affects FS through SID. Results showed no evidence of an interaction between cigarette expenditure and income or education in their effect on SID or FS. Our results imply that spending more on tobacco may result in SID but surprisingly has no direct effect on FS. While most smokers may be adjusting their incomes and consumption to minimise FS, some fail to do so occasionally as indexed by the SID measure. Future studies need to prospectively examine the effect of increased tobacco expenditure on financial burden of smokers. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  2. Coping strategies for financial burdens in families with childhood pneumonia in Bangladesh.

    Science.gov (United States)

    Alamgir, Nadia I; Naheed, Aliya; Luby, Stephen P

    2010-10-19

    This study aimed to determine the out-of pocket expenditure and coping strategies adopted by families of children admitted in a hospital in Bangladesh with pneumonia. Trained interviewers surveyed parents of 90 children and conducted in-depth interviews with six families below the age of 5 years who were admitted to the largest pediatric hospital in Bangladesh with a diagnosis of pneumonia. We estimated the total cost of illness associated with hospitalization and explored the coping strategies of the families. The mean expenditure of the families for the illness episode was US$ 94 (±SD 52.5) with 75% having spent more than half of their total monthly expenditure on this hospitalization. Three fourths (68/90, 76%) of the families managed the expenditure by borrowing, mortgaging or selling assets; 64% had to borrow the full cost of hospitalization and 10% borrowed from the formal sector with a monthly interest rate of 5 to 30%. The burden was highest for the people from poor income strata. Families earning ≤US$ 59 per month were 10 times more likely than families earning ≥US$ 59 per month to borrow money (OR = 10.0, 95% CI: 2.8-38.8). To repay their debts, 22% of families reported that they would work extra hours and 50% planned to reduce spending on food and education for their children. Coping strategies adopted by the families to manage the out-of-pocket expenditure for children requiring hospitalization were catastrophic for the majority of the families. Efforts to prevent childhood pneumonia for example, by vaccination against the most common pathogens, by improving air quality and by improving childhood nutrition can provide a double advantage. They can prevent both disease and poverty.

  3. Coping strategies for financial burdens in families with childhood pneumonia in Bangladesh

    Directory of Open Access Journals (Sweden)

    Luby Stephen P

    2010-10-01

    Full Text Available Abstract Background This study aimed to determine the out-of pocket expenditure and coping strategies adopted by families of children admitted in a hospital in Bangladesh with pneumonia. Methods Trained interviewers surveyed parents of 90 children and conducted in-depth interviews with six families below the age of 5 years who were admitted to the largest pediatric hospital in Bangladesh with a diagnosis of pneumonia. We estimated the total cost of illness associated with hospitalization and explored the coping strategies of the families. Results The mean expenditure of the families for the illness episode was US$ 94 (±SD 52.5 with 75% having spent more than half of their total monthly expenditure on this hospitalization. Three fourths (68/90, 76% of the families managed the expenditure by borrowing, mortgaging or selling assets; 64% had to borrow the full cost of hospitalization and 10% borrowed from the formal sector with a monthly interest rate of 5 to 30%. The burden was highest for the people from poor income strata. Families earning ≤US$ 59 per month were 10 times more likely than families earning ≥US$ 59 per month to borrow money (OR = 10.0, 95% CI: 2.8-38.8. To repay their debts, 22% of families reported that they would work extra hours and 50% planned to reduce spending on food and education for their children. Conclusions Coping strategies adopted by the families to manage the out-of-pocket expenditure for children requiring hospitalization were catastrophic for the majority of the families. Efforts to prevent childhood pneumonia for example, by vaccination against the most common pathogens, by improving air quality and by improving childhood nutrition can provide a double advantage. They can prevent both disease and poverty.

  4. The Great Recession, unemployment and suicide.

    Science.gov (United States)

    Norström, Thor; Grönqvist, Hans

    2015-02-01

    How have suicide rates responded to the marked increase in unemployment spurred by the Great Recession? Our paper puts this issue into a wider perspective by assessing (1) whether the unemployment-suicide link is modified by the degree of unemployment protection, and (2) whether the effect on suicide of the present crisis differs from the effects of previous economic downturns. We analysed the unemployment-suicide link using time-series data for 30 countries spanning the period 1960-2012. Separate fixed-effects models were estimated for each of five welfare state regimes with different levels of unemployment protection (Eastern, Southern, Anglo-Saxon, Bismarckian and Scandinavian). We included an interaction term to capture the possible excess effect of unemployment during the Great Recession. The largest unemployment increases occurred in the welfare state regimes with the least generous unemployment protection. The unemployment effect on male suicides was statistically significant in all welfare regimes, except the Scandinavian one. The effect on female suicides was significant only in the eastern European country group. There was a significant gradient in the effects, being stronger the less generous the unemployment protection. The interaction term capturing the possible excess effect of unemployment during the financial crisis was not significant. Our findings suggest that the more generous the unemployment protection the weaker the detrimental impact on suicide of the increasing unemployment during the Great Recession. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Public health implications of sleep loss: the community burden.

    Science.gov (United States)

    Hillman, David R; Lack, Leon C

    2013-10-21

    Poor sleep imparts a significant personal and societal burden. Therefore, it is important to have accurate estimates of its causes, prevalence and costs to inform health policy. A recent evaluation of the sleep habits of Australians demonstrates that frequent (daily or near daily) sleep difficulties (initiating and maintaining sleep, and experiencing inadequate sleep), daytime fatigue, sleepiness and irritability are highly prevalent (20%-35%). These difficulties are generally more prevalent among females, with the exception of snoring and related difficulties. While about half of these problems are likely to be attributable to specific sleep disorders, the balance appears attributable to poor sleep habits or choices to limit sleep opportunity. Study of the economic impact of sleep disorders demonstrates financial costs to Australia of $5.1 billion per year. This comprises $270 million for health care costs for the conditions themselves, $540 million for care of associated medical conditions attributable to sleep disorders, and about $4.3 billion largely attributable to associated productivity losses and non-medical costs resulting from sleep loss-related accidents. Loss of life quality added a substantial further non-financial cost. While large, these costs were for sleep disorders alone. Additional costs relating to inadequate sleep from poor sleep habits in people without sleep disorders were not considered. Based on the high prevalence of such problems and the known impacts of sleep loss in all its forms on health, productivity and safety, it is likely that these poor sleep habits would add substantially to the costs from sleep disorders alone.

  6. 39 CFR 233.5 - Requesting financial records from a financial institution.

    Science.gov (United States)

    2010-07-01

    ... INSPECTION SERVICE AUTHORITY § 233.5 Requesting financial records from a financial institution. (a... Department of the U.S. Postal Service to request financial records from a financial institution pursuant to... authorized to request financial records of any customer from a financial institution pursuant to a formal...

  7. The Burden of Schizophrenia on Caregivers

    OpenAIRE

    Filiz Adana; Hulya Arslantas

    2011-01-01

    Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family suc...

  8. Integrated Financial Management Program

    Science.gov (United States)

    Pho, Susan

    2004-01-01

    Having worked in the Employees and Commercial Payments Branch of the Financial Management Division for the past 3 summers, I have seen the many changes that have occurred within the NASA organization. As I return each summer, I find that new programs and systems have been adapted to better serve the needs of the Center and of the Agency. The NASA Agency has transformed itself the past couple years with the implementation of the Integrated Financial Management Program (IFMP). IFMP is designed to allow the Agency to improve its management of its Financial, Physical, and Human Resources through the use of multiple enterprise module applications. With my mentor, Joseph Kan, being the branch chief of the Employees and Commercial Payments Branch, I have been exposed to several modules, such as Travel Manager, WebTads, and Core Financial/SAP, which were implemented in the last couple of years under the IFMP. The implementation of these agency-wide systems has sometimes proven to be troublesome. Prior to IFMP, each NASA Center utilizes their own systems for Payroll, Travel, Accounts Payable, etc. But with the implementation of the Integrated Financial Management Program, all the "legacy" systems had to be eliminated. As a result, a great deal of enhancement and preparation work is necessary to ease the transformation from the old systems to the new. All this work occurs simultaneously; for example, e-Payroll will "go live" in several months, but a system like Travel Manager will need to have information upgraded within the system to meet the requirements set by Headquarters. My assignments this summer have given me the opportunity to become involved with such work. So far, I have been given the opportunity to participate in projects resulting from a congressional request, several bankcard reconciliations, updating routing lists for Travel Manager, updating the majordomo list for Travel Manager approvers and point of contacts, and a NASA Headquarters project involving

  9. [The coroner's autopsies in the Great Britain: the problems related to the quality of the studies, standardization, auditing, financial support and the approaches to their solution].

    Science.gov (United States)

    Makarov, I Yu; Kuprina, T A; Fetisov, V A; Minaeva, P V

    2018-01-01

    This article continues the series of previous publications of the authors based on the analysis of the detailed report of the experts of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD) designed to evaluate the quality of autopsies carried out by the coroners in the Great Britain. It was shown that only in 13 to 55% of the 1,691 case the operators had an opportunity to refer the necropsy materials for the pathological study. The problems encountered in association with histological and toxicological analysis arose from the misunderstanding between the coroners and the pathologists as regard the organizational aspects of autopsy studies as swell as the financial and economic considerations. The Coroner Rules that had been adopted in 1984 and remained in force in the country until 2005 needed to be radically revised, corrected, and amended to facilitate the solution of a number of problems and eliminate the formal organizational and technical contradictions that hampered the further improvement of the quality of autopsies that must be performed by the corners at the national rather than the local level. The maximum number of the unacceptable results were revealed in the protocols of autopsires carried out by the forensic medical experts. All pathologists in the Great Britain are recommended to pay special attention to all cases of sudden death of the adult subjects and the deceased epileptic patients. The detailed investigations are mandatory in all cases of death following medical manipulations, such as surgical interventions, and complications.

  10. Financial Statements Analysis

    OpenAIRE

    Tănase Alin-Eliodor

    2014-01-01

    This article focuses on analyzing of a consolidated financial statements of a hypothetically SME. The interpretation of the financial position and performances is based on the more than 40 financial key ratios computed by using financial data from consolidated income statement, consolidated financial position and cash flow. However additional data from notes to financial statements are provided.

  11. Health Economic Data in Reimbursement of New Medical Technologies: Importance of the Socio-Economic Burden as a Decision-Making Criterion.

    Science.gov (United States)

    Iskrov, Georgi; Dermendzhiev, Svetlan; Miteva-Katrandzhieva, Tsonka; Stefanov, Rumen

    2016-01-01

    Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies. This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria. Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation. New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies.

  12. Rio+20. Financial resources for improved international environmental governance

    Energy Technology Data Exchange (ETDEWEB)

    Gerstetter, Christiane; Goerlach, Benjamin; Stoessel, Susanah; Ivanova, Maria; Cavalieri, Sandra; Tedsen, Elizabeth; Bar-On, Haran [Ecologic Institute, Berlin (Germany)

    2012-11-01

    In the run-up to the Rio+20 summit, which takes place in June 2012, this study investigates the current system for financing international environmental governance (IEG). The current architecture for IEG finance consists of a growing number of bilateral and multilateral actors, funds and financial mechanisms which leads to incoherence, inefficiencies and extra burdens on recipient countries. The resulting intransparency is exerbated by the lack of a comprehensive system for tracking. Against this background, this study investigates the current state of the IEG funding system from a qualitative and - to a lesser degree - quantitative angle. Some of its flaws are discussed as are options for its improvement - all with a view to formulating recommendations for the Rio+20 summit.

  13. THE ROLE OF FINANCIAL EDUCATION IN DEVELOPING THE FINANCIAL SERVICES MARKET

    OpenAIRE

    Ivanka Daneva

    2015-01-01

    Considering the current complexity of financial markets and of financial instruments and services, financial education is part of population’s financial literacy and it ranks as paramount factor in the complex for the financial markets development.

  14. The burden of rabies in Tanzania and its impact on local communities.

    Directory of Open Access Journals (Sweden)

    Maganga Sambo

    2013-11-01

    Full Text Available Rabies remains a major public health threat in many parts of the world and is responsible for an estimated 55,000 human deaths annually. The burden of rabies is estimated to be around US$20 million in Africa, with the highest financial expenditure being the cost of post-exposure prophylaxis (PEP. However, these calculations may be substantial underestimates because the costs to households of coping with endemic rabies have not been investigated. We therefore aimed to estimate the household costs, health-seeking behaviour, coping strategies, and outcomes of exposure to rabies in rural and urban communities in Tanzania.Extensive investigative interviews were used to estimate the incidence of human deaths and bite exposures. Questionnaires with bite victims and their families were used to investigate health-seeking behaviour and costs (medical and non-medical costs associated with exposure to rabies. We calculated that an average patient in rural Tanzania, where most people live on less than US$1 per day, would need to spend over US$100 to complete WHO recommended PEP schedules. High costs and frequent shortages of PEP led to poor compliance with PEP regimens, delays in presentation to health facilities, and increased risk of death.The true costs of obtaining PEP were twice as high as those previously reported from Africa and should be considered in re-evaluations of the burden of rabies.

  15. Financial literacy and financial literacy education : what might be the components of an effective financial literacy curriculum?

    OpenAIRE

    Lee, Nirmala

    2010-01-01

    Abstract There is concern about lack of financial literacy and need for financial literacy education, but little or no attempt to understand their nature. Three questions were asked: 'What is financial literacy?', 'What is financial literacy education?' and 'What might be the components of an effective financial literacy curriculum?'. Adopting an inductive grounded theory approach and a pragmatist philosophy, in association with real-world organisations such as the National ...

  16. Economic and humanistic burden of illness in generalized anxiety disorder: an analysis of patient survey data in Europe

    Directory of Open Access Journals (Sweden)

    Toghanian S

    2014-04-01

    Full Text Available Samira Toghanian,1 Marco DiBonaventura,2 Krister Järbrink,1 Julie C Locklear31AstraZeneca R&D, Mölndal, Sweden; 2Kantar Health, New York, NY, USA; 3AstraZeneca Pharmaceuticals, Wilmington, DE, USABackground: Whilst studies suggest that generalized anxiety disorder (GAD represents a considerable health care burden in Europe, there is a paucity of published evidence. This study investigated the burden of illness associated with GAD across five European countries (France, Germany, Italy, Spain, and the UK.Methods: Information from the 2008 European National Health and Wellness Survey database was analyzed. Bivariate, multivariate, and cost analyses were used to compare patients with GAD and propensity-matched controls.Results: Compared with non-GAD controls, patients with GAD had more comorbidities and were more likely to smoke but less likely to be employed, use alcohol, or take exercise. They also had significantly worse health-related quality of life, and significantly greater work impairment and resource use, which increased as GAD severity increased. Within-country analyses demonstrated results similar to those for the five European countries overall, with the largest differences in resource use between patients with GAD and non-GAD controls documented in France and Germany. The average mean differences in direct costs were relatively small between the GAD groups and controls; however, indirect costs differed substantially. Costs were particularly high in Germany, mainly due to higher salaries leading to higher costs associated with absence from work. The limitation of this study was that the data were from a self-reported Internet survey, making them subject to reporting bias and possibly sample bias.Conclusion: Across all five European countries, GAD had a significant impact on work impairment, resource use, and economic costs, representing a considerable individual and financial burden that increased with severity of disease. These data

  17. Financial Literacy as the Foundation for Individual Financial Behavior

    Science.gov (United States)

    Dwiastanti, Anis

    2015-01-01

    Research that is dealing with financial literacy turns to be such an important thing to be conducted. It is due to the fact that financial literacy level of Indonesian society is still very low. A good financial literacy is necessary for every individual to manage his/her finances to achieve prosperity. To have a good level of financial literacy,…

  18. Financial Literacy, Financial Education and Economic Outcomes. NBER Working Paper No. 18412

    Science.gov (United States)

    Hastings, Justine S.; Madrian, Brigitte C.; Skimmyhorn, William L.

    2012-01-01

    In this article we review the literature on financial literacy, financial education, and consumer financial outcomes. We consider how financial literacy is measured in the current literature, and examine how well the existing literature addresses whether financial education improves financial literacy or personal financial outcomes. We discuss the…

  19. The burden of migraine in the United States: current and emerging perspectives on disease management and economic analysis.

    Science.gov (United States)

    Hazard, Elisabeth; Munakata, Julie; Bigal, Marcelo E; Rupnow, Marcia F T; Lipton, Richard B

    2009-01-01

    Migraine is often perceived as a low-impact condition that imposes a limited burden to society and the health-care system. This study reviews the current understanding of the burden of migraine in the U.S., the history of economic understanding of migraine treatment and identifies emergent trends for future studies evaluating clinical and economic outcomes of migraine treatment. This study traced the history of economic articles published on migraine by performing a literature search using PubMed MEDLINE database and ancestral searches of relevant articles. The intention was not to provide an exhaustive review of every article or adjudicate between studies with different findings. Migraine affects millions of individuals worldwide, generally during the most productive years of a person's life. Studies show that migraineurs are underdiagnosed, undertreated, and experience substantial decreases in functioning and productivity, which in turn translates into diminished quality of life for individuals, and financial burdens to both health-care systems and employers. Economic evaluations of migraine therapies have evolved with new clinical developments beginning with cognitive-behavioral therapy, introduction of triptans, concern over medication overuse, and emergence of migraine prophylaxis. Now recent clinical studies suggest that migraine may be a progressive disease with cardiovascular, cerebrovascular, and long-term neurologic effects. Migraine imposes a substantial burden on patients, families, employers and societies. The economic standards by which migraine and treatment are evaluated have evolved in response to clinical developments. Emerging evidence suggests that migraine is a chronic and progressive disease. If confirmed, approaches to acute and prophylactic treatments and economic evaluations of migraine treatment may require major reconsideration.

  20. 12 CFR 508.10 - Burden of persuasion.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Burden of persuasion. 508.10 Section 508.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.10 Burden of persuasion. The petitioner has the burden of...

  1. The Effect of Barkley's family-oriented program on the burden of care on families of children with attention deficit-hyperactive disorder

    Directory of Open Access Journals (Sweden)

    Sharifeh Mousavi

    2017-01-01

    Full Text Available Background: Attention deficit-hyperactive disorder (ADHD is the most common behavioral disorders during childhood whose treatment is greatly dependent on families; therefore, families of such children should improve their relation with them so that they could enjoy their lives. Hence, this study was conducted to evaluate the effect of Barkley's family-oriented program on the burden of care on such families. Materials and Methods: This clinical trial was conducted among 64 family care givers for children with ADHD. By simple sampling, samples passing the inclusion criteria were selected and randomly allocated into two groups of control and intervention. The intervention group received Barkley's family education program through 9 sessions; the control group participated in 3 group sessions and expressed their problems and experiences. Data were collected and analyzed using the Zarit Burden Interview. Results: Burden of care was gradually reduced through the study in the intervention group, however, the mean score of burden of care did not have a significant reduction in the control group. Conclusions: Because Barkley's family-oriented program was able to reduce the burden of care in families of children with ADHD, it is recommended to develop similar programs and evaluate them through various studies.

  2. Burden of childhood-onset arthritis

    Directory of Open Access Journals (Sweden)

    Hassett Afton L

    2010-07-01

    Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

  3. Financial Stress and Financial Counseling: Helping College Students

    Science.gov (United States)

    Britt, Sonya L.; Canale, Anthony; Fernatt, Fred; Stutz, Kristen; Tibbetts, Racquel

    2015-01-01

    This study had two distinct purposes. First, to determine the predictors of financial stress among college students who sought free peer-based financial counseling from a large Midwestern university (N = 675). Secondly, to determine the effectiveness of the particular financial counseling center from a subsample of those who sought help (N = 97).…

  4. Current Transformations of the Eurozone Financial and Institutional Space

    Directory of Open Access Journals (Sweden)

    Kornіvska Valerіa O.

    2016-08-01

    Full Text Available The article presents the results of studying the processes of reforming the financial and institutional space of the eurozone, which in the long run creates the foundation for basic changes, which will result in not just a postcrisis “restart” of the system of financial institutions, but the creation of new mechanisms of liquidity circulation and in view of this the restructuring of the current model of investment process from mainly the banking into the market (stock one. On the basis of the analysis of the credit cooperation between banking institutions of the eurozone and the real sector there made conclusions about the limited effectiveness of the current model of investment support due to the inability of the dominant financial institutions (banks to enable economic recovery under conditions of the gap between the complementary interaction of banking institutions and the real sector of the economy. The paper justifies that the gap between the complementarity of the banking system and the real sector emerged also in connection with the formation of the negative in the general economic context complementarity of the state and the banking sector, which greatly distorts the competitive foundations of the European financial and institutional space, contributes to the banking lobby, hinders the process of reforming the banking space, which will be of limited effectiveness in the future

  5. Childhood socioeconomic circumstances and depressive symptom burden across 15 years of follow-up during midlife: Study of Women's Health Across the Nation (SWAN).

    Science.gov (United States)

    Bromberger, Joyce T; Schott, Laura L; Matthews, Karen A; Kravitz, Howard M; Harlow, Siobán D; Montez, Jennifer Karas

    2017-08-01

    Childhood socioeconomic disadvantage may contribute to adult depression. Understanding pathways by which early socioeconomic adversity may shape adult depression is important for identifying areas for intervention. Studies to date have focused on one potential pathway, adult socioeconomic status (SES), and assessed depression at only one or a few time points. Our aims were to examine (a) the association between childhood SES (low vs. high) and depressive symptom burden in midlife and (b) whether adult socioeconomic, psychosocial, and physical health characteristics are important pathways. Using annual data from a cohort of 1109 black and white US women recruited in 1996-1997, we evaluated the association between childhood SES and depressive symptom burden across 15 years in midlife and whether adult characteristics-financial difficulty, lower education, stressful events, low social support, low role functioning, medical conditions, and bodily pain-mediated the association. Depressive symptom burden was estimated by calculating area under the curve of annual scores across 15 years of the Center for Epidemiological Studies Depression (CES-D). In unadjusted models, low childhood SES was associated with greater depressive burden (P = 0.0002). Each hypothesized mediator, individually, did not reduce the association. However, when five of the hypothesized mediators were included together in the same analysis, they explained more than two thirds of the association between childhood SES and depressive symptom burden reducing the P value for childhood SES to non-significance (P = 0.20). These results suggest that childhood SES influences midlife depressive symptom burden through a cluster of economic stress, limited social resources, and physical symptoms in adulthood.

  6. Framework for financial ratio analysis of audited federal financial reports

    OpenAIRE

    Brady, Richard T.

    1999-01-01

    Federal agencies have traditionally prepared financial reports to monitor and report the obligation and expenditure of federal funding. With the passage of the Chief Financial Officers Act of 1990, Congress called for the production of financial statements that fully disclose a federal entity's financial position and results of operations. The disclosure of this type of information, it was believed, would enable decision-makers to understand the financial implications of budgetary, policy and...

  7. The financial position and funding of French non-financial corporations

    OpenAIRE

    G. Cette.; J.-P. Villetelle.

    2015-01-01

    This study, based on recent company statistics from national accounts and financial statements, shows a deterioration in the financial position of French non-financial corporations. This is affecting their performances and is prompting them to diversify their sources of funding in order to rationalise their financial structure.

  8. APPLICATION OF FINANCIAL ETHICS IN ANNUAL FINANCIAL REPORTING OF BANKS

    Directory of Open Access Journals (Sweden)

    Ayuba A. Aminu

    2016-03-01

    Full Text Available The importance of financial ethics and its application in financial reporting of banks cannot be ignored as it assists in building public confidence and fostering professionalism. However, the non-compliance and conformity with Nigerian Financial Regulatory Authorities prudential guidelines in the preparation of financial statements lead to incomplete or false information. The objective of the study is to examine the application of financial ethics in annual financial reporting of banks. The study employed primary and secondary data and stratified and purposive sampling techniques were used in which 20 questionnaires were administered to respondents. ANOVA and chi-square were in analysis and the findings revealed that there are significant unethical practices in the preparation of financial reports of banks in Nigeria. The study recommends that more emphasis and attention should be given to ethical standards in all banks and banks should give out clear reports of their financial activities to the regulatory authorities.

  9. Financial Planners: Educating Widows in Personal Financial Planning

    Science.gov (United States)

    Korb, Brian R.

    2010-01-01

    Widows constitute a growing segment of the U.S. population; however, very little has been done to educate them on the basics of personal financial planning. The creation and implementation of financial planning education programs for widows can help them become more financially literate and free them from anxiety and fear. Interviews with eight…

  10. Does Financial Inclusion Induce Financial Stability? Evidence from Cross-country Analysis

    Directory of Open Access Journals (Sweden)

    Md. Nur Alam Siddik

    2018-04-01

    Full Text Available In recent times, financial inclusion and financial stability issue have become a priority on policy agendas across the world. However, there is relative dearth of empirical studies addressing and establishing the link between the same. This study fills this gap. Using panel data of 2001-2013, this study empirically investigated whether financial inclusion contributes to country’s financial stability, measured by Z-score. Robust results from GMM dynamic panel data estimator show that financial inclusion variables as measured by number of SME borrowers to total borrowers and ratio of outstanding SME loans to total loans have significant positive contributions to financial stability. Findings also indicate that GDP per capita, liquidity, proportion of private credit to GDP are positively and proportion of domestic credit provided to private sector and financial crisis are negatively associated with financial stability. Empirical findings of this study is of greater significance to the policymakers as it will invoke the attention of governments and policymakers to undertake such policies to accelerate financial inclusion of their countries which in turn will lead to country’s greater financial stability. This study also contributes to empirical literatures of the issue of financial inclusion and financial stability by reconfirming (or otherwise findings of previous studies.

  11. Banking for health: the role of financial sector actors in investing in global health

    Science.gov (United States)

    Kickbusch, Ilona; Franz, Christian; Wells, Nadya

    2018-01-01

    The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors’ business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm’s employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products. PMID:29736278

  12. Banking for health: the role of financial sector actors in investing in global health.

    Science.gov (United States)

    Krech, Rüdiger; Kickbusch, Ilona; Franz, Christian; Wells, Nadya

    2018-01-01

    The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors' business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm's employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products.

  13. May the Soul of the IFS Financial System Definition RIP in Developing Countries

    Directory of Open Access Journals (Sweden)

    Simplice A. Asongu

    2015-03-01

    Full Text Available In this paper, we dissect with great acuteness contemporary insufficiencies of the IFS (2008 definition of the financial system and conclude from sound theoretical underpinnings and empirical justifications that the foundation, on which it is based, while solid for developed countries, holds less ground in developing countries. Perhaps one of the deepest empirical hollows in the financial development literature has been the equation of financial depth in the perspective of money supply to liquid liabilities. This equation has put on the margin (and skewed burgeoning phenomena of mobile banking, knowledge economy (KE, inequality…etc. We conclude that the informal financial sector, a previously missing component in the IFS conception and definition of the financial system can only be marginalized at the cost of misunderstanding recent burgeoning trends in mobile phone penetration, KE and poverty. Hence, the IFS definition has incontrovertibly fought its final dead battle and lost in the face of soaring trends highlighted above. Despite the plethora of econometric and policy-making sins the definition has committed in developing countries through bias estimates and misleading inferences, may its soul RIP.

  14. Bye, Bye Financial Repression, Hello Financial Deepening: The Anatomy of a Financial Boom

    OpenAIRE

    João Manoel Pinho de Mello; Márcio Gomes Pinto Garcia

    2011-01-01

    Since the conquest of hyperinflation, with the Real Plan, in 1994, the Brazilian financial system has grown from early infancy to late adolescence. We describe the process of maturing with emphasis on the defining features of the Brazilian financial system over the last 20 years: 1) stabilization and the subsequent financial crisis; 2) universality of banks; 3) market segmentation through public lending; 4) institutional improvement. Further paraphrasing Díaz Alejandro (1984), we raise some h...

  15. The current economic and financial crisis: a gender perspective

    OpenAIRE

    Antonopoulos, Rania

    2009-01-01

    Widespread economic recessions and protracted financial crises have been documented as setting back gender equality and other development goals in the past. In the midst of the current global crisis--often referred to as "the Great Recession"--there is grave concern that progress made in poverty reduction and women's equality will be reversed. Indeed, for many developing countries it is particularly worrisome that, through no fault of their own, the global economic downturn has exacerbated ef...

  16. Changes in the structure and relations of property in the Great Britain nuclear power

    International Nuclear Information System (INIS)

    Rumyantsev, V.V.

    1990-01-01

    Analysis of nuclear power development in the Great Britain is given. Currently it is reoriented to a wide application of PWR reactors instead of gas cooled ones, their economic indices being incapable of providing sufficient competitiveness on the British market. Reasons and state of affairs in denationalizing nuclear power, economic and financial difficulties connected with the realization of this politico-economic procedure are reported

  17. Financial Literacy and Financial Education: Review and Policy Implications

    OpenAIRE

    Annamaria Lusardi

    2006-01-01

    In recent years, as workers have gained an unprecedented degree of control over their pensions and savings, the importance of financial literacy and financial education has increased considerably. Large changes in the structure of financial markets, labor markets, and demographics in developed countries have led to this change. Consumers have a bewildering array of complex financial products – from reverse mortgages to annuities – to choose from, making saving decisions increasingly complex. ...

  18. Burden of Respiratory Disease in Korea: An Observational Study on Allergic Rhinitis, Asthma, COPD, and Rhinosinusitis.

    Science.gov (United States)

    Yoo, Kwang Ha; Ahn, Hae Ryun; Park, Jae Kyoung; Kim, Jong Woong; Nam, Gui Hyun; Hong, Soon Kwan; Kim, Mee Ja; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Lin, Horng Chyuan; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Baidya, Santwona; Wang, De Yun; Cho, Sang Heon

    2016-11-01

    The Asia-Pacific Burden of Respiratory Diseases (APBORD) study is a cross-sectional, observational one which has used a standard protocol to examine the disease and economic burden of allergic rhinitis (AR), asthma, chronic obstructive pulmonary disorder (COPD), and rhinosinusitis across the Asia-Pacific region. Here, we report on symptoms, healthcare resource use, work impairment, and associated costs in Korea. Consecutive participants aged ≥18 years with a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed a survey detailing respiratory symptoms, healthcare resource use, and work productivity and activity impairment. Costs included direct medical cost and indirect cost associated with lost work productivity. The study enrolled 999 patients. Patients were often diagnosed with multiple respiratory disorders (42.8%), with asthma/AR and AR/rhinosinusitis the most frequently diagnosed combinations. Cough or coughing up phlegm was the primary reason for the medical visit in patients with a primary diagnosis of asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the main reasons in those with AR and rhinosinusitis. The mean annual cost for patients with a respiratory disease was US$8,853 (SD 11,245) per patient. Lost productivity due to presenteeism was the biggest contributor to costs. Respiratory disease has a significant impact on disease burden in Korea. Treatment strategies for preventing lost work productivity could greatly reduce the economic burden of respiratory disease.

  19. Health economic data in reimbursement of new medical technologies: importance of the socio-economic burden as a decision-making criterion

    Directory of Open Access Journals (Sweden)

    Georgi Iskrov

    2016-08-01

    Full Text Available Background: Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies.Objective: This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria.Results/Conclusions: Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation.New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies.

  20. Economic Conditions of Young Adults Before and After the Great Recession.

    Science.gov (United States)

    Sironi, Maria

    2018-01-01

    Transition to adulthood has undoubtedly changed in the last few decades. For youth today, an important marker of adulthood is self-actualization in their professional career, and, consequently, also the achievement of stable financial conditions. Economic conditions of youth are greatly subject to fluctuations in the economy, and the subsequent governmental response. Using the Luxembourg Income Study, this work investigates the trends in income from work of young adults before and after the Great Recession of 2008 in five countries-US, UK, Norway, Germany, and Spain. The findings showed deterioration in economic conditions of young men, but with differences across countries. Young women suffered less from the crisis, and in some countries, their economic situation improved. The general negative trend was especially pronounced for those with high education, which is primarily because they stayed in education longer.

  1. Financial Derivatives

    OpenAIRE

    Janečková, Alena

    2011-01-01

    1 Abstract/ Financial derivatives The purpose of this thesis is to provide an introduction to financial derivatives which has been, from the legal perspective, described in a not satisfactory manner as quite little literature that can be found about this topic. The main objectives of this thesis are to define the term "financial derivatives" and its particular types and to analyse legal nature of these financial instruments. The last objective is to try to draft future law regulation of finan...

  2. FINANCIAL BALANCE - BASIC TOOL IN APPROACHING FINANCIAL DIAGNOSIS FOR FIRM VALUATION

    OpenAIRE

    Dorel BERCEANU; Nicolae SICHIGEA; Marcel DRĂCEA

    2010-01-01

    This paper addresses a very topical issue, namely the importance in assessing the company's financial accounts. Thus, after a brief role in evaluating company financial diagnosis and approaches related to the concept of financial balance, we presented the financial balance sheet in terms of logic building financial stability analysis. At the end of the paper were presented some conclusions.

  3. Transtorno afetivo bipolar: carga da doença e custos relacionados Bipolar disorder: burden of disease and related costs

    Directory of Open Access Journals (Sweden)

    Anna Maria Niccolai Costa

    2008-01-01

    Full Text Available CONTEXTO: O transtorno afetivo bipolar (TAB é uma doença recorrente, crônica e grave. Comorbidades psiquiátricas e físicas, aumento do risco de suicídio, maior utilização de serviços de saúde e prejuízo na esfera social/profissional aumentam significativamente a carga e custos relacionados à doença. OBJETIVOS: Revisar aspectos clínicos, de carga da doença e conseqüentes desfechos financeiros do TAB. MÉTODOS: Pesquisa de base de dados MEDLINE/PubMed utilizando os termos bipolar disorder, epidemiology, burden of disease, comorbidity, cost of illness, outcomes e financial consequences, publicados entre 1980 e 2006. RESULTADOS: O TAB apresenta alta comorbidade com outros transtornos, o que agrava seu prognóstico e eleva os custos com os serviços de saúde. Os indivíduos com TAB apresentam mais fatores de risco cardiovascular e, conseqüentemente, maior risco de morte por evento cardíaco. O atraso e o erro diagnóstico no TAB elevam consideravelmente a carga e os custos da doença. CONCLUSÕES: As comorbidades, o risco de suicídio, o prejuízo social/profissional e a baixa adesão ao tratamento contribuem para a alta carga e os custos associados à doença. A pesquisa de comorbidades pode ajudar os médicos a ajustarem suas estratégias de tratamento, considerando cuidadosamente todos os fatores de risco e custos associados, fatores estes que devem ser levados em conta também pelos profissionais que trabalham com gestão de saúde, tanto no setor privado quanto público.BACKGROUND: Bipolar disorder (BD is a recurrent, chronic and severe disease. Mental and physical comorbidities, risk of suicide, health services use and impairment of social and professional domains significantly worsen the burden and increase the costs of illness. OBJECTIVES: Review clinical aspects, burden of disease, and consequent financial outcomes of BD. METHODS: MEDLINE/PubMed database search using the terms bipolar disorder, epidemiology, burden of

  4. Emerging markets and the international financial architecture: a blueprint for reform

    Directory of Open Access Journals (Sweden)

    JAN KREGEL

    2015-06-01

    Full Text Available If emerging markets are to achieve their objective of joining the ranks of industrialized, developed countries, they must use their economic and political influence to support radical change in the international financial system. This working paper recommends John Maynard Keynes's "clearing union" as a blueprint for reform of the international financial architecture that could address emerging market grievances more effectively than current approaches. Keynes's proposal for the postwar international system sought to remedy some of the same problems currently facing emerging market economies. It was based on the idea that financial stability was predicated on a balance between imports and exports over time, with any divergence from balance providing automatic financing of the debit countries by the creditor countries via a global clearinghouse or settlement system for trade and payments on current account. This eliminated national currency payments for imports and exports; countries received credits or debits in a notional unit of account fixed to national currency. Since the unit of account could not be traded, bought, or sold, it would not be an international reserve currency. The credits with the clearinghouse could only be used to offset debits by buying imports, and if not used for this purpose they would eventually be extinguished; hence the burden of adjustment would be shared equally - credit generated by surpluses would have to be used to buy imports from the countries with debit balances. Emerging market economies could improve upon current schemes for regionally governed financial institutions by using this proposal as a template for the creation of regional clearing unions using a notional unit of account.

  5. Financial Development, Financial Structure, and Macroeconomic Volatility: Evidence from China

    Directory of Open Access Journals (Sweden)

    Feng Wei

    2016-11-01

    Full Text Available Using annual data from 1997–2014 of 30 provinces, municipalities, and autonomous regions, subdividing trended and cyclical volatility of macroeconomics and inflation, considering different indicators of financial development and financial structure, this paper investigated the impact of financial development and financial structure on macroeconomic volatility. The empirical results found that (1 the trended and cyclical volatility of the previous macroeconomic period had a significantly positive impact on that of the current period, and the impact of trended volatility was greater than that of cyclical volatility; (2 financial development had a significantly negative impact on macroeconomic cyclical volatility through inflation cyclical volatility, but inflation trended volatility would amplify macroeconomic volatility; financial markets have no significant effect on macroeconomic volatility; financial structure measured with the ratio of stock market turnover and the efficiency of the financial development had a significant positive impact on macroeconomic cyclical volatility; and (3 inflation trended volatility had a significantly negative impact on macroeconomic cyclical volatility and trended volatility, while inflation cyclical volatility had a significantly positive impact on macroeconomic cyclical volatility.

  6. Financial and Non Financial Factors on Going-Concern Opinion

    Directory of Open Access Journals (Sweden)

    Junaidi Junaidi

    2012-09-01

    Full Text Available Company's ability to survive is a fundamental uncertainty faced in the preparation and auditing financial statements. Provision of going-concern opinion on these financial statements the company is still being debated. Public Accountant Professional Standards in section 341 states that the auditor is responsible for evaluating whether there is a major doubt on the ability of entities in the continued survival of the appropriate period of time, not more than one year from the date of the financial statements being audited. This research analyzed the financial and non financial factors that affected the provision of going-concern opinion. This research used samples of 63 companies with 315 observations, taken from years 2005-2009. The logistic regression analysis showed that the company's financial condition variables, mitigating evidence, and disclosure significantly influence the acceptance of going-concern opinion. Enterprise risk was not significant at propensity of going-concern opinion.

  7. Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis.

    Science.gov (United States)

    Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

    2017-04-20

    To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000-2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Systematic analysis of all open-access data. Public and philanthropic funding to all UK cancer research institutions, 2000-2013. Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded-the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies. Funding agencies and industry should openly document their research investments to

  8. On Rural Financial and Accounting Work under the Background of Rapid Agricultural Economic Development

    Institute of Scientific and Technical Information of China (English)

    Yaozheng; TANG

    2013-01-01

    Under the background of rapid agricultural economic development,rural financial and accounting work is of great significance. From rural accounting management system,rural accountant allocation and rural accounting training,this paper analyzes current situations of rural accounting work in China. In rural financial and accounting work,there are following problems. ( 1) Accounting behavior is not standard,and basic accounting work is to be further strengthened; ( 2) Internal control is not perfect and implementation of supervision mechanism is formalized; ( 3) Few people manipulate accounting behavior and accounting information is not transparent. In view of these problems,it puts forward countermeasures for improving rural accounting work: ( 1) establishing perfect agricultural accounting system; ( 2) regulating fund management order; ( 3) promoting computerized agricultural financial and accounting work; ( 4) improving professional and comprehensive quality of rural accountants.

  9. Economic burden of COPD in a Swedish cohort: the ARCTIC study

    Directory of Open Access Journals (Sweden)

    Lisspers K

    2018-01-01

    comorbidities in COPD would offer clinical benefits and relieve the financial burden of disease. Keywords: COPD, direct cost, indirect cost, burden, Sweden

  10. The financial process in small and medium enterprises

    Directory of Open Access Journals (Sweden)

    Mariela Andrade Arias

    2018-02-01

    Full Text Available The small medium enterprises contribute to productive apparatus of Quevedo Canton in this line of our country. These institutions count on a great number of entrepreneurs in the all productive levels. But it has generated some difficulties in the organizations’ control, even occasionally by managers’ oversight. There also are weak supports in the control and enterprise’s addressing. The present research was done with the purpose to determine the incidence of financial management is small and medium enterprises of Quevedo Canton. Empirical and theoretical methods were used and also some researching techniques such as surveys and documentary and literature review and the law and regulations of these enterprises were consulted. One of the main results was the necessity to incorporate integral training plans to improve the financial economic management of each enterprise. It concludes panting out that 74 % of small enterprises didn´t count on appropriate organizational structure to develop productive activities like the 68 % medium enterprises.

  11. Financial Policies and the Prevention of Financial Crises in Emerging Market Countries

    OpenAIRE

    Frederic S. Mishkin

    2001-01-01

    This paper outlines a set of financial policies that can help make financial crises less likely in emerging market countries. To justify these policies, the paper first explains what a financial crisis is, the factors that promote a financial crisis and the dynamics of a financial crisis. It then examines twelve basic areas of financial policies to prevent financial crises: 1) prudential supervision, 2) accounting and disclosure requirements, 3) legal and judicial systems, 4) market-based dis...

  12. The Great Recession And Increased Cost Sharing In European Health Systems.

    Science.gov (United States)

    Palladino, Raffaele; Lee, John Tayu; Hone, Thomas; Filippidis, Filippos T; Millett, Christopher

    2016-07-01

    European health systems are increasingly adopting cost-sharing models, potentially increasing out-of-pocket expenditures for patients who use health care services or buy medications. Government policies that increase patient cost sharing are responding to incremental growth in cost pressures from aging populations and the need to invest in new health technologies, as well as to general constraints on public expenditures resulting from the Great Recession (2007-09). We used data from the Survey of Health, Ageing and Retirement in Europe to examine changes from 2006-07 to 2013 in out-of-pocket expenditures among people ages fifty and older in eleven European countries. Our results identify increases both in the proportion of older European citizens who incurred out-of-pocket expenditures and in mean out-of-pocket expenditures over this period. We also identified a significant increase over time in the percentage of people who incurred catastrophic health expenditures (greater than 30 percent of the household income) in the Czech Republic, Italy, and Spain. Poorer populations were less likely than those in the highest income quintile to incur an out-of-pocket expenditure and reported lower mean out-of-pocket expenditures, which suggests that measures are in place to provide poorer groups with some financial protection. These findings indicate the substantial weakening of financial protection for people ages fifty and older in European health systems after the Great Recession. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Attention-deficit/hyperactivity disorder, delay discounting, and risky financial behaviors: A preliminary analysis of self-report data.

    Science.gov (United States)

    Beauchaine, Theodore P; Ben-David, Itzhak; Sela, Aner

    2017-01-01

    Delay discounting-often referred to as hyperbolic discounting in the financial literature-is defined by a consistent preference for smaller, immediate rewards over larger, delayed rewards, and by failure of future consequences to curtail current consummatory behaviors. Previous research demonstrates (1) excessive delay discounting among individuals with attention-deficit/hyperactivity disorder (ADHD), (2) common neural substrates of delay discounting and hyperactive-impulsive symptoms of ADHD, and (3) associations between delay discounting and both debt burden and high interest rate borrowing. This study extends prior research by examining associations between ADHD symptoms, delay discounting, and an array of previously unevaluated financial outcomes among 544 individuals (mean age 35 years). Controlling for age, income, sex, education, and substance use, ADHD symptoms were associated with delay discounting, late credit card payments, credit card balances, use of pawn services, personal debt, and employment histories (less time spent at more jobs). Consistent with neural models of reward processing and associative learning, more of these relations were attributable to hyperactive-impulsive symptoms than inattentive symptoms. Implications for financial decision-making and directions for future research are discussed.

  14. A financial network perspective of financial institutions' systemic risk contributions

    Science.gov (United States)

    Huang, Wei-Qiang; Zhuang, Xin-Tian; Yao, Shuang; Uryasev, Stan

    2016-08-01

    This study considers the effects of the financial institutions' local topology structure in the financial network on their systemic risk contribution using data from the Chinese stock market. We first measure the systemic risk contribution with the Conditional Value-at-Risk (CoVaR) which is estimated by applying dynamic conditional correlation multivariate GARCH model (DCC-MVGARCH). Financial networks are constructed from dynamic conditional correlations (DCC) with graph filtering method of minimum spanning trees (MSTs). Then we investigate dynamics of systemic risk contributions of financial institution. Also we study dynamics of financial institution's local topology structure in the financial network. Finally, we analyze the quantitative relationships between the local topology structure and systemic risk contribution with panel data regression analysis. We find that financial institutions with greater node strength, larger node betweenness centrality, larger node closeness centrality and larger node clustering coefficient tend to be associated with larger systemic risk contributions.

  15. Burden of Proof in Bioethics.

    Science.gov (United States)

    Koplin, Julian J; Selgelid, Michael J

    2015-11-01

    A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.

  16. Financial Toxicity among Patients with Bladder Cancer: Reasons for Delay in Care and Effect on Quality of Life.

    Science.gov (United States)

    Casilla-Lennon, Marianne M; Choi, Seul Ki; Deal, Allison M; Bensen, Jeannette T; Narang, Gopal; Filippou, Pauline; McCormick, Benjamin; Pruthi, Raj; Wallen, Eric; Tan, Hung-Jui; Woods, Michael; Nielsen, Matthew; Smith, Angela

    2018-05-01

    Costly surveillance and treatment of bladder cancer can lead to financial toxicity, a treatment related financial burden. Our objective was to define the prevalence of financial toxicity among patients with bladder cancer and identify delays in care and its effect on health related quality of life. We identified patients with bladder cancer in the University of North Carolina Health Registry/Cancer Survivorship Cohort. Financial toxicity was defined as agreement with having "to pay more for medical care than you can afford." Health related quality of life was measured using general and cancer specific validated questionnaires. Statistical analyses were performed using the Fisher exact test and the Student t-test. A total of 138 patients with bladder cancer were evaluated. Median age was 66.9 years, 75% of the patients were male and 89% were white. Of the participants 33 (24%) endorsed financial toxicity. Participants who were younger (p = 0.02), black (p = 0.01), reported less than a college degree (p = 0.01) and had noninvasive disease (p = 0.04) were more likely to report financial toxicity. On multivariable analysis only age was a significant predictor of financial toxicity. Patients who endorsed financial toxicity were more likely to report delaying care (39% vs 23%, p = 0.07) due to the inability to take time off work or afford general expenses. On general health related quality of life questionnaires patients with financial toxicity reported worse physical and mental health (p = 0.03 and life (p = 0.01), physical well-being (p = 0.01) and functional well-being (p = 0.05). Financial toxicity is a major concern among patients with bladder cancer. Younger patients were more likely to experience financial toxicity. Those who endorsed financial toxicity experienced delays in care and poorer health related quality of life, suggesting that treatment costs should have an important role in medical decision making. Copyright © 2018 American Urological Association

  17. FINANCIAL REPORTING IN PUBLIC INSTITUTIONS AND NON-FINANCIAL ENTITIES. SIMILARITIES AND DIFFERENCES

    OpenAIRE

    Daniela Vitan

    2011-01-01

    The present paperwork contains issues regarding financial reporting at the public institutions and non – financial entities. The main aspects are regarding the obligation of all entities to present the financial statements, the content of financial statements in public institutions and non-financial entities. Also, is presented the similarities and the differences aspects between financial reporting of these two patrimonial entities.

  18. Workplace Financial Education Facilitates Improvement in Personal Financial Behaviors

    Science.gov (United States)

    Prawitz, Aimee D.; Cohart, Judith

    2014-01-01

    Based on the life-cycle theory of consumption, this quasi-experimental study of 995 employees examined changes in financial behaviors following employee-needs-driven workplace financial education. Repeated-measures ANOVA compared participants and non-participants on perceived financial wellness and savings ratios; main effects indicated that both…

  19. Financial mathematics

    CERN Document Server

    Jothi, A Lenin

    2009-01-01

    Financial services, particularly banking and insurance services is the prominent sector for the development of a nation. After the liberalisation of financial sector in India, the scope of getting career opportunities has been widened. It is heartening to note that various universities in India have introduced professional courses on banking and insurance. A new field of applied mathematics has come into prominence under the name of Financial Mathematics. Financial mathematics has attained much importance in the recent years because of the role played by mathematical concepts in decision - m

  20. The CEA at the heart of great new challenges - Annual report 2015. The CEA - Financial report 2015

    International Nuclear Information System (INIS)

    2016-06-01

    The French Alternative Energies and Atomic Energy Commission (CEA) is a key player in research, development and innovation in four main areas: defence and security, nuclear energy (fission and fusion), technological research for industry, fundamental research in the physical sciences and life sciences. Drawing on its widely acknowledged expertise, the CEA actively participates in collaborative projects with a large number of academic and industrial partners. The CEA is established in nine centers spread throughout France. It works in partnership with many other research bodies, local authorities and universities. Within this context, the CEA is a stakeholder in a series of national alliances set up to coordinate French research in energy (ANCRE), life sciences and health (AVIESAN), digital science and technology (ALLISTENE), environmental sciences (AllEnvi) and human and social sciences (ATHENA). The CEA in figures (2015): 9 research centres; 15958 technicians, engineers, researchers and staff; 51 joint research units (UMR); 53 framework agreements with universities and schools; 753 priority patents filed in 2015; 27 Equipex (facilities of excellence); 33 Labex (Laboratories of excellence); 3 Idex (Initiatives of excellence); 187 start-ups since 1972 in the innovative technologies sector; 4,1 billion euros budget; 438 ongoing European projects in 2015. This document is the activity report of CEA over the year 2015 (Defence, energy, technologies, fundamental research..). It is followed by a Management and a financial report (annual Financial Statements)

  1. Can environmental investment and expenditure enhance financial performance of US electric utility firms under the clean air act amendment of 1990?

    International Nuclear Information System (INIS)

    Sueyoshi, Toshiyuki; Goto, Mika

    2009-01-01

    This study investigates the causality from environmental investment (as a long-term effort) and expenditure (as a short-term effort) to financial performance in the US electric utility industry. The industry is one of the large air polluters in the United States. This empirical study finds that the environmental expenditure under the US Clean Air Act has had a negative impact from 1989 to 2001. The negative impact has become much effective after the implementation of the Title IV Program (1995) of the US Clean Air Act. This study cannot find the influence of environmental investment on financial performance by a statistical test although it indicates a positive impact. In the United States, fossil-fueled power plants such as coal-fired ones still produce a large portion of electricity. The generation structure is inconsistent with the betterment in the US environmental protection and imposes a financial burden to electric utility firms.

  2. The Collapse of the United States Banking System During the Great Depression, 1929 to 1933. New Archival Evidence

    Directory of Open Access Journals (Sweden)

    Gary Richardson

    2007-03-01

    Full Text Available During the Great Depression, one third of all banks in the United States failed. Scholarsdispute reason for their demise. This essay analyzes new evidence on the sources of bankdistress. The data demonstrates that contagion via correspondent networks and bank runspropagated the initial banking panics in the fall of 1930. As the depression deepened and assetvalues declined, insolvency loomed as the principal threat to depository institutions. Thesepatterns corroborate some and question other conjectures concerning the causes andconsequences of the financial crisis during the Great Contraction.

  3. INSTABILITY IN THE CEE BANKING SYSTEM. EVIDENCE FROM THE RECENT FINANCIAL CRISIS

    Directory of Open Access Journals (Sweden)

    Renata Karkowska

    2013-12-01

    Full Text Available Sparked by the recent great recession and the role of financial markets, considerable interest exists among researchers within both the academic and public community in measuring and modeling systemic risk. This article introduces a new framework for measuring systemic risk by using a risk-adjusted balance sheet approach. In this regard, the analysis of 21 largest commercial banks operating in 7 countries from Central and Eastern Europe, shows potential risk which could threaten all the financial system. The paper concludes new directions for measuring systemic risk by using Merton model. It shows how risk management tools can be applied in new ways to measure and analyze systemic risk in European banking system.

  4. Overcoming financial barriers to wider use of renewable energy technology in Africa

    International Nuclear Information System (INIS)

    Davidson, O.R.; Turkson, J.

    2001-01-01

    Future energy demand in Africa will rise dramatically due to development desires and increased industrial needs. Coping with this demand will pose a serious challenge because of the economic and environmental constraints of the continent. Exploiting its vast renewable energy sources for this purpose will assist greatly, but financial and other barriers to the rapid growth of associated technologies are significant. This paper explores measures that can be implemented to reduce these financial barriers. The analyses, which are based on lessons from experiences in and out of the region, show that replicating and enhancing current initiatives along with the implementation of suggested policy options could substantially increase the use of renewable energy technologies in Africa. (author)

  5. Framework for Financial Ratio Analysis of Audited Federal Financial Reports

    National Research Council Canada - National Science Library

    Brady, Richard

    1999-01-01

    .... With the passage of the Chief Financial Officers Act of 1990, Congress called for the production of financial statements that fully disclose a federal entity's financial position and results of operations...

  6. Financial Economy and Financial System: Basis of Structural Interconnection

    OpenAIRE

    Khorosheva Olena I.

    2014-01-01

    The goal of the article lies in identification of grounds of interconnection of the financial economy and financial system. The study was conducted with consideration of main provisions of the theory of finance and concept of financial economy, which is a set of means used in the process of reproduction of finance by their owner for formation and / or maintenance of the own system of values in the viable state. For the first time ever the structure of the financial system is identified as an ...

  7. Financial Literacy and Financial Sophistication in the Older Population

    Science.gov (United States)

    Lusardi, Annamaria; Mitchell, Olivia S.; Curto, Vilsa

    2017-01-01

    Using a special-purpose module implemented in the Health and Retirement Study, we evaluate financial sophistication in the American population over the age of 50. We combine several financial literacy questions into an overall index to highlight which questions best capture financial sophistication and examine the sensitivity of financial literacy responses to framing effects. Results show that many older respondents are not financially sophisticated: they fail to grasp essential aspects of risk diversification, asset valuation, portfolio choice, and investment fees. Subgroups with notable deficits include women, the least educated, non-Whites, and those over age 75. In view of the fact that retirees increasingly must take on responsibility for their own retirement security, such meager levels of knowledge have potentially serious and negative implications. PMID:28553191

  8. Financial Literacy and Financial Sophistication in the Older Population.

    Science.gov (United States)

    Lusardi, Annamaria; Mitchell, Olivia S; Curto, Vilsa

    2014-10-01

    Using a special-purpose module implemented in the Health and Retirement Study, we evaluate financial sophistication in the American population over the age of 50. We combine several financial literacy questions into an overall index to highlight which questions best capture financial sophistication and examine the sensitivity of financial literacy responses to framing effects. Results show that many older respondents are not financially sophisticated: they fail to grasp essential aspects of risk diversification, asset valuation, portfolio choice, and investment fees. Subgroups with notable deficits include women, the least educated, non-Whites, and those over age 75. In view of the fact that retirees increasingly must take on responsibility for their own retirement security, such meager levels of knowledge have potentially serious and negative implications.

  9. RISK MANAGEMENT WITH FINANCIAL DERIVATIVES: EMPIRICAL EVIDENCE FROM ROMANIAN NON-FINANCIAL FIRMS

    Directory of Open Access Journals (Sweden)

    Sorin Gabriel Anton

    2016-12-01

    Full Text Available Financial risk management has rapidly evolved over the past two decades and has become an indispensable function in many institutions from different area of activities. In the last two decades, as the financial markets have become more and more mature, an increasing number of firms from emerging economies have chosen to use derivatives to hedge financial risks. As a result, risk management with financial derivatives has attracted much attention recently, becoming an important topic in the financial literature. However, we know little about the use of financial derivatives by firms from emerging economies and about the effect of these instruments on firms’ risk and value. The aim of the paper is to provide new insights into the use of financial derivatives for hedging purpose by non-financial firms from emerging markets. We analyzed risk management practices on a sample of 68 non-financial firms listed at Bucharest Stock Exchange (BSE over a long time frame (2001 to 2011. We found that Romanian non-financial firms from our sample are exposed mainly to commodity price risk, currency risk, interest rate risk, and liquidity risk. More than half of the firms in our sample (55.88% publish in their annual reports the goal of risk management process. Our results show that 10.29% of non-financial firms in our sample use financial derivatives to hedge their currency, interest rate or commodity price risks. We also found that the volatility caused by the global financial crisis determined many firms to use financial derivatives over the period 2007-2011. Nevertheless, the use of financial derivatives by Romanian non-financial firms is low relative to values registered for other emerging economies. The most important factors that hindered the use of financial derivatives have been the low liquidity of exchange derivatives markets, high hedging costs, and the lack of risk management expertise. The traditional approach of managing risks individually is

  10. Diet, Lifestyle and Chronic disease burden

    NARCIS (Netherlands)

    Struijk, E.A.

    2014-01-01

    Background Diet, Body Mass Index (BMI), physical activity and smoking are among the most important lifestyle factors that influence global disease burden. In this thesis we investigate the relations of these factors with total disease burden in a large Dutch population, the EPIC-NL cohort. In this

  11. Economic and humanistic burden of illness in generalized anxiety disorder: an analysis of patient survey data in Europe.

    Science.gov (United States)

    Toghanian, Samira; Dibonaventura, Marco; Järbrink, Krister; Locklear, Julie C

    2014-01-01

    Whilst studies suggest that generalized anxiety disorder (GAD) represents a considerable health care burden in Europe, there is a paucity of published evidence. This study investigated the burden of illness associated with GAD across five European countries (France, Germany, Italy, Spain, and the UK). Information from the 2008 European National Health and Wellness Survey database was analyzed. Bivariate, multivariate, and cost analyses were used to compare patients with GAD and propensity-matched controls. Compared with non-GAD controls, patients with GAD had more comorbidities and were more likely to smoke but less likely to be employed, use alcohol, or take exercise. They also had significantly worse health-related quality of life, and significantly greater work impairment and resource use, which increased as GAD severity increased. Within-country analyses demonstrated results similar to those for the five European countries overall, with the largest differences in resource use between patients with GAD and non-GAD controls documented in France and Germany. The average mean differences in direct costs were relatively small between the GAD groups and controls; however, indirect costs differed substantially. Costs were particularly high in Germany, mainly due to higher salaries leading to higher costs associated with absence from work. The limitation of this study was that the data were from a self-reported Internet survey, making them subject to reporting bias and possibly sample bias. Across all five European countries, GAD had a significant impact on work impairment, resource use, and economic costs, representing a considerable individual and financial burden that increased with severity of disease. These data may help us to understand better the burden and costs associated with GAD.

  12. Health spending, illicit financial flows and tax incentives in Malawi.

    Science.gov (United States)

    O'Hare, B; Curtis, M

    2014-12-01

    This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

  13. The Great Recession was not so Great

    NARCIS (Netherlands)

    van Ours, J.C.

    2015-01-01

    The Great Recession is characterized by a GDP-decline that was unprecedented in the past decades. This paper discusses the implications of the Great Recession analyzing labor market data from 20 OECD countries. Comparing the Great Recession with the 1980s recession it is concluded that there is a

  14. Enhancing Financial Security in Agricultural Business: Financial and Property Aspects

    OpenAIRE

    Yuliya Bezdushna

    2014-01-01

    The article provides the analysis of information support for the developing agrarian businesses financial security activities. The impact of financial statements on financial security has been proved through generalization procedure of such calculating indicators as operating margin, return on assets, total liquidity ratio and financial autonomy ratio. A causal effect between mass underestimation of operating fixed assets in accounting and inflated profitability rates in agribusinesses operat...

  15. A comparative study of care burden and social support among caregivers of persons with schizophrenia and epilepsy

    Directory of Open Access Journals (Sweden)

    Nilufer Karim

    2015-07-01

    Full Text Available Background: The caregivers of persons with epilepsy and schizophrenia undergo severe emotional, physical, financial burden due to the nature, chronicity, disability, and stigma attached to the illness. Aim: To assess the burden and social support among caregivers of persons with schizophrenia and epilepsy. Method: The study was conducted at the Out Patient Department of LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur. It was a comparative study. Purposive sampling technique was used for selection of the sample. The sample for the current study comprised of caregivers of 30 persons with schizophrenia and 30 persons suffering from epilepsy. A semi-structured socio-demographic data sheet, the Burden Assessment Schedule (BAS, the Social Support Questionnaire, and the General Health Questionnaire were administered to the caregivers. Results: There was no significant difference reported by the caregivers in the two groups with the entire domains of BAS and perceived social support. Physical and mental health, and caregivers’ strategy domains of BAS had significant negative correlation at 0.05 levels with perceived social support. External support, support of patient, taking responsibility, and other relation domains of BAS had significant negative correlation at the 0.01 level with perceived social support. Conclusion: While the two groups had no significant difference with the entire domains of BAS and perceived social support; physical and mental health, and caregivers’ strategy had significant negative correlation with perceived social support.

  16. Integrating physical and financial approaches to manage environmental financial risk

    Science.gov (United States)

    Characklis, Gregory; Meyer, Eliot; Foster, Benjamin

    2017-04-01

    Physical and/or engineered solutions have long been used to manage risks associated with adverse environmental events. Examples include reservoirs as a tool for mitigating drought-related supply risk, levees for managing flood risk and dredging of inland waterways to ensure navigability during low flow periods. These measures can reduce many types of risk (e.g., loss of life), but are often employed as a means of protecting against financial losses. When the focus is on managing environmental financial risk, physical solutions can be effective, but also costly. In many cases, non-physical tools can provide a less expensive means of managing financial risk, with these often taking the form of financial instruments such as hedging contracts, contingency funds or insurance. Some of these instruments, such as flood insurance, are widely available, but historically many environmental financial risks have been managed primarily (or solely) via physical solutions without much consideration of alternatives, thereby opening opportunities for innovation in developing financial solutions. Recent research has demonstrated that financial instruments can play a significant role in managing drought-related financial risk in sectors as diverse as water utilities, energy generation and inland navigation. Nonetheless, this work has largely considered the use of these instruments within systems in which physical solutions are already in place (but failing to achieve desired performance). The next step in the evolution of managing environmental financial risk involves developing methods for designing risk management strategies that do not assume an established physical system. Here the goal is to identify the relative role that physical solutions and financial instruments should play as they are integrated into a comprehensive risk management strategy. This is not a straightforward challenge as one approach reduces the risk of financial losses and the other redistributes those losses

  17. Financial performance of the teaching pharmacies in Isfahan: an economic evaluation.

    Science.gov (United States)

    Sabzghabaee, A M; Etebari, M; Sajjadi, H; Badri, Sh; Hosseini-Biuki, S M; Sheikhaboumasoudi, R

    2009-07-01

    Teaching pharmacies are amongst the important cornerstones of a healthcare system for drug supplying, pharmacy education and pharmacy practice research. Assessment of the Iranian healthcare system costs shows that after personnel charges, drug outlay is the second expensive factor. This great financial mass requires integral audit and management in order to provide costumers satisfaction in addition to financial viability. Teaching pharmacies are required to realize financial viability as well as providing several educational and drug servicing goals, which makes microeconomic analysis important. The aim of this study was to evaluate the financial performance of the teaching pharmacies affiliated with the Isfahan University of Medical Sciences (with the abrreviated names as: SHM, ISJ, AZH for the confidentialiy of the financial data). This is a descriptive and cross-sectional study done in 2008. The target pharmacies of this study were all the 3 teaching pharmacies affiliated with the Isfahan University of Medical Sciences. The data collecting template was prepared using the standard scientific methods according to the goals of this research The goals also nominated necessary items needed in economic profit evaluation. The data collection template was completed by reference to the teaching pharmacies financial documents and reports, used as a base for calculating the total income and the total costs in 2007-2008 financial year. The difference between these two balances showed the value of profits or loss. The profit/cost ratio was also calculated, using the proportion of the total income to the total costs. The collected data was statistically analyzed using the Excel software (Microsoft 2007). For the financial year 2007-2008, the difference between the total income and the total costs was -831.6 million Rials (excess costs to income) for the SHM pharmacy, + 25.4 billion Rials for the ISJ pharmacy and -429.5 million Rials for the AZH pharmacy. According to our

  18. Burden of Rabies

    Science.gov (United States)

    ... this? Submit Button Past Emails The Burden of Rabies Recommend on Facebook Tweet Share Compartir Learn how ... bitten by an animal that has the disease. Rabies in the U.S. Rabies continues to be a ...

  19. Donor Financing of Global Mental Health, 1995-2015: An Assessment of Trends, Channels, and Alignment with the Disease Burden.

    Directory of Open Access Journals (Sweden)

    F J Charlson

    Full Text Available A recent report by the Institute for Health Metrics and Evaluation (IHME highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH in two significant ways; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year as estimated by the Global Burden of Disease Studies.In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas-development assistance for health (in US Dollars per DALY.DAMH increased from USD 18 million in 1995 to USD 132 million in 2015, which equates to 0.4% of total DAH in 2015. Over 1990 to 2015, private philanthropy was the most significant source (USD 435 million, 30% of DAMH, while the United States government provided USD 270 million of total DAMH. South and Southeast Asia received the largest proportion of funding for mental health in 2013 (34%. DAMH available per DALY in 2013 ranged from USD 0.27 in East Asia and the Pacific to USD 1.18 in the Middle East and North Africa. HIV/AIDS received the largest ratio of funds to burden-approximately USD150 per DALY in 2013. Mental and substance use disorders and its broader category of non-communicable disease received less than USD1 of DAH per DALY.Combining estimates of disease burden and development assistance for health

  20. Donor Financing of Global Mental Health, 1995-2015: An Assessment of Trends, Channels, and Alignment with the Disease Burden.

    Science.gov (United States)

    Charlson, F J; Dieleman, J; Singh, L; Whiteford, H A

    2017-01-01

    A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH) in two significant ways; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Studies. In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars) and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs) produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas-development assistance for health (in US Dollars) per DALY. DAMH increased from USD 18 million in 1995 to USD 132 million in 2015, which equates to 0.4% of total DAH in 2015. Over 1990 to 2015, private philanthropy was the most significant source (USD 435 million, 30% of DAMH), while the United States government provided USD 270 million of total DAMH. South and Southeast Asia received the largest proportion of funding for mental health in 2013 (34%). DAMH available per DALY in 2013 ranged from USD 0.27 in East Asia and the Pacific to USD 1.18 in the Middle East and North Africa. HIV/AIDS received the largest ratio of funds to burden-approximately USD150 per DALY in 2013. Mental and substance use disorders and its broader category of non-communicable disease received less than USD1 of DAH per DALY. Combining estimates of disease burden and development assistance for health provides

  1. The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study.

    Science.gov (United States)

    2017-08-03

    Mental disorders are among the leading causes of nonfatal burden of disease globally. We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.

  2. Financial Risk Management

    OpenAIRE

    Catalin-Florinel Stanescu; Laurentiu Mircea Simion

    2011-01-01

    Concerns about the financial risk is increasing. In this climate, companies of all types and sizes want a robust framework for financial risk management to meet compliance requirements, contribute to better decision making and increase performance. Financial risk management professionals working with financial institutions and other corporate clients to achieve these objectives.

  3. Future of European Financial Supervision, Towards a European System of Financial Supervisors

    NARCIS (Netherlands)

    Arons, T.M.C.

    The 2008 financial crisis made clear the shortcomings in the European structure of financial supervision. In the cur­rent system of financial supervision the financial supervi­sor of the home Member State is in principle the only autho­rity entitled to supervise financial institutions even in case

  4. DEVELOPMENT OF THE US SECURITIES MARKET IN THE 1940-S: THE ROAD TO FINANCIAL LEADERSHIP

    Directory of Open Access Journals (Sweden)

    S. Z. Moshenskyi

    2016-12-01

    Full Text Available The Second World War radically changed not only political, but also financial landscape of the world. After the War ended the United States became the main source of capital. The American financial market and the stock market determined all the trends in the credit and financial sphere of other countries. In the 1930-s the US economy (and the stock market were stagnant during the «Great Depression». Industry began activating when the war intensified government military orders, and the stock market began reviving after the emission of bonds of military loans. When the war was over the United States funded the postwar recovery in Japan, Germany and other Western European countries. By the Bretton Woods conference in 1944 the dollar has become a major international currency, and it was a financial basis for US influence in the second half of the twentieth century, often called Pax Americana, that is «American world».

  5. Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

    Directory of Open Access Journals (Sweden)

    Randall Kuhn

    Full Text Available The Global Burden of Disease (GBD studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.We estimate the avoidable burden associated with HAP using International Futures (IFs, an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI and four noncommunicable diseases (NCDs. We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs

  6. A CROSS-COUNTRY ANALYSIS OF THE BANKS’ FINANCIAL SOUNDNESS: THE CASE OF THE CEE-3 COUNTRIES

    Directory of Open Access Journals (Sweden)

    Sargu Alina Camelia

    2013-07-01

    Full Text Available The European integration process has a direct impact on all the components of the macroeconomic environment. The existence of a well functioning and sound banking sector becomes of great importance for the integration process as the European Union economy is financed especially through this channel. The banking sectors of the new EU member countries have undergone through tremendous changes in the last decade, both from an ownership and also from a business strategy point of view, these changes having a direct impact on their financial soundness. Thus, the aim of our research is to empirically examine the financial soundness of the banks operating in Bulgaria, Czech Republic and Romania, three EU members countries from Central and Eastern Europe (CEE-3. In order to achieve this we have employed a combine quantitative analysis based on the CAMELS framework (namely Capital Adequacy, Asset quality, Management soundness, Earnings, Liquidity, Sensitivity to market risk and the Z-score, thus being able to underline simultaneously the financial soundness and the possibility of default for the banks from our sample. The analysed period is 2004-2011 providing us with an evaluation of the impact that the EU ascension and also the global financial crisis had on the financial soundness of the analysed banks. Our sample is composed from 40 commercial banks that operate in Bulgaria, the Czech Republic and Romania, that overall own over 75% of the total banking assets, making this study one of the most comprehensive undertaken to this date. The data that we have employed in our research is obtained from the Bureau Van Dijk Bankscope database and the annual financial statements of the banks from our sample. The paper through its original dual approach contributes to the academic debate by providing not only insight into the financial soundness of the banks operating in the CEE-3 countries but also underling their financial strength through the usage of the Z

  7. Financial Stress, Self-Efficacy, and Financial Help-Seeking Behavior of College Students

    Science.gov (United States)

    Lim, HanNa; Heckman, Stuart J.; Letkiewicz, Jodi C.; Montalto, Catherine P.

    2014-01-01

    Financial stress and self-efficacy are examined in relationship to college students' financial help-seeking behavior utilizing Grable and Joo's (1999) framework. A cognitive approach is taken by focusing on the moderating role of financial self-efficacy on the relationship between financial stress and financial help-seeking. Data from the 2010…

  8. Baby steps: The expanding financial base of local government in Ireland

    Directory of Open Access Journals (Sweden)

    Considine John

    2015-08-01

    Full Text Available There are two essential elements to this paper. In the first instance, we explore the specific details of revenue and expenditure trends for local authorities over the last decade. The analysis is framed against a longer-term political context of forty years which focuses especially on the weakness of local government in Ireland. Despite an official narrative of financial overdependence on central government, the comparative examination of budgetary records of local authorities reveals considerable diversity in both the revenue and expenditure patterns of authorities across the state. While some authorities are heavily reliant on central government funding, others have a much stronger base of local funding, and indeed the financial crisis since 2008 may have increased these differences. The second dimension to the research is an exploration of the impact of the great recession from 2008 on local government finance in Ireland. Using a framework of new institutionalism, we identify the crisis as another critical moment for local government. We consider the political, economic and administrative variables which have brought local government to a financial crossroads, and we explore the potential for long-lasting financial change in local government, as well as speculating on the nature and outcome of that change.

  9. Direct economic burden of hepatitis B virus related diseases: evidence from Shandong, China

    Directory of Open Access Journals (Sweden)

    Lu Jingjing

    2013-01-01

    Full Text Available Abstract Background Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the economic burden associated with hepatitis B virus (HBV related diseases is not well addressed. In order to provide evidence to address the economic disease burden of HBV, we conducted a survey to investigate the direct economic burden of acute and chronic hepatitis B, cirrhosis and liver cancer caused by HBV-related disease. Methods From April 2010 to November 2010, we conducted a survey of inpatients with HBV-related diseases and who were hospitalized for seven or more days in one of the seven tertiary and six secondary hospitals in Shandong, China. Patients were recorded consecutively within a three-to-five month time period from each sampled hospital; an in-person survey was conducted to collect demographic and socio-economic information, as well as direct medical and nonmedical expenses during the last month and last year prior to the current hospitalization. Direct medical costs included total outpatient, inpatient, and self-treatment expenditures; direct nonmedical costs included spending on nutritional supplements, transportation, and nursing. Direct medical costs during the current hospitalization were also obtained from the hospital financial database. The direct economic cost was calculated as the sum of direct medical and nonmedical costs. Our results call for the importance of implementing clinical guideline, improving system accountability, and helping secondary and smaller hospitals to improve efficiency. This has important policy implication for the on-going hospital reform in China. Results Our data based on inpatients with HBV-related diseases suggested that the direct cost in US dollars for acute hepatitis B, severe hepatitis B, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis and primary liver cancer was $2954, $10834, $4552, $7400.28, $6936 and $10635

  10. Direct economic burden of hepatitis B virus related diseases: evidence from Shandong, China.

    Science.gov (United States)

    Lu, Jingjing; Xu, Aiqiang; Wang, Jian; Zhang, Li; Song, Lizhi; Li, Renpeng; Zhang, Shunxiang; Zhuang, Guihua; Lu, Mingshan

    2013-01-31

    Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the economic burden associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the economic disease burden of HBV, we conducted a survey to investigate the direct economic burden of acute and chronic hepatitis B, cirrhosis and liver cancer caused by HBV-related disease. From April 2010 to November 2010, we conducted a survey of inpatients with HBV-related diseases and who were hospitalized for seven or more days in one of the seven tertiary and six secondary hospitals in Shandong, China. Patients were recorded consecutively within a three-to-five month time period from each sampled hospital; an in-person survey was conducted to collect demographic and socio-economic information, as well as direct medical and nonmedical expenses during the last month and last year prior to the current hospitalization. Direct medical costs included total outpatient, inpatient, and self-treatment expenditures; direct nonmedical costs included spending on nutritional supplements, transportation, and nursing. Direct medical costs during the current hospitalization were also obtained from the hospital financial database. The direct economic cost was calculated as the sum of direct medical and nonmedical costs. Our results call for the importance of implementing clinical guideline, improving system accountability, and helping secondary and smaller hospitals to improve efficiency. This has important policy implication for the on-going hospital reform in China. Our data based on inpatients with HBV-related diseases suggested that the direct cost in US dollars for acute hepatitis B, severe hepatitis B, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis and primary liver cancer was $2954, $10834, $4552, $7400.28, $6936 and $10635, respectively. These costs ranged from 30.72% (for acute

  11. Development of a system dynamics model for financially sustainable management of municipal watermain networks.

    Science.gov (United States)

    Rehan, R; Knight, M A; Unger, A J A; Haas, C T

    2013-12-15

    This paper develops causal loop diagrams and a system dynamics model for financially sustainable management of urban water distribution networks. The developed causal loop diagrams are a novel contribution in that it illustrates the unique characteristics and feedback loops for financially self-sustaining water distribution networks. The system dynamics model is a mathematical realization of the developed interactions among system variables over time and is comprised of three sectors namely watermains network, consumer, and finance. This is the first known development of a water distribution network system dynamics model. The watermains network sector accounts for the unique characteristics of watermain pipes such as service life, deterioration progression, pipe breaks, and water leakage. The finance sector allows for cash reserving by the utility in addition to the pay-as-you-go and borrowing strategies. The consumer sector includes controls to model water fee growth as a function of service performance and a household's financial burden due to water fees. A series of policy levers are provided that allow the impact of various financing strategies to be evaluated in terms of financial sustainability and household affordability. The model also allows for examination of the impact of different management strategies on the water fee in terms of consistency and stability over time. The paper concludes with a discussion on how the developed system dynamics water model can be used by water utilities to achieve a variety of utility short and long-term objectives and to establish realistic and defensible water utility policies. It also discusses how the model can be used by regulatory bodies, government agencies, the financial industry, and researchers. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  12. Analysis of the Financial Cost of Diabetes Mellitus in Four Cocoa Clinics of Ghana.

    Science.gov (United States)

    Quaye, Ernest Attuquaye; Amporful, Edward O; Akweongo, Patricia; Aikins, Moses K

    2015-09-01

    To estimate the financial cost of managing diabetes mellitus in four Cocoa clinics of Ghana. A descriptive cross-sectional study of diabetes management was carried out in the four Cocoa clinics of Ghana from January to December 2009. The "cost-of-illness" approach from the institutional perspective was used. A pretested data extraction form was used to review the medical records of 304 randomly selected diabetic patients. The patients' mean age was 55.4 ± 9.4 years. The mean annual financial cost of managing one diabetic case at the clinics was estimated to be Ghana cedi (GHS) 540.35 (US $372.65). Service cost constituted 22% of the cost, whereas direct medical cost constituted 78% of the cost. Drug cost was 71% of the financial cost. The cost of hospitalization per patient-day at Cocoa clinics was estimated at GHS 32.78 (US $22.61). The total financial cost of diabetes management was estimated at GHS 420,087.67 (US $289,715.63). This accounted for 8% of the total expenditure for the clinics in the year 2009. The study showed that facility type, type of diabetes, and presence of complication are associated with the cost of diabetes management to Cocoa clinics. The mean age of detection suggests delay in diagnosis of diabetes mellitus and accompanying complications, which has cost implications. Policy that enhances early detection of diabetes in clinical practice would therefore improve management and reduce costs. The financial cost of managing diabetes can be used to forecast the economic burden of the disease in the area. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Financial Literacy and Long- and Short-Term Financial Behavior in Different Age Groups

    Science.gov (United States)

    Henager, Robin; Cude, Brenda J.

    2016-01-01

    The purpose of this study was to examine the relationship between financial literacy and financial behaviors among various age groups. Financial literacy was measured in three ways: objective financial knowledge, subjective financial knowledge or confidence, and subjective financial management ability. The age groups were 18-24, 25-34, 35-44,…

  14. Investments in cancer research awarded to UK institutions and the global burden of cancer 2000–2013: a systematic analysis

    Science.gov (United States)

    Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

    2017-01-01

    Objectives To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000–2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Design Systematic analysis of all open-access data. Setting and participants Public and philanthropic funding to all UK cancer research institutions, 2000–2013. Main outcome measures Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. Results We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded—the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Conclusions Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies

  15. Subjective burden on spouses of schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Surekha Kumari

    2009-01-01

    Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family