45 CFR 260.33 - When are expenditures on State or local tax credits allowable expenditures for TANF-related...

Science.gov (United States)

2010-10-01

... State or local tax credits allowable expenditures for TANF-related purposes? (a) To be an allowable expenditure for TANF-related purposes, any tax credit program must be reasonably calculated to accomplish one... credit to be an allowable expenditure. (2) Under a State Earned Income Tax Credit (EITC) program, the...

Food Expenditures away from Home by Elderly Households

OpenAIRE

Yen, Steven T.; Kasteridis, Panagiotis P.; Riley, John B.

2012-01-01

This study investigates the differentiated effects of economic and socio-demographic variables on food away from home (FAFH) expenditures by type of facility among elderly households in the United States. Using data from the 2008–2010 Consumer Expenditure Surveys, the systems of expenditures on full-service, fast food, and other restaurants are estimated with a multivariate sample selection estimator which also accommodates heteroscedasticity in the error distribution. Statistical significanc...

Estimates of state-level health-care expenditures associated with disability.

Science.gov (United States)

Anderson, Wayne L; Armour, Brian S; Finkelstein, Eric A; Wiener, Joshua M

2010-01-01

We estimated state-level disability-associated health-care expenditures (DAHE) for the U.S. adult population. We used a two-part model to estimate DAHE for the noninstitutionalized U.S. civilian adult population using data from the 2002-2003 Medical Expenditure Panel Survey and state-level data from the Behavioral Risk Factor Surveillance System. Administrative data for people in institutions were added to generate estimates for the total adult noninstitutionalized population. Individual-level data on total health-care expenditures along with demographic, socioeconomic, geographic, and payer characteristics were used in the models. The DAHE for all U.S. adults totaled $397.8 billion in 2006, with state expenditures ranging from $598 million in Wyoming to $40.1 billion in New York. Of the national total, the DAHE were $118.9 billion for the Medicare population, $161.1 billion for Medicaid recipients, and $117.8 billion for the privately insured and uninsured populations. For the total U.S. adult population, 26.7% of health-care expenditures were associated with disability, with proportions by state ranging from 16.9% in Hawaii to 32.8% in New York. This proportion varied greatly by payer, with 38.1% for Medicare expenditures, 68.7% for Medicaid expenditures, and 12.5% for nonpublic health-care expenditures associated with disability. DAHE vary greatly by state and are borne largely by the public sector, and particularly by Medicaid. Policy makers need to consider initiatives that will help reduce the prevalence of disabilities and disability-related health disparities, as well as improve the lives of people with disabilities.

The economic burden of opioid prescription by dentists: A 12-month survey of consumer expenditure in Brazil.

Science.gov (United States)

Nogueira, Tulio Eduardo; Lino, Patrícia Azevedo; Martins, Maria Auxiliadora Parreiras; Silva, Maria Elisa Souza; Leles, Claudio Rodrigues; Abreu, Mauro Henrique Nogueira Guimarães

2017-09-01

To describe consumer expenditure on opioids prescribed by dentists in Brazil during a 12-month period. We surveyed individual dispensed prescriptions of opioids in private pharmacies from October 2012 to September 2013. A descriptive analysis of costs included a calculation of the overall and mean maximum price to consumers. Monetary costs were converted from local currency units (Brazilian Real - BRL) to international dollars using purchasing power parity (PPP) exchanging rates. 129,708 prescriptions were retrieved from the database. The overall expenditure on opioids was R$4,316,383.46 BRL or $2,721,315.82 (PPP). The mean cost of an individual prescription was R$33.27 BRL ($20.98 PPP), ranging from 14.19 to 3,255.60 BRL. Codeine was frequently prescribed (87.2 percent). The expenditure on opioids is a significant cost to Brazilian patients, especially given that the Brazilian Public Health System should dispense these drugs free of charge. Codeine was the most prescribed opioid. © 2017 American Association of Public Health Dentistry.

Modeling Per Capita State Health Expenditure Variat...

Data.gov (United States)

U.S. Department of Health & Human Services — Modeling Per Capita State Health Expenditure Variation State-Level Characteristics Matter, published in Volume 3, Issue 4, of the Medicare and Medicaid Research...

THE ECONOMIC CRISIS IMPACT ON PUBLIC EXPENDITURES IN EU NEW MEMBER STATES

Directory of Open Access Journals (Sweden)

Sabau-Popa Diana Claudia

2012-07-01

Full Text Available This article analyzes the main trends of public expenditures in the New Member States 12 in the last decade. We develop a synthetic analysis of the total public expenditures and also an analytical inquiry of major categories of public expenditures according to COFOG. Based on data provided by Eurostat from 2000 to 2010 we try to capture the impact of global financial crisis on the major trends of the public expenditures for new member states. Our purpose is to reveal a global view of the state of public expenditures in this group of EU countries and also we try to make a comparison between Romania and these countries considering that the stance of public finance is quite similar to the new member states. The major findings of this study are the high increase of the public expenditures for all the countries especially in 2009, due to a huge increase of the social protection expenditures. In this context we underline some correlations between the public expenditures evolution and economic growth.

The rise of digital direct-to-consumer advertising?: Comparison of direct-to-consumer advertising expenditure trends from publicly available data sources and global policy implications.

Science.gov (United States)

Mackey, Tim K; Cuomo, Raphael E; Liang, Bryan A

2015-06-19

Pharmaceutical marketing is undergoing a major shift in the United States, in part due to new transparency regulations under the healthcare reform act. Changes in pharmaceutical marketing practices include a possible shift from more traditional forms of direct-to-consumer advertising towards emerging use of Internet-based DTCA ("eDTCA") given the growing importance of digital health or "eHealth." Though legally allowed only in the U.S. and New Zealand, eDTCA poses novel regulatory challenges, as it can cross geopolitical boundaries and impact health systems and populations outside of these countries. We wished to assess whether changes in DTCA and eDTCA expenditure trends was occurring using publicly available pharmaceutical marketing data. DTCA data was analyzed to compare trends in aggregate marketing expenditures and to assess if there were statistically significant differences in trends and magnitudes for data sources and DTCA sub-categories (including eDTCA). This was accomplished using regression lines of DTCA trend data and conducting pairwise comparisons of regression coefficients using t-tests. Means testing was utilized for comparing magnitude of DTCA expenditure. Data from multiple data sources indicate that aggregate DTCA expenditures have slightly declined during the period from 2005-2009 and are consistent with results from other studies. For DTCA sub-categories, television remained the most utilized form of DTCA, though experienced trends of declining expenditures (-13.2 %) similar to other traditional media platforms such as radio (-30.7 %) and outdoor ads (-12.1 %). The only DTCA sub-category that experienced substantial increased expenditures was eDTCA (+109.0 %) and it was the only medium that had statistically significant differences in its marketing expenditure trends compared to other DTCA sub-categories. Our study indicates that traditional DTCA marketing may be on the decline. Conversely, the only DTCA sub-category that experienced

Children as consumers: investigating child diary expenditure data

OpenAIRE

Lisa Farrell; Michael A. Shields

2007-01-01

We investigate expenditure behaviour of school-aged children using child diary information contained in the British Family Expenditure Survey. The estimates from an Almost Ideal Demand System (AIDS) for child expenditure suggest that drinks, sweets, books, and toys are `normal' goods for children, but clothes, travel, leisure and vice products are `luxury' items with income elasticities greater than one. Being a lone-parent child and having a working mother are important factors in determinin...

Household energy consumption and expenditures 1993

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-10-05

This presents information about household end-use consumption of energy and expenditures for that energy. These data were collected in the 1993 Residential Energy Consumption Survey; more than 7,000 households were surveyed for information on their housing units, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information represents all households nationwide (97 million). Key findings: National residential energy consumption was 10.0 quadrillion Btu in 1993, a 9% increase over 1990. Weather has a significant effect on energy consumption. Consumption of electricity for appliances is increasing. Houses that use electricity for space heating have lower overall energy expenditures than households that heat with other fuels. RECS collected data for the 4 most populous states: CA, FL, NY, TX.

Adjusting Health Expenditures for Inflation: A Review of Measures for Health Services Research in the United States.

Science.gov (United States)

Dunn, Abe; Grosse, Scott D; Zuvekas, Samuel H

2018-02-01

To provide guidance on selecting the most appropriate price index for adjusting health expenditures or costs for inflation. Major price index series produced by federal statistical agencies. We compare the key characteristics of each index and develop suggestions on specific indexes to use in many common situations and general guidance in others. Price series and methodological documentation were downloaded from federal websites and supplemented with literature scans. The gross domestic product implicit price deflator or the overall Personal Consumption Expenditures (PCE) index is preferable to the Consumer Price Index (CPI-U) to adjust for general inflation, in most cases. The Personal Health Care (PHC) index or the PCE health-by-function index is generally preferred to adjust total medical expenditures for inflation. The CPI medical care index is preferred for the adjustment of consumer out-of-pocket expenditures for inflation. A new, experimental disease-specific Medical Care Expenditure Index is now available to adjust payments for disease treatment episodes. There is no single gold standard for adjusting health expenditures for inflation. Our discussion of best practices can help researchers select the index best suited to their study. © Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Veterans Affairs Geographic Distribution of Expenditures FY07 by State and County

Data.gov (United States)

Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...

Veterans Affairs Geographic Distribution of Expenditures FY08 by State and County

Data.gov (United States)

Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...

Direct-to-Consumer Marketing of Cigar Products in the United States.

Science.gov (United States)

Ganz, Ollie; Teplitskaya, Lyubov; Cantrell, Jennifer; Hair, Elizabeth C; Vallone, Donna

2016-05-01

Although cigar use and sales have increased in the United States over the past decade, little is known about how these products are promoted. Direct-to-consumer (DTC) advertising is a common method used to promote tobacco products and may be a potential channel through which cigars are advertised. Comperemedia (Mintel) was used to acquire opt-in direct mail and email advertising for the top 10 cigar brands in the United States between January 2013 and July 2014. The advertisement and corresponding data on brand, advertising spend, and mail volume were downloaded and summarized. Promotions such as coupons, giveaways, and sweepstakes were also examined. A total of 92 unique advertisements met the search criteria and included two brands: Black & Mild (n = 77) and Swisher Sweets (n = 15). Expenditures on direct mail advertising during this period totaled $12 809 630. Black & Mild encompassed 80% of total direct mail volume and 78% of direct mail advertising expenditures. Almost all advertisements contained at least one promotion (88%) and included a URL to the product website (85%). The results suggest that Black & Mild and Swisher Sweets are the primary cigar brands using DTC advertising. Promotional offers were nearly ubiquitous among the advertisements, which may appeal to price-sensitive populations. Future studies should continue to examine cigar advertising via direct mail and email, in addition to other channels, such as the point-of-sale. Although cigar use and sales have increased in the United States over the past decade, there is limited data on cigar advertising. This article provides a snapshot of expenditures, volume, and promotional content of DTC cigar advertising in the United States between January 2013 and July 2014. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The new Nordic diet - consumer expenditures and economic incentives estimated from a controlled intervention

DEFF Research Database (Denmark)

Jensen, Jørgen Dejgård; Poulsen, Sanne Kellebjerg

2013-01-01

Background: Several studies suggest that a healthy diet with high emphasis on nutritious, low-energy components such as fruits, vegetables, and seafood tends to be more costly for consumers. Derived from the ideas from the New Nordic Cuisine – and inspired by the Mediterranean diet, the New Nordic...... expenditure of the ADD as represented in the unadjusted intervention (ADD-i) amounted to 36.02 DKK for the participants. The daily food expenditure in the unadjusted New Nordic Diet (NND-i) costs 44.80 DKK per day per head, and is hence about 25% more expensive than the Average Danish Diet (or about 17% when...... adjusting for energy content of the diet). Adjusting for price incentives in a real market setting, the estimated cost of the Average Danish Diet is reduced by 2.50 DKK (ADD-m), compared to the unadjusted ADD-i diet, whereas the adjusted cost of the New Nordic Diet (NND-m) is reduced by about 3.50 DKK...

EXPENDITURES AND CONSUMER BEHAVIOR OF THE TOURISM SPORTS IN ROMANIA

Directory of Open Access Journals (Sweden)

Răbonţu Cecilia Irina

2011-12-01

Full Text Available In Romania, scale sports tourism gets well deserved lately. Tourism and sport has a close relationship since the beginning of their existence, and today we are witnessing a strengthening of it, because we talk about quality of life and greatly enhanced awareness of the beneficial effects of tourism and sport, both contributing to the restoration of working capacity, to increase the health of the population and spending free time pleasant and useful. We have proposed in this paper to analyze consumer behavior of sports tourism in Romania but also places where the cost of sports activities in total expenditures grouped according to several criteria. We conducted a preliminary conceptualization of the notion of tourism and tourist sports, controversial and difficult concept to define. We used for this purpose an extensive bibliographic material and statistical data provided by the National Institute of Statistics of Romania.

The Impact of State Medical Malpractice Reform on Individual-Level Health Care Expenditures.

Science.gov (United States)

Yu, Hao; Greenberg, Michael; Haviland, Amelia

2017-12-01

Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012. We took a difference-in-differences approach to specify a two-part model for analyzing individual-level health spending. We applied the recycled prediction method and the bootstrapping technique to examining the difference in health spending growth between states with and without a reform. All expenditures were converted to 2010 U.S. dollars. Only two of the 10 major state-level malpractice reforms had significant impacts on the growth of individual-level health expenditures. The average annual expenditures in states with caps on attorney contingency fees increased less than that in states without the reform (p negligence rule, the average annual expenditures increased more in both states with a pure comparative fault reform (p < .05) and states with a comparative fault reform that barred recovery if the plaintiff's fault was equal to or greater than the defendant's (p < .05). A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform. © Health Research and Educational Trust.

Expenditures on Children by Families: 1997 Annual Report.

Science.gov (United States)

Lino, Mark

Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 1997 dollars using the Consumer Price Index. Data and…

Expenditures on Children by Families: 1999 Annual Report.

Science.gov (United States)

Lino, Mark

Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 1999 dollars using the Consumer Price Index. Data and…

Expenditures on Children by Families: 1998 Annual Report.

Science.gov (United States)

Lino, Mark

Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 1998 dollars using the Consumer Price Index. Data and…

Expenditures on Children by Families: 2000 Annual Report.

Science.gov (United States)

Lino, Mark

Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 2000 dollars using the Consumer Price Index. Data and…

Expenditures on Children by Families: 2001 Annual Report.

Science.gov (United States)

Lino, Mark

Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 2001 dollars using the Consumer Price Index. Data and…

Expenditures on Children by Families: 2002 Annual Report.

Science.gov (United States)

Lino, Mark

Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 2002 dollars using the Consumer Price Index. Data and…

Food Insecurity and Health Care Expenditures in the United States, 2011-2013.

Science.gov (United States)

Berkowitz, Seth A; Basu, Sanjay; Meigs, James B; Seligman, Hilary K

2018-06-01

To determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. Nationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). Longitudinal retrospective cohort. A total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS. Their total health care expenditures in 2012 and 2013 were recorded in MEPS. Expenditure data were analyzed using zero-inflated negative binomial regression and adjusted for age, gender, race/ethnicity, education, income, insurance, and residence area. Fourteen percent of individuals reported food insecurity, representing 41,616,255 Americans. Mean annualized total expenditures were $4,113 (standard error $115); 9.2 percent of all individuals had no health care expenditures. In multivariable analyses, those with food insecurity had significantly greater estimated mean annualized health care expenditures ($6,072 vs. $4,208, p insecurity was associated with greater subsequent health care expenditures. Future studies should determine whether food insecurity interventions can improve health and reduce health care costs. © Health Research and Educational Trust.

Gender disparities in medical expenditures attributable to hypertension in the United States.

Science.gov (United States)

Basu, Rituparna; Franzini, Luisa; Krueger, Patrick M; Lairson, David R

2010-01-01

We sought to examine and attempt to explain gender disparities in hypertension-attributable expenditure among noninstitutionalized individuals in the United States. Using the 2001-2004 Medical Expenditure Panel Survey and the Aday and Andersen health care use model, we estimated hypertension-attributable health care expenditures for inpatient stay, outpatient visits, prescription drugs, office visits, and emergency room (ER) visits among men and women by applying the method of recycled prediction. Hypertensive individuals were identified using International Classification of Diseases, 9th edition, codes or self-report of a diagnosis of hypertension. The adjusted mean hypertension-attributable expenditure per individual was significantly higher for women than for men for prescription drugs, inpatient stays, office visits, outpatient visits and ER visits expenditures. However, as age increased, the gender difference in adjusted mean expenditures became smaller and eventually reversed. This reversal occurred at different ages for different expenditures. For prescription drugs, office visits and outpatient expenditures, the reversal in expenditures occurred around age 50 to 59. The maximum difference was observed in outpatient expenditures, where women's average expenditure was $102 more than men's below age 45 but $103 less than men's above age 75. These differences remained significant even after controlling for predisposing, enabling, and need predictors of health care use. Our findings imply that there are gender disparities in hypertension-related expenditures, but that this disparity depends on age. These findings support recent findings on gender disparities in heart diseases and raise the question of physicians' bias in their diagnostic or prognostic approaches to hypertension in men and women. Copyright 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

ANALISIS CATEGORY ADVERTISING EXPENDITURE DAN CONSUMER MEDIA HABIT DI MEDIA TELEVISI DAN MEDIA CETAK

Directory of Open Access Journals (Sweden)

Zifwen Zifwen

2011-08-01

Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 The purpose of the study is to identify the category of advertising expenditure and media habit on media advertising, especially on television and print ad such as newspapers, magazines and tabloids. The Data were collected  from Nielsen Media Research (NMR data base from a number of cities in Indonesia, such as Jakarta,Surabaya, Bandung, Semarang, Surabaya, Yogyakarta, Bali, Medan,Palembang and Makassar. There are three different type of data used to acquire the secondary data for the study: (1  Telescope (data collected for rating analysis January 1st, 2005 to March 31st, 2005, (2 Print scope (data collected from the readership of magazines, tabloids and newspaper January 1st, 2004 to December 31st, 2004 and (3 Ad quest (data collected from advertising expenditure for all categories. The data were collected, calculated and analyzed from January 1st, 2002 to December 31st, 2004. The purpose of the study is to uncover the trend of advertising budget from all categories on the television and print ads, in order to describe the consumption tendency of the people within advertising media. Index analysis and Biplot were used to analyze the data. Based on the result of advertising expenditure analysis of data, showing that all categories were completely different in the utilization of the media for advertisement. Some categories used mix media to support their campaign and others used a single media. Characteristic of the categories were strongly involved in the decision making in way of choosing and using the advertising media. The result of consumer media analysis found that the people habit were completely different and unique in media consumption. Different of age, sex and social economic status can create a different habit in term of hobbies and desire within the channel, programme, newspaper, magazines and the tabloids. Finally, to create an effective and efficient advertising activity

Economic development and workforce impacts of state DOT highway expenditures.

Science.gov (United States)

2014-01-01

The research measured the impact of Georgia Department of Transportations highway : expenditures on economic activity in the State. The analysis covered awards made between January 2009 : and April 2013. The research is unique in that it not only ...

Field Report - Consumer Survey

DEFF Research Database (Denmark)

Nielsen, Kristian S.; Gwozdz, Wencke

The present report outlines the purpose, scope, and methodology of a recently conducted four-country consumer survey that explored sustainable clothing consumption. The report also presents a sample of the descriptive findings from the survey (see Gwozdz, Nielsen & Müller, 2017 for further results...... foundation for upcoming deliverables relating to quality of life, acceptance of new business models, and consumer policy recommendations. The results presented in the report relate, specifically, to consumers’ general clothing consumption patterns, acceptance of new business models, and environmental...... purchasing outlets, and acceptance of new business models. Polish and American consumers purchased the most clothing items. Polish consumers also reported the lowest expenditures on clothing, whereas German consumers reported the highest expenditures. Only a limited proportion of consumers had previously...

Obesity and health expenditures: evidence from Australia.

Science.gov (United States)

Buchmueller, Thomas C; Johar, Meliyanni

2015-04-01

Rising rates of obesity are a public health concern in every industrialized country. This study investigates the relationship between obesity and health care expenditure in Australia, where the rate of obesity has tripled in the last three decades. Now one in four Australians is considered obese, defined as having a body mass index (BMI, kg/m(2)) of 30 or over. The analysis is based on a random sample survey of over 240,000 adults aged 45 and over that is linked at the individual-level to comprehensive administrative health care claims for the period 2006-2009. This sub-population group has an obesity rate that is nearly 30% and is a major consumer of health services. Relative to the average annual health expenditures of those with normal weight, we find that the health expenditures of those with a BMI between 30 and 35 (obese type I) are 19% higher and expenditures of those with BMI greater than 35 (obese type II/III) are 51% higher. We find large and significant differences in all types of care: inpatient, emergency department, outpatient and prescription drugs. The obesity-related health expenditures are higher for obese type I women than men, but in the obese type II/III state, obesity-related expenditures are higher for men. When we stratify further by age groups, we find that obesity has the largest impact among men over age 75 and women aged 60-74 years old. In addition, we find that obesity impacts health expenditures not only through its link to chronic diseases, but also because it increases the cost of recovery from acute health shocks. Copyright © 2015 Elsevier B.V. All rights reserved.

Household energy consumption and expenditures, 1990

International Nuclear Information System (INIS)

1993-01-01

This report, Household Energy Consumption and Expenditures 1990, is based upon data from the 1990 Residential Energy Consumption Survey (RECS). Focusing on energy end-use consumption and expenditures of households, the 1990 RECS is the eighth in a series conducted since 1978 by the Energy Information Administration (EIA). Over 5,000 households were surveyed, providing information on their housing units, housing characteristics, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information provided represents the characteristics and energy consumption of 94 million households nationwide

E-cigarette advertising expenditures in the U.S., 2011-2012.

Science.gov (United States)

Kim, Annice E; Arnold, Kristin Y; Makarenko, Olga

2014-04-01

Electronic cigarettes (e-cigarettes) are growing in popularity, but little is known about the extent to which these products are advertised to consumers. To estimate expenditures for e-cigarette advertising in magazines, TV, the Internet, newspapers, and radio in the U.S. from 2011 to 2012. E-cigarette advertising data were obtained from leading media intelligence companies, Kantar Media and Nielsen. Estimated e-cigarette advertising expenditures were summarized across media channels for 2011 and 2012. Additional information on brands advertised and market-level buys (i.e., local versus national) also was examined. Overall, e-cigarette advertising expenditures across media channels tripled from $6.4 million in 2011 to $18.3 million in 2012. Expenditures were highest in magazines and TV and lowest in newspapers and on the Internet. More than 80 unique brands were advertised, but blu eCigs dominated ad spending, comprising 76.7% of all e-cigarette advertising expenditures in 2012. National markets were increasingly targeted from 54.9% of ad buys in 2011 to 87.0% of ad buys in 2012. E-cigarette advertising expenditures are increasing, with a greater focus on national markets and TV ads, which will likely increase consumer awareness and use of e-cigarettes in the future. Federal-level efforts are needed to mandate that e-cigarette companies report their advertising expenditures. Future studies should examine how e-cigarette advertising expenditures and message content influence consumer awareness of, interest in, and use of e-cigarettes. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

Skipping meals and alcohol consumption. The regulation of energy intake and expenditure among weight loss participants.

Science.gov (United States)

Carels, Robert A; Young, Kathleen M; Coit, Carissa; Clayton, Anna Marie; Spencer, Alexis; Wagner, Marissa

2008-11-01

Research suggests that specific eating patterns (e.g., eating breakfast) may be related to favorable weight status. This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise). Fifty-four overweight or obese adults (BMI> or =27 kg/m(2)) participated in a self-help or therapist-assisted weight loss program. Daily energy intake from breakfast, lunch, dinner, and alcoholic beverages, total daily energy intake, total daily energy expenditure, physical activity, and weekly weight loss were assessed. On days that breakfast or dinner was skipped, or alcoholic beverages were not consumed, less total daily energy was consumed compared to days that breakfast, dinner, or alcoholic beverages were consumed. On days that breakfast or alcohol was consumed, daily energy expenditure (breakfast only) and duration of exercise were higher compared to days that breakfast or alcohol was not consumed. Individuals who skipped dinner or lunch more often had lower energy expenditure and exercise duration than individuals who skipped dinner or lunch less often. Individuals who consumed alcohol more often had high daily energy expenditure than individuals who consumed alcohol less often. Skipping meals or consuming alcoholic beverages was not associated with weekly weight loss. In this investigation, weight loss program participants may have compensated for excess energy intake from alcoholic beverages and meals with greater daily energy expenditure and longer exercise duration.

Tobacco Advertising and Promotional Expenditures in Sports and Sporting Events - United States, 1992-2013.

Science.gov (United States)

Agaku, Israel T; Odani, Satomi; Sturgis, Stephanie; Harless, Charles; Glover-Kudon, Rebecca

2016-08-19

Smokeless tobacco has been actively promoted by tobacco companies using endorsements by major sport figures, and research indicates that tobacco advertising can lead to youth initiation of tobacco use (1,2). Television and radio advertisements for cigarettes and smokeless tobacco have been prohibited since 1969,* and the 1998 Master Settlement Agreement(†) further prohibited tobacco companies from targeting youths with tobacco product advertisements in specified areas. In 2010, the Food and Drug Administration (FDA), under authority of the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA), prohibited tobacco-brand sponsorship (i.e., sponsorship of sports and entertainment events or other social or cultural events using the tobacco brand name or anything identifiable with any brand of cigarettes or smokeless tobacco).(§) However, corporate-name tobacco sponsorship (i.e., sponsorship using the name of the corporation that manufactures regulated tobacco products) is still permitted under certain conditions.(¶) To monitor tobacco advertising and promotional activities in sports in the United States, CDC analyzed trends in sports-related marketing expenditures for cigarettes and smokeless tobacco during 1992-2013 using data from the Federal Trade Commission (FTC). During 1992-2013, sports-related marketing expenditures, adjusted by the consumer price index to constant 2013 dollars, decreased significantly for both cigarettes (from $136 million in 1992 to $0 in 2013) and smokeless tobacco (from $34.8 million in 1992 to $2.1 million in 2013). During 2010-2013, after the prohibition of tobacco-brand sponsorship in sports under the FSPTCA, cigarette manufacturers reported no spending (i.e., $0) on sports-related advertising and promotional activities; in contrast, smokeless tobacco manufacturers reported expenditures of $16.3 million on advertising and promoting smokeless tobacco in sports during 2010-2013. These findings indicate that despite prohibitions

Accuracy of Consumer Monitors for Estimating Energy Expenditure and Activity Type.

Science.gov (United States)

Woodman, James A; Crouter, Scott E; Bassett, David R; Fitzhugh, Eugene C; Boyer, William R

2017-02-01

Increasing use of consumer-based physical activity (PA) monitors necessitates that they are validated against criterion measures. Thus, the purpose of this study was to examine the accuracy of three consumer-based PA monitors for estimating energy expenditure (EE) and PA type during simulated free-living activities. Twenty-eight participants (mean ± SD: age, 25.5 ± 3.7 yr; body mass index, 24.9 ± 2.6 kg·m) completed 11 activities ranging from sedentary behaviors to vigorous intensities. Simultaneous measurements were made with an Oxycon portable calorimeter (criterion), a Basis Peak and Garmin Vivofit on the nondominant wrist, and three Withings Pulse devices (right hip, shirt collar, dominant wrist). Repeated-measures ANOVA were used to examine differences between measured and predicted EE. Intraclass correlation coefficients were calculated to determine reliability of EE predictions between Withings placements. Paired samples t tests were used to determine mean differences between observed minutes and Basis Peak predictions during walking, running, and cycling. On average, the Basis Peak was within 8% of measured EE for the entire PA routine (P > 0.05); however, there were large individual errors (95% prediction interval, -290.4 to +233.1 kcal). All other devices were significantly different from measured EE for the entire PA routine (P types, Basis Peak correctly identified ≥92% of actual minutes spent walking and running (P > 0.05), and 40.4% and 0% of overground and stationary cycling minutes, respectively (P < 0.001). The Basis Peak was the only device that did not significantly differ from measured EE; however, it also had the largest individual errors. Additionally, the Basis Peak accurately predicted minutes spent walking and running, but not cycling.

Association Between Modifiable Risk Factors and Pharmaceutical Expenditures Among Adults With Atherosclerotic Cardiovascular Disease in the United States: 2012-2013 Medical Expenditures Panel Survey.

Science.gov (United States)

Salami, Joseph A; Valero-Elizondo, Javier; Ogunmoroti, Oluseye; Spatz, Erica S; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Younus, Adnan; Arrieta, Alejandro; Blaha, Michael J; Veledar, Emir; Nasir, Khurram

2017-06-09

Atherosclerotic cardiovascular disease (ASCVD) causes most deaths in the United States and accounts for the highest healthcare spending. The association between the modifiable risk factors (MRFs) of ASCVD and pharmaceutical expenditures are largely unknown. We examined the association between MRFs and pharmaceutical expenditures among adults with ASCVD using the 2012 and 2013 Medical Expenditure Panel Survey. A 2-part model was used while accounting for the survey's complex design to obtain nationally representative results. All costs were adjusted to 2013 US dollars using the gross domestic product deflator. The annual total pharmaceutical expenditure among those with ASCVD was $71.6 billion, 33% of which was for medications for cardiovascular disease and 14% medications for diabetes mellitus. The adjusted relationship between MRFs and pharmaceutical expenditures showed significant marginal increase in average annual pharmaceutical expenditure associated with inadequate physical activity ($519 [95% confidence interval (CI), $12-918; P =0.011]), dyslipidemia ($631 [95% CI, $168-1094; P =0.008]), hypertension: ($1078 [95% CI, $697-1460; P expenditures among patients with established ASCVD regardless of non-ASCVD comorbidity. In-depth studies of the roles played by other factors in this association can help reduce medication-related expenditures among ASCVD patients. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

State of Income and Expenditure within the Youth in Tehran, Iran: A Socio-Financial Survey

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Mohammad Taghi Sheykhi

2016-02-01

Full Text Available The article investigates the income-expenditure relationship as reflected among the youth who are very sensitive in kind and demographic group. Due to the imbalance between population and economic growth, a large number of youth at working age in Iran are out of job and financially dependent on their parents. The research explores how the youth are facing controversies due to disequilibrium between their income and expenditure, while their lifestyles are rapidly changing and new expectations and needs emerging. The article concludes how adequate source of income and social inclusion will meet the youth's aspirations and their self-confidence. Similarly, bridging the gap between youth's income and expenditure will provide them with more dynamism, satisfaction and socio-economic development as a whole. To conduct the survey, some 555 youth samples of both genders were randomly chosen from among different districts of Tehran City, and with whom the pre-designed questionnaires were completed. The present research is based on the main hypothesis that: "reasonable permanent income determines the propensity to consume". Similarly, the research has used various relevant theoretical perspectives to prove that income factor must be ahead of expenditure, and that contributes to a well-maintaining consumption function.

Determining consumer preferences for a cash option: Arkansas survey results.

Science.gov (United States)

Simon-Rusinowitz, L; Mahoney, K J; Desmond, S M; Shoop, D M; Squillace, M R; Fay, R A

1997-01-01

As long-term care (LTC) expenditures have risen, policymakers have sought ways to control costs while maintaining consumer satisfaction. Concurrently, there is increasing interest within the aging and disability communities in consumer-directed care. The Cash and Counseling Demonstration and Evaluation (CCDE) seeks to increase consumer direction and control costs by offering a cash allowance and information services to persons with disabilities, enabling them to purchase needed assistance. The authors present results from a telephone survey conducted to assess consumer preferences for a cash option in Arkansas and describe how findings from the four-State CCDE can inform consumer information efforts and policymakers.

Convergence analysis of household expenditures using the absolute β-convergence method

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Anto Domazet

2012-01-01

Full Text Available Background: The paper examines the convergence of household expenditures, in terms of a possible usage of the standardized, rather than consumer-tailored marketing, mainly on a regional level. Objectives: The main goal of this research is to study the existence of consumption expenditure convergence in the EU-27 countries, in the period between 2000 and 2007. Methods/Approach: The analysis used the absolute β-convergence method, in order to investigate the existence of a negative correlation between the growth over time in the overall consumption expenditure in EU member- countries for each individual product and service category and the initial expenditure level. Results: According to the obtained results, in the period between 2000 and 2007, the EU-27 countries reached a high level of consumer expenditure convergence, which provides a basis for developing a regional concept of the standardized international marketing for these countries’ markets. Conclusions: The results provide an empirical contribution to claims on consumer convergence in the countries included into economic integrations. Also, the obtained results can be used to create a basis for defining and applying the regional marketing concept for companies focusing on the EU-27 countries’ market.

National Health Expenditure Data

Data.gov (United States)

U.S. Department of Health & Human Services — National Health Expenditure Accounts are comprised of the following, National Health Expenditures - Historical and Projected, Age Estimates, State Health...

Where Money Mattered: Organizational and Economic Consequences of State Public School Expenditures in the United States: 1880-1940.

Science.gov (United States)

Balfanz, Robert

1997-01-01

Uses historical, state-level schooling data, manufacturing productivity measures, and quantitative research to examine relationships between changes in rate and distribution of public school expenditures, public schooling organization, and state-level economic growth from 1880-1940. Significant effects for per-student spending on school…

Activities Contributing to Total Energy Expenditure in the United States: Results from the NHAPS Study

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Block Gladys

2004-02-01

Full Text Available Abstract Background Physical activity is increasingly recognized as an important factor influencing health and disease status. Total energy expenditure, both low-intensity and high-intensity, contributes to maintenance of healthy body weight. This paper presents the results of a quantitative approach to determining the activities that contribute to total energy expenditure in the United States. Methods Data from the National Human Activity Pattern Survey (NHAPS were used. In 1992–1994 the NHAPS sampled 4,185 females and 3,330 males, aged 18 years and over, weighted to be representative of the 48 contiguous United States. A detailed report of each activity performed in the previous 24 hours was obtained. A score was created for each activity, by multiplying duration and intensity for each individual and summing across individuals. This score was then used to rank each activity according to its contribution to total population energy expenditure, for the total sample and separately for each gender, race, age, region, and season. Results This analysis reveals our society to be primarily sedentary; leisure time physical activity contributed only approximately 5% of the population's total energy expenditure. Not counting sleeping, the largest contributor to energy expenditure was "Driving a car", followed by "Office work" and "Watching TV". Household activities accounted for 20.1% and 33.3% of energy expenditure for males and females respectively. Conclusion The information presented in this paper may be useful in identifying common activities that could be appropriate targets for behavioral interventions to increase physical activity.

Washington state foster care: dental utilization and expenditures.

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Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David

2014-01-01

To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages WA FC program for ≥11 months (N = 10,177). Regression models were used to examine associations between utilization and expenditures and sex, race, age group, Supplemental Security Income (SSI) (i.e., disability), substance abuse, behavior problems, placement setting (Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.

Social sector expenditure and child mortality in India: a state-level analysis from 1997 to 2009.

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Susanna M Makela

Full Text Available BACKGROUND: India is unlikely to meet the Millennium Development Goal for child mortality. As public policy impacts child mortality, we assessed the association of social sector expenditure with child mortality in India. METHODS AND FINDINGS: Mixed-effects regression models were used to assess the relationship of state-level overall social sector expenditure and its major components (health, health-related, education, and other with mortality by sex among infants and children aged 1-4 years from 1997 to 2009, adjusting for potential confounders. Counterfactual models were constructed to estimate deaths averted due to overall social sector increases since 1997. Increases in per capita overall social sector expenditure were slightly higher in less developed than in more developed states from 1997 to 2009 (2.4-fold versus 2-fold, but the level of expenditure remained 36% lower in the former in 2009. Increase in public expenditure on health was not significantly associated with mortality reduction in infants or at ages 1-4 years, but a 10% increase in health-related public expenditure was associated with a 3.6% mortality reduction (95% confidence interval 0.2-6.9% in 1-4 years old boys. A 10% increase in overall social sector expenditure was associated with a mortality reduction in both boys (6.8%, 3.5-10.0% and girls (4.1%, 0.8-7.5% aged 1-4 years. We estimated 119,807 (95% uncertainty interval 53,409-214,662 averted deaths in boys aged 1-4 years and 94,037 (14,725-206,684 in girls in India in 2009 that could be attributed to increases in overall social sector expenditure since 1997. CONCLUSIONS: Further reduction in child mortality in India would be facilitated if policymakers give high priority to the social sector as a whole for resource allocation in the country's 5-year plan for 2012-2017, as public expenditure on health alone has not had major impact on reducing child mortality.

Social sector expenditure and child mortality in India: a state-level analysis from 1997 to 2009.

Science.gov (United States)

Makela, Susanna M; Dandona, Rakhi; Dilip, T R; Dandona, Lalit

2013-01-01

India is unlikely to meet the Millennium Development Goal for child mortality. As public policy impacts child mortality, we assessed the association of social sector expenditure with child mortality in India. Mixed-effects regression models were used to assess the relationship of state-level overall social sector expenditure and its major components (health, health-related, education, and other) with mortality by sex among infants and children aged 1-4 years from 1997 to 2009, adjusting for potential confounders. Counterfactual models were constructed to estimate deaths averted due to overall social sector increases since 1997. Increases in per capita overall social sector expenditure were slightly higher in less developed than in more developed states from 1997 to 2009 (2.4-fold versus 2-fold), but the level of expenditure remained 36% lower in the former in 2009. Increase in public expenditure on health was not significantly associated with mortality reduction in infants or at ages 1-4 years, but a 10% increase in health-related public expenditure was associated with a 3.6% mortality reduction (95% confidence interval 0.2-6.9%) in 1-4 years old boys. A 10% increase in overall social sector expenditure was associated with a mortality reduction in both boys (6.8%, 3.5-10.0%) and girls (4.1%, 0.8-7.5%) aged 1-4 years. We estimated 119,807 (95% uncertainty interval 53,409-214,662) averted deaths in boys aged 1-4 years and 94,037 (14,725-206,684) in girls in India in 2009 that could be attributed to increases in overall social sector expenditure since 1997. Further reduction in child mortality in India would be facilitated if policymakers give high priority to the social sector as a whole for resource allocation in the country's 5-year plan for 2012-2017, as public expenditure on health alone has not had major impact on reducing child mortality.

The Effects of State R&D Tax Credits in Stimulating Private R&D Expenditure: A Cross-State Empirical Analysis

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Wu, Yonghong

2005-01-01

This is a cross-state empirical study which examines the effects of state research and development (R&D) tax credits on private R&D expenditure in the states. Other explanatory variables include federal R&D subsidies, public services in higher education and R&D-targeted programs as well as other control variables. The statistical result shows that…

The expenditure for the protection of the environment in 2012

International Nuclear Information System (INIS)

Diel, Olivier

2014-11-01

Illustrated by several graphs, this publication comments the evolution of public expenditure for the protection of the environment, compares the current expenditure and the capital expenditure. It comments the share of waste management and wastewater sanitation with respect to the global expenditure (it represents 62 pc of it) and the evolutions of the expenditures for each domain of the environment (protection of the environment and ecosystems, waste management and struggle against noise pollution, research and development, public actions for regulation and administration). It comments the increase of prices of sanitation services and the decrease of consumed volumes of water, the increase of R and D expenditure, the influence of the legal context on the increase of industry investments for air protection. The expenditures for the protection of the environment in the European countries are indicated and compared

Consumer Education in the States: A Blueprint for Action.

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Bonner, Patricia A., Comp.

This document is designed to assist in development of state plans for action for consumer education. Its purpose is to serve as a catalyst for new and expanded public-private partnerships among state and local leaders that strengthen consumer education in the schools. Section 1 defines consumer education, discusses consumer concepts, and lists…

Medicaid Expenditures for Fee-for-Service Enrollees with Behavioral Diagnoses: Findings from a 50 State Claims Analysis.

Science.gov (United States)

Ward, Martha C; Lally, Cathy; Druss, Benjamin G

2017-01-01

Medicaid is an important funder of care for individuals with behavioral (psychiatric and/or substance use) diagnoses, and expenditures will likely increase with expansion of services under the Affordable Care Act. This study provides national estimates of Medicaid expenditures using a comprehensive sample of fee-for-service Medicaid enrollees with behavioral diagnoses. Data for analysis came from 2003 to 2004 Medicaid Analytic eXtract (MAX) files for 50 states and the District of Columbia. Individuals with behavioral diagnoses had high rates of chronic medical comorbidities, and expenditures for medical (non-behavioral) diagnoses accounted for 74 % of their health care expenditures. Total Medicaid expenditure was approximately 15 billion dollars (equivalent to 18.91 billion in 2016 dollars) for individuals with any behavioral diagnosis. Medicaid fee-for-service beneficiaries with behavioral diagnoses have a high treated prevalence of individual medical comorbid conditions, and the majority of health care expenditures in these individuals are for medical, rather than behavioral health, services.

Modeling per capita state health expenditure variation: state-level characteristics matter.

Science.gov (United States)

Cuckler, Gigi; Sisko, Andrea

2013-01-01

In this paper, we describe the methods underlying the econometric model developed by the Office of the Actuary in the Centers for Medicare & Medicaid Services, to explain differences in per capita total personal health care spending by state, as described in Cuckler, et al. (2011). Additionally, we discuss many alternative model specifications to provide additional insights for valid interpretation of the model. We study per capita personal health care spending as measured by the State Health Expenditures, by State of Residence for 1991-2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. State-level demographic, health status, economic, and health economy characteristics were gathered from a variety of U.S. government sources, such as the Census Bureau, Bureau of Economic Analysis, the Centers for Disease Control, the American Hospital Association, and HealthLeaders-InterStudy. State-specific factors, such as income, health care capacity, and the share of elderly residents, are important factors in explaining the level of per capita personal health care spending variation among states over time. However, the slow-moving nature of health spending per capita and close relationships among state-level factors create inefficiencies in modeling this variation, likely resulting in incorrectly estimated standard errors. In addition, we find that both pooled and fixed effects models primarily capture cross-sectional variation rather than period-specific variation.

11 CFR 106.2 - State allocation of expenditures incurred by authorized committees of Presidential primary...

Science.gov (United States)

2010-01-01

... to any State in which the primary election has already been held. (E) National advertising... production of media advertising, whether or not that advertising is used in more than one State, need not be... to any State if the fees are charged for consulting on national campaign strategy. Expenditures for...

A Four-State Comparison of Expenditures and Income Sources of Financial Aid Recipients in Public Colleges and Universities.

Science.gov (United States)

Stampen, Jacob O.; Fenske, Robert H.

The way public college students finance college was studied, based on student resource and expenditure surveys from four states: Arizona, California, New York, and Wisconsin. Comparisons were made of demographic and academic variables, as well as expenditure patterns of students receiving different kinds of aid. The following four aid recipient…

Public Expenditures, Budgetary Sustainability and the Assessment of Management of Public Expenditures in Kosovo

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Behxhet Brajshori

2009-05-01

Full Text Available Public expenditures are public outlays which competent state organs realize for the purpose of fulfilling obligations of general public interest. They are manifested in different forms and in different social, economic and political areas. Public expenditures produce direct and indirect effects in production and influence consumption and prices. Economic structure and conjectural courses of one country have an impact on the highness of the public expenditures. Economic and social subsidies present the main instruments for achieving economic and social effects through the policy of public expenditures, whilst in conjectural economies; the effect of public expenditures is large and is realized through the mechanism of multiplicators which are used when the economy is in the state of economic stagnation and recession. After the war, Kosovo built a new fiscal system according to the best international practices. The tax system consists of some taxes, it has a wide spread of tax charges and applies relatively low tax rates. Both budgetary revenues and budgetary consumption have marked certain variations in relation to GDP. Currently, The Kosovo Consolidated Budget (KCB is completely fulfilled by domestic revenues. It is considered that, even if the budgetary consumption increases up to 30-34% of GDP, this raise will not endanger budgetary sustainability of the country. According to the World Bank assessment (PEFA document- 2006 on the Effectiveness of Management of Public Expenditures in Kosovo, based on the performance of main indicators of management of public finances, the effectiveness of management of public expenditures in Kosovo is relatively satisfactory. According to the draft-document of the World Bank and the Government of Kosovo (PEFA-2008, the quality of management of public expenditures in 2008 has been profoundly improved.

Public Expenditure and Scheduled Community Enrolment in Higher Education: A Comparison across Indian States

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Sumithra, S.; Vardhan, R. Vishnu; Aruna, C.

2014-01-01

In India, the gross enrolment ratio has increased from 13.1 per cent in 2007-2008 to 15 per cent in 2011-2012 which moves the country from elite to a mass higher education system. This article seeks to examine the enrolment of scheduled caste (SC) students across various states in the country and the expenditure by each state and its effect on SC…

Adult mental health needs and expenditure in Australia.

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Burgess, Philip; Pirkis, Jane; Buckingham, Bill; Burns, Jane; Eagar, Kathy; Eckstein, Gary

2004-06-01

Relatively little international work has examined whether mental health resource allocation matches need. This study aimed to determine whether adult mental health resources in Australia are being distributed equitably. Individual measures of need were extrapolated to Australian Areas, and Area-based proxies of need were considered. Particular attention was paid to the prevalence of mental health problems, since this is arguably the most objective measure of need. The extent to which these measures predicted public sector, private sector and total adult mental health expenditure at an Area level was examined. In the public sector, 41.6% of expenditure variation was explained by the prevalence of affective disorders, personality disorders, cognitive impairment and psychosis, as well as the Area's level of economic resources and State/Territory effects. In the private sector, 72.4% of expenditure variation was explained by service use and State/Territory effects (with an alternative model incorporating service use and State/Territory supply of private psychiatrists explaining 69.4% of expenditure variation). A relatively high proportion (58.7%) of total expenditure variation could be explained by service utilisation and State/Territory effects. For services to be delivered equitably, the majority of variation in expenditure would have to be accounted for by appropriate measures of need. The best model for public sector expenditure included an appropriate measure of need but had relatively poor explanatory power. The models for private sector and total expenditure had greater explanatory power, but relied on less appropriate measures of need. It is concluded that mental health services in Australia are not yet being delivered equitably.

The effect of climate change on electricity expenditures in Massachusetts

International Nuclear Information System (INIS)

Véliz, Karina D.; Kaufmann, Robert K.; Cleveland, Cutler J.; Stoner, Anne M.K.

2017-01-01

Climate change affects consumer expenditures by altering the consumption of and price for electricity. Previous analyses focus solely on the former, which implicitly assumes that climate-induced changes in consumption do not affect price. But this assumption is untenable because a shift in demand alters quantity and price at equilibrium. Here we present the first empirical estimates for the effect of climate change on electricity prices. Translated through the merit order dispatch of existing capacity for generating electricity, climate-induced changes in daily and monthly patterns of electricity consumption cause non-linear changes in electricity prices. A 2 °C increase in global mean temperature increases the prices for and consumption of electricity in Massachusetts USA, such that the average household’s annual expenditures on electricity increase by about 12%. Commercial customers incur a 9% increase. These increases are caused largely by higher prices for electricity, whose impacts on expenditures are 1.3 and 3.6 fold larger than changes in residential and commercial consumption, respectively. This suggests that previous empirical studies understate the effects of climate change on electricity expenditures and that policy may be needed to ensure that the market generates investments in peaking capacity to satisfy climate-driven changes in summer-time consumption. - Highlights: • Climate change increases summer peak of load curve in US state of Massachusetts. • Climate change increases electricity prices more than consumption. • Previous studies understate the effect of climate change on electricity expenditures. • Adaptation that reduces electricity demand may reduce the price effect. • Adaptation may raise prices by increasing capacity but lowering utilization rate.

77 FR 32901 - State Enforcement of Household Goods Consumer Protection

Science.gov (United States)

2012-06-04

... enforce certain consumer protection provisions of Title 49 of the United States Code (U.S.C.) and related... bring civil actions in the U.S. district courts to enforce the consumer protection provisions that apply..., 386, and 387 State Enforcement of Household Goods Consumer Protection AGENCY: Federal Motor Carrier...

44 CFR 361.8 - Ineligible expenditures.

Science.gov (United States)

2010-10-01

... OF HOMELAND SECURITY PREPAREDNESS NATIONAL EARTHQUAKE HAZARDS REDUCTION ASSISTANCE TO STATE AND LOCAL GOVERNMENTS Earthquake Hazards Reduction Assistance Program § 361.8 Ineligible expenditures. (a) Expenditures... for the purchase or rental of any equipment such as radio/telephone communications equipment, warning...

Wealth, Health Expenditure, and Cancer: A National Perspective.

Science.gov (United States)

Chahoud, Jad; Semaan, Adele; Rieber, Alyssa

2016-08-01

The US health care system is characterized by high health expenditures with penultimate outcomes. This ecological study evaluates the associations between wealth, health expenditure, and cancer outcomes at the state level. We extracted gross domestic product (GDP) and health expenditure per capita from the 2009 Bureau of Economic Analysis and the Centers for Medicare & Medicaid Services, respectively. Using data from the NCI, we retrieved colorectal cancer (CRC), breast cancer, and all-cancer age-adjusted rates and computed mortality/incidence (M/I) ratios. We used the Spearman's rank correlation to determine the association between the financial indicators and cancer outcomes, and we constructed geographic distribution maps to describe these associations. GDP per capita significantly correlated with lower M/I ratios for all cancers, breast cancer, and CRC. As for health expenditure per capita, preliminary analysis highlighted a rift between the Northeastern and Southern states, which translated into worse breast and all-cancer outcomes in Southern states. Further analysis showed that higher health expenditure significantly correlated with decreased breast cancer M/I ratio. However, CRC outcomes were not significantly affected by health expenditure, nor were all-cancer outcomes. All cancers, breast cancer, and CRC outcomes significantly correlated with wealth, whereas only breast cancer correlated with higher health expenditure. Future research is needed to evaluate the potential role of policies in optimizing resource allocation in the states' efforts against CRC and minimizing disparities in interstate cancer outcomes. Copyright © 2016 by the National Comprehensive Cancer Network.

Medicaid CMS-64 New Adult Group Expenditures

Data.gov (United States)

U.S. Department of Health & Human Services — This dataset reports summary level expenditure data associated with the new adult group established under the Affordable Care Act. These state expenditures are...

Does consuming breakfast influence activity levels? An experiment into the effect of breakfast consumption on eating habits and energy expenditure.

Science.gov (United States)

Halsey, Lewis G; Huber, Jörg W; Low, Tzetze; Ibeawuchi, Chinwe; Woodruff, Polly; Reeves, Sue

2012-02-01

To experimentally compare the effects of eating or skipping breakfast on energy expenditure, activity levels and dietary habits. A randomised cross-over trial, lasting 2 weeks. Participants were provided breakfast during one week and were required to fast until mid-day during the other week. University campus. Forty-nine participants (twenty-six female and twenty-three male participants) were recruited. Food intake was monitored using food diaries, and energy expenditure was assessed using pedometers and heart rate monitors. Morningness-eveningness, physical activity and health were assessed using validated questionnaires. Across all participants, daily energy expenditure did not differ between the two experimental conditions. Total energy intake over 24 h did not vary with condition (male participants: 8134 (sd 447) kJ/d and 7514 (sd 368) kJ/d; female participants: 7778 (sd 410) kJ/d and 7531 (sd 535) kJ/d, for the breakfast and no-breakfast conditions, respectively). However, when comparing habitual breakfast eaters with those with irregular or breakfast-skipping habits, it was found that male non-habitual breakfast eaters consumed significantly (P = 0·029) more energy during the breakfast condition. Furthermore, female participants who were habitual breakfast eaters were found to eat significantly (P = 0·005) more and later in the day under the no-breakfast condition. Although the suggestion that breakfast is a behavioural marker for appropriate dietary and physical activity patterns is not refuted by the present findings, our data suggest that the effect of breakfast may vary as a function of gender and morning eating habits, and thus there may be other mechanisms that link BMI and breakfast consumption behaviour.

Restaurants and hotels expenditure in Polish households of the elderly

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Piekut Marlena

2016-03-01

Full Text Available The age of household members is an important factor for expenditures. The aim of the study is to investigate the level of expenditure on restaurants and hotels incurred in Polish households of the elderly in 2004-2013 and to identify the factors affecting such expenditures. The source of information used in the study was the household budget survey of the Central Statistical Office of Poland. The main methods used in this study were variance analysis and regression analysis. Restaurants and hotels expenditure increases every year together with their share in total household expenditure. The most important factors affecting the restaurants and hotels spending in Polish households of the elderly are: income per capita and the level of education of the head of the family. The study on consumption determinants at different groups leads to better understanding of consumer behavior circumstances and thereby ensuring a good quality of life for the people of the elderly.

Health Literacy Impact on National Healthcare Utilization and Expenditure.

Science.gov (United States)

Rasu, Rafia S; Bawa, Walter Agbor; Suminski, Richard; Snella, Kathleen; Warady, Bradley

2015-08-17

Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA® 11.0 statistical software. The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare

The private sector economic and employment benefits to the nation and to each state of proposed FY 1990 NASA procurement expenditures

Science.gov (United States)

1989-01-01

The private sector economic and employment benefits (disaggregated among 80 industries and 475 occupations) of the proposed FY 1990 NASA procurement expenditures to the nation and to each state are estimated. Nationwide, it is found that FY 1990 NASA procurement expenditures of $11.3 billion will have an economic multiplier of 2.1 and will create, directly and indirectly, 237,000 jobs, $23.2 billion in total industry sales, $2.4 billion in corporate profits, and $7.4 billion in Federal, state, and local government tax revenues. These benefits are widely dispersed throughout the United States and are significant in many states not normally considered to be major beneficiaries of NASA spending. The indirect economic benefits are identified for each state resulting from the second-, third-, and fourth rounds of industry purchases generated by NASA procurement expenditures. Each state is ranked on the basis of several criteria, including the total benefits, indirect benefits, and per capita benefits received from NASA spending. The estimates developed are important for maintaining a viable U.S. Space Program through the remainder of this century.

Advertising and Consumer Welfare: Scaling versus Translating

OpenAIRE

Alston, Julian M.; Chalfant, James A.; Piggott, Nicholas E.

1997-01-01

Controversy has surrounded the welfare effects of advertising, mainly concerning the consumer welfare effects. Unfortunately, the measures of consumer welfare effects in most studies have been ad hoc and incorrect. The consumer welfare consequences of advertising can be measured consistently when consumer demand equations are derived from an expenditure function. This is illustrated using the Almost Ideal demand system, which is popular in econometric estimation of food demand systems. An emp...

Consumer behavior on the market with food

Directory of Open Access Journals (Sweden)

Jana Turčínková

2006-01-01

Full Text Available The paper deals with consumer behavior on the market with selected food products. It focuses on expenditures on food, development of prices and comparison of results among EU countries. When comparing the development of consumer prices and incomes in 1990–2003, it is obvious that the growth of income was lower then the total increase of consumer prices. There were not only changes in price levels, but also in the structure of consumer expenditures, where we can see growth of expenditures for housing and decline in share of expenditures for food. In the Czech Republic, there was a decrease in consumption of beef and pork meet, and increase in poultry consumption. The consumption of fish is significantly below the EU average. Consumption of butter, potatoes and sugar reaches the similar level as the EU average. The analysis of motives for changes in consumption of selected foodstuffs provides some insight in reasons for changes in consumption of bakery products and sweets, where it mostly is the healthy lifestyle (motive for whole-grain bakery product consumption and improved market offer and advertising (for sweets and durable bakery products. Changes in meat consumption are motivated by healthy lifestyle for poultry and fish and improved market offer and advertising for canned meat products and salamis. Advertising and improved market offer played an important role for changes in consumption of yoghurts and cheeses, healthy lifestyle caused changes of yoghurts and milk. In category of selected beverages, it were advertising and improved market offer the motives for change of consumption of tea, wine and mineral waters, while healthy lifestyle motivated the change of mineral water consumption.

Spending to save? State health expenditure and infant mortality in India.

Science.gov (United States)

Bhalotra, Sonia

2007-09-01

There are severe inequalities in health in the world, poor health being concentrated amongst poor people in poor countries. Poor countries spend a much smaller share of national income on health expenditure than do richer countries. What potential lies in political or growth processes that raise this share? This depends upon how effective government health spending in developing countries is. Existing research presents little evidence of an impact on childhood mortality. Using specifications similar to those in the existing literature, this paper finds a similar result for India, which is that state health spending saves no lives. However, upon allowing lagged effects, controlling in a flexible way for trended unobservables and restricting the sample to rural households, a significant effect of health expenditure on infant mortality emerges, the long run elasticity being about -0.24. There are striking differences in the impact by social group. Slicing the data by gender, birth order, religion, maternal and paternal education and maternal age at birth, I find the weakest effects in the most vulnerable groups (with the exception of a large effect for scheduled tribes). Copyright (c) 2007 John Wiley & Sons, Ltd.

Energy expenditure in patients with chronic renal failure.

Science.gov (United States)

Monteon, F J; Laidlaw, S A; Shaib, J K; Kopple, J D

1986-11-01

Although nondialyzed, chronically uremic patients and patients undergoing maintenance hemodialysis often show evidence for wasting and calorie malnutrition and have low dietary energy intakes, their energy expenditure has never been systematically evaluated. It is possible that low energy intakes are an adaptive response to reduced energy needs; alternatively, energy expenditure could be normal or high and the low energy intakes would be inappropriate. Energy expenditure was therefore measured by indirect calorimetry in 12 normal individuals, 10 nondialyzed patients with chronic renal failure, and 16 patients undergoing maintenance hemodialysis. Energy expenditure was measured in the resting state, during quiet sitting, during controlled exercise on an exercise bicycle, and for four hours after ingestion of a test meal. Resting energy expenditure (kcal/min/1.73 m2) in the normal subjects, chronically uremic patients and hemodialysis patients was, respectively, 0.94 +/- 0.24 (SD), 0.91 +/- 0.20, and 0.97 +/- 0.10. There was also no difference among the three groups in energy expenditure during sitting, exercise, or the postprandial state. Within each group, energy expenditure during resting and sitting was directly correlated. During bicycling, energy expenditure was directly correlated with work performed, and the regression equation for this relationship was similar in each of the three groups. These findings suggest that for a given physical activity, energy expenditure in nondialyzed, chronically uremic patients and maintenance hemodialysis patients is not different from normal. The low energy intakes of many of these patients may be inadequate for their needs.

Consumer Behavior of College Students in the Czech Republic

Directory of Open Access Journals (Sweden)

Horakova Monika

2015-12-01

Full Text Available This contribution is a follow-up to the topic of consumer behavior which is analyzed from the economic theory perspective on microeconomic as well as a macroeconomic level. The main objective of the article is to reveal the structure of college students’ consumer basket determined according to disposable income and its changes. In this article, the methodology of a consumer basket was used. The division of it was done by Czech Statistical Office to calculate the inflation rate in the environment of the Czech Republic. In this article, the analysis of college students’ consumer basket was done. The pressure on having a higher qualification in tertiary education is a typical trend across Europe, which is also one of strategic goals of EU Strategy 2020 and its concept. There is clear evidence of a growing segment of college students that represents a significant demand group on the product and service market. The knowledge of their consumer habits is definitely beneficial for companies regarding their competitive advantage and reaching higher incomes from the products offered. The market product consumption is dependent on the total disposable income mainly. That is fundamentally dependent on hours of paid work or other fund contributions. The current disposable income shows the differences regarding consumption expenditures of a consumer basket and its various categories. A lower disposable income is typical for flowing the highest consumer expenditures from class 1 (Food and non-alcoholic beverages to class 4 (Housing, water, electricity, gas and other fuels of a higher disposal income. If the current disposable income of college students increases, there would be higher consumption expenditures regarding classes 9, 3 and 5 (Recreation and culture; Clothing and footwear; Furnishings, household equipment and routine household maintenance. On the contrary, a lower disposable income would mean lower expenditures regarding classes 3, 2 and 9

Quality-quantity decomposition of income elasticity of U.S. hospital care expenditure using state-level panel data.

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Chen, Weiwei; Okunade, Albert; Lubiani, Gregory G

2014-11-01

Economic theory suggests that income growth could lead to changes in consumption quantity and quality as the spending on a commodity changes. Similarly, the volume and quality of healthcare consumption could rise with incomes because of demographic changes, usage of innovative medical technologies, and other factors. Hospital healthcare spending is the largest component of aggregate US healthcare expenditures. The novel contribution of our paper is estimating and decomposing the income elasticity of hospital care expenditures (HOCEXP) into its quantity and quality components. By using a 1999-2008 panel dataset of the 50 US states, results from the seemingly unrelated regressions model estimation reveal the income elasticity of HOCEXP to be 0.427 (std. error=0.044), with about 0.391 (calculated std. error=0.044) arising from care quality improvements and 0.035 (std. error=0.050) emanating from the rise in usage volume. Our novel research findings suggest the following: (i) the quantity part of hospital expenditure is inelastic to income change; (ii) almost the entire income-induced rise in hospital expenditure comes from care quality changes; and (iii) the 0.427 income elasticity of HOCEXP, the largest component of total US healthcare expenditure, makes hospital care a normal commodity and a much stronger technical necessity than aggregate healthcare. Policy implications are discussed. Copyright © 2013 John Wiley & Sons, Ltd.

Costs and consequences of direct-to-consumer advertising for clopidogrel in Medicaid.

Science.gov (United States)

Law, Michael R; Soumerai, Stephen B; Adams, Alyce S; Majumdar, Sumit R

2009-11-23

Direct-to-consumer advertising (DTCA) is assumed to be a major driver of rising pharmaceutical costs. Yet, research on how it affects costs is limited. Therefore, we studied clopidogrel, a commonly used and heavily marketed antiplatelet agent, which was first sold in 1998 and first direct-to-consumer advertised in 2001. We examined pharmacy data from 27 Medicaid programs from 1999 through 2005. We used interrupted time series analysis to analyze changes in the number of units dispensed, cost per unit dispensed, and total pharmacy expenditures after DTCA initiation. In 1999 and 2000, there was no DTCA for clopidogrel; from 2001 through 2005, DTCA spending exceeded $350 million. Direct-to-consumer advertising did not change the preexisting trend in the number of clopidogrel units dispensed per 1000 enrollees (P = .10). However, there was a sudden and sustained increase in cost per unit of $0.40 after DTCA initiation (95% confidence interval, $0.31-$0.49; P consumer advertising was not associated with an increase in clopidogrel use over and above preexisting trends. However, Medicaid pharmacy expenditures increased substantially after the initiation of DTCA because of a concomitant increase in the cost per unit. If drug price increases after DTCA initiation are common, there are important implications for payers and for policy makers in the United States and elsewhere.

Innovations in Statistical Observations of Consumer Prices

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Olga Stepanovna Oleynik

2016-10-01

Full Text Available This article analyzes the innovative changes in the methodology of statistical surveys of consumer prices. These changes are reflected in the “Official statistical methodology for the organization of statistical observation of consumer prices for goods and services and the calculation of the consumer price index”, approved by order of the Federal State Statistics Service of December 30, 2014 no. 734. The essence of innovation is the use of mathematical methods in determining the range of studies objects of trade and services, in calculating the sufficient observable price quotes based on price dispersion, the proportion of the observed product (service, a representative of consumer spending, as well as the indicator of the complexity of price registration. The authors analyzed the mathematical calculations of the required number of quotations for observation in the Volgograd region in 2016, the results of calculations are compared with the number of quotes included in the monitoring. The authors believe that the implementation of these mathematical models allowed to substantially reduce the influence of the subjective factor in the organization of monitoring of consumer prices, and therefore to increase the objectivity of the resulting statistics on consumer prices and inflation. At the same time, the proposed methodology needs further improvement in terms of payment for goods, products (services by representatives having a minor share in consumer expenditure.

Trends in health care expenditure among US adults with heart failure: The Medical Expenditure Panel Survey 2002-2011.

Science.gov (United States)

Echouffo-Tcheugui, Justin B; Bishu, Kinfe G; Fonarow, Gregg C; Egede, Leonard E

2017-04-01

Population-based national data on the trends in expenditures related to heart failure (HF) are scarce. Assessing the time trends in health care expenditures for HF in the United States can help to better define the burden of this condition. Using 10-year data (2002-2011) from the national Medical Expenditure Panel Survey (weighted sample of 188,708,194US adults aged ≥18years) and a 2-part model (adjusting for demographics, comorbidities, and time); we estimated adjusted mean and incremental medical expenditures by HF status. The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency department, inpatient hospital, pharmacy, home health care, and other medical expenditures). Compared with expenditures for individuals without HF ($5511 [95% CI 5405-5617]), individuals with HF had a 4-fold higher mean expenditures of ($23,854 [95% CI 21,733-25,975]). Individuals with HF had $3446 (95% CI 2592-4299) higher direct incremental expenditures compared with those without HF, after adjusting for demographics and comorbidities. Among those with HF, costs continuously increased by $5836 (28% relative increase), from $21,316 (95% CI 18,359-24,272) in 2002/2003 to $27,152 (95% CI 20,066-34,237) in 2010/2011, and inpatient costs ($11,318 over the whole period) were the single largest component of total medical expenditure. The estimated unadjusted total direct medical expenditures for US adults with HF were $30 billion/y and the adjusted total incremental expenditure was $5.8 billion/y. Heart failure is costly and over a recent 10-year period, and direct expenditure related to HF increased markedly, mainly driven by inpatient costs. Copyright © 2017 Elsevier Inc. All rights reserved.

Estimating the common trend rate of inflation for consumer prices and consumer prices excluding food and energy prices

OpenAIRE

Michael T. Kiley

2008-01-01

I examine the common trend in inflation for consumer prices and consumer prices excluding prices of food and energy. Both the personal consumption expenditure (PCE) indexes and the consumer price indexes (CPI) are examined. The statistical model employed is a bivariate integrated moving average process; this model extends a univariate model that fits the data on inflation very well. The bivariate model forecasts as well as the univariate models. The results suggest that the relationship betwe...

Validating self-reported food expenditures against food store and eating-out receipts.

Science.gov (United States)

Tang, W; Aggarwal, A; Liu, Z; Acheson, M; Rehm, C D; Moudon, A V; Drewnowski, A

2016-03-01

To compare objective food store and eating-out receipts with self-reported household food expenditures. The Seattle Obesity Study II was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007 to 2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared with receipts using paired t-tests, Bland-Altman plots and κ-statistics. Bias by sociodemographics was also examined. Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores or eating out. However, the highest-income strata showed weaker agreement. Bland-Altman plots confirmed no significant bias across both methods-mean difference: 6.4; agreement limits: -123.5 to 143.4 for total food expenditures, mean difference 5.7 for food stores and mean difference 1.7 for eating out. The κ-statistics showed good agreement for each (κ 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. Self-reported food expenditures using NHANES questions, both for food stores and eating out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high-income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts.

Private dental insurance expenditure in Brazil

Science.gov (United States)

Cascaes, Andreia Morales; de Camargo, Maria Beatriz Junqueira; de Castilhos, Eduardo Dickie; Silva, lexandre Emídio Ribeiro; Barros, Aluísio J D

2018-01-01

ABSTRACT OBJECTIVE To quantify the household expenditure per capita and to estimate the percentage of Brazilian households that have spent with dental insurance. METHODS We analyzed data from 55,970 households that participated in the research Pesquisa de Orçamentos Familiares in 2008–2009. We have analyzed the annual household expenditure per capita with dental insurance (business and private) according to the Brazilian states and the socioeconomic and demographic characteristics of the households (sex, age, race, and educational level of the head of the household, family income, and presence of an older adult in the household). RESULTS Only 2.5% of Brazilian households have reported spending on dental insurance. The amount spent per capita amounted to R$5.10 on average, most of which consisted of private dental insurance (R$4.70). Among the characteristics of the household, higher educational level and income were associated with higher spending. São Paulo was the state with the highest household expenditure per capita (R$10.90) and with the highest prevalence of households with expenditures (4.6%), while Amazonas and Tocantins had the lowest values, in which both spent less than R$1.00 and had a prevalence of less than 0.1% of households, respectively. CONCLUSIONS Only a small portion of the Brazilian households has dental insurance expenditure. The market for supplementary dentistry in oral health care covers a restricted portion of the Brazilian population. PMID:29489995

A basket two-part model to analyze medical expenditure on interdependent multiple sectors.

Science.gov (United States)

Sugawara, Shinya; Wu, Tianyi; Yamanishi, Kenji

2018-05-01

This study proposes a novel statistical methodology to analyze expenditure on multiple medical sectors using consumer data. Conventionally, medical expenditure has been analyzed by two-part models, which separately consider purchase decision and amount of expenditure. We extend the traditional two-part models by adding the step of basket analysis for dimension reduction. This new step enables us to analyze complicated interdependence between multiple sectors without an identification problem. As an empirical application for the proposed method, we analyze data of 13 medical sectors from the Medical Expenditure Panel Survey. In comparison with the results of previous studies that analyzed the multiple sector independently, our method provides more detailed implications of the impacts of individual socioeconomic status on the composition of joint purchases from multiple medical sectors; our method has a better prediction performance.

Wait, bond, and buy : Consumer responses to economic crisis

NARCIS (Netherlands)

Yabar, J.

2012-01-01

Although economic crises tend to be perceived as a time in which consumers cut back on expenditures (including cars, clothes, and houses), market data also shows that sales of certain products increase during economic downturns. How do consumers respond to an economic crisis? And what is the

Factors associated with variations in hospital expenditures for acute heart failure in the United States.

Science.gov (United States)

Ziaeian, Boback; Sharma, Puza P; Yu, Tzy-Chyi; Johnson, Katherine Waltman; Fonarow, Gregg C

2015-02-01

Relatively little contemporary data are available that describe differences in acute heart failure (AHF) hospitalization expenditures as a function of patient and hospital characteristics, especially from a population-based investigation. This study aimed to evaluate factors associated with variations in hospital expenditures for AHF in the United States. A cross-sectional analysis using discharge data from the 2011 Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, was conducted. Discharges with primary International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis codes for AHF in adults were included. Costs were estimated by converting Nationwide Inpatient Sample charge data using the Healthcare Cost and Utilization Project Cost-to-Charge Ratio File. Discharges with highest (≥80th percentile) versus lowest (≤20th percentile) costs were compared for patient characteristics, hospital characteristics, utilization of procedures, and outcomes. Of the estimated 1 million AHF hospital discharges, the mean cost estimates were $10,775 per episode. Younger age, higher percentage of obesity, atrial fibrillation, pulmonary disease, fluid/electrolyte disturbances, renal insufficiency, and greater number of cardiac/noncardiac procedures were observed in stays with highest versus lowest costs. Highest-cost discharges were more likely to be observed in urban and teaching hospitals. Highest-cost AHF discharges also had 5 times longer length of stay, were 9 times more costly, and had higher in-hospital mortality (5.6% vs 3.5%) compared with discharges with lowest costs (all P heart failure hospitalizations are costly. Expenditures vary markedly among AHF hospitalizations in the United States, with substantial differences in patient and hospital characteristics, procedures, and in-hospital outcomes among discharges with highest compared with lowest costs. Copyright © 2014 Elsevier Inc. All rights reserved.

Medicaid expenditures for children living with smokers

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Levy Douglas E

2011-05-01

Full Text Available Abstract Background Children's exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States. Methods Data were overall and service-specific (i.e., inpatient, ambulatory, emergency department, prescription drug, and dental annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers' presence in households was determined by adult respondents' self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics. Results Children with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children's overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 (95% CI $3, $18 higher emergency department expenditures per year than those living with no smokers. Conclusions Living with at least one smoker (a proxy for secondhand smoke exposure is unrelated to children's overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.

Exercise, energy expenditure and energy balance, as measured with doubly labelled water.

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Westerterp, Klaas R

2018-02-01

The doubly labelled water method for the measurement of total daily energy expenditure (TDEE) over 1-3 weeks under daily living conditions is the indicated method to study effects of exercise and extreme environments on energy balance. Subjects consume a measured amount of doubly labelled water (2H2 18O) to increase background enrichment of body water for 18O and 2H, and the subsequent difference in elimination rate between 18O and 2H, as measured in urine, saliva or blood samples, is a measure for carbon dioxide production and thus allows calculation of TDEE. The present review describes research showing that physical activity level (PAL), calculated as TDEE (assessed with doubly labelled water) divided by resting energy expenditure (REE, PAL = TDEE/REE), reaches a maximum value of 2·00-2·40 in subjects with a vigorously active lifestyle. Higher PAL values, while maintaining energy balance, are observed in professional athletes consuming additional energy dense foods to compete at top level. Exercise training can increase TDEE/REE in young adults to a value of 2·00-2·40, when energy intake is unrestricted. Furthermore, the review shows an exercise induced increase in activity energy expenditure can be compensated by a reduction in REE and by a reduction in non-exercise physical activity, especially at a negative energy balance. Additionally, in untrained subjects, an exercise-induced increase in activity energy expenditure is compensated by a training-induced increase in exercise efficiency.

Buying health: assessing the impact of a consumer-side vegetable subsidy on purchasing, consumption and waste.

Science.gov (United States)

Smith-Drelich, Noah

2016-02-01

To measure the impact of a reimbursement-based consumer subsidy on vegetable expenditures, consumption and waste. Two-arm randomized controlled trial; two-week baseline observation period, three-week intervention period. Participants' vegetable expenditures, consumption and waste were monitored using receipts collection and through an FFQ. During the intervention period, the treatment group received reimbursement of up to 50 US dollars ($) for purchased vegetables. Participants were solicited from Palo Alto, CA, USA using materials advertising a 'consumer behavior study' and a small participation incentive. To prevent selection bias, solicitation materials did not describe the specific behaviour being evaluated. One hundred and fifty potential participants responded to the solicitations and 144 participants enrolled in the study; 138 participants completed all five weekly surveys. Accounting for the control group (n 69) and the two-week baseline period, the intervention significantly impacted the treatment group's (n 69) vegetable expenditures (+$8.16 (sd 2.67)/week, Pconsumer subsidy significantly increased participants' vegetable expenditures, but not consumption or waste, suggesting that this type of subsidy might not have the effects anticipated. Reimbursement-based consumer subsidies may therefore not be as useful a policy tool for impacting vegetable consumption as earlier studies have suggested. Moreover, moderation analysis revealed that the subsidy's effect on participants' vegetable expenditures was significant only in men. Additional research should seek to determine how far reaching gender-specific effects are in this context. Further research should also examine the effect of a similar consumer subsidy on high-risk populations and explore to what extent increases in participants' expenditures are due to the purchase of more expensive vegetables, purchasing of vegetables during the study period that were consumed outside the study period, or a shift

Trends in Health Care Expenditure among U.S. Adults with Heart Failure - The Medical Expenditure Panel Survey 2002–2011

Science.gov (United States)

Echouffo-Tcheugui, Justin B.; Bishu, Kinfe G.; Fonarow, Gregg C; Egede, Leonard E.

2017-01-01

Background Population-based national data on the trends in expenditures related to heart failure (HF) is scarce. Assessing the time trends in health care expenditures for HF in the United States can help to better define the burden of this condition. Methods Using 10-year data (2002–2011) from the national Medical Expenditure Panel Survey (weighted sample of 188,708,194 U.S adults aged ≥18 years) and a two-part model (adjusting for demographics, comorbidities and time); we estimated adjusted mean and incremental medical expenditures by HF status. The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency room, inpatient hospital, pharmacy, home health care, and other medical expenditures). Results Compared to expenditures for individuals without HF ($5,511 [95% confidence interval (CI): 5,405–5,617]), individuals with HF had a four-fold higher mean expenditures of ($23,854 [95%CI: 21,733–25,975]). Individuals with HF had $3,446 (95%CI: 2,592–4,299) higher direct incremental expenditures compared with those without HF, after adjusting for demographics and comorbidities. Among those with HF, costs continuously increased by $5836 (28% relative increase), from $21,316 (95%CI: 18,359–24,272) in 2002/2003 to $27,152 (95%CI: 20,066–34,237) in 2010/2011; and inpatient costs ($11,318 over the whole period) were the single largest component of total medical expenditure. The estimated unadjusted total direct medical expenditures for US adults with HF were $30 billion/year and the adjusted total incremental expenditure $5.8 billion/year. Conclusions Heart failure is costly and over a recent 10-year period, direct expenditure related to HF increased markedly, mainly driven by inpatient costs. PMID:28454834

The effects of government expenditure on economic growth: the case of Malaysia

OpenAIRE

Hasnul, Al Gifari

2015-01-01

The relationship between government expenditure and economic growth has been debated for decades and has not clearly stated yet. This paper gives a further evidence on the relationship between government expenditure and economic growth in the case of Malaysia. In this study, the government expenditure has been disaggregated in to the government operating and development expenditure. We also classified the government expenditure based on the sector of which it expensed. We used OLS technique t...

42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

Science.gov (United States)

2010-10-01

... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

Science.gov (United States)

Phillips, Charles D.

2015-01-01

Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges. PMID:26740744

The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges.

Science.gov (United States)

Phillips, Charles D

2015-01-01

Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.

The Pediatric Home Care/Expenditure Classification Model (P/ECM: A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

Directory of Open Access Journals (Sweden)

Charles D. Phillips

2015-01-01

Full Text Available Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.

Trends in direct-to-consumer advertising of prescription contraceptives.

Science.gov (United States)

Wu, Min H; Bartz, Deborah; Avorn, Jerry; Seeger, John D

2016-05-01

Despite much speculation about the role of direct-to-consumer advertising (DTCA) in increasing demand for prescription contraceptives in the United States, there is little published research on this topic. We sought to quantify the prevalence and magnitude of DTCA for prescription contraceptives over the last decade. Using cross-sectional data from January 2005 through December 2014, we performed descriptive analyses on trends in DTCA expenditure for prescription contraceptives. We also quantified the amount of DTCA according to contraceptive method category and individual brand. During the study period, pharmaceutical companies spent a total of US$1.57 billion in the United States on DTCA of prescription contraceptives. Annual expenditure for contraceptive DTCA reached a peak value of US$260 million in 2008, with a progressive decline to a nadir of US$69 million by 2013. Of the contraceptive methods, oral contraceptive pills (OCPs) have been the most heavily promoted, with Yaz (drospirenone/ethinyl estradiol) - the most advertised brand - accounting for US$347 million of cumulative DTCA expenditure. However, DTCA spending on OCPs peaked in 2007 and was overtaken in 2012 by the DTCA of long-acting reversible contraceptives (LARCs), the contraceptive method now receiving the largest amount of DTCA promotion. DTCA is a major form of promotion for prescription contraceptives. Recent trends in DTCA expenditure indicate a shift from promotion of the OCPs to the LARCs. DTCA's effect on provider and patient utilization of various contraceptive methods has yet to be determined. This study provides the first quantitative evaluation of DTCA of prescription contraceptive methods and reveals DTCA's importance as a form of promotion. Recent DTCA trends indicate increased promotion of LARCs, coinciding with greater uptake of LARC methods by patients and prescribers. Copyright © 2016 Elsevier Inc. All rights reserved.

Veterans Affairs Geographic Distribution of Expenditures FY09 by Congressional District

Data.gov (United States)

Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...

Veterans Affairs Geographic Distribution of Expenditures FY08 by Congressional District

Data.gov (United States)

Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...

26 CFR 1.162-20 - Expenditures attributable to lobbying, political campaigns, attempts to influence legislation...

Science.gov (United States)

2010-04-01

... fashion, expenditures for advertising which presents views on economic, financial, social, or other... consumer may reduce the demand for them. Legislation which would provide an income tax credit or exclusion...

Earnings and Expenditures on Household Services in Married and Cohabiting Unions

Science.gov (United States)

Treas, Judith; de Ruijter, Esther

2008-01-01

Despite the rise in women's paid employment, little is known about how women and their partners allocate money to outsource domestic tasks, especially in unmarried unions. Tobit analyses of 6,170 married and cohabiting couples in the 1998 Consumer Expenditure Survey test hypotheses that recognize gender inequality between partners, gender typing…

The complexity of changes in the domain of managing public expenditures

Directory of Open Access Journals (Sweden)

Dimitrijević Marina

2016-01-01

Full Text Available Public expenditures are a huge problem in contemporary states. In the conditions of a global economic crisis and the circumstances involving high level of citizen dissatisfaction related to the former methods of funding and managing the public sector (reflected in ruining the funding sources, irrational spending of public expenditure funds, increase in the budget deficit and the level of public debt, the changes in the domain of managing public expenditures have become a priority. By their nature, these changes are complex and long-lasting, and they should bring significant improvements in the field of public expenditure; they have to provide for lawful and purposeful spending of public funds. It is expected to lower the needed public incomes for financing public expenditure, to improve production and competition in the market economy, and to increase personal consumption, living standard and the quality of life of the population. Regardless of the social, economic, legal or political environment in each of state, the topical issue of reforming the management of public expenditures seems to imply a return to a somewhat neglected need for the public sector to function within its own financial possibilities. The state modernisation processes and advancement in the process of managing public expenditures call for a realistic evaluation of the existing condition and circumstances in which these processes occur, as well as the assessment of potential and actual risks that may hinder their effectiveness. Otherwise, it seems that the establishment of a significant level of responsibility in spending the budget funds and a greater transparency of public expenditure may be far-fetched goals.

COMPARATIVE ASPECTS REGARDING CONSUMPTION AND CONSUMERS IN EUROPEAN COUNTRIES

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Cristina LEOVARIDIS

2010-01-01

Full Text Available Consumers are considered, within the European vision, the “life force” of the economy. Although the technological means are increasingly available, both European SMEs and consumers are still suspicious of conducting cross-border trade. Single European market has the potential to become the largest market in the world. Currently, it remains largely fragmented along national borders, forming 27 mini-markets. The European Commission’s aim is to achieve a more integrated internal market such that consumers from each Member State have an equally high level of confidence in products, traders, selling methods, as well as consumer protection – no matter where they decide to make their purchases within the EU. The paper presents a secondary analysis of data regarding the many differences in terms of Europeans’ consumption patterns for different product categories (as a percentage of total expenditures. For example, the share of household budget used to purchase food is highest in our country and lowest in Luxembourg.. Also, the largest proportion of family budget allocated for utilities (water, electricity, gas we find in Bulgaria, and for cultural activities – in Austria.

23 CFR 420.107 - What is the minimum required expenditure of State planning and research funds for research...

Science.gov (United States)

2010-04-01

... RESEARCH PROGRAM ADMINISTRATION Administration of FHWA Planning and Research Funds § 420.107 What is the... 23 Highways 1 2010-04-01 2010-04-01 false What is the minimum required expenditure of State planning and research funds for research development and technology transfer? 420.107 Section 420.107...

Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

Science.gov (United States)

Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

2017-01-01

Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

Influence of household demographic and socio-economic factors on household expenditure on tobacco in six New Independent States

Directory of Open Access Journals (Sweden)

Gotsadze George

2007-08-01

Full Text Available Abstract Background To identify demographic and socio-economic factors that are associated with household expenditure on tobacco in Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Russian Federation, and Tajikistan. Methods Secondary analysis of the data available through the World Bank Living Standards Monitoring Survey conducted in aforementioned countries in 1995–2000. The role of different variables (e.g. mean age of household members, household area of residence, household size, share of adult males, share of members with high education in determining household expenditure on tobacco (defined as tobacco expenditure share out of total monthly HH consumption was assessed by using multiple regression analysis. Results Significant differences were found between mean expenditure on tobacco between rich and poor – in absolute terms the rich spend significantly more compared with the poor. Poor households devote significantly higher shares of their monthly HH consumption for tobacco products. Shares of adult males were significantly associated with the share of household consumption devoted for tobacco. There was a significant negative association between shares of persons with tertiary education within the HH and shares of monthly household consumption devoted for tobacco products. The correlation between household expenditures on tobacco and alcohol was found to be positive, rather weak, but statistically significant. Conclusion Given the high levels of poverty and high rates of smoking in the New Independent States, these findings have important policy implications. They indicate that the impact and opportunity costs of smoking on household finances are more significant for the poor than for the rich. Any reductions in smoking prevalence within poor households could have a positive economic impact.

Consumer influence on retail prices of rice in Imo state of Nigeria ...

African Journals Online (AJOL)

Consumer influence on retail prices of rice in Imo state of Nigeria. ... Nigeria Agricultural Journal ... The study aimed at estimating consumers bargaining power and its effect on price flexibility of rice in the area. ... to retailers by educating consumers on technicality involved in marketing. ... AJOL African Journals Online.

Geographic Distribution of VA Expenditures FY 2016

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY2010

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY2012

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY2004

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY1998

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY2009

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY2013

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Geographic Distribution of VA Expenditures FY2002

Data.gov (United States)

Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

Consumer bankruptcy law for Ethiopia: Lessons from United States ...

African Journals Online (AJOL)

After deregulation of consumer credit and resultant availability, ... Germany, United States, United Kingdom and France are some of the countries ... social insurance, development policy and rehabilitative function of discharge and fresh start.

Projecting future drug expenditures--2009.

Science.gov (United States)

Hoffman, James M; Shah, Nilay D; Vermeulen, Lee C; Doloresco, Fred; Martin, Patrick K; Blake, Sharon; Matusiak, Linda; Hunkler, Robert J; Schumock, Glen T

2009-02-01

Drug expenditure trends in 2007 and 2008, projected drug expenditures for 2009, and factors likely to influence drug expenditures are discussed. Various factors are likely to influence drug expenditures in 2009, including drugs in development, the diffusion of new drugs, drug safety concerns, generic drugs, Medicare Part D, and changes in the drug supply chain. The increasing availability of important generic drugs and drug safety concerns continue to moderate growth in drug expenditures. The drug supply chain remains dynamic and may influence drug expenditures, particularly in specialized therapeutic areas. Initial data suggest that the Medicare Part D benefit has influenced drug expenditures, but the ultimate impact of the benefit on drug expenditures remains unclear. From 2006 to 2007, total U.S. drug expenditures increased by 4.0%, with total spending rising from $276 billion to $287 billion. Drug expenditures in clinics continue to grow more rapidly than in other settings, with a 9.9% increase from 2006 to 2007. Hospital drug expenditures increased at a moderate rate of only 1.6% from 2006 to 2007; through the first nine months of 2008, hospital drug expenditures increased by only 2.8% compared with the same period in 2007. In 2009, we project a 0-2% increase in drug expenditures in outpatient settings, a 1-3% increase in expenditures for clinic-administered drugs, and a 1-3% increase in hospital drug expenditures.

Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

Directory of Open Access Journals (Sweden)

Sulakshana Nandi

Full Text Available Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private and out of pocket (OOP expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members of the 2014 National Sample Survey (71st Round on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure. The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests

Out-of-pocket expenditure for hospitalization in Haryana State of India: Extent, determinants & financial risk protection

Directory of Open Access Journals (Sweden)

Deepshikha Sharma

2017-01-01

>Interpretation & conclusions: Our findings showed that hospitalization resulted in significant OOP expenditure, leading to CHEs and impoverishment of households. Impact of OOP expenditures was inequitably more on the vulnerable groups. OOP expenditure may be curtailed through provision of free medicines and diagnostics and removal of any form of user charges.

A smooth mixture of Tobits model for healthcare expenditure.

Science.gov (United States)

Keane, Michael; Stavrunova, Olena

2011-09-01

This paper develops a smooth mixture of Tobits (SMTobit) model for healthcare expenditure. The model is a generalization of the smoothly mixing regressions framework of Geweke and Keane (J Econometrics 2007; 138: 257-290) to the case of a Tobit-type limited dependent variable. A Markov chain Monte Carlo algorithm with data augmentation is developed to obtain the posterior distribution of model parameters. The model is applied to the US Medicare Current Beneficiary Survey data on total medical expenditure. The results suggest that the model can capture the overall shape of the expenditure distribution very well, and also provide a good fit to a number of characteristics of the conditional (on covariates) distribution of expenditure, such as the conditional mean, variance and probability of extreme outcomes, as well as the 50th, 90th, and 95th, percentiles. We find that healthier individuals face an expenditure distribution with lower mean, variance and probability of extreme outcomes, compared with their counterparts in a worse state of health. Males have an expenditure distribution with higher mean, variance and probability of an extreme outcome, compared with their female counterparts. The results also suggest that heart and cardiovascular diseases affect the expenditure of males more than that of females. Copyright © 2011 John Wiley & Sons, Ltd.

Electricity tariffs in India: an assessment of consumers' ability and willingness to pay in Gujarat

International Nuclear Information System (INIS)

Ranjan Kumar Bose; Megha Shukla

2001-01-01

A sample of electricity consumers covering agricultural, residential and industrial consumers, in the Indian State of Gujarat was surveyed in 1997 to investigate the consumers' ability and willingness to pay for electricity supplied from the grid. The ability to pay was estimated using the weight of the cost of electricity to meet at least the basic household needs in relation to the overall income or expenditure. The willingness to pay was estimated using the costs of meeting the needs by alternative sources of energy, namely diesel in the case of farmers to pump water for irrigation and captive power generation using diesel generators in the case of industrial users. Survey results reveal the proportion of consumers in different categories, which do not have the ability to pay more or are even not willing to pay more for electricity. The survey findings have been used as a guideline in the proposed adjustment of tariffs charged by the Gujarat Electricity Board. (author)

Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review.

Science.gov (United States)

Stamatakis, Emmanuel; Weiler, Richard; Ioannidis, John P A

2013-05-01

Expenditure on industry products (mostly drugs and devices) has spiraled over the last 15 years and accounts for substantial part of healthcare expenditure. The enormous financial interests involved in the development and marketing of drugs and devices may have given excessive power to these industries to influence medical research, policy, and practice. Review of the literature and analysis of the multiple pathways through which the industry has directly or indirectly infiltrated the broader healthcare systems. We present the analysis of the industry influences at the following levels: (i) evidence base production, (ii) evidence synthesis, (iii) understanding of safety and harms issues, (iv) cost-effectiveness evaluation, (v) clinical practice guidelines formation, (vi) healthcare professional education, (vii) healthcare practice, (viii) healthcare consumer's decisions. We located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased. To serve its interests, the industry masterfully influences evidence base production, evidence synthesis, understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and healthcare professional education and also exerts direct influences on professional decisions and health consumers. There is an urgent need for regulation and other action towards redefining the mission of medicine towards a more objective and patient-, population- and society-benefit direction that is free from conflict of interests. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by Blackwell Publishing Ltd.

LOCAL PUBLIC 0 EXPENDITURE AUTONOMY – MEASURING APPROACH

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Irina BILAN

2013-06-01

Full Text Available The decentralization process was continuous in Romania starting with 1990, generating the implication of local authorities in local public finance, as a result of exclusives, shared and delegate competences and, so, the necessity of ensuring a good management of resources and expenditures. Therefore, the decentralization of competences / responsibilities from State to local governments was a major Romanian political theme and a first rank component of management of local public finance, as main driving instrument for local development. Specific legal framework of local responsibilities is established both to European and national level. Researchers based on regulation and practice have tried to quantify the responsibilities developing different models to measure local revenue and expenditures autonomy. The paper aims is to identify some models for measuring local expenditure autonomy and to apply for Romania. The study is oriented to measure local expenditure autonomy in Romania using Bell, Ebel, Kaiser and Rojchaichainthorn's model.

Expiry of patent protection on statins: effects on pharmaceutical expenditure in Australia.

Science.gov (United States)

Clarke, Philip M; Fitzgerald, Edmund M

2010-06-07

To compare changes in the costs of statins following patent expiry in Australia and England, and to estimate projected savings for Australia based on the government and consumers paying prices equivalent to those in England and increased use of generics. Review of administrative data and predictive models based on recent trends. Administrative price and quantity data for the Pharmaceutical Benefits Scheme between January 2002 and October 2009, and comparable information from England. Total government and consumer expenditure on statins whose patent has expired, and projected expenditure on all statins from January 2009 to December 2019 under various scenarios regarding pricing and prescribing trends. From January 2005 to October 2009, the cumulative loss to the Australian community from paying more than the English price for generic statins was more than $900 million. Expenditure could have been reduced by a further $1087 million if Australia had increased the proportion of generic medications prescribed to match trends in England. Future savings depend on the proportion of statin prescriptions that are subject to lower generic pricing. From January 2009 to December 2019, potential savings from paying English prices could be as high as $3.21 billion, and savings of up to $9.31 billion could be made by paying English prices and using generic statins only. The current arrangement for pricing statins places a considerable burden on the Australian community. Alternative pricing arrangements that provide incentives to lower statin prices and increase the proportion of generic prescriptions could be highly advantageous.

Outsourcing the Gender Factory : Living Arrangements and Service Expenditures on Female and Male Tasks

NARCIS (Netherlands)

Ruijter, Esther de; Treas, Judith K.; Cohen, Philip N.

2005-01-01

Using data from the U.S. Consumer Expenditure Survey 1998, this study analyzes how much money different types of households spend for domestic services on “female” and “male” tasks.We test alternative hypotheses based on economic and sociological theories of gender differentiation. Contrary to

78 FR 8530 - Price Index Adjustments for Contribution and Expenditure Limitations and Lobbyist Bundling...

Science.gov (United States)

2013-02-06

... an expenditure limitation for each general election held to fill a seat in the House of... limitation for 2013 general elections for House candidates in these states is $46,600. \\1\\ Currently, these... Congressional District Both the national and state party committees have an expenditure limitation for a general...

Domestic Price, (Expected) Foreign Price, and Travel Spending by Canadians in the United States

OpenAIRE

Jan Vilasuso; Fredric C. Menz

1998-01-01

In this paper, the authors develop and test a model to explain travel expenditures in the United States by Canadians. The model examines a consumer's choice problem where income is allocated between domestic and foreign consumption. Consumers do not know the foreign price level and base their spending in part on expected foreign price. In addition to expected foreign price, domestic price, exchange rates, income, and foreign price uncertainty influence travel spending. Empirically, each deter...

11 CFR 104.4 - Independent expenditures by political committees (2 U.S.C. 434(b), (d), and (g)).

Science.gov (United States)

2010-01-01

... whether the independent expenditure is made in support of, or in opposition to, the candidate involved. In... of State for the State in which the candidate is seeking election. (3) For independent expenditures... 11 Federal Elections 1 2010-01-01 2010-01-01 false Independent expenditures by political...

Northeast Marine Recreational Fishing Expenditure Survey 1998

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — A series of expenditure surveys have been done both regionally and nationally. This data pertains to the Northeast U.S. states that was collected in 1998....

Analysis of the Unified Health System funding and expenditure in the municipalities of the "Rota dos Bandeirantes" health region, State of São Paulo, Brazil.

Science.gov (United States)

Santos, João Alves Dos; Mendes, Áquilas Nogueira; Pereira, Antônio Carlos; Paranhos, Luiz Renato

2017-04-01

The national scenario of lack of resources in the Brazilian Unified Health System (SUS) has led to major differences in the municipalities funding models. Thus, this study aims to analyze SUS funding and expenditure in seven cities of the Rota dos Bandeirantes health region, State of São Paulo, SP, Brazil, from 2009 to 2012. Settled expenditure indicators were collected from the Public Health Budgets Information System (SIOPS) for analysis, showing descriptive data with absolute and relative frequency calculations. We identified that the per capita income available for the city of Barueri is almost tenfold that of the city of Carapicuíba, and that Barueri's health expenditure per capita is more than double that of the regional average and almost fivefold that of Carapicuíba. The Federal Government is responsible for 95.4% of all funding to municipalities. Most of the available income of the municipalities in the region include their own taxes and state transfers. All the municipalities showed a significant positive trend, both for available income and health expenditure. The regional average of own revenue spent on health is 27.3%. Carapicuíba achieved a level of 37.5%, which is much higher than the minimum of 15% required by the Federal Constitution.

Impact of morbid obesity on medical expenditures in adults.

Science.gov (United States)

Arterburn, D E; Maciejewski, M L; Tsevat, J

2005-03-01

Morbid obesity (body mass index (BMI) > or =40 kg/m2) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly

What matters most in advertising campaigns? The relative effect of media expenditure and message content strategy

NARCIS (Netherlands)

van den Putte, B.

2009-01-01

Three main factors determine the effect of advertising campaigns: message content strategy, advertising expenditure and previous consumer behaviour. This study investigates the relative strength of each of these influences. Four possible campaign targets are taken into account: campaign recall,

ADMINISTRATIVE EXPENDITURES OF SOCIAL SECURITY FUNDS IN UKRAINE

Directory of Open Access Journals (Sweden)

Nataliia Ivanchuk

2017-12-01

Full Text Available Along with the expenditures for social protection, social security funds finance administrative direction, which should correspond to the amount of functions performed by a particular fund. The purpose of the paper is to determine ways to reduce administrative expenditures of state social security funds in the conditions of reforming Ukrainian economy. For this purpose, the authors investigate distribution of the expenditures between social security funds, analyse dynamics and structure of assignments for fund administration, and suggest possible ways to rationalize maintenance cost for these institutions. Methodology. Administrative expenditures are an integral part of the cost of social security funds and include particular items of expenses in the budget of these institutions. Applying a systematic approach to calculating the administrative costs of social security funds of Ukraine the authors have taken into account the expenditures related to funding management, support for information systems, and organization of work with insured people. Results of the survey showed that in 2007–2016 Pension Fund of Ukraine incurred the largest part of social expenditures (more than 90% compared with other social insurance funds (less than 10%. At the same time, the administrative expenses were divided approximately into two halves between Pension Fund and other social security funds. In 2015, the government launched a reform of social insurance funds that aimed to reduce funds to three institutions but a decrease in the total amount of administrative expenditures has not been achieved yet. In addition, Pension Fund of Ukraine was least burdened with administrative expenses, while other social security funds with a relatively small share of social expenditures were burdened with administrative expenditures much more. Practical implications. Research showed that nowadays the existence of several social security funds in Ukraine is economically

Changes in clinical and hotel expenditures following publication of the nursing home compare report card.

Science.gov (United States)

Mukamel, Dana B; Spector, William D; Zinn, Jacqueline; Weimer, David L; Ahn, Richard

2010-10-01

Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical versus hotel aspects of quality in their search and choice of a nursing home. To examine the hypothesis that nursing homes responding to these changes in demand shifted the balance of resources from hotel to clinical activities. The study included 10,022 free-standing nursing homes nationwide during 2001 to 2006. RESEARCH DESIGN AND DATA: A retrospective multivariate statistical analysis of trends in the ratio of clinical to hotel expenditures, using Medicare cost reports, Minimum Data Set and Online Survey, Certification and Reporting data, controlling for changes in residents' acuity and facility fixed effects. Inference is based on robust standard errors. The ratio of clinical to hotel expenditures averaged 1.78. It increased significantly (P hotel expenditures following publication of the report card suggests that nursing homes responded as expected to the changes in the elasticity of demand with respect to clinical quality brought about by the public reporting of clinical quality measures. The response was stronger among nursing homes facing stronger incentives.

Household use of insecticide consumer products in a dengue endemic area in México

Science.gov (United States)

Loroño-Pino, María Alba; Chan-Dzul, Yamili N.; Zapata-Gil, Rocio; Carrillo-Solís, Claudia; Uitz-Mena, Ana; García-Rejón, Julián E.; Keefe, Thomas J.; Beaty, Barry J.; Eisen, Lars

2014-01-01

Objectives To evaluate household use of insecticide consumer products to kill mosquitoes and other insect pests, as well as the expenditures for using these products, in a dengue endemic area in México. Methods A questionnaire was administered to 441 households in Mérida City or other communities in Yucatán State to assess household use of insecticide consumer products. Results Most (86.6%) households took action to kill insect pests with consumer products. Among those households, the most commonly used product types were insecticide aerosol spray cans (73.6%), electric plug-in insecticide emitters (37.4%), and mosquito coils (28.3%). Mosquitoes were targeted by 89.7% of households using insecticide aerosol spray cans and >99% of households using electric plug-in insecticide emitters or mosquito coils. During the part of the year when a given product type was used, the frequency of use was daily or every 2 days in most of the households for insecticide aerosol spray cans (61.4%), electric plug-in insecticide emitters (76.2%), and mosquito coils (82.1%). For all products used to kill insect pests, the median annual estimated expenditure per household that took action was 408 Mexican pesos ($MXN), which corresponded to ∼31 $U.S. These numbers are suggestive of an annual market in excess of 75 million $MXN (>5.7 million $U.S.) for Mérida City alone. Conclusion Mosquitoes threaten human health and are major nuisances in homes in the study area in México. Households were found to have taken vigorous action to kill mosquitoes and other insect pests and spent substantial amounts of money on insecticide consumer products. PMID:25040259

The Impact of Direct-to-Consumer Advertising on Pharmaceutical Prices and Demand

OpenAIRE

Dhaval Dave; Henry Saffer

2010-01-01

Expenditures on prescription drugs are one of the fastest growing components of national health care spending, rising by almost three-fold between 1995 and 2007. Coinciding with this growth in prescription drug expenditures has been a rapid rise in direct-to-consumer advertising (DTCA), made feasible by the Food and Drug Administration's (FDA) clarification and relaxation of the rules governing broadcast advertising in 1997 and 1999. This study investigates the separate effects of broadcast a...

The Relationship of Government Revenue and Government Expenditure: A case study of Malaysia

OpenAIRE

Ullah, Nazim

2016-01-01

Malaysia is a developing Islamic state that faced budget deficit since 1998. But it is not accepted by all and hopes that state should be in a position of either balance budget or surplus budget. The optimum level of Government budget is the state where government expenditure is totally offset by source of government revenue and that can be achieved through increasing tax revenue or decreasing expenditure. The aim of this study to find out the theoretical relationship betwee...

77 FR 9925 - Price Index Adjustments for Expenditure Limitations and Lobbyist Bundling Disclosure Threshold

Science.gov (United States)

2012-02-21

... FEDERAL ELECTION COMMISSION [Notice 2012-02] Price Index Adjustments for Expenditure Limitations...)(A)) are adjusted periodically to reflect changes in the consumer price index. See 2 U.S.C. 434(i)(3... difference between the price index, as certified to the Commission by the Secretary of Labor, for the 12...

Do coverage mandates affect direct-to-consumer advertising for pharmaceuticals? Evidence from parity laws.

Science.gov (United States)

Nathenson, Robert; Richards, Michael R

2018-01-29

Direct-to-consumer advertising (DTCA) for prescription drugs is a relatively unique feature of the US health care system and a source of tens of billions of dollars in annual spending. It has also garnered the attention of researchers and policymakers interested in its implications for firm and consumer behavior. However, few economic studies have explored the DTCA response to public policies, especially those mandating coverage of these products. We use detailed advertising expenditure data to assess if pharmaceutical firms increase their marketing efforts after the implementation of relevant state and federal health insurance laws. We focus on mental health parity statutes and related drug therapies-a potentially ripe setting for inducing stronger consumer demand. We find no clear indication that firms expect greater value from DTCA after these regulatory changes. DTCA appears driven by other considerations (e.g., product debut); however, it remains a possibility that firms respond to these laws through other, unobserved channels (e.g., provider detailing).

Energy intensities of the Netherlands consumer expenditures in 1996

International Nuclear Information System (INIS)

Kok, R.; Benders, R.M.J.; Moll, H.C.

2001-03-01

The Energy Analysis Programme (EAP) is a method developed to calculate the direct and indirect fossil fuel energy consumption of consumer products. EAP is based on both the analysis of the process as the analysis of the input and output. This report is an update of the 1990 data of EAP. The data concern energy indicators of basic materials and packages, industrial and other sectors, transport, trade and services, energy sources and waste processing in the Netherlands [nl

Using time-series intervention analysis to understand U.S. Medicaid expenditures on antidepressant agents.

Science.gov (United States)

Ferrand, Yann; Kelton, Christina M L; Guo, Jeff J; Levy, Martin S; Yu, Yan

2011-03-01

Medicaid programs' spending on antidepressants increased from $159 million in 1991 to $2 billion in 2005. The National Institute for Health Care Management attributed this expenditure growth to increases in drug utilization, entry of newer higher-priced antidepressants, and greater prescription drug insurance coverage. Rising enrollment in Medicaid has also contributed to this expenditure growth. This research examines the impact of specific events, including branded-drug and generic entry, a black box warning, direct-to-consumer advertising (DTCA), and new indication approval, on Medicaid spending on antidepressants. Using quarterly expenditure data for 1991-2005 from the national Medicaid pharmacy claims database maintained by the Centers for Medicare and Medicaid Services, a time-series autoregressive integrated moving average (ARIMA) intervention analysis was performed on 6 specific antidepressant drugs and on overall antidepressant spending. Twenty-nine potentially relevant interventions and their dates of occurrence were identified from the literature. Each was tested for an impact on the time series. Forecasts from the models were compared with a holdout sample of actual expenditure data. Interventions with significant impacts on Medicaid expenditures included the patent expiration of Prozac® (P0.05), implying that the expanding market for antidepressants overwhelmed the effect of generic competition. Copyright © 2011 Elsevier Inc. All rights reserved.

Households across all income quintiles, especially the poorest, increased animal source food expenditures substantially during recent Peruvian economic growth.

Science.gov (United States)

Humphries, Debbie L; Behrman, Jere R; Crookston, Benjamin T; Dearden, Kirk A; Schott, Whitney; Penny, Mary E

2014-01-01

Relative to plant-based foods, animal source foods (ASFs) are richer in accessible protein, iron, zinc, calcium, vitamin B-12 and other nutrients. Because of their nutritional value, particularly for childhood growth and nutrition, it is important to identify factors influencing ASF consumption, especially for poorer households that generally consume less ASFs. To estimate differential responsiveness of ASF consumption to changes in total household expenditures for households with different expenditures in a middle-income country with substantial recent income increases. The Peruvian Young Lives household panel (n = 1750) from 2002, 2006 and 2009 was used to characterize patterns of ASF expenditures. Multivariate models with controls for unobserved household fixed effects and common secular trends were used to examine nonlinear relationships between changes in household expenditures and in ASF expenditures. Households with lower total expenditures dedicated greater percentages of expenditures to food (58.4% vs.17.9% in 2002 and 24.2% vs. 21.5% in 2009 for lowest and highest quintiles respectively) and lower percentages of food expenditures to ASF (22.8% vs. 33.9% in 2002 and 30.3% vs. 37.6% in 2009 for lowest and highest quintiles respectively). Average percentages of overall expenditures spent on food dropped from 47% to 23.2% between 2002 and 2009. Households in the lowest quintiles of expenditures showed greater increases in ASF expenditures relative to total consumption than households in the highest quintiles. Among ASF components, meat and poultry expenditures increased more than proportionately for households in the lowest quintiles, and eggs and fish expenditures increased less than proportionately for all households. Increases in household expenditures were associated with substantial increases in consumption of ASFs for households, particularly households with lower total expenditures. Increases in ASF expenditures for all but the top quintile of

The Roles of Public Higher Education Expenditure and the Privatization of the Higher Education on U.S. States Economic Growth

Science.gov (United States)

Curs, Bradley R.; Bhandari, Bornali; Steiger, Christina

2011-01-01

Previous empirical literature finds that government expenditure on higher education has a negative, or null, effect on U.S. economic growth rates. This empirical result may be driven by omission of an important variable--the privatization of higher education. Using state-level panel data from 1970 to 2005, this analysis investigates whether the…

THE PROGNOSIS OF TOTAL PUBLIC EXPENDITURES AND TYPES OF EXPENDITURES IN ROMANIA

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ANA-PETRINA STANCIU

2012-12-01

Full Text Available The purpose of the paper is to provide a prognosis of total public expenditure and types of expenditures, starting from the evolution in time of total public expenditure and spending on public services, defense, public order and safety, economic affairs, environmental protection, housing and community amenities, health, recreation, culture and religion, education and social protection.

Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003-2014.

Science.gov (United States)

Kirkland, Elizabeth B; Heincelman, Marc; Bishu, Kinfe G; Schumann, Samuel O; Schreiner, Andrew; Axon, R Neal; Mauldin, Patrick D; Moran, William P

2018-05-30

One in 3 US adults has high blood pressure, or hypertension. As prior projections suggest hypertension is the costliest of all cardiovascular diseases, it is important to define the current state of healthcare expenditures related to hypertension. We used a nationally representative database, the Medical Expenditure Panel Survey, to calculate the estimated annual healthcare expenditure for patients with hypertension and to measure trends in expenditure longitudinally over a 12-year period. A 2-part model was used to estimate adjusted incremental expenditures for individuals with hypertension versus those without hypertension. Sex, race/ethnicity, education, insurance status, census region, income, marital status, Charlson Comorbidity Index, and year category were included as covariates. The 2003-2014 pooled data include a total sample of 224 920 adults, of whom 36.9% had hypertension. Unadjusted mean annual medical expenditure attributable to patients with hypertension was $9089. Relative to individuals without hypertension, individuals with hypertension had $1920 higher annual adjusted incremental expenditure, 2.5 times the inpatient cost, almost double the outpatient cost, and nearly triple the prescription medication expenditure. Based on the prevalence of hypertension in the United States, the estimated adjusted annual incremental cost is $131 billion per year higher for the hypertensive adult population compared with the nonhypertensive population. Individuals with hypertension are estimated to face nearly $2000 higher annual healthcare expenditure compared with their nonhypertensive peers. This trend has been relatively stable over 12 years. Healthcare costs associated with hypertension account for about $131 billion. This warrants intense effort toward hypertension prevention and management. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Household expenditures on dietary supplements sold for weight loss, muscle building, and sexual function: Disproportionate burden by gender and income.

Science.gov (United States)

Austin, S Bryn; Yu, Kimberly; Liu, Selena Hua; Dong, Fan; Tefft, Nathan

2017-06-01

Dietary supplements sold for weight loss (WL), muscle building (MB), and sexual function (SF) are not medically recommended. They have been shown to be ineffective in many cases and pose serious health risks to consumers due to adulteration with banned substances, prescription pharmaceuticals, and other dangerous chemicals. Yet no prior research has investigated how these products may disproportionately burden individuals and families by gender and socioeconomic position across households. We investigated household (HH) cost burden of dietary supplements sold for WL, MB, and SF in a cross-sectional study using data from 60,538 U.S. households (HH) in 2012 Nielsen/IRi National Consumer Panel, calculating annual HH expenditures on WL, MB, and SF supplements and expenditures as proportions of total annual HH income. We examined sociodemographic patterns in HH expenditures using Wald tests of mean differences across subgroups. Among HH with any expenditures on WL, MB, or SF supplements, annual HH first and ninth expenditure deciles were, respectively: WL $5.99, $145.36; MB $6.99, $141.93; and SF $4.98, $88.52. Conditional on any purchases of the products, female-male-headed HH spent more on WL supplements and male-headed HH spend more on MB and SF supplements compared to other HH types ( p -values supplements types ( p -values supplements ( p -values supplements sold for WL, MB, and SF disproportionately burden HH by income and gender.

Simulating Revenue and Expenditure Limit Projections for a Community College in Arizona.

Science.gov (United States)

Gose, Frank J.

In 1980, the Constitution of the State of Arizona was amended to establish expenditure limits for a number of political entities, including community colleges. Limits were also established on revenue derived from local tax levies. Concern that limitations on revenue and expenditures could place real constraints on community college operations…

Elm Street School:A Case Study of Professional Development Expenditures

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H. Alix Gallagher

2002-05-01

Full Text Available This article addresses the question of how much is spent on teachers' professional development.  A review of the literature finds two problems that have frequently led to inaccurate estimates of professional development spending: 1 the accounting codes that are used in many studies provide little description of spending, and 2 studies generally focus on district or state expenditures for professional development, but do not collect data on school-level spending.  These problems are compounded by the fact that studies define professional development spending differently, and thus it is difficult to compare findings across studies.  In an effort to begin to address this problem, this study utilizes a detailed cost structure to analyze both district and school site expenditures on professional development across cost categories.  The study found that school-level expenditures were a significant source of professional development for teachers.  This has implications for the methodologies used to estimate current professional development expenditures and what level of expenditures would be necessary to generate dramatic improvements in student achievement.

Determinants of Medical and Health Care Expenditure Growth for Urban Residents in China: A Systematic Review Article.

Science.gov (United States)

Zhu, Xiaolong; Cai, Qiong; Wang, Jin; Liu, Yun

2014-12-01

In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China's health care system, benefiting the country, society and every household. This paper employs panel data from China's provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index) of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research.

Russia - Public Expenditure Review

OpenAIRE

World Bank

2011-01-01

The primary objective of the Public Expenditure Review (PER) is to assist the Ministry of Finance (MOF) in identifying opportunities for efficiency gains in some key categories of government expenditure. In this context, policy makers face two related fiscal dilemmas. First, how can expenditure efficiency are increased to provide public services with fewer resources? Second, how can the fi...

Energy Expenditure in Infants in Health and Disease

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Ross Shepherd

1997-01-01

Full Text Available Measurement of energy balance represents a basic theoretical concept in the determination of nutritional and fluid requirements in humans in health and disease. Infants have special nutrient requirements, more limited reserves and relative immaturity of organ function. Energy requirements of infants have been based either retrospectively on intakes required to achieve normal growth or on equations derived from energy expenditure studies performed early this century. Recently, improved techniques for studying resting energy expenditure (REE, total energy expenditure (TEE and metabolically active body compartments in infants have facilitated more accurate estimates of energy requirements. Such studies indicated that current reference values for energy requirements are overestimates, and that compared with measured values, predicted values vary markedly between the various predictive equations with wide co-efficients of variation. In disease states with altered body composition, such as cystic fibrosis and end-stage liver disease, predictive equations markedly underestimate both energy and fluid requirements. In cystic fibrosis, both TEE and REE are 25% higher than values in healthy infants. In extrahepatic biliary atresia, energy expenditure per unit body cell mass is markedly elevated, suggesting that this is a catabolic condition in infants. Current estimates of energy and fluid requirements in both health and disease in infants need reappraisal. Bedside and free living energy expenditure methodology should be used to define accurately components of energy requirement in individual infants.

Cointegration and Causality between Public Expenditure and Economic Growth: Case of Kyrgyzstan

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Raziye ABDIYEVA

2017-01-01

Full Text Available According to Wagner’s law there is unidirectional relationship from economic growth to public expenditure. Wagner’s states that increase of national income leads to faster growth of public expenditure. In other words, out of economic and social development in the country, people will demand more public goods and it will increase public expenditure at a faster rate than national income. This study is analyzing the long term and causality relationship between public expenditure and economic growth in Kyrgyzstan and tests the validity of Wagner's law in Kyrgyz economy by using an ARDL and Error Correction models over the period 1995 to 2014. Empirical results showed that there is an unidirectional causality relationship between economic growth and public expenditure in long term. Empirical evidence is support the validity of Wagner’s law in Kyrgyz economy.

75 FR 69910 - Revisions to the California State Implementation Plan, California Air Resources Board-Consumer...

Science.gov (United States)

2010-11-16

...'s national Consumer Products rule. The TSD has more information on our evaluation. C. Public Comment... the California State Implementation Plan, California Air Resources Board--Consumer Products AGENCY... revisions concern volatile organic compound (VOC) emissions from consumer products. We are approving a local...

76 FR 62004 - Revisions to the California State Implementation Plan, California Air Resources Board-Consumer...

Science.gov (United States)

2011-10-06

... Organic Compound Emission Standards for Consumer Products. B. Does the rule meet the evaluation criteria... the California State Implementation Plan, California Air Resources Board--Consumer Products AGENCY... revisions concern volatile organic compound (VOC) emissions from consumer products. We are approving a local...

Development Situation, Trend and Countermeasure of Consumer-level UAV Market in China

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Kang Yu-Lei

2017-01-01

Full Text Available This paper is based on the status of Chinese consumer-level UAV(Unmanned Aerial Vehicle market. According to the main problems in Chinese consumer-level UAV market, the author analyses the trends of Chinese consumer-level UAV market. Then, the author put forward some suggestions to develop Chinese consumer-level UAV market. In 21st century, the research and development expenditure presents the explosive growth in Chinese consumer-level UAV market. From the year of 2012, DJI released their first consumer-level UAV product. Amazon, Facebook, Google and other companies have announced their entry into the UAV market. In 2016, Huawei also announced that it will enter the UAV market.

Medical Expenditures Associated With Diabetes Among Youth With Medicaid Coverage.

Science.gov (United States)

Shrestha, Sundar S; Zhang, Ping; Thompson, Theodore J; Gregg, Edward W; Albright, Ann; Imperatore, Giuseppina

2017-07-01

Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States. We analyzed data from 2008 to 2012 MarketScan multistate Medicaid database for 6502 youths with diagnosed diabetes and 6502 propensity score matched youths without diabetes, enrolled in fee-for-service payment plans. We stratified analysis by Medicaid eligibility criteria (poverty or disability). We used 2-part regression models to estimate diabetes-related excess medical expenditures, adjusted for age, sex, race/ethnicity, year of claims, depression status, asthma status, and interaction terms. For poverty-based Medicaid enrollees, estimated annual diabetes-related total medical expenditure was $9046 per person [$3681 (no diabetes) vs. $12,727 (diabetes); PMedicaid enrollees, the estimated annual diabetes-related total medical expenditure was $9944 per person ($14,149 vs. $24,093; PMedicaid programs are substantial, which is larger among those with disabilities than without disabilities. Identifying cost-effective ways of managing diabetes in this vulnerable segment of the youth population is needed.

The rise of digital direct-to-consumer advertising?: Comparison of direct-to-consumer advertising expenditure trends from publicly available data sources and global policy implications

OpenAIRE

Mackey, Tim K.; Cuomo, Raphael E.; Liang, Bryan A.

2015-01-01

Background Pharmaceutical marketing is undergoing a major shift in the United States, in part due to new transparency regulations under the healthcare reform act. Changes in pharmaceutical marketing practices include a possible shift from more traditional forms of direct-to-consumer advertising towards emerging use of Internet-based DTCA (?eDTCA?) given the growing importance of digital health or ?eHealth.? Though legally allowed only in the U.S. and New Zealand, eDTCA poses novel regulatory ...

The Impact of Handicapping Conditions on Consumer Attitudes in Families.

Science.gov (United States)

Collins, Eleanor M.; And Others

The report summarizes results of a study of attitudes of 222 undergraduate university students (University of Minnesota, Duluth) toward financial decisions involving a family member with a handicap. The Situational Attitude Scale--Handicapped Family Consumer (which assesses attitudes toward parental expenditure of money for siblings or…

Consuming America : A Data-Driven Analysis of the United States as a Reference Culture in Dutch Public Discourse on Consumer Goods, 1890-1990

OpenAIRE

Wevers, M.J.H.F.

2017-01-01

Consuming America offers a data-driven, longitudinal analysis of the historical dynamics that have underpinned a long-term, layered cultural-historical process: the emergence of the United States as a dominant reference culture in Dutch public discourse on consumer goods between 1890 and 1990. The ideas, values, and practices associated with the United States in public discourse remained relatively steady over time, which might explain the country’s longevity as a reference culture and its po...

Annual Medical Expenditure and Productivity Loss Among Colorectal, Female Breast, and Prostate Cancer Survivors in the United States.

Science.gov (United States)

Zheng, Zhiyuan; Yabroff, K Robin; Guy, Gery P; Han, Xuesong; Li, Chunyu; Banegas, Matthew P; Ekwueme, Donatus U; Jemal, Ahmedin

2016-05-01

There are limited nationally representative estimates of the annual economic burden among survivors of the three most prevalent cancers (colorectal, female breast, and prostate) in both nonelderly and elderly populations in the United States. The 2008 to 2012 Medical Expenditure Panel Survey data were used to identify colorectal (n = 540), female breast (n = 1568), and prostate (n = 1170) cancer survivors and individuals without a cancer history (n = 109 423). Excess economic burden attributable to cancer included per-person excess annual medical expenditures and productivity losses (employment disability, missed work days, and days stayed in bed). All analyses were stratified by cancer site and age (nonelderly: 18-64 years vs elderly: ≥ 65 years). Multivariable analyses controlled for age, sex, race/ethnicity, marital status, education, number of comorbidities, and geographic region. All statistical tests were two-sided. Compared with individuals without a cancer history, cancer survivors experienced annual excess medical expenditures (for the nonelderly population, colorectal: $8647, 95% confidence interval [CI] = $4932 to $13 974, P productivity loss at work (7.2 days, P productivity losses as those without a cancer history. Colorectal, breast, and prostate cancer survivors experienced statistically significantly higher economic burden compared with individuals without a cancer history; however, excess economic burden varies by cancer site and age. Targeted efforts will be important in reducing the economic burden of colorectal, breast, and prostate cancer. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Consuming America : A Data-Driven Analysis of the United States as a Reference Culture in Dutch Public Discourse on Consumer Goods, 1890-1990

NARCIS (Netherlands)

Wevers, M.J.H.F.

2017-01-01

Consuming America offers a data-driven, longitudinal analysis of the historical dynamics that have underpinned a long-term, layered cultural-historical process: the emergence of the United States as a dominant reference culture in Dutch public discourse on consumer goods between 1890 and 1990. The

The marginal utility of money: A modern Marshallian approach to consumer choice

OpenAIRE

Friedman, Daniel; Sákovics, József

2011-01-01

We reformulate neoclassical consumer choice by focusing on [lambda], the marginal utility of money. As the opportunity cost of current expenditure, [lambda] is approximated by the slope of the indirect utility function of the continuation. We argue that [lambda] can largely supplant the role of an arbitrary budget constraint in partial equilibrium analysis. The result is a better grounded, more exible and more intuitive approach to consumer choice.

Toward estimating the impact of changes in immigrants' insurance eligibility on hospital expenditures for uncompensated care

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Curtis Lesley H

2003-01-01

Full Text Available Abstract Background The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA of 1996 gave states the option to withdraw Medicaid coverage of nonemergency care from most legal immigrants. Our goal was to assess the effect of PRWORA on hospital uncompensated care in the United States. Methods We collected the following state-level data for the period from 1994 through 1999: foreign-born, noncitizen population and health uninsurance rates (US Census Current Population Survey; percentage of teaching hospitals (American Hospital Association Annual Survey of Hospitals; and each state's decision whether to implement the PRWORA Medicaid bar for legal permanent residents or to continue offering nonemergency Medicaid coverage using state-only funds (Urban Institute. We modeled uncompensated care expenditures by state (also from the Annual Survey of Hospitals in both univariate and multivariable regression analyses. Results When measured at the state level, there was no significant relationship between uncompensated care expenditures and states' percentage of noncitizen immigrants. Uninsurance rates were the only significant factor in predicting uncompensated hospital care expenditures by state. Conclusions Reducing the number of uninsured patients would most surely reduce hospital expenditures for uncompensated care. However, data limitations hampered our efforts to obtain a monetary estimate of hospitals' financial losses due specifically to the immigrant eligibility changes in PRWORA. Quantifying the impact of these provisions on hospitals will require better data sources.

The role of mortgages and consumer credit in the business cycle

NARCIS (Netherlands)

Sterk, V.

2011-01-01

Many households rely on mortgages and consumer credit to finance their expenditures. Lenders usually impose certain conditions on loans, such as limits on the amounts that can be borrowed. Conventional intuition suggests that such conditions are important for our understanding of the business cycle,

Performance of the Public Expenditure Management at Local Level in Romania

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Ani MATEI

2008-06-01

Full Text Available The current paper aims to analyze the performance of the public expenditure management based on the decrease of the administrative costs. The paper is grounded on the following premises: (1 Romania as an EU Member State is under a continuous process to harmonize its legislation with the EU legislation. (2 The integration of Romania in EU in 2007 has determined a significant change in the administrative expenditure amount. (3 Strengthening local autonomy through the decentralization and the devolution processes emphasizes clearer the need for improving the performance of the expenditure management at local level. (4 Internal order, flows of communication and transfer, synergy of the governance system assume administrative expenditure that can be determined. (5 The performance of public organizations in managing local governance issues depends directly also on the administrative expenditure level**. [** Paper accepted to be presented at the Fourth TransAtlantic Dialogue “The Status of Inter-Governmental Relations and Multi-Level Governance in Europe and the US”, Workshop 5: “Performance measurement and accountability in IGR-MLG”.

Associations Between Magnitude of Child Maltreatment and Medicaid Expenditures for Psychotropic Medications.

Science.gov (United States)

Raghavan, Ramesh; Brown, Derek S; Allaire, Benjamin T; Ross, Raven E; Landsverk, John

2016-08-01

This study examined relationships between various measures of the severity of child maltreatment and expenditures on psychotropic drugs among children in the welfare system. Child participants (N=4,453) in the first National Survey of Child and Adolescent Well-Being (NSCAW) were linked to their Medicaid claims from 36 states. Three specifications for severity of maltreatment were developed. A two-part regression of logistic and generalized linear models of expenditures on psychotropic medications was estimated for each specification. Physically abused children had higher odds (odds ratio [OR]=1.34) and neglected children had lower odds (OR=.76) of incurring psychotropic drug expenditures. Children who experienced the most severe level of harm had higher odds (OR=1.33) of medication use, compared with children without appreciable harm. No maltreatment specifications were associated with increased expenditures on psychotropic drugs. The magnitude of maltreatment affected odds of use of psychotropic drugs but had no effect on Medicaid expenditures for these drugs.

Elasticities of demand for gasoline in Canada and the United States

International Nuclear Information System (INIS)

Nicol, C.J.

2003-01-01

Fluctuations in the world price of oil, the concern with greenhouse gas emissions and the efforts to revive the 1997 Kyoto Protocol have resulted in renewed interest in the estimation of elasticities of demand for gasoline. In this paper, a complete system of demand equations is estimated, including an equation for the demand for gasoline. Canadian family expenditure (FAMEX) and United States consumer expenditure (CEX) survey data are used. Household-level data permits estimation of elasticities for various household groups. Also, differences in demand responsiveness to own-price and income changes are estimated for different regions in Canada and the United States. Demand is found to be own-price and income inelastic, on the whole, as reported in earlier studies. There is also variation in these elasticities across regions of Canada and the United States. However, larger differences are observed with respect to household size and housing tenure, than to region of residence

Tax Expenditures in Croatia

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Vjekoslav Bratić

2006-06-01

Full Text Available The tax system of the Republic of Croatia contains a large number of very diverse kinds of tax expenditures whose the declared aim is to achieve certain social and economic objectives. This paper considers all the items that constitute tax expenditures in Croatia, within the systems of the personal income tax, corporate income tax, and real estate transfer tax and value added tax. The objective of the article is to determine the real level of tax expenditures per form of tax in the 2001-2004 period. We hypothesised that the tax expenditures in the analysed forms of tax are both high and growing, which was ultimately borne out, for almost all the analysed items in the tax forms considered are growing.

Oil sands tax expenditures

International Nuclear Information System (INIS)

Ketchum, K; Lavigne, R.; Plummer, R.

2001-01-01

The oil sands are a strategic Canadian resource for which federal and provincial governments provide financial incentives to develop and exploit. This report describes the Oil Sands Tax Expenditure Model (OSTEM) developed to estimate the size of the federal income tax expenditure attributed to the oil sands industry. Tax expenditures are tax concessions which are used as alternatives to direct government spending for achieving government policy objectives. The OSTEM was developed within the business Income Tax Division of Canada's Department of Finance. Data inputs for the model were obtained from oil sands developers and Natural Resources Canada. OSTEM calculates annual revenues, royalties and federal taxes at project levels using project-level projections of capital investment, operating expenses and production. OSTEM calculates tax expenditures by comparing taxes paid under different tax regimes. The model also estimates the foregone revenue as a percentage of capital investment. Total tax expenditures associated with investment in the oil sands are projected to total $820 million for the period from 1986 to 2030, representing 4.6 per cent of the total investment. 10 refs., 2 tabs., 7 figs

Evaluation of Expenditure Alternates

Science.gov (United States)

Poehlein, Gary W.; And Others

1973-01-01

Illustrates a system of calculating dollar expenditures over periods of time in terms of present value. The system enables planners, school boards, and administrators to compare expenditure alternatives as a decisionmaking factor. (Author)

When do fat taxes increase consumer welfare?

Science.gov (United States)

Lusk, Jayson L; Schroeter, Christiane

2012-11-01

Previous analyses of fat taxes have generally worked within an empirical framework in which it is difficult to determine whether consumers benefit from the policy. This note outlines on simple means to determine whether consumers benefit from a fat tax by comparing the ratio of expenditures on the taxed good to the weight effect of the tax against the individual's willingness to pay for a one-pound weight reduction. Our empirical calculations suggest that an individual would have to be willing to pay about $1500 to reduce weight by one pound for a tax on sugary beverages to be welfare enhancing. The results suggest either that a soda tax is very unlikely to increase individual consumer welfare or that the policy must be justified on some other grounds that abandon standard rationality assumptions. Copyright © 2011 John Wiley & Sons, Ltd.

National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey.

Science.gov (United States)

Salami, Joseph A; Warraich, Haider J; Valero-Elizondo, Javier; Spatz, Erica S; Desai, Nihar R; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Khera, Amit; Blaha, Michael J; Blumenthal, Roger S; Katzen, Barry T; Lloyd-Jones, Donald; Krumholz, Harlan M; Nasir, Khurram

2018-01-22

Evidence supporting nonstatin lipid-lowering therapy in atherosclerotic cardiovascular disease risk reduction is variable. We aim to examine nonstatin utilization and expenditures in the United States between 2002 and 2013. We used the Medical Expenditure Panel Survey database to estimate national trends in nonstatin use and cost (total and out-of-pocket, adjusted to 2013 US dollars using a gross domestic product deflator) among adults 40 years or older. Nonstatin users increased from 3 million (2.5%) in 2002-2003 (20.1 million prescriptions) to 8 million (5.6%) in 2012-2013 (45.8 million prescriptions). Among adults with atherosclerotic cardiovascular disease, nonstatin use increased from 7.5% in 2002-2003 to 13.9% in 2012-2013 after peaking at 20.3% in 2006-2007. In 2012-2013, 15.9% of high-intensity statin users also used nonstatins, versus 9.7% of low/moderate-intensity users and 3.6% of statin nonusers. Nonstatin use was significantly lower among women (odds ratio 0.80; 95% confidence interval 0.75-0.86), racial/ethnic minorities (odds ratio 0.41; 95% confidence interval 0.36-0.47), and the uninsured (odds ratio 0.47; 95% confidence interval 0.40-0.56). Total nonstatin expenditures increased from $1.7 billion (out-of-pocket cost, $0.7 billion) in 2002-2003 to $7.9 billion (out-of-pocket cost $1.6 billion) in 2012-2013, as per-user nonstatin expenditure increased from $550 to $992. Nonstatin expenditure as a proportion of all lipid-lowering therapy expenditure increased 4-fold from 8% to 32%. Between 2002 and 2013, nonstatin use increased by 124%, resulting in a 364% increase in nonstatin-associated expenditures. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Sugary beverage taxation in South Africa: Household expenditure, demand system elasticities, and policy implications.

Science.gov (United States)

Stacey, Nicholas; Tugendhaft, Aviva; Hofman, Karen

2017-12-01

South Africa faces a severe and growing obesity epidemic. Obesity and its co-morbidities raise public and private expenditures on healthcare. Sugary beverages are heavily consumed in South Africa and are linked to the onset of overweight and obesity. Excise taxation of sugary beverages has been proposed and adopted in other settings as a means to reduce harms from their consumption. A tax on the sugar content of non-alcoholic beverages has been proposed for implementation in South Africa, however, the public health effects and revenue raising potential of this measure hinges on estimates of the targeted beverages own- and cross-price elasticities. This study applies demand system methods by combining expenditure survey data and sub-national price data to provide the first estimates of price and expenditure elasticities for categories of soft drinks that would be subject to South Africa's proposed sugary beverage tax. The results suggest that demand for these products is sufficiently price-elastic such that a significant reduction in consumption may result from a tax. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2013-14 (Fiscal Year 2014). First Look. NCES 2016-301

Science.gov (United States)

Cornman, Stephen Q.; Zhou, Lei

2016-01-01

This "First Look" contains national and state totals of revenues and expenditures for public elementary and secondary education for school year 2013-14. This "First Look" includes revenues by source and expenditures by function and object, including current expenditures per pupil and instructional expenditures per pupil. This…

Novel methodology for pharmaceutical expenditure forecast.

Science.gov (United States)

Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Mzoughi, Olfa; Toumi, Mondher

2014-01-01

The value appreciation of new drugs across countries today features a disruption that is making the historical data that are used for forecasting pharmaceutical expenditure poorly reliable. Forecasting methods rarely addressed uncertainty. The objective of this project was to propose a methodology to perform pharmaceutical expenditure forecasting that integrates expected policy changes and uncertainty (developed for the European Commission as the 'EU Pharmaceutical expenditure forecast'; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). 1) Identification of all pharmaceuticals going off-patent and new branded medicinal products over a 5-year forecasting period in seven European Union (EU) Member States. 2) Development of a model to estimate direct and indirect impacts (based on health policies and clinical experts) on savings of generics and biosimilars. Inputs were originator sales value, patent expiry date, time to launch after marketing authorization, price discount, penetration rate, time to peak sales, and impact on brand price. 3) Development of a model for new drugs, which estimated sales progression in a competitive environment. Clinical expected benefits as well as commercial potential were assessed for each product by clinical experts. Inputs were development phase, marketing authorization dates, orphan condition, market size, and competitors. 4) Separate analysis of the budget impact of products going off-patent and new drugs according to several perspectives, distribution chains, and outcomes. 5) Addressing uncertainty surrounding estimations via deterministic and probabilistic sensitivity analysis. This methodology has proven to be effective by 1) identifying the main parameters impacting the variations in pharmaceutical expenditure forecasting across countries: generics discounts and penetration, brand price after patent loss, reimbursement rate, the penetration of biosimilars and discount price, distribution chains, and the time

Uranium exploration expenditures in 1976 and plans for 1977--78

International Nuclear Information System (INIS)

1977-05-01

A survey of actual and planned uranium exploration activities was made by the Grand Junction Office of the U.S. Energy Research and Development Administration as part of an overall program to evaluate future supplies of nuclear fuel. The survey covered: land acquired in 1976 for exploration and cost of acquisition; 1976 surface drilling footage and cost; all other exploration expenditures in 1976; estimates of 1977-78 exploration activities and costs; exploration for non-sandstone deposits; exploration in non-established areas; foreign uranium exploration expenditures by U.S. companies; foreign participation in exploration activities in the United States; aerial radiometric exploration activities in the United States, 1972-76; and solution-mining production drilling during 1976. Data from the replies of 108 companies are compiled

STATE-LEVEL DIETARY DIVERSITY AS A CONTEXTUAL DETERMINANT OF NUTRITIONAL STATUS OF CHILDREN IN INDIA: A MULTILEVEL APPROACH.

Science.gov (United States)

Borkotoky, Kakoli; Unisa, Sayeed; Gupta, Ashish Kumar

2018-01-01

This study aimed to identify the determinants of nutritional status of children in India with a special focus on dietary diversity at the state level. Household-level consumption data from three rounds of the Consumer Expenditure Survey of the National Sample Survey Organization (1993-2012) were used. Information on the nutritional status of children was taken from the National Family Health Survey (2005-06). Dietary diversity indices were constructed at the state level to examine diversity in quantity of food consumed and food expenditure. Multilevel regression analysis was applied to examine the association of state-level dietary diversity and other socioeconomic factors with the nutritional status of children. It was observed that significant variation in childhood stunting, wasting and underweight could be explained by community- and state-level factors. The results indicate that dietary diversity has increased in India over time, and that dietary diversity at the state level is significantly associated with the nutritional status of children. Moreover, percentage of households with a regular salaried income in a state, percentage of educated mothers and mothers receiving antenatal care in a community are important factors for improving the nutritional status of children. Diversity in complementary child feeding is another significant determinant of nutritional status of children. The study thus concludes that increasing dietary diversity at the state level is an effective measure to reduce childhood malnutrition in India.

Consumer Health Information and the Demand for Physician Visits.

Science.gov (United States)

Schmid, Christian

2015-12-01

The present study empirically investigates the effect of consumer health information on the demand for physician visits. Using a direct information measure based on questions from the Swiss Health Survey, we estimate a Poisson hurdle model for office visits. We find that information has a negative effect on health care utilization, contradicting previous findings in the literature. We consider differences in the used information measures to be the most likely explanation for the different findings. However, our results suggest that increasing consumer health information has the potential to reduce health care expenditures. Copyright © 2014 John Wiley & Sons, Ltd.

Analysis of Researching Dynamics and Structure of Consumer Expenditure of the Russian Population

OpenAIRE

Buneeva, Raisa Ilyinichna; Buneeva, Maria Vitalyevna; Toropov, Valery Valeryevich; Khryuchkina, Elena Alekxeevna

2016-01-01

The model of consumption, consumer behavior (character of consumption), volume and structure of consumption are determined by the person’s style and lifestyle. In their turn, style and lifestyle are formed on the basis of the consumer’s level of life, i.e., the level of prosperity and benefits consumption defined by the needs, ways and forms to satisfy them based on the real consumer demand. The article shows the results of the analysis related to the researches that prove the influence of th...

Prescription drug coupons: evolution and need for regulation in direct-to-consumer advertising.

Science.gov (United States)

Mackey, Tim K; Yagi, Nozomi; Liang, Bryan A

2014-01-01

Pharmaceutical marketing in the United States had undergone a shift from largely exclusively targeting physicians to considerable efforts in targeting patients through various forms of direct-to-consumer advertising ("DTCA"). This includes the use of DTCA in prescription drug coupons ("PDCs"), a new form of DTCA that offers discounts and rebates directly to consumers to lower costs of drug purchasing. Our examination of PDCs reveals that the use and types of PDC programs is expanding and includes promotion of the vast majority of top grossing pharmaceuticals. However, controversy regarding this emerging form of DTCA has given rise to health policy concerns about their overall impact on prescription drug expenditures for consumers, payers, and the health care system, and whether they lead to optimal long-term utilization of pharmaceuticals. In response to these concerns and the growing popularity of PDCs, what we propose here are clearer regulation and regulatory guidance for PDC DTCA use. This would include review for appropriate disclosure of marketing claims, increased transparency in PDC use for pharmaceutical pricing, and leveraging potential positive benefits of PDC use for vulnerable or underserved patient populations. Copyright © 2014 Elsevier Inc. All rights reserved.

Direct-to-consumer advertising: its effects on stakeholders.

Science.gov (United States)

Montoya, Isaac D; Lee-Dukes, Gwen; Shah, Dhvani

2008-01-01

The escalating growth in the development of pharmaceutical drugs has caused the pharmaceutical industry to market drugs directly to consumers. Direct-to-consumer (DTC) advertising has increased immensely in the past 15 years and continues to grow each year. The advantages of DTC advertising include an increase in consumer knowledge, patient autonomy, and possibly providing physicians and pharmacists with up-to-date information about the recent trends in the marketplace. However, there is also an equally notable list of disadvantages, which include concerns about the quality of information provided, loss in physician productivity due to time spent convincing patients that what they want is not in their best interest, and increases in the reimbursement expenditure of the insurers. Because of these conflicting outcomes, the issue of DTC advertising has become controversial. This report offers an overview of DTC advertising and focuses on its effects on physicians, pharmacists, consumers, insurers, the government, and pharmaceutical manufacturers.

76 FR 50887 - Elections Regarding Start-Up Expenditures, Corporation Organizational Expenditures, and...

Science.gov (United States)

2011-08-17

... begins an active trade or business, an amount equal to the lesser of (1) the amount of the start-up... begins. All start-up expenditures that relate to the active trade or business are considered in... active trade or business to which the expenditures relate begins. The election either to amortize start...

Health care expenditures of children and adults with spina bifida in a privately insured U.S. population.

Science.gov (United States)

Ouyang, Lijing; Grosse, Scott D; Armour, Brian S; Waitzman, Norman J

2007-07-01

We provide new estimates of medical care utilization and expenditures over the lifespan for persons living with spina bifida in the United States. Updated estimates are essential for calculations of lifetime costs and for economic evaluations of prevention and management strategies for spina bifida. We analyzed data from the 2001-2003 MarketScan database on paid medical and prescription drug claims of persons covered by employer-sponsored health insurance in the United States. Medical care utilization and expenditures during 2003 were analyzed for persons with a diagnosis of spina bifida recorded during 2001-2003 who had 12 months of coverage in a fee-for-service health plan. To calculate expenditures during infancy, a separate analysis was performed for those born during 2002 with claims and expenditures data during the first 12 months of life. We compared medical expenditures for persons with and without spina bifida by age groups. Average incremental medical expenditures comparing patients with spina bifida and those without were $41,460 per year at age 0, $14,070 at ages 1-17, $13,339 at ages 18-44, and $10,134 at ages 45-64. Children ages 1-17 years with spina bifida had average medical expenditures 13 times greater than children without spina bifida. Adults with spina bifida had average medical expenditures three to six times greater than adults without spina bifida in this privately insured population. Although per capita medical care utilization and expenditures are highest among children, adults constitute an important and growing share of the population living with spina bifida. (c) 2007 Wiley-Liss, Inc.

Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

Science.gov (United States)

Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

2017-05-01

Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

Disparity of out of pocket expenditure on reproductive health related ...

African Journals Online (AJOL)

MESKE

Results: The mean expenditure for laboratory tests and treatment by women with RTI ... policy relevant questions on equity pertaining to poverty, ... was employed to collect household level data on ..... educational enrollments in states of India.

Mankiw's Puzzle on Consumer Durables: A Misspecification

OpenAIRE

Tam Bang Vu

2005-01-01

Mankiw (1982) shows that consumer durables expenditures should follow a linear ARMA(1,1) process, but the data analyzed supports an AR(1) process instead; thus, a puzzle. In this paper, we employ a more general utility function than Mankiw's quadratic one. Further, the disturbance and depreciation rate are respecified, respectively, as multiplicative and stochastic. The analytical consequence is a nonlinear ARMA(infinity,1) process, which implies that the linear ARMA(1,1) is a misspecificatio...

42 CFR 403.754 - Monitoring expenditure level.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Monitoring expenditure level. 403.754 Section 403..., Conditions of Participation, and Payment § 403.754 Monitoring expenditure level. (a) Tracking expenditures... between the trigger level and Medicare expenditures for a FFY results in a carry forward that either...

Pharmaceutical expenditure changes in Serbia and Greece during the global economic recession

Directory of Open Access Journals (Sweden)

Mihajlo Jakovljevic

2016-04-01

Full Text Available Aim: Clarity on health expenditures is essential for the timely identification of risks that jeopardize the democratic provision of health services and the credibility of health insurance systems. Furthermore, observing health outcomes with geographical scope is essential for making multilateral associations. This study aimed at conveying information on the variability of important economic parameters of the health sector of Serbia and Greece from 2007 to 2012, when the most serious financial crisis in the post-war economic history hit the global economy. Methods: Exchange rates, purchase-power-parities (PPP and price indices were used for the bilateral review of health and pharmaceutical expenditure dynamics during 2007-2012. Prescription and dispensing changes were also studied taking into account the anatomical therapeutic chemical (ATC structure of drugs consumed. Results: Greece was forced to cut down its total health care and pharmaceutical expenditure and mainly its out-of-pocket payments were more seriously affected by the recession. Surprisingly, emerging market of Serbia, although severely damaged by global recession, succeeded to maintain 19% growth of its per capita health expenditure and even 25% increase of its per capita spending on pharmaceuticals. Innovative pharmaceuticals showed an upward trend in both countries. Conclusions: These two countries might serve as an example of two distinct pathways of mature and emerging health care markets during financial constraints caused by global recession. Our findings show that producing disease-based feedback, in the long run, may empower the assessment of the return on investment on medical technology and healthcare systems’ cost-effectiveness.

High Vegetable Fats Intake Is Associated with High Resting Energy Expenditure in Vegetarians.

Science.gov (United States)

Montalcini, Tiziana; De Bonis, Daniele; Ferro, Yvelise; Carè, Ilaria; Mazza, Elisa; Accattato, Francesca; Greco, Marta; Foti, Daniela; Romeo, Stefano; Gulletta, Elio; Pujia, Arturo

2015-07-17

It has been demonstrated that a vegetarian diet may be effective in reducing body weight, however, the underlying mechanisms are not entirely clear. We investigated whether there is a difference in resting energy expenditure between 26 vegetarians and 26 non-vegetarians and the correlation between some nutritional factors and inflammatory markers with resting energy expenditure. In this cross-sectional study, vegetarians and non-vegetarians were matched by age, body mass index and gender. All underwent instrumental examinations to assess the difference in body composition, nutrient intake and resting energy expenditure. Biochemical analyses and 12 different cytokines and growth factors were measured as an index of inflammatory state. A higher resting energy expenditure was found in vegetarians than in non-vegetarians (p = 0.008). Furthermore, a higher energy from diet, fibre, vegetable fats intake and interleukin-β (IL-1β) was found between the groups. In the univariate and multivariable analysis, resting energy expenditure was associated with vegetarian diet, free-fat mass and vegetable fats (p vegetarian's diet, i.e., vegetable fats. Furthermore, we showed that IL-10 was positively associated with resting energy expenditure in this population.

Out-of-pocket expenditure on institutional delivery in India.

Science.gov (United States)

Mohanty, Sanjay K; Srivastava, Akanksha

2013-05-01

Though promotion of institutional delivery is used as a strategy to reduce maternal and neonatal mortality, about half of the deliveries in India are conducted at home without any medical care. Among women who deliver at home, one in four cites cost as barrier to facility-based care. The relative share of deliveries in private health centres has increased over time and the associated costs are often catastrophic for poor households. Though research has identified socio-economic, demographic and geographic barriers to the utilization of maternal care, little is known on the cost differentials in delivery care in India. The objective of this paper is to understand the regional pattern and socio-economic differentials in out-of-pocket (OOP) expenditure on institutional delivery by source of provider in India. The study utilizes unit data from the District Level Household and Facility Survey (DLHS-3), conducted in India during 2007-08. Descriptive statistics, principal component analyses and a two-part model are used in the analyses. During 2004-08, the mean OOP expenditure for a delivery in a public health centre in India was US$39 compared with US$139 in a private health centre. The predicted expenditure for a caesarean delivery was six times higher than for a normal delivery. With an increase in the economic status and educational attainment of mothers, the propensity and rate of OOP expenditure increases, linking higher OOP expenditure to quality of care. The OOP expenditure in public health centres, adjusting for inflation, has declined over time, possibly due to increased spending under the National Rural Health Mission. Based on these findings, we recommend that facilities in public health centres of poorly performing states are improved and that public-private partnership models are developed to reduce the economic burden for households of maternal care in India.

Environment-related expenditures in 2013

International Nuclear Information System (INIS)

Diel, Olivier

2015-12-01

In 2013, households, private corporations and general government spent Euro 47.2 billion for environmental protection, an increase of 1.8% over 2012. For the 2000-2013 period on the whole, this expenditure has been rising faster than the gross domestic product (GDP): +4% on an annual average for the environmental protection expenditure compared with +2.8% for the GDP. In connection with the growing environmental concerns of society, public policy contributed to this steady increase through economic incentives ('bonus/malus' system, for instance) and regulation. In particular, the latter led to a technical improvement of processes (selective collection of waste, bringing up to standard of water treatment plants) which participated in the growth of expenditure. Wastewater and waste managements are the two main environmental protection expenditure domains. Furthermore, they are connected with topics related to resource management: drinking water supply and materials recovery. However, the expenditure for the materials recovery sector is decreasing in 2013, due to declines in raw materials prices. Expenditure for renewable energies - another topic related to environment - is considerably growing in 2013. Electricity production notably from water power is rising sharply, as a result of a particularly rainy spring. Nevertheless, the growth of environmental expenditures does not impact the corresponding employment in a systematic way. Thus, even if value added of the environmental goods and services sector (EGSS) increased by 1.8% in 2013, employment decreased by 0.3%. And the labor market in the green economy has been in decay since 2011, at a practically similar rate as for the economy as a whole

High Vegetable Fats Intake Is Associated with High Resting Energy Expenditure in Vegetarians

Directory of Open Access Journals (Sweden)

Tiziana Montalcini

2015-07-01

Full Text Available It has been demonstrated that a vegetarian diet may be effective in reducing body weight, however, the underlying mechanisms are not entirely clear. We investigated whether there is a difference in resting energy expenditure between 26 vegetarians and 26 non-vegetarians and the correlation between some nutritional factors and inflammatory markers with resting energy expenditure. In this cross-sectional study, vegetarians and non-vegetarians were matched by age, body mass index and gender. All underwent instrumental examinations to assess the difference in body composition, nutrient intake and resting energy expenditure. Biochemical analyses and 12 different cytokines and growth factors were measured as an index of inflammatory state. A higher resting energy expenditure was found in vegetarians than in non-vegetarians (p = 0.008. Furthermore, a higher energy from diet, fibre, vegetable fats intake and interleukin-β (IL-1β was found between the groups. In the univariate and multivariable analysis, resting energy expenditure was associated with vegetarian diet, free-fat mass and vegetable fats (p < 0.001; Slope in statistic (B = 4.8; β = 0.42. After adjustment for cytokines, log10 interleukin-10 (IL-10 still correlated with resting energy expenditure (p = 0.02. Resting energy expenditure was positively correlated with a specific component of the vegetarian’s diet, i.e., vegetable fats. Furthermore, we showed that IL-10 was positively associated with resting energy expenditure in this population.

Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons.

Science.gov (United States)

Crivelli, Luca; Filippini, Massimo; Mosca, Ilaria

2006-05-01

Switzerland (7.2 million inhabitants) is a federal state composed of 26 cantons. The autonomy of cantons and a particular health insurance system create strong heterogeneity in terms of regulation and organisation of health care services. In this study we use a single-equation approach to model the per capita cantonal expenditures on health care services and postulate that per capita health expenditures depend on some economic, demographic and structural factors. The empirical analysis demonstrates that a larger share of old people tends to increase health costs and that physicians paid on a fee-for-service basis swell expenditures, thus highlighting a possible phenomenon of supply-induced demand.

Tax Expenditures: A Theoretical Review

Directory of Open Access Journals (Sweden)

Vjekoslav Bratić

2006-06-01

Full Text Available Tax expenditures are an instrument frequently used when a government wishes to achieve certain economic and social effects. But because of the increasing number and scope of tax expenditures, their proper use, quality of administration and record-keeping have become a major challenge for the tax authorities and the whole of the government. The article considers and explains very diverse forms of tax expenditure such as reliefs, tax deductions, tax allowances, tax exceptions and special rates of taxation and the ways in which they are defined and calculated. The key problems in the analysis are the absence of a single definition and of methodology for the calculations; these ultimately make it impossible to compare tax expenditures between or among countries.

Bucking the trend? Health care expenditures in low-income countries 1990-1995.

Science.gov (United States)

Jowett, M

1999-01-01

Health care expenditures in low-income countries are analysed for the years 1990 and 1995 using four key indicators. Key findings include a substantial reduction in public spending per capita across low-income countries between 1990-95; a significant shift towards private expenditures, which appears increasingly to be substituting rather than supplementing public expenditures; a fall in total and public health spending in many countries despite growth in national income, contradicting the relationship found in other studies. Two possible explanations are put forward. First that the patterns found are a direct result of the structural adjustment policies adopted by many low-income countries, which aim to control and often cut public financing, whilst promoting private health expenditures. Secondly, that following the wave of privatization of state industries, many governments are finding problems adapting to their new role as a tax collector, and are thus not benefiting from economic growth to the extent that might be expected.

Health care policies and resisting consumers in a prototypical welfare state

DEFF Research Database (Denmark)

Lykke Hindhede, Anette

2011-01-01

policies. The paper is based on qualitative methods comprising observations and interviews in two hearing clinics. The paper shows that rather than a „withdrawal‟ of the state there has been a process of reform with governing at distance. The data suggests that a distinguishing mark of the consumer role...

26 CFR 1.501(h)-1 - Application of the expenditure test to expenditures to influence legislation; introduction.

Science.gov (United States)

2010-04-01

... expenditures to influence legislation; introduction. 1.501(h)-1 Section 1.501(h)-1 Internal Revenue INTERNAL...) Exempt Organizations § 1.501(h)-1 Application of the expenditure test to expenditures to influence... attempting to influence legislation, (except as otherwise provided in subsection (h)).” This requirement is...

Intersystem return on investment in public mental health: Positive externality of public mental health expenditure for the jail system in the U.S.

Science.gov (United States)

Yoon, Jangho; Luck, Jeff

2016-12-01

This study examines the extent to which increased public mental health expenditures lead to a reduction in jail populations and computes the associated intersystem return on investment (ROI). We analyze unique panel data on 44 U.S. states and D.C. for years 2001-2009. To isolate the intersystem spillover effect, we exploit variations across states and over time within states in per capita public mental health expenditures and average daily jail inmates. Regression models control for a comprehensive set of determinants of jail incarcerations as well as unobserved determinants specific to state and year. Findings show a positive spillover benefit of increased public mental health spending on the jail system: a 10% increase in per capita public inpatient mental health expenditure on average leads to a 1.5% reduction in jail inmates. We also find that the positive intersystem externality of increased public inpatient mental health expenditure is greater when the level of community mental health spending is lower. Similarly, the intersystem spillover effect of community mental health expenditure is larger when inpatient mental health spending is lower. We compute that overall an extra dollar in public inpatient mental health expenditure by a state would yield an intersystem ROI of a quarter dollar for the jail system. There is significant cross-state variation in the intersystem ROI in both public inpatient and community mental health expenditures, and the ROI overall is greater for inpatient mental health spending than for community mental health spending. Copyright © 2016. Published by Elsevier Ltd.

Predictors of high out-of-pocket healthcare expenditure: an analysis using Bangladesh household income and expenditure survey, 2010.

Science.gov (United States)

Molla, Azaher Ali; Chi, Chunhuei; Mondaca, Alicia Lorena Núñez

2017-01-31

Predictors of high out-of-pocket household healthcare expenditure are essential for creating effective health system finance policy. In Bangladesh, 63.3% of health expenditure is out-of-pocket and born by households. It is imperative to know what determines household health expenditure. This study aims to investigate the predicting factors of high out-of-pocket household healthcare expenditure targeting to put forward policy recommendations on equity in financial burden. Bangladesh household income and expenditure survey 2010 provides data for this study. Predictors of high out-of-pocket household healthcare expenditure were analyzed using multiple linear regressions. We have modeled non-linear relationship using logarithmic form of linear regression. Heteroscedasticity and multicollinearity were checked using Breusch-Pagan/Cook-Weishberg and VIF tests. Normality of the residuals was checked using Kernel density curve. We applied required adjustment for survey data, so that standard errors and parameters estimation are valid. Presence of chronic disease and household income were found to be the most influential and statistically significant (p financing in Bangladesh to minimize the burden of high OOP healthcare expenditure.

Economic impact of chikungunya epidemic: out-of-pocket health expenditures during the 2007 outbreak in Kerala, India.

Science.gov (United States)

Vijayakumar, K; George, B; Anish, T S; Rajasi, R S; Teena, M J; Sujina, C M

2013-01-01

The southern state of Kerala, India was seriously affected by a chikungunya epidemic in 2007. As this outbreak was the first of its kind, the morbidity incurred by the epidemic was a challenge to the state's public health system. A cross sectional survey was conducted in five districts of Kerala that were seriously affected by the epidemic, using a two-stage cluster sampling technique to select households, and the patients were identified using a syndromic case definition. We calculated the direct health expenditure of families and checked whether it exceed the margins of catastrophic health expenditure (CHE). The median (IQR) total out-of-pocket (OOP) health expenditure in the study population was USD7.4 (16.7). The OOP health expenditure did not show any significant association with increasing per-capita monthly income.The major share (47.4%) of the costs was utilized for buying medicines, but costs for transportation (17.2%), consultations (16.6%), and diagnoses (9.9%) also contributed significantly to the total OOP health expenditure. The OOP health expenditure was high in private sector facilities, especially in tertiary care hospitals. For more than 15% of the respondents, the OOP was more than double their average monthly family income. The chikungunya outbreak of 2007 had significantly contributed to the OOP expenditure of the affected community in Kerala.The OOP health expenditure incurred was high, irrespective of the level of income. Governments should attempt to ensure comprehensive financial protection by covering the costs of care, along with loss of productivity.

A Performance Analysis of Public Expenditure on Maternal Health in Mexico.

Science.gov (United States)

Servan-Mori, Edson; Avila-Burgos, Leticia; Nigenda, Gustavo; Lozano, Rafael

2016-01-01

We explore the relationship between public expenditure, coverage of adequate ANC (including timing, frequent and content), and the maternal mortality ratio--adjusted by coverage of adequate ANC--observed in Mexico in 2012 at the State level. Additionally, we examine the inequalities and concentration of public expenditure between populations with and without Social Security. Results suggest that in the 2003-2011 period, the public expenditure gap between women with and without Social Security decreased 74%, however, the distribution is less equitable among women without Social Security, across the States. Despite high levels of coverage on each dimension of ANC explored, coverage of adequate ANC was lower among Social Security than non-Social Security women. This variability results in differences up to 1.5 times in State-adjusted maternal mortality rate at the same level of expense and maternal mortality rate, respectively. The increase in the economic resources is only a necessary condition for achieving improved health outcomes. Providing adequate health services and achieving efficient, effective and transparent use of resources in health, are critical elements for health systems performance. The attainment of universal effective coverage of maternal health and reducing maternal mortality in Mexico, requires the adjustment of policy innovations including the rules of allocation and execution of health resources. Health policies should be designed on a more holistic view promoting a balance between accessibility, effective implementation and rigorous stewardship.

Food consumed outside the home in Brazil according to places of purchase

Directory of Open Access Journals (Sweden)

Ilana Nogueira Bezerra

Full Text Available ABSTRACT OBJECTIVE This study aims to describe the places of purchase of food consumed outside the home, characterize consumers according to the places of consumption, and identify the food purchased by place of consumption in Brazil. METHODS We have used data from the Pesquisa de Orçamento Familiar (Household Budget Survey of 2008-2009 with a sample of 152,895 subjects over 10 years of age. The purchase of food outside the home was collected from the records of all expenditures made in seven days. The places of purchase were grouped according to their characteristics: supermarket, bakery, street food, restaurant, snack bar, fruit shop, and other places. The types of food were grouped into nine categories, considering the nutritional aspects and the marketing characteristics of the item. We have estimated the frequency of purchase in the seven groups of places in Brazil and according to gender and type of food purchased per place. We have calculated the average age, income and years of education, as well as the per capita expenditure according to places of purchase of food consumed outside the home. RESULTS The purchase of food outside the home was reported by 41.2% of the subjects, being it greater among men than women (44% versus 38.5%. Adults had a higher frequency (46% than teenagers (37.7% and older adults (24.2%. The highest frequency of places of purchase were snack bar (16.9% and restaurant (16.4%, while the fruit shop (1.2% presented the lowest frequency. Sweets, snack chips and soft drinks were the most purchased items in most places. Average expenditure was higher for restaurant (R$33.20 and lower for fruit shop (R$4.10 and street food (R$5.00. CONCLUSIONS The highest percentage of food consumed outside the home comes from snack bars and restaurants, pointing to important places for the development of public policies focused on promoting healthy eating.

Health Care Expenditures for Children with Autism Spectrum Disorders in Medicaid

Science.gov (United States)

Wang, Li; Leslie, Douglas L.

2010-01-01

Objective: To study trends in health care expenditures associated with autism spectrum disorders (ASDs) in state Medicaid programs. Method: Using Medicaid data from 42 states from 2000 to 2003, patients aged 17 years and under who were continuously enrolled in fee-for-service Medicaid were studied. Patients with claims related to autistic disorder…

Summary of expenditures of rebates from the low-level radioactive waste surcharge escrow account for calendar year 1991

International Nuclear Information System (INIS)

1992-06-01

This is the sixth report submitted to Congress under section 5(d)(2)(E)(ii)(II) of the Low-Level Radioactive Waste Policy Act of 1985 (the Act). This section of the Act directs the Department of Energy (DOE) to summarize the annual expenditures of funds disbursed from the DOE surcharge escrow account and to assess compliance of these expenditures with the limitations specified in the Act. In addition to placing limitations on the use of these funds, the Act also requires the nonsited compact regions and nonmember States to provide DOE with an itemized report of their expenditures on December 31 of each year in which funds are expended. Within 6 months after receiving the individual reports, the Act requires the Secretary to furnish Congress with a summary of the reported expenditures and an assessment of compliance with the specified usage limitations. This report fulfills that requirement. DOE disbursed funds totaling $15,037,778.91 to the States and compact regions following the July 1, 1986, January 1, 1988, and January 1, 1990, milestones specified in the Act. Of this amount, $3,517,020.56 was expended during calendar year 1991 and $6,602,546.24 was expended during the prior 5 years. At the end of December 1991, $4,918,212.11 was unexpended. DOE has reviewed each of the reported expenditures and concluded that all reported expenditures comply with the spending limitations stated in section 5(d)(2)(E)(i) of the Act

State of the art in benefit-risk analysis: consumer perception.

Science.gov (United States)

Ueland, Ø; Gunnlaugsdottir, H; Holm, F; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken, G; Pohjola, M V; Tijhuis, M J; Tuomisto, J T; White, B C; Verhagen, H

2012-01-01

Benefit and risk perception with respect to food consumption, have been a part of human daily life from beginning of time. In today's society the food chain is long with many different types of actors and low degree of transparency. Making informed food choices where knowledge of benefits and risks is part of the decision making process are therefore complicated for consumers. Thus, to understand how consumers perceive benefits and risks of foods, their importance in relation to quality evaluations are aspects that need to be addressed. The objective of this paper is to discuss state of the art in understanding consumer perceptions of benefits and risks of foods in order to improve understanding of consumer behaviour in the food domain. Risks may be associated with both acute and long term consequences, some of which may have serious effects. Perceived risks are connected to morbidity and mortality along two dimensions relating to unknown risk, and to which extent the risk is dreaded by the consumer. Unfamiliar, uncertain, unknown, uncontrollable, and severe consequences are some factors associated with risk perception. Novel food processing techniques, for instance, score high on several of these parameters and are consequently regarded with suspicion and perceived as risky by consumers. On a daily basis, benefits of foods and food consumption are more important in most consumers' minds than risks. Benefits are often associated with food's ability to assuage hunger, and to provide pleasure through eating and socialising. In addition, two main categories of benefits that are important for acceptance of product innovations are health and environmental benefits. Benefit and risk perception of foods seem to be inversely correlated, so when something is perceived as being highly beneficial, it is correspondingly perceived as having low risk. However, slightly different paths are used in the formation of these perceptions; benefit perception is based on heuristics and

PUBLIC EXPENDITURE POLICY IN THE CONTEXT OF ECONOMIC CRISIS - CHALLENGES AND IMPLICATIONS

Directory of Open Access Journals (Sweden)

Petrisor Mihai - Bogdan

2011-07-01

Full Text Available Public spending is a key component for both public finances and government financial policy. In this situation, government expenditures are made in direct relation with the results of governance with economic and financial crises and global social welfare of the nation. From this perspective, our article aims to highlight the correlation between public expenditure and budgetary financial and economic crisis and, also, state government responses, anticipating their impact on medium and long term. Also, in the context of the crisis and the concomitent lack of public revenue, we identify the pillars on which to base the budget reduction in public expenditure. The implications of the economic crisis in Romania are analyzed along with proposed measures to be followed by the Government through budgetary fiscal strategy. In relation to the purpose and objectives of the research, documentation was made both in terms of bibliographic resources and the plan of legislative documents and quantitative reporting. We believe that the issue of increasing allocative efficiency of resources is vital to counter the current crisis, but also to maximize the positive effects of public interventions in general and from another state, we consider that state and, consequently, public expenditure budget which should be used to replace the market, can not be regarded as some suggest to be founded and we suggest a line for developed countries. This work was supported by the grant “Post-doctoral studies in Economics: program for continuous forming of elite researchers – SPODE”, contract POSDRU/89/1.5/S/61755, project financed by the European Social Fund, by the Operational Sectorial Program Development of Human Resources 2007-2013.

Infrastructure expenditures and costs. Practical guidelines to calculate total infrastructure costs for five modes of transport. Final report

International Nuclear Information System (INIS)

2005-11-01

Transport infrastructures in general, and the Trans European Transport Network (TEN-T) in particular, play an important role in achieving the medium and long-term objectives of the European Union. In view of this, the Commission has recently adopted a revision of the guidelines for the TEN-T. The main consequences of this revision are the need for a better understanding of the investments made by the member states in the TEN-T and the need for ensuring optimal consistency in the reporting by the Members States of such investments. With Regulation number 1108/70 the Council of the European Communities introduced an accounting system for expenditure on infrastructure in respect of transport by rail, road and inland waterways. The purpose of this regulation is to introduce a standard and permanent accounting system for infrastructure expenditures. However maritime and aviation infrastructure were not included. Further, the need for an effective and easy to apply classification for infrastructure investments concerning all five transport modes was still pending. Therefore, DG TREN has commissioned ECORYS Transport and CE Delft to study the expenditures and costs of infrastructure, to propose an adequate classification of expenditures, and to propose a method for translating data on expenditures into data on costs. The objectives of the present study are threefold: To set out a classification of infrastructure expenditures, in order to increase knowledge of expenditures related to transport infrastructures. This classification should support a better understanding of fixed and variable infrastructure costs; To detail the various components of such expenditures for five modes of transportation, which would enable the monitoring of infrastructure expenditures and costs; and to set up a methodology to move from annual series of expenditures to costs, including fixed and variable elements.

Hypocretin/orexin and energy expenditure.

Science.gov (United States)

Teske, J A; Billington, C J; Kotz, C M

2010-03-01

The hypocretins or orexins are endogenous neuropeptides synthesized in discrete lateral, perifornical and dorsal hypothalamic neurones. These multi-functional neuropeptides modulate energy homeostasis, arousal, stress, reward, reproduction and cardiovascular function. This review summarizes the role of hypocretins in modulating non-sleep-related energy expenditure with specific focus on the augmentation of whole body energy expenditure as well as hypocretin-induced physical activity and sympathetic outflow. We compare the efficacy of hypocretin-1 and 2 on energy expenditure and evaluate whether the literature implicates hypocretin signalling though the hypocretin-1 and -2 receptor as having shared and or functionally specific physiological effects. Thus far data suggest that hypocretin-1 has a more robust stimulatory effect relative to hypocretin-2. Furthermore, hypocretin-1 receptor predominantly mediates behaviours known to influence energy expenditure. Further studies on the hypocretin-2 receptor are needed.

Does intra-abdominal fluid increase the resting energy expenditure?

Science.gov (United States)

Zarling, E J; Grande, A; Hano, J

1997-10-01

In patients with intra-abdominal fluid collection, caloric needs are based on an estimated dry weight. This is done because intra-abdominal fluid has been assumed to be metabolically inactive. One recent study of patients with slowly resolving ascites suggested otherwise. In our study, the effect of intra-abdominal fluid on the resting energy expenditure (REE) and apparent lean body mass was determined in 10 stable patients requiring peritoneal dialysis. For each subject, in both the empty and full state, we measured REE by indirect calorimetry, and body composition by the bioelectric impedance method. In the full state, the VCO2 was significantly increased (210 +/- 11 versus 197 +/- 9 mL/min, P empty state. This caused an increase in the calculated resting energy expenditure (1531 +/- 88 kcal/d empty versus 1593 +/- 94 kcal/d full, P calories derived from glucose absorbed out of the dialysate. Estimates of body fat, lean body mass, and total water also were not affected by the intra-abdominal fluid. We conclude that intra-abdominal fluid will not affect the measured REE and hence may be considered to be metabolically inactive.

Energy expenditure of acutely ill hospitalised patients

Directory of Open Access Journals (Sweden)

Gariballa Salah

2006-03-01

Full Text Available Abstract Objective To measure energy expenditure of acutely ill elderly patients in hospital and following discharge in the community. Design Sixty-three consecutive hospitalised acutely ill elderly patients were recruited. Eight patients were studied to assess the reliability of the Delta Tract Machine as a measure of energy expenditure; 35 patients had their energy expenditure studied in hospital on two occasions and 20 patients had their energy expenditure measured in hospital and at 6 weeks in the community Results Men had higher basal energy expenditure (BMR values compared to women however the difference was not statistically significant [Men, mean (SD 1405 (321 Kcal, women 1238 (322 kcal; mean difference (95% CI 166 kcal (-17 to 531, p = 0.075]. After adjusting for age, gender and body mass index both medication and C-reactive protein (CRP, concentrations showed significant correlation with measured energy expenditure in hospital, (r = -0.36, "p Conclusion Tissue inflammation and medications were associated with change in measured energy expenditure in acutely ill patients.

45 CFR 96.135 - Restrictions on expenditure of grant.

Science.gov (United States)

2010-10-01

... needle exchange program would be effective in reducing drug abuse and the risk that the public will become infected with the etiologic agent for AIDS. (b) The State shall limit expenditures on the... support paragraph (d)(1) of this section, such as local needs assessments, waiting lists, survey data and...

The impacts of climate change on energy: An aggregate expenditure model for the US

Energy Technology Data Exchange (ETDEWEB)

Morrison, W. [Boston Univ., MA (United States); Mendelsohn, R. [Yale Univ., New Haven, CT (United States). School of Forestry and Environmental Studies

1998-09-01

This paper develops a theoretical model to measure the climate change impacts to the energy sector. Welfare effects are approximately equal to the resulting change in expenditures on energy and buildings. Using micro data on individuals and firms across the United States, energy expenditures are regressed on climate and other control variables to estimate both short-run and long-run climate response functions. The analysis suggests that energy expenditures have a quadratic U-shaped relationship with respect to temperature. Future warming of 2 C is predicted to cause annual damages of about $6 billion but increases of 5 C would increase damages to almost $30 billion.

The impacts of climate change on energy: An aggregate expenditure model for the US

International Nuclear Information System (INIS)

Morrison, W.; Mendelsohn, R.

1998-01-01

This paper develops a theoretical model to measure the climate change impacts to the energy sector. Welfare effects are approximately equal to the resulting change in expenditures on energy and buildings. Using micro data on individuals and firms across the United States, energy expenditures are regressed on climate and other control variables to estimate both short-run and long-run climate response functions. The analysis suggests that energy expenditures have a quadratic U-shaped relationship with respect to temperature. Future warming of 2 C is predicted to cause annual damages of about $6 billion but increases of 5 C would increase damages to almost $30 billion

Local health departments and specific maternal and child health expenditures: relationships between spending and need.

Science.gov (United States)

Bekemeier, Betty; Dunbar, Matthew; Bryan, Matthew; Morris, Michael E

2012-11-01

As a part of the Public Health Activities and Service Tracking study and in collaboration with partners in 2 Public Health Practice-Based Research Network states, we examined relationships between local health department (LHD) maternal and child health (MCH) expenditures and local needs. We used a multivariate pooled time-series design to estimate ecologic associations between expenditures in 3 MCH-specific service areas and related measures of need from 2005 to 2010 while controlling for other factors. Retrospective expenditure data from LHDs and for 3 MCH services represented annual investments in (1) Special Supplemental Nutrition for Women, Infants, and Children (WIC), (2) family planning, and (3) a composite of Maternal, Infant, Child, and Adolescent (MICA) service. Expenditure data from all LHDs in Florida and Washington were then combined with "need" and control variables. Our sample consisted of the 102 LHDs in Florida and Washington and the county (or multicounty) jurisdictions they serve. Expenditures for WIC and for our composite of MICA services were strongly associated with need among LHDs in the sample states. For WIC, this association was positive, and for MICA services, this association was negative. Family planning expenditures were weakly associated, in a positive direction. Findings demonstrate wide variations across programs and LHDs in relation to need and may underscore differences in how programs are funded. Programs with financial disbursements based on guidelines that factor in local needs may be better able to provide service as local needs grow than programs with less needs-based funding allocations.

Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2011-12 (Fiscal Year 2012). First Look. NCES 2014-301

Science.gov (United States)

Cornman, Stephen Q.

2015-01-01

This First Look report introduces new data for national and state-level public elementary and secondary revenues and expenditures for fiscal year (FY) 2012. Specifically, this report includes findings from the following types of school finance data: (1) Revenue and expenditure totals; (2) Revenues by source; (3) Expenditures by function and…

Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2014-15 (Fiscal Year 2015). First Look. NCES 2018-301

Science.gov (United States)

Cornman, Stephen Q.; Zhou, Lei; Howell, Malia R.; Young, Jumaane

2018-01-01

This First Look report introduces new data for national and state-level public elementary and secondary revenues and expenditures for fiscal year (FY) 2015. Specifically, this report includes the following school finance data: (1) revenue and expenditure totals; (2) revenues by source; (3) expenditures by function and object; (4) current…

Using Patent Development, Education Policy and Research and Development Expenditure Policy to Increase Technological Competitiveness of Small European Union Member States

Directory of Open Access Journals (Sweden)

Ferraro Simona

2017-08-01

Full Text Available The Chinese Belt and Road Initiative will open new trade routes between China and the European Union (EU and increase competition pressures on smaller EU member states. This article ranks where states like Estonia stand internationally in terms of innovativeness (and consequent competitiveness by conducting an econometric study of patent development, education policy and research and development (R&D expenditure policy. The authors claim that small member states such as Estonia should follow the example of countries such as Germany and adopt policies which focus more on increased public spending on R&D and innovation in public universities of science and technology, and raise support for high tech startups with a strong focus on international patenting. Member States must go further and subsidise R&D activities by focusing, inter alia, on filing of foreign patents such as triadic patents.

The Consistency of Consumer's Stated Preference and Revealed Preference : Evidence from Agricultural Product Market in China

OpenAIRE

Han, Qing; Zhou, Hui; Nanseki, Teruaki; Wang, Jimin; 南石, 晃明

2012-01-01

This paper analyzes the consistency of consumer's stated preference (SP) and revealed preference (RP) for fresh certified pork by using Beijing urban residents' questionnaire survey data in December 2010. It models the factors of the consistency of SP–RP and calculates the marginal effect coefficients. The results indicate that these factors of whether consumer's household have children under 18 years old, consumer's knowledge about certified products and searching frequency about food qualit...

Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2012-13 (Fiscal Year 2013). First Look. NCES 2015-301

Science.gov (United States)

Cornman, Stephen Q.

2016-01-01

This First Look report introduces new data for national and state-level public elementary and secondary revenues and expenditures for fiscal year 2013 (FY 13). Specifically, this report includes findings from the following types of school finance data: (1) revenue and expenditure totals; (2) revenues by source; (3) expenditures by function and…

Gambling Participation, Expenditure and Risk of Harm in Australia, 1997-1998 and 2010-2011.

Science.gov (United States)

Armstrong, Andrew Richard; Thomas, Anna; Abbott, Max

2018-03-01

Gambling-related harm results primarily from financial losses. Internationally Australia continues to rank as the largest spending nation per capita on gambling products. This would suggest that Australian gamblers are at disproportionately high risk of harm despite almost two decades of industry scrutiny and regulation, and investment in research, treatment and education programs. However, declines in participation rates, per capita expenditure, household expenditure, national disposable income spent on gambling and problem gambling rates have been cited as evidence that fewer people are gambling, that gamblers are spending less, and that gambling safety in Australia has improved. The current study investigated these propositions using national population and accounts data, and statistics from Australia's two population-representative gambling surveys conducted in 1997-1998 and 2010-2011. Despite a falling participation rate the study found no real change in the number of people gambling overall, and increasing numbers consuming casino table games, race wagering and sports betting. Further found were increases rather than decreases in average gambler expenditure, overall, and across most products, particularly electronic gaming machines (EGMs). Potentially risky levels of average expenditure were observed in both periods, overall and for race wagering, casino table gaming, and EGMs. Changes in the proportion of income spent on gambling suggest risks declined overall and for race wagering and casino table gaming, but increased for EGMs. Finally, while problem gambling statistics were not comparable between periods, the study found double the number of moderate risk gamblers previously estimated for 2010-2011 amongst the 2 million Australians found to have experienced one or more gambling-related problems. The findings have implications for public health policy and resourcing, and the way in which prevalence and expenditure statistics have been interpreted by

Optimizing the Level of Renewable Electric R&D Expenditures Using Real Options Analysis

Energy Technology Data Exchange (ETDEWEB)

Davis, G.; Owens, B.

2003-02-01

One of the primary objectives of the United States' federal non-hydro renewable electric R&D program is to promote the development of technologies that have the potential to provide consumers with stable and secure energy supplies. In order to quantify the benefits provided by continued federal renewable electric R&D, this paper uses ''real option'' pricing techniques to estimate the value of renewable electric technologies in the face of uncertain fossil fuel prices. Within the real options analysis framework, the current value of expected future supply from renewable electric technologies, net of federal R&D expenditures, is estimated to be $30.6 billion. Of this value, 86% can be attributed to past federal R&D efforts, and 14% can be attributed to future federal R&D efforts, assuming continued federal R&D funding at $300 million/year. In addition, real options analysis shows that the value of renewable electric technologies increases as current and future R&D funding levels increase. This indicates that the current level of federal renewable electric R&D funding is sub-optimal low.

Sugary beverage taxation in South Africa: Household expenditure, demand system elasticities, and policy implications

OpenAIRE

Stacey, Nicholas; Tugendhaft, Aviva; Hofman, Karen

2017-01-01

South Africa faces a severe and growing obesity epidemic. Obesity and its co-morbidities raise public and private expenditures on healthcare. Sugary beverages are heavily consumed in South Africa and are linked to the onset of overweight and obesity. Excise taxation of sugary beverages has been proposed and adopted in other settings as a means to reduce harms from their consumption. A tax on the sugar content of non-alcoholic beverages has been proposed for implementation in South Africa, how...

ANALYSIS OF CONSUMPTION EXPENDITURE IN ROMANIA, PERIOD 2009-2015

Directory of Open Access Journals (Sweden)

BÂLDAN FLORENTINA CRISTINA

2017-06-01

Full Text Available The paper „Analysis of consumption expenditure in Romania, period 2009-2015” is highlighting a very important phenomenon for the Romanian economy, consumption. The financial and economic crisis determined a change in the income repartition for the basic products and services. The most influent stimulus at which the Romanian consumers are deciding a product acquisition is the price, therefore they were migrating to product segments with low prices, the quality of life being on a decreasing trend. The level of alimentary products consumption depends in a big extent on the macroeconomic policies, that through numerous leverages is influencing the population consumption behavior. From these leverages we may document the income policy, loan policy, monetary and exchange rate policies, social assistance policy, etc.

Summary of expenditures of rebates from the low-level radioactive waste surcharge escrow account for calendar year 1995

International Nuclear Information System (INIS)

1996-06-01

This report is submitted in response to Title 1 of the 1980 Low-Level Radioactive Waste Policy Act, as amended, (the Act). The report summarizes expenditures made by compact regions and unaffiliated states during calendar year 1995 of surcharge rebates from the July 1, 1986, January 1, 1988, and January 1, 1990, milestones, and the January 1, 1993, deadline. Section 5(d)(2)(A) of the Act requires the Department of Energy (DOE) to administer a surcharge escrow account. This account consists of a portion of the surcharge fees paid by generators of low-level radioactive waste in nonsited compact regions (compact regions currently without disposal sites) and nonmember states (states without disposal sites that are not members of compact regions) to the three sited states (states with operating disposal facilities--Nevada, South Carolina, and Washington) for the use of facilities in sited states through the end of 1992. In administering the surcharge escrow account, the Act requires DOE to: (1) Invest the funds in interest-bearing United States Government securities with the highest available yield; (2) Determine eligibility for rebates of the funds by evaluating compact region and state progress toward developing new disposal sites against the milestone requirements set forth in the Act; (3) Disburse the collected rebates and accrued interest to eligible compact regions, states, or generators; (4) Assess compliance of rebate expenditures in accordance with the conditions and limitations prescribed in the Act; and (5) Submit a report annually to Congress summarizing rebate expenditures by state and compact region and assessing the compliance of each such state or compact region with the requirement for expenditure of the rebates as provided in section 5(d)(2)(E) of the Act

Evaluating direct medical expenditures estimation methods of adults using the medical expenditure panel survey: an example focusing on head and neck cancer.

Science.gov (United States)

Coughlan, Diarmuid; Yeh, Susan T; O'Neill, Ciaran; Frick, Kevin D

2014-01-01

To inform policymakers of the importance of evaluating various methods for estimating the direct medical expenditures for a low-incidence condition, head and neck cancer (HNC). Four methods of estimation have been identified: 1) summing all health care expenditures, 2) estimating disease-specific expenditures consistent with an attribution approach, 3) estimating disease-specific expenditures by matching, and 4) estimating disease-specific expenditures by using a regression-based approach. A literature review of studies (2005-2012) that used the Medical Expenditure Panel Survey (MEPS) was undertaken to establish the most popular expenditure estimation methods. These methods were then applied to a sample of 120 respondents with HNC, derived from pooled data (2003-2008). The literature review shows that varying expenditure estimation methods have been used with MEPS but no study compared and contrasted all four methods. Our estimates are reflective of the national treated prevalence of HNC. The upper-bound estimate of annual direct medical expenditures of adult respondents with HNC between 2003 and 2008 was $3.18 billion (in 2008 dollars). Comparable estimates arising from methods focusing on disease-specific and incremental expenditures were all lower in magnitude. Attribution yielded annual expenditures of $1.41 billion, matching method of $1.56 billion, and regression method of $1.09 billion. This research demonstrates that variation exists across and within expenditure estimation methods applied to MEPS data. Despite concerns regarding aspects of reliability and consistency, reporting a combination of the four methods offers a degree of transparency and validity to estimating the likely range of annual direct medical expenditures of a condition. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.

Empirical approach to endorsement marketing and consumer fanaticism of telecom firms Nigeria’s Rivers State

Directory of Open Access Journals (Sweden)

Joy E. Akahome

2017-10-01

Full Text Available The paper is an empirical investigation of the relationship between endorsement marketing and consumer fanaticism of telecom firms in Rivers State. A sample of 200 customers of selected telecom firms was surveyed and 196 copies of the questionnaire were returned and valid after data collation and cleaning for analysis using Pearson’s Product Moment Correlation with the aid of SPSS version 21.0. Based on findings, the paper concludes that celebrity-product-fit has a strong relationship with consumer fanaticism of telecom firms in Rivers State. Amongst the recommendations is that more investment should be made on endorsement marketing activities as it enhances consumers’ brand recognition.

Consumer Energy Atlas

Energy Technology Data Exchange (ETDEWEB)

1980-06-01

This first edition of the Atlas provides, in reference form, a central source of information to consumers on key contacts concerned with energy in the US. Energy consumers need information appropriate to local climates and characteristics - best provided by state and local governments. The Department of Energy recognizes the authority of state and local governments to manage energy programs on their own. Therefore, emphasis has been given to government organizations on both the national and state level that influence, formulate, or administer policies affecting energy production, distribution, and use, or that provide information of interest to consumers and non-specialists. In addition, hundreds of non-government energy-related membership organizations, industry trade associations, and energy publications are included.

Educating, Enrolling, And Engaging: The State Of Marketplace Consumer Assistance Under The Affordable Care Act.

Science.gov (United States)

Grob, Rachel; Schlesinger, Mark

2015-12-01

Programs created under the Affordable Care Act to connect consumers to health care coverage represent an unprecedented public-sector investment. State-level implementation of these programs has varied greatly, making it possible to learn from differences in strategy and performance. In this article we assess the current state of Marketplace enrollment assistance, synthesizing evidence from published evaluations (largely derived from grey literature) and analyses of data from nationwide surveys of assisters. Synthesis of this evidence suggests that assister programs play a vital role supporting consumers in the new Marketplaces, particularly when assisters maintain extended ongoing relationships with consumers; assisters come from and are situated within communities they serve; local programs are well coordinated; and postenrollment issues can be addressed. Stable funding commitments, year-round employment, and enriched training were identified as crucial long-run strategies for building a more professional assister workforce and stronger infrastructure. Project HOPE—The People-to-People Health Foundation, Inc.

Analysis of exploration expenditure for unconventional gas : how investing in exploration would improve reserves and production

International Nuclear Information System (INIS)

Virine, L.

2010-01-01

This paper described a method for analyzing the efficiency of exploration investment, which can improve corporate planning. Exploration expenditure is held to be a main indicator of economic activities in the oil and gas industry because exploration is supposed to lead to booking more reserves and increased production. A model was developed for analyzing the correlation between exploration expenditure and producer's reserves and production for conventional and unconventional gas plays in the United States. The model was used to quantitatively assess the exploration expenditures production and reserves of different producers for various conventional and unconventional gas plays. Producer's booked reserves, production from public sources, and reserves and production forecasts were incorporated into the model, which was used to analyze different types of exploration expenditure (land, drilling, and seismic) incurred at various times prior to reserves and production being booked. There was an overall positive correlation between exploration expenditure and reserves and production, but there was significant variance in the correlation between various producers operating in different plays. Unproved land acquisition was strongly correlated to the booking of proved reserves, but there was no correlation between unproved land acquisition and exploration expenditure ratio, reserves, or production. A number of companies had a high exploration expenditure to overall expenditure ratio, but the resulting payoffs were inconsistent. 6 refs., 1 tab., 6 figs.

Demand Potential for Goat Meat in Southern States: Empirical Evidence from a Multi-State Goat Meat Consumer Survey

OpenAIRE

Nelson, Mack C.; Liu, Xuanli

2005-01-01

A survey conducted in 11 Southeastern states elicits consumers' demand and preferences for various goat meat products. The data permit examination of goat meat demand of ethnic populations and the diversity among the states surveyed. The study uses five econometric models to examine the current demand, potential demand, and demand related to season and occasions on the goat meat market. Our analysis suggests that there exist a substantial demand for goat meat and the potential increase in the...

Tourism expenditure according to mode of transportation: A comparative study between 2009 and 2012

Directory of Open Access Journals (Sweden)

Nataša Slak Valek

2015-12-01

Full Text Available Understanding how tourists move through time and space has become especially important since tourist has become more attentive to prices. This paper explores the issue of changing expenditures as part of understanding tourist’s travel patterns and their role in booking accommodation. The State tourism survey containing information from a sample of 497,466 foreign tourists who visited Slovenia in 2009 and 639,756 who visited in 2012 was used to ensure the representativeness. Analysis of variance was used to test the differences in expenditure made by foreign tourists traveling to Slovenian in 2009 and 2012. The results show that transportation expenditure has increased dramatically, but tourism expenditures on accommodation showed a significant downtrend. Beside the fuel prices other causes of these trends and future implications are discussed. Planners may use data presented here to understand how economic trends will affect future transport activity in relation to booking options.

Consumer attitudes and the benefits of smart grid technologies

Energy Technology Data Exchange (ETDEWEB)

Ablondi, B. [Parks Associates, Dallas, TX (United States)

2010-11-15

This article discussed consumer attitudes regarding the benefits of smart grid technology. Understanding the motivations of consumers and how much they are willing to pay for smart grid technologies allows utilities to tailor their offerings to ensure market success. Surveys revealed that more than 80 percent of consumers are very interested in learning about ways to cut energy expenditures. Most consumers are only willing to pay less than the cost of the special equipment to participate in programs that guarantee cost savings, requiring innovation on the part of both utilities and their vendors to develop viable business models. Remote monitoring systems are a potential residential energy management solution that would increase consumer awareness of energy consumption, but adoption will occur slowly and only after consumer awareness is increased. The segmentation of consumers is necessary for providers to target those with both an interest in and a willingness to pay for an energy monitoring system. Most consumers want to see information on a thermostat with an enhanced display, and there is limited interest in other formats at this time. Consumers are willing to pay a premium for smart appliances, but the premium only amounts to a fraction of the actual cost, leaving no incentive for appliance manufacturers in the absence of tax or utility incentives. It was concluded that consumer attitudes toward smart grid technology are still being formed and that the consumer must be engaged to realize the full benefit of the smart grid in the residential market. 4 figs.

Managing the Effects of Tax Expenditures on National Budgets

OpenAIRE

Swift, Zhicheng Li

2006-01-01

Tax expenditures, in the form of tax provisions, are government expenditures. They are conceptually and functionally distinct from those tax provisions whose purpose is to raise revenue. Tax expenditure programs are comparable to entitlement programs. Therefore, tax expenditures must be analyzed in spending terms and integrated into the budgetary process to ensure fiscal accountability. In addition, tax expenditures must be audited for performance and the information must be published (with c...

Dietary protein content alters energy expenditure and composition of the mass gain in grizzly bears (Ursus arctos horribilis).

Science.gov (United States)

Felicetti, Laura A; Robbins, Charles T; Shipley, Lisa A

2003-01-01

Many fruits contain high levels of available energy but very low levels of protein and other nutrients. The discrepancy between available energy and protein creates a physiological paradox for many animals consuming high-fruit diets, as they will be protein deficient if they eat to meet their minimum energy requirement. We fed young grizzly bears both high-energy pelleted and fruit diets containing from 1.6% to 15.4% protein to examine the role of diet-induced thermogenesis and fat synthesis in dealing with high-energy-low-protein diets. Digestible energy intake at mass maintenance increased 2.1 times, and composition of the gain changed from primarily lean mass to entirely fat when the protein content of the diet decreased from 15.4% to 1.6%. Daily fat gain was up to three times higher in bears fed low-protein diets ad lib., compared with bears consuming the higher-protein diet and gaining mass at the same rate. Thus, bears eating fruit can either consume other foods to increase dietary protein content and reduce energy expenditure, intake, and potentially foraging time or overeat high-fruit diets and use diet-induced thermogenesis and fat synthesis to deal with their skewed energy-to-protein ratio. These are not discrete options but a continuum that creates numerous solutions for balancing energy expenditure, intake, foraging time, fat accumulation, and ultimately fitness, depending on food availability, foraging efficiency, bear size, and body condition.

[Quantitative analysis of drug expenditures variability in dermatology units].

Science.gov (United States)

Moreno-Ramírez, David; Ferrándiz, Lara; Ramírez-Soto, Gabriel; Muñoyerro, M Dolores

2013-01-01

Variability in adjusted drug expenditures among clinical departments raises the possibility of difficult access to certain therapies at the time that avoidable expenditures may also exist. Nevertheless, drug expenditures are not usually applied to clinical practice variability analysis. To identify and quantify variability in drug expenditures in comparable dermatology department of the Servicio Andaluz de Salud. Comparative economic analysis regarding the drug expenditures adjusted to population and health care production in 18 dermatology departments of the Servicio Andaluz de Salud. The 2012 cost and production data (homogeneous production units -HPU-)were provided by Inforcoan, the cost accounting information system of the Servicio Andaluz de Salud. The observed drug expenditure ratio ranged from 0.97?/inh to 8.90?/inh and from 208.45?/HPU to 1,471.95?/ HPU. The Pearson correlation between drug expenditure and population was 0.25 and 0.35 for the correlation between expenditure and homogeneous production (p=0.32 and p=0,15, respectively), both Pearson coefficients confirming the lack of correlation and arelevant degree of variability in drug expenditures. The quantitative analysis of variability performed through Pearson correlation has confirmed the existence of drug expenditure variability among comparable dermatology departments. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.

The state and consumer confidence in eco-labeling: organic labeling in Denmark, Sweden, The United Kingdom and The United States

DEFF Research Database (Denmark)

Sønderskov, Kim Mannemar; Daugbjerg, Carsten

2011-01-01

in different organic food labeling regimes with varying degrees of governmental involvement. Using unique and detailed survey data from the US, United Kingdom, Denmark, and Sweden, the analysis shows that confidence is highest in countries with substantial state involvement. This suggests that governments can...... governmental involvement increases confidence. This suggests that government should just provide the basic legal framework for eco-labeling and leave the rest to non-governmental organizations. However, the empirical underpinning of this conclusion is insufficient. This paper analyses consumer confidence......Trustworthy eco-labels provide consumers with valuable information on environmentally friendly products and thus promote green consumerism. But what makes an eco-label trustworthy and what can government do to increase consumer confidence? The scant existing literature indicates that low...

Use of econometric models to estimate expenditure shares.

Science.gov (United States)

Trogdon, Justin G; Finkelstein, Eric A; Hoerger, Thomas J

2008-08-01

To investigate the use of regression models to calculate disease-specific shares of medical expenditures. Medical Expenditure Panel Survey (MEPS), 2000-2003. Theoretical investigation and secondary data analysis. Condition files used to define the presence of 10 medical conditions. Incremental effects of conditions on expenditures, expressed as a fraction of total expenditures, cannot generally be interpreted as shares. When the presence of one condition increases treatment costs for another condition, summing condition-specific shares leads to double-counting of expenditures. Condition-specific shares generated from multiplicative models should not be summed. We provide an algorithm that allows estimates based on these models to be interpreted as shares and summed across conditions.

An analysis of at-home demand for ice cream in the United States.

Science.gov (United States)

Davis, C G; Blayney, D P; Yen, S T; Cooper, J

2009-12-01

Ice cream has been manufactured commercially in the United States since the middle of the 19th century. Ice cream and frozen dessert products comprise an important and relatively stable component of the United States dairy industry. As with many other dairy products, ice cream is differentiated in several dimensions. A censored translog demand system model was employed to analyze purchases of 3 ice cream product categories. The objective of this study was to determine the effect that changes in retail prices and consumer income have on at-home ice cream consumption. The analysis was based on Nielsen 2005 home scan retail data and used marital status, age, race, education, female employment status, and location in the estimations of aggregate demand elasticities. Results revealed that price and consumer income were the main determinants of demand for ice cream products. Calculated own-price elasticities indicated relatively elastic responses by consumers for all categories except for compensated bulk ice cream. All expenditure elasticities were inelastic except for bulk ice cream, and most of the ice cream categories were substitutes. Ongoing efforts to examine consumer demand for these products will assist milk producers, dairy processors and manufacturers, and dairy marketers as they face changing consumer responses to food and diet issues.

Cost-offsets of prescription drug expenditures: data analysis via a copula-based bivariate dynamic hurdle model.

Science.gov (United States)

Deb, Partha; Trivedi, Pravin K; Zimmer, David M

2014-10-01

In this paper, we estimate a copula-based bivariate dynamic hurdle model of prescription drug and nondrug expenditures to test the cost-offset hypothesis, which posits that increased expenditures on prescription drugs are offset by reductions in other nondrug expenditures. We apply the proposed methodology to data from the Medical Expenditure Panel Survey, which have the following features: (i) the observed bivariate outcomes are a mixture of zeros and continuously measured positives; (ii) both the zero and positive outcomes show state dependence and inter-temporal interdependence; and (iii) the zeros and the positives display contemporaneous association. The point mass at zero is accommodated using a hurdle or a two-part approach. The copula-based approach to generating joint distributions is appealing because the contemporaneous association involves asymmetric dependence. The paper studies samples categorized by four health conditions: arthritis, diabetes, heart disease, and mental illness. There is evidence of greater than dollar-for-dollar cost-offsets of expenditures on prescribed drugs for relatively low levels of spending on drugs and less than dollar-for-dollar cost-offsets at higher levels of drug expenditures. Copyright © 2013 John Wiley & Sons, Ltd.

Health care expenditures among Asian American subgroups.

Science.gov (United States)

Chen, Jie; Vargas-Bustamante, Arturo; Ortega, Alexander N

2013-06-01

Using two nationally representative data sets, this study examined health care expenditure disparities between Caucasians and different Asian American subgroups. Multivariate analyses demonstrate that Asian Americans, as a group, have significantly lower total expenditures compared with Caucasians. Results also point to considerable heterogeneities in health care spending within Asian American subgroups. Findings suggest that language assistance programs would be effective in reducing disparities among Caucasians and Asian American subgroups with the exception of Indians and Filipinos, who tend to be more proficient in English. Results also indicate that citizenship and nativity were major factors associated with expenditure disparities. Socioeconomic status, however, could not explain expenditure disparities. Results also show that Asian Americans have lower physician and pharmaceutical costs but not emergency department or hospital expenditures. These findings suggest the need for culturally competent policies specific to Asian American subgroups and the necessity to encourage cost-effective treatments among Asian Americans.

Consumer flexibility - State and challenges

International Nuclear Information System (INIS)

Grande, Ove S.; Saele, Hanne; Morch, Andrei Z.

2002-02-01

This report summarises experiences and results from relevant projects carried out within the area of consumer flexibility in the last years. A general description of the projects is presented. In addition are testing activities, economical signals for motivating the end user for load reductions and appropriate technology for communication and effect management mentioned separately. Briefly summarised is the following achieved: 1) The potential for effect regulating measures in ordinary consumption and in power demanding industry is analysed and estimated to 1750 MW and 3360 MW respectively. 2) Time varied rates are developed and are tested. The NVE has decided on this basis that all the network owners should offer season varied rates to their customers. 3) Test projects in Drammen, Oslo and Trondheim have shown that it is possible to motivate smaller consumers for and implement load reductions. 4) Technology for load management for the end user is evaluated. 5) A survey is made viewing the technology for two way communication. In addition the ''option'' market for the reserves of the Statnett has proved that a steady compensation is a sufficient incentive for producing substantial effect reserves in the load sector (power intensive industry). In the last part of the report the incentives and frame conditions for establishing technical solutions and infrastructure are discussed. Further work will focus on the consumer flexibility in shortage situations. The main challenges are connected to: 1) Establishing a foundation for decisions concerning cost efficient investments in necessary technical equipment. 2) To find an optimal combination of a price flexible and remote controlled load reduction

Targeted health department expenditures benefit birth outcomes at the county level.

Science.gov (United States)

Bekemeier, Betty; Yang, Youngran; Dunbar, Matthew D; Pantazis, Athena; Grembowski, David E

2014-06-01

Public health leaders lack evidence for making decisions about the optimal allocation of resources across local health department (LHD) services, even as limited funding has forced cuts to public health services while local needs grow. A lack of data has also limited examination of the outcomes of targeted LHD investments in specific service areas. This study used unique, detailed LHD expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes. A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000-2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida. Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three specific examined MCH service areas demonstrating the strongest effects. Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and ensuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Escalating Health Care Expenditures in Cancer Decedents' Last Year of Life: A Decade of Evidence from a Retrospective Population-Based Cohort Study in Taiwan.

Science.gov (United States)

Hung, Yen-Ni; Liu, Tsang-Wu; Wen, Fur-Hsing; Chou, Wen-Chi; Tang, Siew Tzuh

2017-04-01

No population-based longitudinal studies on end-of-life (EOL) expenditures were found for cancer decedents. This population-based, retrospective cohort study examined health care expenditures from 2001 to 2010 among 339,546 Taiwanese cancer decedents' last year of life. Individual patient-level data were linked from administrative datasets. Health care expenditures were converted from Taiwan dollars to U.S. dollars by health-specific purchasing power parity conversions to account for different health-purchasing powers. Associations of patient, physician, hospital, and regional factors with EOL care expenditures were evaluated by multilevel linear regression model by generalized estimating equation method. Mean annual EOL care expenditures for Taiwanese cancer decedents increased from 2000 to 2010 from U.S. $49,591 to U.S. $68,773, respectively, with one third of spending occurring in the patients' last month. Increased EOL care expenditures were associated with male gender, younger age, being married, diagnosed with hematological malignancies and cancers other than lung, gastric, and hepatic-pancreatic cancers, and dying within 7-24 months of diagnosis. Patients spent less at EOL when they had higher comorbidities and metastatic disease, died within 6 months of diagnosis, were under care of oncologists, gastroenterologists, and intensivists, and received care at a teaching hospital with more terminally ill cancer patients. Higher EOL care expenditures were associated with greater EOL care intensity at the primary hospital and regional levels. Taiwanese cancer decedents consumed considerable National Health Insurance disbursements at EOL, totaling more than was consumed in six developed non-U.S. countries surveyed in 2010. To slow increasing cost and improve EOL cancer care quality, interventions to ensure appropriate EOL care provision should target hospitals and clinicians less experienced in providing EOL care and those who tend to provide aggressive EOL care to

Escalating Health Care Expenditures in Cancer Decedents' Last Year of Life: A Decade of Evidence from a Retrospective Population‐Based Cohort Study in Taiwan

Science.gov (United States)

Hung, Yen‐Ni; Liu, Tsang‐Wu; Wen, Fur‐Hsing; Chou, Wen‐Chi

2017-01-01

Abstract Background. No population‐based longitudinal studies on end‐of‐life (EOL) expenditures were found for cancer decedents. Methods. This population‐based, retrospective cohort study examined health care expenditures from 2001 to 2010 among 339,546 Taiwanese cancer decedents' last year of life. Individual patient‐level data were linked from administrative datasets. Health care expenditures were converted from Taiwan dollars to U.S. dollars by health‐specific purchasing power parity conversions to account for different health‐purchasing powers. Associations of patient, physician, hospital, and regional factors with EOL care expenditures were evaluated by multilevel linear regression model by generalized estimating equation method. Results. Mean annual EOL care expenditures for Taiwanese cancer decedents increased from 2000 to 2010 from U.S. $49,591 to U.S. $68,773, respectively, with one third of spending occurring in the patients' last month. Increased EOL care expenditures were associated with male gender, younger age, being married, diagnosed with hematological malignancies and cancers other than lung, gastric, and hepatic‐pancreatic cancers, and dying within 7–24 months of diagnosis. Patients spent less at EOL when they had higher comorbidities and metastatic disease, died within 6 months of diagnosis, were under care of oncologists, gastroenterologists, and intensivists, and received care at a teaching hospital with more terminally ill cancer patients. Higher EOL care expenditures were associated with greater EOL care intensity at the primary hospital and regional levels. Conclusion. Taiwanese cancer decedents consumed considerable National Health Insurance disbursements at EOL, totaling more than was consumed in six developed non‐U.S. countries surveyed in 2010. To slow increasing cost and improve EOL cancer care quality, interventions to ensure appropriate EOL care provision should target hospitals and clinicians less experienced in

21 CFR 101.44 - What are the 20 most frequently consumed raw fruits, vegetables, and fish in the United States?

Science.gov (United States)

2010-04-01

... fruits, vegetables, and fish in the United States? 101.44 Section 101.44 Food and Drugs FOOD AND DRUG... raw fruits, vegetables, and fish in the United States? (a) The 20 most frequently consumed raw fruits..., and watermelon. (b) The 20 most frequently consumed raw vegetables are: Asparagus, bell pepper...

Propensity Analysis on Consumption Expenditure of Rural Residents in Hebei Province, China

OpenAIRE

Liu, Meng; Wang, Guirong; Wang, Huijun

2009-01-01

Consumption expenditure of rural residents can be divided into eight types of indices, such as food consumption expenditure, clothing consumption expenditure, household equipment and service consumption expenditure, health care consumption expenditure, transportation and communication consumption expenditure, cultural and educational entertainment and service consumption expenditure, housing consumption expenditure, and other goods and services consumption expenditure. Changes in structures o...

Executive function, episodic memory, and Medicare expenditures.

Science.gov (United States)

Bender, Alex C; Austin, Andrea M; Grodstein, Francine; Bynum, Julie P W

2017-07-01

We examined the relationship between health care expenditures and cognition, focusing on differences across cognitive systems defined by global cognition, executive function, or episodic memory. We used linear regression models to compare annual health expenditures by cognitive status in 8125 Nurses' Health Study participants who completed a cognitive battery and were enrolled in Medicare parts A and B. Adjusting for demographics and comorbidity, executive impairment was associated with higher total annual expenditures of $1488 per person (P episodic memory impairment was found. Expenditures exhibited a linear relationship with executive function, but not episodic memory ($584 higher for every 1 standard deviation decrement in executive function; P < .01). Impairment in executive function is specifically and linearly associated with higher health care expenditures. Focusing on management strategies that address early losses in executive function may be effective in reducing costly services. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Government expenditure and energy intensity in China

International Nuclear Information System (INIS)

Yuxiang, Karl; Chen, Zhongchang

2010-01-01

The recent economic stimulus package of China has raised growing concern about its potential impact on energy demand and efficiency. To what extent does such expansion of government expenditure influence energy intensity? This question has not been well answered by the previous research. Using provincial panel data, this paper provides some evidence of a link between government expenditure and energy intensity in China. The empirical results demonstrate that the expansion of government expenditure since Asian financial crisis has exerted a significant influence on energy intensity. An increase in government expenditure in China leads to an increase in energy intensity. Further analysis compares such relationships in different economic situations. The comparison shows that such positive effect of government expenditure remains significant after the alteration in economic situation. Therefore, the results suggest introducing some measures to consolidate China's existing gains in energy efficiency. The analysis also explains why the downward trend in energy intensity is reversed in China since 2002. (author)

[Adaptation of food ingestion to energy expenditure].

Science.gov (United States)

Louis-Sylvestre, J

1987-01-01

Body energy balance is regulated in adults. The accuracy of the phenomenon is particularly evident in laboratory animals under steady conditions. Moreover, it has been repeatedly demonstrated that this balance is maintained in spite of fluctuations in food intake or energy expenditure. When animals such as rats, dogs or rabbits are presented with a diluted or concentrated version of familiar food, they compensate rapidly by increasing or decreasing their ponderal intake. This is achieved first by a change in meal frequency, then meal size adapts to the new caloric content and meal frequency returns to the original pattern. This adaptation is based on the learning of post-ingestive cues. Hypo or hyperphagia leads to reduced or increased energy expenditure, as the case may be; the basal metabolic rate is modulated by thyroid hormones and diet-induced thermogenesis by the sympathetic system. These variations are partly regulatory. In a cold environment, the increase in energy expenditure caused by increased thermogenesis is rapidly compensated by increased caloric intake. Physical activity activates the sympathetic system responsible for numerous hormonal changes, the most important of which is insulin hyposecretion. In animals or humans, moderate aerobic exercise induces a small weight loss; afterwards, weight gain is normalized and increased caloric intake compensates for energy expenditures such as exercise, increased basal metabolic rate and diet-induced thermogenesis. Extreme changes in body weight and fat are produced by gestation and lactation; they are satisfactorily explained by concomitant hormonal changes. Especially during lactation, food intake is regulated so that it allows body weight to return to pregestation level. Studies on the mechanisms implicated in the regulation of body energy balance are still in progress. Friedman and Ramirez (1985) suggest that the way fatty acids are utilized is important. Kasser et al. (1985) show a striking difference in

Geographic variation in expenditures for workers' compensation physician claims.

Science.gov (United States)

Miller, T R; Levy, D T

1997-07-01

We examine interstate variations in the cost of claims for physician care using injury claims from Worker's Compensation, and consider some of the factors that may explain cost differences. Multivariate regression analysis is used to isolate state variations, while controlling for personal and injury characteristics, and state characteristics. Statistical analyses reveal considerable variation in expenditures for physician care of injuries across states, even after controlling for case mix and state characteristics. We also find that the presence of HMOs and of general practitioners as a percent of physicians are associated with lower claims, and that the percent of the state that is urban is associated with higher claims. The large variation in costs suggests a potential to affect the costs of physician care for work-related injuries.

A general consumer-resource population model

Science.gov (United States)

Lafferty, Kevin D.; DeLeo, Giulio; Briggs, Cheryl J.; Dobson, Andrew P.; Gross, Thilo; Kuris, Armand M.

2015-01-01

Food-web dynamics arise from predator-prey, parasite-host, and herbivore-plant interactions. Models for such interactions include up to three consumer activity states (questing, attacking, consuming) and up to four resource response states (susceptible, exposed, ingested, resistant). Articulating these states into a general model allows for dissecting, comparing, and deriving consumer-resource models. We specify this general model for 11 generic consumer strategies that group mathematically into predators, parasites, and micropredators and then derive conditions for consumer success, including a universal saturating functional response. We further show how to use this framework to create simple models with a common mathematical lineage and transparent assumptions. Underlying assumptions, missing elements, and composite parameters are revealed when classic consumer-resource models are derived from the general model.

Military Expenditure and Socio-Economic Development.

Science.gov (United States)

Ball, Nicole

1983-01-01

The relationship between military expenditure and the stimulation of aggregate demand, inflation, investment, trade balance, foreign exchange, the improvement of taxation, and employment creation and industrialization in the Third World is analyzed. To some extent military expenditure does promote economic growth, but it does not automatically…

Chronic condition combinations and health care expenditures and out-of-pocket spending burden among adults, Medical Expenditure Panel Survey, 2009 and 2011.

Science.gov (United States)

Meraya, Abdulkarim M; Raval, Amit D; Sambamoorthi, Usha

2015-01-29

Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions. We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden. Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04). Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers.

National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure?

Directory of Open Access Journals (Sweden)

Olayinka Stephen Ilesanmi

2014-05-01

Full Text Available Background The major objective of the National Health Insurance Scheme (NHIS in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars and the range was 7,000–680,000 naira (46.7–4,533 US dollars in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars and the range was 10-17,700 naira (0.1–118 US dollars in 2012. In all, 67 (9.4% households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9% and CHE occurred in 42 (6.6% households. CHE occurred in 14 (10.9% of the households in the lowest quintile compared to 3 (2.5% in the highest wealth quintile (P= 0.004. The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI: 4.7 (1.3–16.8, P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.

Economic growth and inflation rate: implications for municipal revenue and health expenditure of the municipalities of Pernambuco, Brazil.

Science.gov (United States)

Feliciano, Marciana; Bezerra, Adriana Falangola Benjamin; Santo, Antônio Carlos Gomes do Espírito

2017-06-01

This paper analyzes the implications of municipal budget revenue growth and the monetary policy's inflation rates goals in the availability of public health resources of municipalities. This is a descriptive, exploratory, quantitative, retrospective and longitudinal cross-sectional study covering the period 2002-2011. We analyzed health financing and expenditure variables in the municipalities of the state of Pernambuco, Brazil, describing the trend and the relationship between them. Data showed the growth of the variables and trend towards homogeneity. The exception was for the participation of Intergovernmental Transfers in the Total Health Expenditure of the Municipality. We found a significant correlation between Budget Revenue per capita and Health Expenditure per capita and a strong significant negative correlation between Inflation Rate, Budget Revenue per capita and Health Expenditure per capita. We concluded that increased health expenditure is due more to higher municipal tax revenue than to increased transfers that, in relative terms, did not increase. The strong inverse relationship between inflation rate and the Financing and Expenditure variables show that the monetary policy's inflation goals have restricted health financing to municipalities.

Health Care Crossroads: What's the Right Solution? Putting Consumer-Driven Ideas to Work at Louisiana State University

Science.gov (United States)

Benedict, Forest; Guinn, Shayla

2006-01-01

Idling at the crossroads and faced with ever-increasing health care costs, the Louisiana State University System chose the road less traveled and instituted a consumer-driven benefits plan. In this article, the authors provide an overview of the consumer-driven programs LSU has adopted and how these programs have helped curb costs and improve the…

Household energy and consumption and expenditures, 1990

International Nuclear Information System (INIS)

1993-01-01

The purpose of this supplement to the Household Energy Consumption and Expenditures 1990 report is to provide information on the use of energy in residential housing units, specifically at the four Census regions and nine Census division levels. This report includes household energy consumption, expenditures, and prices for natural gas, electricity, fuel oil, liquefied petroleum gas (LPG), and kerosene as well as household wood consumption. For national-level data, see the main report, Household Energy Consumption and Expenditures 1990

Household use of insecticide consumer products in a dengue-endemic area in México.

Science.gov (United States)

Loroño-Pino, María Alba; Chan-Dzul, Yamili N; Zapata-Gil, Rocio; Carrillo-Solís, Claudia; Uitz-Mena, Ana; García-Rejón, Julián E; Keefe, Thomas J; Beaty, Barry J; Eisen, Lars

2014-10-01

To evaluate the household use of insecticide consumer products to kill mosquitoes and other insect pests, as well as the expenditures for using these products, in a dengue-endemic area of México. A questionnaire was administered to 441 households in Mérida City and other communities in Yucatán to assess household use of insecticide consumer products. A total of 86.6% of surveyed households took action to kill insect pests with consumer products. The most commonly used product types were insecticide aerosol spray cans (73.6%), electric plug-in insecticide emitters (37.4%) and mosquito coils (28.3%). Mosquitoes were targeted by 89.7% of households using insecticide aerosol spray cans and >99% of households using electric plug-in insecticide emitters or mosquito coils. Products were used daily or every 2 days in most of the households for insecticide aerosol spray cans (61.4%), electric plug-in insecticide emitters (76.2%) and mosquito coils (82.1%). For all products used to kill insect pests, the median annual estimated expenditure per household that took action was 408 Mexican pesos ($MXN), which corresponded to approximately 31 $US. These numbers are suggestive of an annual market in excess of 75 million $MXN (>5.7 million $US) for Mérida City alone. Mosquitoes threaten human health and are major nuisances in homes in the study area in México. Households were found to have taken vigorous action to kill mosquitoes and other insect pests and spent substantial amounts of money on insecticide consumer products. © 2014 John Wiley & Sons Ltd.

Political determinants of social expenditures in Greece: an empirical analysis

OpenAIRE

Canikalp, Ebru; Unlukaplan, Ilter

2017-01-01

A view prominently expounded is that the interaction between the composition and the volume of public expenditures is directly affected by political, institutional, psephological and ideological indicators. A crucial component of public expenditures, social expenditures play an important role in the economy as they directly and indirectly affect the distribution of income and wealth. Social expenditures aim at reallocating income and wealth unequal distribution. These expenditures comprise ca...

Managing the effects of tax expenditures on the national budget

OpenAIRE

Swift, Zhicheng Li

2006-01-01

Tax expenditures, in the form of tax provisions, are government expenditures. They are conceptually and functionally distinct from those tax provisions whose purpose is to raise revenue. Tax expenditure programs are comparable to entitlement programs. Therefore, tax expenditures must be analyzed in spending terms and integrated into the budgetary process to ensure fiscal accountability. In addition, tax expenditures must be audited for performance and the information must be published (with c...

Are the Elderly a Threat to Educational Expenditures?

OpenAIRE

Alejandra Cattaneo; Stefan C. Wolter

2007-01-01

Empirical research has given cause to fear that the demographic ageing in industrialized countries is likely to exert a negative impact on educational spending. These papers have linked the share of the elderly with the per capita or per pupil spending on education at the local, state-wide or national level, trying to control for other exogenous effects. Although this line of research shows in many cases a negative correlation between the shares of elderly people and educational expenditures,...

Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study.

Science.gov (United States)

Hung, Man; Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

2015-01-01

Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties.

Market Analysis and Consumer Impacts Source Document. Part II. Review of Motor Vehicle Market and Consumer Expenditures on Motor Vehicle Transportation

Science.gov (United States)

1980-12-01

This source document on motor vehicle market analysis and consumer impacts consists of three parts. Part II consists of studies and review on: motor vehicle sales trends; motor vehicle fleet life and fleet composition; car buying patterns of the busi...

Pharmaceutical expenditure forecast model to support health policy decision making.

Science.gov (United States)

Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

2014-01-01

With constant incentives for healthcare payers to contain their pharmaceutical budgets, modelling policy decision impact became critical. The objective of this project was to test the impact of various policy decisions on pharmaceutical budget (developed for the European Commission for the project 'European Union (EU) Pharmaceutical expenditure forecast' - http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). A model was built to assess policy scenarios' impact on the pharmaceutical budgets of seven member states of the EU, namely France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. The following scenarios were tested: expanding the UK policies to EU, changing time to market access, modifying generic price and penetration, shifting the distribution chain of biosimilars (retail/hospital). Applying the UK policy resulted in dramatic savings for Germany (10 times the base case forecast) and substantial additional savings for France and Portugal (2 and 4 times the base case forecast, respectively). Delaying time to market was found be to a very powerful tool to reduce pharmaceutical expenditure. Applying the EU transparency directive (6-month process for pricing and reimbursement) increased pharmaceutical expenditure for all countries (from 1.1 to 4 times the base case forecast), except in Germany (additional savings). Decreasing the price of generics and boosting the penetration rate, as well as shifting distribution of biosimilars through hospital chain were also key methods to reduce pharmaceutical expenditure. Change in the level of reimbursement rate to 100% in all countries led to an important increase in the pharmaceutical budget. Forecasting pharmaceutical expenditure is a critical exercise to inform policy decision makers. The most important leverages identified by the model on pharmaceutical budget were driven by generic and biosimilar prices, penetration rate, and distribution. Reducing, even slightly, the prices of

Summary of expenditures of rebates from the low-level radioactive waste surcharge escrow account for calendar year 1988

International Nuclear Information System (INIS)

1989-06-01

This is the third report submitted to Congress under Public Law 99-240, ''The Low-Level Radioactive Waste Policy Amendments Act of 1985'' (the Act). This section of the Act requires the Department of Energy to summarize the annual expenditures made by states and compacts of funds disbursed from the Department's Surcharge Escrow Account, and to assess the compliance of these expenditures with the specified limitations. This report covers expenditures made during calendar year 1988 from funds disbursed to states and compacts following the July 1, 1986, and January 1, 1988, milestones. The next milestone in the Act is January 1, 1990, following which the accumulated surcharge deposits in the Department's Surcharge Escrow Account will again be disbursed. The Act authorizes states with operating low-level radioactive waste disposal sites (sited states) to collect surcharges on disposal of waste from generators located in compact regions currently without disposal sites (non-sited compacts) and in states that do not have sites and that are not members of compacts (nonmember states). The Act requires the sited states to make a monthly deposit to the Department of Energy's Surcharge Escrow Account of 25 percent of the surcharges they collect. Following each milestone date, the Department is required to disburse these funds, with accrued interest, back to those non-sited compacts and nonmember states found in compliance with the milestone requirements for new disposal site development. 4 tabs

Military Expenditure, Threats, and Growth

OpenAIRE

Aizenman, Joshua; Glick, Reuven

2003-01-01

This paper clarifies one of the puzzling results of the economic growth literature: the impact of military expenditure is frequently found to be non-significant or negative, yet most countries spend a large fraction of their GDP on defense and the military. We start by empirical evaluation of the non- linear interactions between military expenditure, external threats, corruption, and other relevant controls. While growth falls with higher levels of military spending, given the values of the o...

Assessment of physical activity, energy expenditure and energy intakes of young men practicing aerobic sports.

Science.gov (United States)

Wierniuk, Alicja; Włodarek, Dariusz

2014-01-01

Adequate nutrition and energy intake play key rule during the training period and recovery time. The assessment of athlete's energetic needs should be calculated individually, based on personal energy expenditure and Sense Wear PRO3 Armband (SWA) mobile monitor is a useful tool to achieve this goal. However, there is still few studies conducted with use of this monitor. To assess individual energy needs of athletes by use of SWA and to determine whether their energy intake fulfils the body's energy expenditure. Subjects were 15 male students attending Military University of Technology in Warsaw, aged 19-24 years, practicing aerobic. The average body mass was 80.7 ± 7.7 kg and average height was 186.9 ± 5.2 cm, (BMI 23.09 ± 1.85 kg/m2). Assessment of physical activity and energy expenditure (TEE) was established using SWA, which was placed on the back side of dominant hand and worn continuously for 48 hours (during the training and non-training day). The presented results are the average values of these 2 days. Assessment of athletes' physical activity level was established by use of metabolic equivalent of task (MET) and number of steps (NS). Estimation of energy intake was based on three-day dietary recalls (two weekdays and one day of the weekend), evaluated using the Polish Software 'Energia' package. The average TEE of examined athletes was 3877 ± 508 kcal/day and almost half of this energy was spend on physical activity (1898 ± 634 kcal/day). The number of steps was on average 19498 ± 5407 and average MET was 2.05 ± 2.09. The average daily energy intake was 2727 ± 576 kcal. Athletes consumed inadequate amount of energy in comparison to their energy expenditure. Examined group did not have an adequate knowledge about their energy requirement, which shows the need of nutritional consulting and education among these athletes. athletes, aerobic sports, energy expenditure, energy intake.

The impact of population ageing on future Danish drug expenditure

DEFF Research Database (Denmark)

Kildemoes, Helle Wallach

expenditure among the elderly partly is due the high "costs of dying". Aims The aim of this study was to estimate the impact of the ageing Danish population on future total expenditures on out-of-hospital prescription drugs and to describe the association between age and drug expenditure among survivors......Background Population ageing is likely to place an increasing burden on future health care budgets. Several studies have demonstrated that the impact of ageing on future hospital expenditures will be overestimated when not accounting for proximity to death. This is because greater health care...... compared to that of decedents. Methods Taking expenditure during the last year of life and the changes in mortality rates into account, future drug expenditure was projected by multiplying estimated mean annual drug expenditure according to age, gender and survival status by the predicted future number...

Expenditures for Resources in School Library Media Centers, FY 1991-92.

Science.gov (United States)

Miller, Marilyn L.; Shontz, Marilyn

1993-01-01

The sixth in a series of "School Library Journal" reports on trends in school library expenditures for program development shows that commitment to the teaching and motivating of reading is in conflict with fascination with technology and that access to books is being seriously curtailed by the deteriorating state of school library collections.…

A Cost-Benefit Analysis for Per-Student Expenditures and Academic Achievement

Science.gov (United States)

Womack, Sid T.; Roberts, Kerry; Bell, C. David; Womack, Karen

2015-01-01

Cost-benefit correlations have been subject to "selective sampling" in the media. Usually extremes of data from a very few high-funding and low-funding states are cited in the media to construct the case that there is no relationship between economic inputs and academic outputs. This study, using average per-pupil expenditures and ACT…

Allocation of R&D Equipment Expenditure Based on Organisation Discipline Profiles

Science.gov (United States)

Wells, Xanthe E.; Foster, Nigel; Finch, Adam; Elsum, Ian

2017-01-01

Sufficient and state-of-the-art research equipment is one component required to maintain the research competitiveness of a R&D organisation. This paper describes an approach to inform more optimal allocation of equipment expenditure levels in a large and diverse R&D organisation, such as CSIRO. CSIRO is Australia's national science agency,…

26 CFR 53.4955-1 - Tax on political expenditures.

Science.gov (United States)

2010-04-01

... turnout, or voter education constitute other expenses, treated as political expenditures by reason of... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Tax on political expenditures. 53.4955-1... Tax on political expenditures. (a) Relationship between section 4955 excise taxes and substantive...

Labelled drug-related public expenditure in relation to gross domestic product (GDP) in Europe: a luxury good?

LENUS (Irish Health Repository)

Prieto, Luis

2010-01-01

"Labelled drug-related public expenditure" is the direct expenditure explicitly labelled as related to illicit drugs by the general government of the state. As part of the reporting exercise corresponding to 2005, the European Monitoring Centre for Drugs and Drug Addiction\\'s network of national focal points set up in the 27 European Union (EU) Member States, Norway, and the candidates countries to the EU, were requested to identify labelled drug-related public expenditure, at the country level. This was reported by 10 countries categorised according to the functions of government, amounting to a total of EUR 2.17 billion. Overall, the highest proportion of this total came within the government functions of Health (66%), and Public Order and Safety (POS) (20%). By country, the average share of GDP was 0.023% for Health, and 0.013% for POS. However, these shares varied considerably across countries, ranging from 0.00033% in Slovakia, up to 0.053% of GDP in Ireland in the case of Health, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and the lowest countries for Health, and a 6-fold difference for POS. Why do Ireland and the UK spend so much in Health and POS, or Slovakia and Portugal so little, in GDP terms? To respond to this question and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared Health and POS spending and GDP in the 10 reporting countries. Results found suggest GDP to be a major determinant of the Health and POS drug-related public expenditures of a country. Labelled drug-related public expenditure showed a positive association with the GDP across the countries considered: r = 0.81 in the case of Health, and r = 0.91 for POS. The percentage change in Health and POS expenditures due to a one percent increase in GDP (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively. Being highly income elastic

Economic growth and military expenditure linkages: a panel data analysis

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Ahmed Shahid

2015-12-01

Full Text Available This paper has made an attempt to examine relationship between military expenditure and economic growth using 56 country panel data spanning over 1995—2011. Panel fixed effect model has been estimated for all 56 countries and sub-groups classified on the basis of World Bank income criteria. The results of this study indicate a positive effect of military expenditure on economic growth but this positive effect is negligible compared to the alternative uses of scare resources on non-military expenditure. Thus, the effect of military expenditure on economic growth is very low compared to the effect of expenditure on capital formation, hence military expenditure as a sub-optimal means of increasing economic growth compared to alternative uses of government spending on formation of fixed capital. This study raises an important argument of huge opportunity cost of military expenditure. The present study concludes that the boosting of economic growth through higher military expenditure is neither effective nor efficient way of achieving higher growth in the economy.

Political determinants of social expenditures in Greece: an empirical analysis

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Ebru Canikalp

2017-09-01

Full Text Available A view prominently expounded is that the interaction between the composition and the volume of public expenditures is directly affected by political, institutional, psephological and ideological indicators. A crucial component of public expenditures, social expenditures play an important role in the economy as they directly and indirectly affect the distribution of income and wealth. Social expenditures aim at reallocating income and wealth unequal distribution. These expenditures comprise cash benefits, direct in-kind provision of goods and services, and tax breaks with social purposes.The aim of this study is to determine the relationship between political structure, i.e. government fragmentation, ideological composition, elections and so on, and the social expenditures in Greece. Employing data from the Comparative Political Dataset (CPDS and the OECD Social Expenditure Database (SOCX, a time series analysis was conducted for Greece for the 1980-2014 period. The findings of the study indicate that voter turnout, spending on the elderly population and the number of government changes have positive and statistically significant effects on social expenditures in Greece while debt stock and cabinet composition have negative effects.

Average State IQ, State Wealth and Racial Composition as Predictors of State Health Statistics: Partial Support for "g" as a Fundamental Cause of Health Disparities

Science.gov (United States)

Reeve, Charlie L.; Basalik, Debra

2010-01-01

This study examined the degree to which differences in average IQ across the 50 states was associated with differences in health statistics independent of differences in wealth, health care expenditures and racial composition. Results show that even after controlling for differences in state wealth and health care expenditures, average IQ had…

Socioeconomic inequality in catastrophic health expenditure in Brazil.

Science.gov (United States)

Boing, Alexandra Crispim; Bertoldi, Andréa Dâmaso; Barros, Aluísio Jardim Dornellas de; Posenato, Leila Garcia; Peres, Karen Glazer

2014-08-01

To analyze the evolution of catastrophic health expenditure and the inequalities in such expenses, according to the socioeconomic characteristics of Brazilian families. Data from the National Household Budget 2002-2003 (48,470 households) and 2008-2009 (55,970 households) were analyzed. Catastrophic health expenditure was defined as excess expenditure, considering different methods of calculation: 10.0% and 20.0% of total consumption and 40.0% of the family's capacity to pay. The National Economic Indicator and schooling were considered as socioeconomic characteristics. Inequality measures utilized were the relative difference between rates, the rates ratio, and concentration index. The catastrophic health expenditure varied between 0.7% and 21.0%, depending on the calculation method. The lowest prevalences were noted in relation to the capacity to pay, while the highest, in relation to total consumption. The prevalence of catastrophic health expenditure increased by 25.0% from 2002-2003 to 2008-2009 when the cutoff point of 20.0% relating to the total consumption was considered and by 100% when 40.0% or more of the capacity to pay was applied as the cut-off point. Socioeconomic inequalities in the catastrophic health expenditure in Brazil between 2002-2003 and 2008-2009 increased significantly, becoming 5.20 times higher among the poorest and 4.17 times higher among the least educated. There was an increase in catastrophic health expenditure among Brazilian families, principally among the poorest and those headed by the least-educated individuals, contributing to an increase in social inequality.

Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study

Science.gov (United States)

Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

2015-01-01

Background Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. Objective The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Methods Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. Results The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. Conclusions We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties. PMID:27227131

Local health department food safety and sanitation expenditures and reductions in enteric disease, 2000-2010.

Science.gov (United States)

Bekemeier, Betty; Yip, Michelle Pui-Yan; Dunbar, Matthew D; Whitman, Greg; Kwan-Gett, Tao

2015-04-01

In collaboration with Public Health Practice-Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000-2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking.

(Inefficiency of corporate income tax expenditures on underdeveloped areas of special tax treatment in Croatia

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Vjekoslav Bratic

2012-12-01

Full Text Available The introduction of various tax expenditures by the tax authorities, mostly in corporate income taxation (CIT, in order to kick start development in areas affected by the war as well as in economically underdeveloped areas has been characteristic of the Croatian tax system since 2000. Although the purpose of such forms of state aid was to foster economic development and equalize the level over the entire country, at the same time they caused forgone tax revenues and it is therefore necessary to analyze their advantages and disadvantages and evaluate their possible positive or negative effects. This paper deals with the analysis of tax expenditures in the system of CIT in Croatia and it investigates their effect on the budget and the possible advantages brought by their introduction. The main purpose of the paper is to answer the questions as to whether the expenditures that have been introduced in CIT justify their purpose and the goal of their introduction and what can be done to improve the existing CIT expenditures system.

Obesity and people with disabilities: the implications for health care expenditures.

Science.gov (United States)

Anderson, Wayne L; Wiener, Joshua M; Khatutsky, Galina; Armour, Brian S

2013-12-01

This study estimates additional average health care expenditures for overweight and obesity for adults with disabilities vs. without. Descriptive and multivariate methods were used to estimate additional health expenditures by service type, age group, and payer using 2004-2007 Medical Expenditure Panel Survey data. In 2007, 37% of community-dwelling Americans with disabilities were obese vs. 27% of the total population. People with disabilities had almost three times ($2,459) the additional average obesity cost of people without disabilities ($889). Prescription drug expenditures for obese people with disabilities were three times as high and outpatient expenditures were 74% higher. People with disabilities in the 45- to 64-year age group had the highest obesity expenditures. Medicare had the highest additional average obesity expenditures among payers. Among people with prescription drug expenditures, obese people with disabilities had nine times the prevalence of diabetes as normal weight people with disabilities. Overweight people with and without disabilities had lower expenditures than normal-weight people with and without disabilities. Obesity results in substantial additional health care expenditures for people with disabilities. These additional expenditures pose a serious current and future problem, given the potential for higher obesity prevalence in the coming decade. Copyright © 2013 The Obesity Society.

Favorable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs and Resource Utilization: The 2012 Medical Expenditure Panel Survey.

Science.gov (United States)

Valero-Elizondo, Javier; Salami, Joseph A; Ogunmoroti, Oluseye; Osondu, Chukwuemeka U; Aneni, Ehimen C; Malik, Rehan; Spatz, Erica S; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Blaha, Michael J; Veledar, Emir; Nasir, Khurram

2016-03-01

The American Heart Association's 2020 Strategic Goals emphasize the value of optimizing risk factor status to reduce the burden of morbidity and mortality. In this study, we aimed to quantify the overall and marginal impact of favorable cardiovascular risk factor (CRF) profile on healthcare expenditure and resource utilization in the United States among those with and without cardiovascular disease (CVD). The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS). Direct and indirect costs were calculated for all-cause healthcare resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias, or heart failure), ascertained by International Classification of Diseases, Ninth Edition, Clinical Modification codes, and CRF profile (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity, and obesity). Two-part econometric models were used to study expenditure data. The final study sample consisted of 15 651 MEPS participants (58.5±12 years, 54% female). Overall, 5921 (37.8%) had optimal, 7002 (44.7%) had average, and 2728 (17.4%) had poor CRF profile, translating to 54.2, 64.1, and 24.9 million adults in United States, respectively. Significantly lower health expenditures were noted with favorable CRF profile across CVD status. Among study participants with established CVD, overall healthcare expenditures with optimal and average CRF profile were $5946 and $3731 less compared with those with poor CRF profile. The respective differences were $4031 and $2560 in those without CVD. Favorable CRF profile is associated with significantly lower medical expenditure and healthcare utilization among individuals with and without established CVD. © 2016 American Heart Association, Inc.

Cancer insurance policies in Japan and the United States.

Science.gov (United States)

Bennett, C L; Weinberg, P D; Lieberman, J J

1998-01-01

Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States.

National health expenditure projections: modest annual growth until coverage expands and economic growth accelerates.

Science.gov (United States)

Keehan, Sean P; Cuckler, Gigi A; Sisko, Andrea M; Madison, Andrew J; Smith, Sheila D; Lizonitz, Joseph M; Poisal, John A; Wolfe, Christian J

2012-07-01

For 2011-13, US health spending is projected to grow at 4.0 percent, on average--slightly above the historically low growth rate of 3.8 percent in 2009. Preliminary data suggest that growth in consumers' use of health services remained slow in 2011, and this pattern is expected to continue this year and next. In 2014, health spending growth is expected to accelerate to 7.4 percent as the major coverage expansions from the Affordable Care Act begin. For 2011 through 2021, national health spending is projected to grow at an average rate of 5.7 percent annually, which would be 0.9 percentage point faster than the expected annual increase in the gross domestic product during this period. By 2021, federal, state, and local government health care spending is projected to be nearly 50 percent of national health expenditures, up from 46 percent in 2011, with federal spending accounting for about two-thirds of the total government share. Rising government spending on health care is expected to be driven by faster growth in Medicare enrollment, expanded Medicaid coverage, and the introduction of premium and cost-sharing subsidies for health insurance exchange plans.

Modeling Health Care Expenditures and Use.

Science.gov (United States)

Deb, Partha; Norton, Edward C

2018-04-01

Health care expenditures and use are challenging to model because these dependent variables typically have distributions that are skewed with a large mass at zero. In this article, we describe estimation and interpretation of the effects of a natural experiment using two classes of nonlinear statistical models: one for health care expenditures and the other for counts of health care use. We extend prior analyses to test the effect of the ACA's young adult expansion on three different outcomes: total health care expenditures, office-based visits, and emergency department visits. Modeling the outcomes with a two-part or hurdle model, instead of a single-equation model, reveals that the ACA policy increased the number of office-based visits but decreased emergency department visits and overall spending.

Determinants of catastrophic health expenditure in iran.

Science.gov (United States)

Abolhallaje, M; Hasani, Sa; Bastani, P; Ramezanian, M; Kazemian, M

2013-01-01

This study will provide detailed specification of those variables and determinants of unpredictable health expenditure in Iran, and the requirements to reduce extensive effects of the factors affecting households' payments for health and other goods and services inappropriately. This study aims to identify measures of fair financing of health services and determinants of fair financing contribution, regarding the required share of households that prevents their catastrophic payments. In this regard, analysis of shares of households' expenditures on main groups of goods and services in urban and rural areas and in groups of deciles in the statistics from households' expenditure surveys was applied. The growth of spending in nominal values within the years 2002-2008 was considerably high and the rate for out-of-pocket payments is nearly the same or greater than the rate for total health expenditure. In 2008, urban and rural households in average pay 6.4% and 6.35% of their total expenditure on health services. Finally three categories of determinants of unfair and catastrophic payments by households were recognized in terms of households' socio-economic status, equality/inequality conditions of the distribution of risk of financing, and economic aspects of health expenditure distribution. While extending the total share of government and prepayment sources of financing health services are considered as the simplest policy for limiting out-of-pocket payments, indicators and policies introduced in this study could also be considered important and useful for the development of health sector and easing access to health services, irrespective of health financing fairness.

Association between uncoupling protein 2, adiponectin and resting energy expenditure in obese women with normal and low resting energy expenditure.

Science.gov (United States)

Taghadomi Masoumi, Zahra; Eshraghian, Mohammad Reza; Hedayati, Mahdi; Pishva, Hamideh

2018-02-01

Obesity is recognized as the most prevalent metabolic disease worldwide. Decreases in energy expenditure may increase risk of obesity. One of the key regulators of energy balance is uncoupling protein2 (UCP2), a transporter protein presents in mitochondrial inner membrane. Moreover, adiponectin is the most abundant adipocytokine, it may play a role in energy metabolism and gene expression of UCP2. The aim of this study was to investigate potential associations between the level of uncoupling protein 2 and adiponectin and their relationship with REE (Resting Energy Expenditure) in obese women with normal and low resting energy expenditure. A total of 49 subjects (women, 25-50 years old), were included in current study, 16 subjects with BMI > 30 and low resting energy expenditure, 17 subjects with BMI > 30 and normal resting energy expenditure and 16 non-obese subjects as a control group. Anthropometric, body composition parameters and resting energy expenditure were measured. Plasma adiponectin, UCP2 protein and total protein in PBMC were determined. Measured resting energy expenditure in obese subjects with low REE was significantly lower than other groups. Plasma adiponectin in the obese subjects with low REE was significantly lower compared to normal weight group. There was a significant relationship between 'UCP2 protein/Total protein' ratio and plasma adiponectin in obese group with low REE and in three groups when we pooled. There was a significant association between REE and plasma adiponectin in three groups when we pooled. There was a significant association between plasma adiponectin and REE. Moreover, there was a significant relationship between UCP2 and REE.

An analysis of Malaysia's corporate income tax expenditures and negative income tax expenditures using accounting standards as the benchmark tax base

OpenAIRE

Yussof, Salwa Hana

2017-01-01

Tax expenditures are government indirect spending, hidden in the tax system, often used to support government’s social and economic objectives. Instead of directly allocating money for a particular objective, the government forgoes tax revenues from those who undertake activities that could achieve the objective. Therefore, tax expenditures should be analysed as government spending programs. Tax expenditure reporting and analysis has been a regular practice among many countries in the worl...

Does the pharmacy expenditure of patients always correspond with their morbidity burden? Exploring new approaches in the interpretation of pharmacy expenditure

Directory of Open Access Journals (Sweden)

Abad-Díez José

2010-05-01

Full Text Available Abstract Background The computerisation of primary health care (PHC records offers the opportunity to focus on pharmacy expenditure from the perspective of the morbidity of individuals. The objective of the present study was to analyse the behaviour of pharmacy expenditure within different morbidity groups. We paid special attention to the identification of individuals who had higher values of pharmacy expenditure than their morbidity would otherwise suggest (i.e. outliers. Methods Observational study consisting of 75,574 patients seen at PHC centres in Zaragoza, Spain, at least once in 2005. Demographic and disease variables were analysed (ACG® 8.1, together with a response variable that we termed 'total pharmacy expenditure per patient'. Outlier patients were identified based on boxplot methods, adjusted boxplot for asymmetric distributions, and by analysing standardised residuals of tobit regression models. Results The pharmacy expenditure of up to 7% of attendees in the studied PHC centres during one year exceeded expectations given their morbidity burden. This group of patients was responsible for up to 24% of the total annual pharmacy expenditure. There was a significantly higher number of outlier patients within the low-morbidity band which matched up with the higher variation coefficient observed in this group (3.2 vs. 2.0 and 1.3 in the moderate- and high-morbidity bands, respectively. Conclusions With appropriate validation, the methodologies of the present study could be incorporated in the routine monitoring of the prescribing profile of general practitioners. This could not only enable evaluation of their performance, but also target groups of outlier patients and foster analyses of the causes of unusually high pharmacy expenditures among them. This interpretation of pharmacy expenditure gives new clues for the efficiency in utilisation of healthcare resources, and could be complementary to management interventions focused on

Household Expenditures on Private Tutoring: Emerging Evidence from Malaysia

Science.gov (United States)

Kenayathulla, Husaina Banu

2013-01-01

Private tutoring has been a burgeoning phenomenon in Malaysia for decades. This study examines the determinants of private tutoring expenditures in Malaysia using the 2004/2005 Household Expenditures Survey and applies hurdle regression models to the data. The results indicate that total household expenditures, household head's level of education,…

Direct‐to‐consumer advertising of pharmaceuticals: developed countries experiences and Turkey

Science.gov (United States)

Semin, Semih; Aras, Şahbal; Guldal, Dilek

2006-01-01

Abstract While several major problems concerning drugs occur in the world, the attempts to direct‐to‐consumer advertising (DTCA) has gained a considerable impetus lately in both developed and developing countries. DTCA has increasingly become an appealing advertising alternative for the pharmaceutical industry as drug companies have come to wrestle with such problems as the expansion of the drug market; the decline of the medical representatives’ work efficiency; drug reimbursement restrictions; and the escalating role of the Internet in the consumer market. Some of the main disadvantages of the DTCA are: increasing drug expenditures, unnecessary drug consumption and adverse effect risks. Even though the influence of pharmaceuticals on health services and the economy hold the same importance in the developed and developing countries, its negative consequences have increased by encompassing developing countries in its grip. Therefore, in this review, using Turkey as an example, the situation of direct‐to‐consumer advertisements in developing countries is analysed in relation with developed countries. PMID:17324191

Direct-to-consumer advertising of pharmaceuticals: developed countries experiences and Turkey.

Science.gov (United States)

Semin, Semih; Aras, Sahbal; Guldal, Dilek

2007-03-01

While several major problems concerning drugs occur in the world, the attempts to direct-to-consumer advertising (DTCA) has gained a considerable impetus lately in both developed and developing countries. DTCA has increasingly become an appealing advertising alternative for the pharmaceutical industry as drug companies have come to wrestle with such problems as the expansion of the drug market; the decline of the medical representatives' work efficiency; drug reimbursement restrictions; and the escalating role of the Internet in the consumer market. Some of the main disadvantages of the DTCA are: increasing drug expenditures, unnecessary drug consumption and adverse effect risks. Even though the influence of pharmaceuticals on health services and the economy hold the same importance in the developed and developing countries, its negative consequences have increased by encompassing developing countries in its grip. Therefore, in this review, using Turkey as an example, the situation of direct-to-consumer advertisements in developing countries is analysed in relation with developed countries.

Automatic energy expenditure measurement for health science

NARCIS (Netherlands)

Catal, Cagatay; Akbulut, Akhan

2018-01-01

Background and objective: It is crucial to predict the human energy expenditure in any sports activity and health science application accurately to investigate the impact of the activity. However, measurement of the real energy expenditure is not a trivial task and involves complex steps. The

The State Regulation and Accounting and Analytical Support of the Development of E-Commerce in the Consumer Sector

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Koval Viktor V

2016-08-01

Full Text Available The aim of the article is to study the theoretical and methodological principles of the state regulation and accounting and analytical support of the development of e-commerce in the consumer sector. The peculiarities of the state regulation and accounting and analytical support of the development of e-commerce in the consumer sector have been considered. The international and domestic experience in the field of regulatory support of e-commerce is studied. There systematized the ways of solving the problems of e-commerce in Ukraine based on the need to minimize the direct regulation with the perfection of the institutional environment to improve business conditions including the issues of the fiscal regime and simplification of the customs tariff regulation. The state regulation of e-commerce should constructively contribute to the development of entrepreneurship among other measures by solving the problem of financial control of electronic transactions and supporting the payment infrastructure of e-commerce in the consumer market on the basis of its corresponding accounting and analytical support. Prospects of further research in this direction are definition of a clear and harmonized with international standards state policy in the sphere of regulation of e-commerce in the consumer market on the basis of the relevant accounting and analytical support, since the appearance of new objects and forms of economic activity sets new tasks for the accounting, which develops in parallel with these changes and generates information for managing at both the micro and macro level.

Does drug price-regulation affect healthcare expenditures?

Science.gov (United States)

Ben-Aharon, Omer; Shavit, Oren; Magnezi, Racheli

2017-09-01

Increasing health costs in developed countries are a major concern for decision makers. A variety of cost containment tools are used to control this trend, including maximum price regulation and reimbursement methods for health technologies. Information regarding expenditure-related outcomes of these tools is not available. To evaluate the association between different cost-regulating mechanisms and national health expenditures in selected countries. Price-regulating and reimbursement mechanisms for prescription drugs among OECD countries were reviewed. National health expenditure indices for 2008-2012 were extracted from OECD statistical sources. Possible associations between characteristics of different systems for regulation of drug prices and reimbursement and health expenditures were examined. In most countries, reimbursement mechanisms are part of publicly financed plans. Maximum price regulation is composed of reference-pricing, either of the same drug in other countries, or of therapeutic alternatives within the country, as well as value-based pricing (VBP). No association was found between price regulation or reimbursement mechanisms and healthcare costs. However, VBP may present a more effective mechanism, leading to reduced costs in the long term. Maximum price and reimbursement mechanism regulations were not found to be associated with cost containment of national health expenditures. VBP may have the potential to do so over the long term.

PUBLIC EXPENDITURE ON HEALTH IN LOCAL BUDGETS

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Cristinel ICHIM

2017-06-01

Full Text Available This paper entitled "Public expenditure on health in local budgets" aims analysing and deepening major spending categories that public authorities finance at local level, namely health expenditure. In the first part of the article we have specified the content and role of this category of expenditure in local budgets and also made some feedback on decentralization in health. In the second part of the work, based on data available in Statistical Yearbook of Romania, we have carried out an analysis of the dynamics of health spending from local budgets to emphasize their place and role in the health care expenses. The research carried out follows that the evolution and structure of health expenditure financed from local budgets is determined, along with the legislative framework in the field, by several variables that differ from one territorial administrative unit to another: the existence of sanitary units, their type, the involving of local public authorities in their development and modernization, the number and the social structure of the population. The research shows that over the period 1993-2015, the dynamics of the share of health spending in total expenditures of local budgets is sinusoidal, with a minimum threshold in 2000 of only 0.3%.

Effects of hydrolysed casein, intact casein and intact whey protein on energy expenditure and appetite regulation

DEFF Research Database (Denmark)

Bendtsen, Line Quist; Lorenzen, Janne Kunchel; Gomes, Sisse

2014-01-01

Casein and whey differ in amino acid composition and in the rate of absorption; however, the absorption rate of casein can be increased to mimic that of whey by exogenous hydrolysis. The objective of the present study was to compare the effects of hydrolysed casein (HC), intact casein (IC......) and intact whey (IW) on energy expenditure (EE) and appetite regulation, and thereby to investigate the influence of amino acid composition and the rate of absorption. In the present randomised cross-over study, twenty-four overweight and moderately obese young men and women consumed three isoenergetic...

Energy expenditure during sexual activity in young healthy couples.

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Julie Frappier

Full Text Available OBJECTIVE: To determine energy expenditure in kilocalories (kcal during sexual activity in young healthy couples in their natural environment and compare it to a session of endurance exercise. METHODS: The study population consisted of twenty one heterosexual couples (age: 22.6 ± 2.8 years old from the Montreal region. Free living energy expenditure during sexual activity and the endurance exercise was measured using the portable mini SenseWear armband. Perceived energy expenditure, perception of effort, fatigue and pleasure were also assessed after sexual activity. All participants completed a 30 min endurance exercise session on a treadmill at a moderate intensity. RESULTS: Mean energy expenditure during sexual activity was 101 kCal or 4.2 kCal/min in men and 69.1 kCal or 3.1 kCal/min in women. In addition, mean intensity was 6.0 METS in men and 5.6 METS in women, which represents a moderate intensity. Moreover, the energy expenditure and intensity during the 30 min exercise session in men was 276 kCal or 9.2 kCal/min and 8.5 METS, respectively and in women 213 kCal or 7.1 kCal/min and 8.4 METS, respectively. Interestingly, the highest range value achieved by men for absolute energy expenditure can potentially be higher than that of the mean energy expenditure of the 30 min exercise session (i.e. 306.1 vs. 276 kCal, respectively whereas this was not observed in women. Finally, perceived energy expenditure during sexual activity was similar in men (100 kCal and in women (76.2 kCal when compared to measured energy expenditure. CONCLUSION: The present study indicates that energy expenditure during sexual activity appears to be approximately 85 kCal or 3.6 kCal/min and seems to be performed at a moderate intensity (5.8 METS in young healthy men and women. These results suggest that sexual activity may potentially be considered, at times, as a significant exercise.

Relationship Between Education Expenditure And Economic Growth ...

African Journals Online (AJOL)

The empirical part of the result shows that there is unidirectional relationship between education and economic growth with causality running from education expenditure to economic growth. The result therefore suggests that policy makers should boost expenditure on education as it will further improve economic growth in ...

Intergenerational enrollment and expenditure changes in Medicaid: trends from 1991 to 2005

Directory of Open Access Journals (Sweden)

Patrick Stephen W

2012-09-01

Full Text Available Abstract Background From its inception, Medicaid was aimed at providing insurance coverage for low income children, elderly, and disabled. Since this time, children have become a smaller proportion of the US population and Medicaid has expanded to additional eligibility groups. We sought to evaluate relative growth in spending in the Medicaid program between children and adults from 1991-2005. We hypothesize that this shifting demographic will result in fewer resources being allocated to children in the Medicaid program. Methods We utilized retrospective enrollment and expenditure data for children, adults and the elderly from 1991 to 2005 for both Medicaid and Children’s Health Insurance Program Medicaid expansion programs. Data were obtained from the Centers for Medicare and Medicaid Services using their Medicaid Statistical Information System. Results From 1991 to 2005, the number of enrollees increased by 83% to 58.7 million. This includes increases of 33% for children, 100% for adults and 50% for the elderly. Concurrently, total expenditures nationwide rose 150% to $273 billion. Expenditures for children increased from $23.4 to $65.7 billion, adults from $46.2 to $123.6 billion, and elderly from $39.2 to $71.3 billion. From 1999 to 2005, Medicaid spending on long-term care increased by 31% to $84.3 billion. Expenditures on the disabled grew by 61% to $119 billion. In total, the disabled account for 43% and long-term care 31%, of the total Medicaid budget. Conclusion Our study did not find an absolute decrease in the overall resources being directed toward children. However, increased spending on adults on a per-capita and absolute basis, particularly disabled adults, is responsible for much of the growth in spending over the past 15 years. Medicaid expenditures have grown faster than inflation and overall national health expenditures. A national strategy is needed to ensure adequate coverage for Medicaid recipients while dealing with the

Energy Expenditure in Vinyasa Yoga Versus Walking.

Science.gov (United States)

Sherman, Sally A; Rogers, Renee J; Davis, Kelliann K; Minster, Ryan L; Creasy, Seth A; Mullarkey, Nicole C; O'Dell, Matthew; Donahue, Patrick; Jakicic, John M

2017-08-01

Whether the energy cost of vinyasa yoga meets the criteria for moderate-to-vigorous physical activity has not been established. To compare energy expenditure during acute bouts of vinyasa yoga and 2 walking protocols. Participants (20 males, 18 females) performed 60-minute sessions of vinyasa yoga (YOGA), treadmill walking at a self-selected brisk pace (SELF), and treadmill walking at a pace that matched the heart rate of the YOGA session (HR-Match). Energy expenditure was assessed via indirect calorimetry. Energy expenditure was significantly lower in YOGA compared with HR-Match (difference = 79.5 ± 44.3 kcal; P YOGA = 3.6 ± 0.6; P YOGA, showed energy expenditure was significantly lower in YOGA compared with HR-Match (difference = 68.0 ± 40.1 kcal; P YOGA meets the criteria for moderate-intensity physical activity. Thus, YOGA may be a viable form of physical activity to achieve public health guidelines and to elicit health benefits.

[Systemic Antimicrobials Consumption and Expenditures in Departments of Surgery of Multi-Profile Hospitals in the Russian Federation and the Republic of Belarus: Results of Multicentre Pharmacoepidemiological Study].

Science.gov (United States)

Belkova, Yu A; Rachina, S A; Kozlov, R S; Mishchenko, V M; Pavlukov, R A; Abubakirova, A I; Berezhanskiy, B V; Eliseeva, E V; Zubareva, N A; Karpov, I A; Kopylova, I A; Palyutin, Sh Kh; Portnyagina, U S; Pribytkova, O V; Samuylo, E K

2016-01-01

The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides. Only 55-70% of the consumed AM belonged to the drugs of choice, whereas the improper AM consumption and expenditure rates amounted up to 10-18%. The study outputs can be used for the budget allocation and AM distribution improvement in the departments of surgery, as well as for the development and efficacy control of the local antimicrobial stewardship programs.

Improving military expenditure decisionmaking in sub-Saharan Africa

OpenAIRE

Geoff Harris

2010-01-01

This article begins by emphasizing that the number and intensity of armed conflict has fallen substantially but that military expenditure levels in sub-Saharan Africa have nonetheless increased, largely as a result of South African expenditure. The article attempts to answer two questions. First, how can the budget of the security sector be allocated so as to result in effective and efficient security outcomes? Second, how can an appropriate level of military expenditure for a country be dete...

Forecasting military expenditure

Directory of Open Access Journals (Sweden)

Tobias Böhmelt

2014-05-01

Full Text Available To what extent do frequently cited determinants of military spending allow us to predict and forecast future levels of expenditure? The authors draw on the data and specifications of a recent model on military expenditure and assess the predictive power of its variables using in-sample predictions, out-of-sample forecasts and Bayesian model averaging. To this end, this paper provides guidelines for prediction exercises in general using these three techniques. More substantially, however, the findings emphasize that previous levels of military spending as well as a country’s institutional and economic characteristics particularly improve our ability to predict future levels of investment in the military. Variables pertaining to the international security environment also matter, but seem less important. In addition, the results highlight that the updated model, which drops weak predictors, is not only more parsimonious, but also slightly more accurate than the original specification.

Playing active video games increases energy expenditure in children.

Science.gov (United States)

Graf, Diana L; Pratt, Lauren V; Hester, Casey N; Short, Kevin R

2009-08-01

To compare energy expenditure rates in children playing the physically active video games, Dance Dance Revolution (DDR) and Nintendo's Wii Sports in relation to treadmill walking. Energy expenditure, heart rate, step rate, and perceived exertion were measured in 14 boys and 9 girls (ages 10-13 years; BMI at 3-98th percentile for age and gender) while watching television at rest, playing DDR at 2 skill levels, playing Wii bowling and boxing, and walking at 2.6, 4.2, and 5.7 km/h. Arterial elasticity was measured at rest and immediately after gaming. Compared with watching television, energy expenditure while gaming or walking increased 2- to 3-fold. Similarly, high rates of energy expenditure, heart rate, and perceived exertion were elicited from playing Wii boxing, DDR level 2, or walking at 5.7 km/h. This occurred despite variations in step rate among activities, reflecting greater use of upper body during Wii play (lowest step rate) than during walking (highest step rate) or DDR play. Wii bowling and beginner level DDR elicited a 2-fold increase in energy expenditure compared to television watching. Large-artery elasticity declined immediately after both DDR and Wii. The change was inversely related to the increment in energy expenditure above rest achieved during the activity. Energy expenditure during active video game play is comparable to moderate-intensity walking. Thus, for children who spend considerable time playing electronic screen games for entertainment, physically active games seem to be a safe, fun, and valuable means of promoting energy expenditure.

Pharmaceutical expenditure forecast model to support health policy decision making

Science.gov (United States)

Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

2014-01-01

Background and objective With constant incentives for healthcare payers to contain their pharmaceutical budgets, modelling policy decision impact became critical. The objective of this project was to test the impact of various policy decisions on pharmaceutical budget (developed for the European Commission for the project ‘European Union (EU) Pharmaceutical expenditure forecast’ – http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). Methods A model was built to assess policy scenarios’ impact on the pharmaceutical budgets of seven member states of the EU, namely France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. The following scenarios were tested: expanding the UK policies to EU, changing time to market access, modifying generic price and penetration, shifting the distribution chain of biosimilars (retail/hospital). Results Applying the UK policy resulted in dramatic savings for Germany (10 times the base case forecast) and substantial additional savings for France and Portugal (2 and 4 times the base case forecast, respectively). Delaying time to market was found be to a very powerful tool to reduce pharmaceutical expenditure. Applying the EU transparency directive (6-month process for pricing and reimbursement) increased pharmaceutical expenditure for all countries (from 1.1 to 4 times the base case forecast), except in Germany (additional savings). Decreasing the price of generics and boosting the penetration rate, as well as shifting distribution of biosimilars through hospital chain were also key methods to reduce pharmaceutical expenditure. Change in the level of reimbursement rate to 100% in all countries led to an important increase in the pharmaceutical budget. Conclusions Forecasting pharmaceutical expenditure is a critical exercise to inform policy decision makers. The most important leverages identified by the model on pharmaceutical budget were driven by generic and biosimilar prices, penetration rate

Changes in consumer behavior on the market with food

Directory of Open Access Journals (Sweden)

Jana Turčínková

2009-01-01

Full Text Available Czech Republic has experienced significant changes on the market with food in last two decades. The paper presents summary of results of conducted analyses focusing on changes in levels of most important food categories, changes in consumer preferences, and suggests what trends we can expect in the near future. The analyses were based on date from Czech Statistical Office Yearbooks, EUROSTAT, INCOMA and GfK, and data from primary researches conducted on sample of total 2522 households in the Czech Republic through questionnaire researches in 2005, 2006 and 2007. The results show that in the Czech Republic, the ratio of expenditures for food out of total consumer expenditures is slowly decreasing and advances to (still lower level typical for traditional EU countries. We have experienced growth of demand for products with higher added value; customers put more emphasis on perceived quality, longer durability and special product characteristics. Czech con­su­mers increase their consumption of vegetables and fruit, bottled beverages, wine and alcoholic beverages, cheese, they decreased their consumption of meat (in total, milk and potatoes, stagnation was typical for bakery products, sugar and fats and oils. Development in all social classes was very similar. For the future, we can expect growing interest for food products in smaller packages and targeted at specific needs, growing demand for food products with higher added value, consumption of food formerly unusual for the Czech, more frequent out-of-home eating, and growing differences between individual segments of social groups, mainly due to uneven income distribution.

High-Expenditure Pharmaceutical Use Among Children in Medicaid.

Science.gov (United States)

Cohen, Eyal; Hall, Matt; Lopert, Ruth; Bruen, Brian; Chamberlain, Lisa J; Bardach, Naomi; Gedney, Jennifer; Zima, Bonnie T; Berry, Jay G

2017-09-01

Medication use may be a target for quality improvement, cost containment, and research. We aimed to identify medication classes associated with the highest expenditures among pediatric Medicaid enrollees and to characterize the demographic, clinical, and health service use of children prescribed these medications. Retrospective, cross-sectional study of 3 271 081 Medicaid-enrolled children. Outpatient medication spending among high-expenditure medication classes, defined as the 10 most expensive among 261 mutually exclusive medication classes, was determined by using transaction prices paid to pharmacies by Medicaid agencies and managed care plans among prescriptions filled and dispensed in 2013. Outpatient medications accounted for 16.6% of all Medicaid expenditures. The 10 most expensive medication classes accounted for 63.9% of all medication expenditures. Stimulants (amphetamine-type) accounted for both the highest proportion of expenditures (20.6%) and days of medication use (14.0%) among medication classes. Users of medications in the 10 highest-expenditure classes were more likely to have a chronic condition of any complexity (77.9% vs 41.6%), a mental health condition (35.7% vs 11.9%), or a complex chronic condition (9.8% vs 4.3%) than other Medicaid enrollees (all P costs may benefit from better delineation of the appropriate prescription of these medications. Copyright © 2017 by the American Academy of Pediatrics.

Novel methodology for pharmaceutical expenditure forecast

OpenAIRE

Vataire, Anne-Lise; Cetinsoy, Laurent; Aball?a, Samuel; R?muzat, C?cile; Urbinati, Duccio; Kornfeld, ?sa; Mzoughi, Olfa; Toumi, Mondher

2014-01-01

Background and objective: The value appreciation of new drugs across countries today features a disruption that is making the historical data that are used for forecasting pharmaceutical expenditure poorly reliable. Forecasting methods rarely addressed uncertainty. The objective of this project was to propose a methodology to perform pharmaceutical expenditure forecasting that integrates expected policy changes and uncertainty (developed for the European Commission as the ‘EU Pharmaceutical e...

Development and changes in consumption expenditures of the population

Directory of Open Access Journals (Sweden)

Zuzana Toufarová

2008-01-01

Full Text Available The paper deals with development and changes in consumption expenditures of population. It uses secondary data to analyze consumption expenditures of EU-25 and the Czech Republic and concetrates on changes in the expenditure groups over the period of past years. Other part of this paper is devoted to primary data analysis. Primary data were obtained in a questionnaire survey. Primary data analysis is based on statistical methods and it investigates changes in the structure of consumption expenditures of households in relation to changes in household income. By using dependency analysis the paper verifies dependency of surveyed groups of consumption expenditures and groups of households sorted by identification characteristics. Additionally, also based on the primary research, the paper tries to find out the way households allocate money surplus remaining after covering all the adequate expenses.

Aspects of marginal expenditures in energy sector

International Nuclear Information System (INIS)

Stojchev, D.; Kynev, K.

1994-01-01

Technical and economical problems of marginal analysis methodology, its application procedure in energy sector and marginal expenditures determination are outlined. A comparative characteristics of the application is made for different periods of time. The differences in calculation of the marginal expenditures and prices are discussed. The operational costs, investments and inflation are analyzed. The mechanism of application of this approach in different planing horizon is outlined. The role of the change in the costs in time, the time unit, volume, the scope of application, etc. are determined. The areas of transition from one to other form of marginal expenditures are shown. 4 refs. (orig.)

Nonresidential buildings energy consumption survey: 1979 consumption and expenditures. Part 2. Steam, fuel oil, LPG, and all fuels

Energy Technology Data Exchange (ETDEWEB)

Patinkin, L.

1983-12-01

This report presents data on square footage and on total energy consumption and expenditures for commercial buildings in the contiguous United States. Also included are detailed consumption and expenditures tables for fuel oil or kerosene, liquid petroleum gas (LPG), and purchased steam. Commercial buildings include all nonresidential buildings with the exception of those where industrial activities occupy more of the total square footage than any other type of activity. 7 figures, 23 tables.

THE ROMANIAN CONSUMER UNDER THE INFLUENCE OF THE GLOBAL CRISIS

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SAVU MIHAELA

2015-03-01

Full Text Available At present, consumers focus on meeting their higher needs, as opposed to previously meeting the base ones. However this trend is not among priorities for the Romanian consumer. He/she uses almost 43% of the total consumption expenditures for the purchase of food, being restricted in his/her choices by the income and the price of products. The food products analysed in the period 2001 – 2012 have an upward trend, but with no substantial differences. The only product category that has a downward trend is represented by wine and wine products. Consumption in Romania was negatively influenced by the effects of the global crisis for the products analysed, except for meat and meat products. Despite the fact that we are far from the average annual meat consumption, however, the highest quantity recorded in our country was in 2009.

Criterion 6, indicator 34 : value of capital investment and annual expenditure in forest management, wood and non-wood product industries, forest-based environmental services, recreation, and tourism

Science.gov (United States)

Ken Skog; John Bergstrom; Elizabeth Hill; Ken Cordell

2010-01-01

USDA Forest Service capital investment in management infrastructure was $501 and $390 million (2005$) for 2005 and 2007, respectively. National forest programs expenditures decreased from $3.0 to $2.7 billion between 2004 and 2007 and wildfire management expenditures increased from $1.7 to $2.1 billion (2005$). State forestry program expenditures for 1998, 2002, and...

A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection

Science.gov (United States)

Donohue, Julie

2006-01-01

Direct-to-consumer advertising (DTCA) of prescription drugs in the United States is controversial. Underlying the debate are disagreements over the role of consumers in medical decision making, the appropriateness of consumers engaging in self-diagnosis, and the ethics of an industry promoting potentially dangerous drugs. Drug advertising and federal policy governing drug advertising have both responded to and reinforced changes in the consumer's role in health care and in the doctor-patient relationship over time. This article discusses the history of DTCA in the context of social movements to secure rights for health care patients and consumers, the modern trend toward consumer-oriented medicine, and the implications of DTCA and consumer-oriented medicine for contemporary health policy debates about improving the health care system. PMID:17096638

A history of drug advertising: the evolving roles of consumers and consumer protection.

Science.gov (United States)

Donohue, Julie

2006-01-01

Direct-to-consumer advertising (DTCA) of prescription drugs in the United States is controversial. Underlying the debate are disagreements over the role of consumers in medical decision making, the appropriateness of consumers engaging in self-diagnosis, and the ethics of an industry promoting potentially dangerous drugs. Drug advertising and federal policy governing drug advertising have both responded to and reinforced changes in the consumer's role in health care and in the doctor-patient relationship over time. This article discusses the history of DTCA in the context of social movements to secure rights for health care patients and consumers, the modern trend toward consumer-oriented medicine, and the implications of DTCA and consumer-oriented medicine for contemporary health policy debates about improving the health care system.

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

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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

Tailor-made finance versus tailor-made service : Can the state improve consumer choice in healthcare by reforming the financial structure?

NARCIS (Netherlands)

K.J. Grit (Kor); A.A. de Bont (Antoinette)

2010-01-01

textabstractABSTRACT Background: Policy instruments based on the working of markets have been introduced to empower consumers of healthcare, however it is not easy to become a critical consumer in healthcare. Objectives: The aim of this study is to analyze the possibilities of the state to

24 CFR 982.157 - Budget and expenditure.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Budget and expenditure. 982.157... and PHA Administration of Program § 982.157 Budget and expenditure. (a) Budget submission. Each PHA fiscal year, the PHA must submit its proposed budget for the program to HUD for approval at such time and...

Effect of chewing speed on energy expenditure in healthy subjects.

Science.gov (United States)

Paphangkorakit, Jarin; Leelayuwat, Naruemon; Boonyawat, Nattawat; Parniangtong, Auddamar; Sripratoom, Jindamanee

2014-08-01

The aim of the study was to investigate the effect of rate of chewing on energy expenditure in human subjects. Fourteen healthy subjects (aged 18-24 years) within the normal range of BMI participated in a cross-over experiment consisting of two 6-min sessions of gum chewing, slow (∼60 cycles/min) and fast (∼120 cycles/min) chewing. The resting energy expenditure (REE) and during gum chewing was measured using a ventilated hood connected to a gas analyzer system. The normality of data was explored using the Shapiro-Wilk test. The energy expenditure rate during chewing and the energy expenditure per chewing cycle were compared between the two chewing speeds using Wilcoxon signed ranks tests. The energy expenditure per chewing cycle during slow chewing (median 1.4, range 5.2 cal; mean 2.1±1.6 cal) was significantly higher than that during fast chewing (median 0.9, range 2.2 cal; mean 1.0±0.7 cal) (p chewing speeds (p > 0.05). The results of this study suggest that chewing at a slower speed could increase the energy expenditure per cycle and might affect the total daily energy expenditure.

ACCOUNTING CONTROVERSY ON THE RECOGNITION AND EVALUATION OF DEVELOPMENT EXPENDITURE

Directory of Open Access Journals (Sweden)

TULVINSCHI MIHAELA

2017-12-01

Full Text Available The development of technology in recent decades has forced the transition from the industrialized society, where the main role was occupied by tangible assets, to an information society, where the essential place is played by intangible assets. These are assets that can not be touched or felt, but are very important to produce wealth and to maintain competitiveness. Within these, development expenditure occupies an important place because it influences the analysis of an entity and its future. The accounting practices applicable to development expenditure are based on theoretical fundamentals and ambiguous typologies. The purpose of the article is to present the controversies about recognizing and evaluating development expenditure. Although development expenditure involves large initial investments, it generates, on medium and long term, significant savings. Depending on the purpose for which it is carried out, research and development expenditure can in time generate identifiable intangible assets but also intangible unidentifiable assets. An optimistic attitude regarding the chances of success of a development project will lead to the capitalization of development expenditure. Capitalizing development expenditures, the usefulness of financial statements is increased, which is generally measured in the ability to explain stock prices through earnings and accounting values.

Circadian rhythm of energy expenditure and oxygen consumption.

Science.gov (United States)

Leuck, Marlene; Levandovski, Rosa; Harb, Ana; Quiles, Caroline; Hidalgo, Maria Paz

2014-02-01

This study aimed to evaluate the effect of continuous and intermittent methods of enteral nutrition (EN) administration on circadian rhythm. Thirty-four individuals, aged between 52 and 80 years, were fed through a nasoenteric tube. Fifteen individuals received a continuous infusion for 24 hours/d, and 19 received an intermittent infusion in comparable quantities, every 4 hours from 8:00 to 20:00. In each patient, 4 indirect calorimetric measurements were carried out over 24 hours (A: 7:30, B: 10:30, C: 14:30, and D: 21:30) for 3 days. Energy expenditure and oxygen consumption were significantly higher in the intermittent group than in the continuous group (1782 ± 862 vs 1478 ± 817 kcal/24 hours, P = .05; 257 125 vs 212 117 ml/min, P = .048, respectively). The intermittent group had higher levels of energy expenditure and oxygen consumption at all the measured time points compared with the continuous group. energy expenditure and oxygen consumption in both groups were significantly different throughout the day for 3 days. There is circadian rhythm variation of energy expenditure and oxygen consumption with continuous and intermittent infusion for EN. This suggests that only one indirect daily calorimetric measurement is not able to show the patient's true needs. Energy expenditure is higher at night with both food administration methods. Moreover, energy expenditure and oxygen consumption are higher with the intermittent administration method at all times.

Catastrophic household expenditure on health in Nepal: a cross-sectional survey.

Science.gov (United States)

Saito, Eiko; Gilmour, Stuart; Rahman, Md Mizanur; Gautam, Ghan Shyam; Shrestha, Pradeep Krishna; Shibuya, Kenji

2014-10-01

To determine the incidence of - and illnesses commonly associated with - catastrophic household expenditure on health in Nepal. We did a cross-sectional population-based survey in five municipalities of Kathmandu Valley between November 2011 and January 2012. For each household surveyed, out-of-pocket spending on health in the previous 30 days that exceeded 10% of the household's total expenditure over the same period was considered to be catastrophic. We estimated the incidence and intensity of catastrophic health expenditure. We identified the illnesses most commonly associated with such expenditure using a Poisson regression model and assessed the distribution of expenditure by economic quintile of households using the concentration index. Overall, 284 of the 1997 households studied in Kathmandu, i.e. 13.8% after adjustment by sampling weight, reported catastrophic health expenditure in the 30 days before the survey. After adjusting for confounders, this expenditure was found to be associated with injuries, particularly those resulting from road traffic accidents. Catastrophic expenditure by households in the poorest quintile were associated with at least one episode of diabetes, asthma or heart disease. In an urban area of Nepal, catastrophic household expenditure on health was mostly associated with injuries and noncommunicable diseases such as diabetes and asthma. Throughout Nepal, interventions for the control and management of noncommunicable diseases and the prevention of road traffic accidents should be promoted. A phased introduction of health insurance should also reduce the incidence of catastrophic household expenditure.

Consumers' perceptions regarding tradeoffs between food and fuel expenditures: A case study of U.S. and Belgian fuel users

International Nuclear Information System (INIS)

Skipper, Daniel; Popp, Michael; Vickery, Gina; Van de Velde, Liesbeth; Van Huylenbroeck, Guido; Verbeke, Wim

2009-01-01

Biofuels have been suggested as a sustainable alternative to fossil-based fuels, but when produced with inputs traditionally used as food and feed grain, the production of biofuels has contributed to price increases in the food sector. In the fall of 2006, a survey was administered to compare consumer perceptions regarding the tradeoff between renewable fuels and food in the United States (U.S.) (n = 242) and Belgium (n = 363). Results show that respondents in both countries prefer lower food prices to lower fuel prices (67.6% in the U.S. and 78.9% in Belgium). A logit model was estimated to determine which variables impacted whether a consumer favored policies that lower fuel prices at the cost of higher food prices. While the sample of Belgian respondents appeared to realize that lower fuel prices eventually had to come at the cost of higher food prices, the sample of U.S. respondents felt domestic agriculture could provide some low-cost, environmentally friendly alternatives with little impact on food prices. Accessible public transportation in Belgium acted as an important fuel saving strategy in that country and led respondents to emphasize food price decreases over fuel price decreases. Also, respondents with heightened awareness towards the environment recognized that the expansion of renewable fuels may need to come at the cost of higher food prices. These attitudes were similar in both countries. Finally, in both countries older respondents placed more importance on lower food prices than lower fuel prices. (author)

CHARACTERISTICS OF INDONESIAN HOUSEHOLD’S LIVING EXPENDITURE

Directory of Open Access Journals (Sweden)

Duddy Roesmara Donna

2014-09-01

Full Text Available The aim of this study is to estimate and analize the characteristics of Indonesian household expenditure on goods and services, for example food, clothes, household utensils, housing, medical care, education, oil and transportation, gas, electricity and communication. Linear Expenditure System (LES model and seemingly uncorrelated regression (SUR estimation method were applied. This study has some conclusions. First, if ones have more incomes, they will proportionally allocate them for housing, oil and transportation, education, food, and medical care. Second, medical care, education and communication are categorized as superior or deluxe commodities. Third, the approximation of minimum living expenditure to survive is Rp 147.236 for a household per week.  

10 CFR 603.310 - Use of an expenditure-based TIA.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Use of an expenditure-based TIA. 603.310 Section 603.310 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS... expenditure-based TIA. In general, the contracting officer must use an expenditure-based TIA under conditions...

Consumer acceptance of irradiated food in the United States

International Nuclear Information System (INIS)

Bord, R.J.

1991-01-01

An analysis is presented of the public acceptance of the irradiated food issue in the United States as it stands in late Summer, 1990. This analysis will rely on survey and marketing data but will go beyond those findings to assess other impacts and the interaction of multiple factors. This assessment will proceed along three tracks: first, public opinion surveys and marketing research will be overviewed in an effort to discern patterns and trends; second, recent popular literature on food irradiation will be discussed in terms of the images being presented to the reading public; finally, the potential for future shifts in consumer acceptance will be assessed in the light of what is known about the impact of public interest groups, the media, and decision making concerning risky technologies. A summary and conclusion section will provide the synthesis. (author)

Romanian Public Expenditures Policy during the Economic Crisis

Directory of Open Access Journals (Sweden)

Anca-Ştefania SAVA

2011-03-01

Full Text Available The aim of this paper is to discuss the Romanian public expenditures policy promoted in the context of the economic and financial crisis. Firstly, we present a brief introduction on the effects of public expenditures policy to economic growth and the role of automatic stabilizers in times of economic recessions. Secondly, the paper analyzes the evolution of current and capital public expenditures before and during the economic and financial crisis, according to which unproductive spending prevailed, in detriment of productive investments which can stimulate the economic recovery.

Postprandial energy expenditure in whole-food and processed-food meals: implications for daily energy expenditure.

Science.gov (United States)

Barr, Sadie B; Wright, Jonathan C

2010-07-02

Empirical evidence has shown that rising obesity rates closely parallel the increased consumption of processed foods (PF) consumption in USA. Differences in postprandial thermogenic responses to a whole-food (WF) meal vs. a PF meal may be a key factor in explaining obesity trends, but currently there is limited research exploring this potential link. The goal was to determine if a particular PF meal has a greater thermodynamic efficiency than a comparable WF meal, thereby conferring a greater net-energy intake. Subjective satiation scores and postprandial energy expenditure were measured for 5-6 h after isoenergetic meals were ingested. The meals were either 'whole' or 'processed' cheese sandwiches; multi-grain bread and cheddar cheese were deemed whole, while white bread and processed cheese product were considered processed. Meals were comparable in terms of protein (15-20%), carbohydrate (40-50%), and fat (33-39%) composition. Subjects were healthy women (n=12) and men (n=5) studied in a crossover design. There were no significant differences in satiety ratings after the two meals. Average energy expenditure for the WF meal (137+/-14.1 kcal, 19.9% of meal energy) was significantly larger than for the PF meal (73.1+/-10.2 kcal, 10.7% of meal energy). Ingestion of the particular PF meal tested in this study decreases postprandial energy expenditure by nearly 50% compared with the isoenergetic WF meal. This reduction in daily energy expenditure has potential implications for diets comprised heavily of PFs and their associations with obesity.

Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2011-12 (Fiscal Year 2012). First Look. NCES 2014-303

Science.gov (United States)

Cornman, Stephen Q.

2015-01-01

This First Look report presents data on public elementary and secondary education revenues and expenditures at the local education agency (LEA) or school district level for fiscal year (FY) 2012.1. Specifically, this report includes findings from the following types of school finance data: (1) Revenue and expenditure totals by state and the 100…

Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2012-13 (Fiscal Year 2013). First Look. NCES 2015-303

Science.gov (United States)

Cornman, Stephen Q.

2016-01-01

This First Look report presents data on public elementary and secondary education revenues and expenditures at the local education agency (LEA) or school district level for fiscal year (FY) 2013. Specifically, this report includes findings from the following types of school finance data: (1) revenue and expenditure totals by state and the 100…

Energy expenditure in caving.

Directory of Open Access Journals (Sweden)

Giorgia Antoni

Full Text Available The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE was in the range 225-287 kcal/h for women-men (MET = 4.1, respectively; subjects had an energy intake from food in the range 1000-1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue.

Organic labbeling systems and consumer confidence

OpenAIRE

Sønderskov, Kim Mannemar; Daugbjerg, Carsten

2009-01-01

A research analysis suggests that a state certification and labelling system creates confidence in organic labelling systems and consequently green consumerism. Danish consumers have higher levels of confidence in the labelling system than consumers in countries where the state plays a minor role in labelling and certification.

Geographic variation in expenditures for Workers' Compensation hospitalized claims.

Science.gov (United States)

Miller, T R; Levy, D T

1999-02-01

Past literature finds considerable variation in the cost of physician care and in the utilization of medical procedures. Variation in the cost of hospitalized care has received little attention. We examine injury costs of hospitalized claims across states. Multivariate regression analysis is used to isolate state variations, while controlling for personal and injury characteristics, and state characteristics. Injuries to workers filing Workers' Compensation lost workday claims. About 35,000 randomly sampled Workers' Compensation claims from 17 states filed between 1979 and 1988. Medical payments per episode of three injury groups: upper and lower extremity fractures and dislocations, other upper extremity injuries, and back strains and sprains. Statistical analyses reveal considerable variation in expenditures for hospitalized injuries across states, even after controlling for case mix and state characteristics. A substantial portion of the variation is explained by state rate regulations; regulated states have lower costs. The large variation in costs suggests a potential to affect the costs of hospitalized care. Efforts should be directed at those areas that have higher costs without sufficient input price, quality, or case mix justification.

Protection for the Consumer; Business Education: 6463.07.

Science.gov (United States)

Finora, Daniel

This course is designed to acquaint the student with the functions, criticisms, costs, and consumer analysis of advertising; Federal and State regulations of industry operation and advertising; Federal, State, and city agencies for consumer protection; private and business-sponsored organizations for consumer protection; and rights and…

Summary of expenditures of rebates from the low-level radioactive waste surcharge escrow account for calendar year 1990

International Nuclear Information System (INIS)

1991-06-01

This is the fifth report submitted to Congress under Title 1, section 5(d)(2)(E) of Public Law 99--240, ''The Low-Level Radioactive Waste Policy Amendments Act of 1985'' (the Act). This section of the Act requests the Department of Energy (DOE) to summarize the annual expenditures of funds disbursed from the DOE surcharge escrow account and to assess compliance of these expenditures with the specified limitations. The Act places limitations on the use of these funds and requires the nonsited compact regions and nonmember States to provide DOE with an itemized report of their expenditures on December 31 of each year in which funds are expended. Within 6 months after receiving the individual reports, DOE is to furnish Congress a summary of the reported expenditures and an assessment of compliance with the limitations on the use of these funds specified in the Act. This report fulfills that requirements. DOE disbursed funds totaling $15,006,587.76 to the States and compact regions following the July 1, 1986, January 1, 1988, and January 1, 1990, milestones. Of this amount, $4,328,340.44 was expended during calendar year 1990 and $2,239,205.80 was expended during the prior 4 years. At the end of December 1990, $8,439,041.52 was unexpended. 5 tabs

Productive Government Expenditure in Monetary Business Cycle Models

NARCIS (Netherlands)

Linnemann, L.; Schabert, A.

2006-01-01

This paper assesses the transmission of fiscal policy shocks in a New Keynesian framework where government expenditures contribute to aggregate production. It is shown that even if the impact of government expenditures on production is small, this assumption helps to reconcile the models'

Productivity and Energy Expenditure by Sawyers When Using ...

African Journals Online (AJOL)

Therefore, based on overall results it is concluded that, the PLSP is technically more appropriate technology or method for reducing energy expenditure and for increasing productivity during timber harvesting in agroforestry farms. Keywords: Productivity, Energy expenditure, Pitsawing and Portable log sawing. Rwanda ...

Government expenditure, efficiency and economic growth: a panel ...

African Journals Online (AJOL)

Finally Generalized Methods of Moments (GMM) is applied to answer the two research questions. The results demonstrate that increasing government expenditure accelerates economic growth of low income countries in Sub Saharan Africa. However, when government expenditure is interacted with government efficiency ...

Consumer Mobile Health Apps: Current State, Barriers, and Future Directions.

Science.gov (United States)

Kao, Cheng-Kai; Liebovitz, David M

2017-05-01

This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low-cost, around-the-clock access to high-quality, evidence-based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence-based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud-based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

[Legal development of consumer protection from the Federal Office of Consumer Protection and Food Safety standpoint].

Science.gov (United States)

Püster, M

2010-06-01

Ten years after publication of the White Paper on Food Safety, health consumer protection has made significant progress and, today, is a key field in politics at both the European and German levels. In addition to the protection of health and security of consumers, consumer information has become a core element of consumer protection for the Federal Office of Consumer Protection and Food Safety (Bundesamt für Verbraucherschutz and Lebensmittelsicherheit, BVL). State authorities are provided with new means of communication and interaction with consumers.

Incentives of Health Care Expenditure

Directory of Open Access Journals (Sweden)

Eero Siljander

2012-12-01

Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

Energy intensity ratios as net energy measures of United States energy production and expenditures

International Nuclear Information System (INIS)

King, C W

2010-01-01

In this letter I compare two measures of energy quality, energy return on energy invested (EROI) and energy intensity ratio (EIR) for the fossil fuel consumption and production of the United States. All other characteristics being equal, a fuel or energy system with a higher EROI or EIR is of better quality because more energy is provided to society. I define and calculate the EIR for oil, natural gas, coal, and electricity as measures of the energy intensity (units of energy divided by money) of the energy resource relative to the energy intensity of the overall economy. EIR measures based upon various unit prices for energy (e.g. $/Btu of a barrel of oil) as well as total expenditures on energy supplies (e.g. total dollars spent on petroleum) indicate net energy at different points in the supply chain of the overall energy system. The results indicate that EIR is an easily calculated and effective proxy for EROI for US oil, gas, coal, and electricity. The EIR correlates well with previous EROI calculations, but adds additional information on energy resource quality within the supply chain. Furthermore, the EIR and EROI of oil and gas as well as coal were all in decline for two time periods within the last 40 years, and both time periods preceded economic recessions.

Energy Expenditure in Rock/Pop Drumming

OpenAIRE

De La Rue, S; Draper, Stephen B; Potter, Christopher R; Smith, M.

2013-01-01

Despite the vigorous nature of rock/pop drumming, there are no precise data on the energy expenditure of this activity. The aim of this study was to quantify the energy cost of rock/pop drumming. Fourteen male drummers (mean +/- SD; age 27 +/- 8 yrs.) completed an incremental drumming test to establish the relationship between energy expenditure and heart rate for this activity and a ramped cycle ergometer test to exhaustion as a criterion measure for peak values (oxygen uptake and heart rate...

Health Care Expenditure of Rural Households in Pondicherry, India

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Poornima Varadarajan

2013-11-01

Full Text Available Background: Shortcomings in healthcare delivery has led people to spend a substantial proportion of their incomes on medical treatment. World Health Organization (2005 estimates reveal that every year 25 million households are forced into poverty by illness and the struggle to pay for healthcare. Thus we planned to calculate the health care expenditure of rural households and to assess the households incurring catastrophic health expenditure. Methods: A cross-sectional study was conducted in the service area of Sri Manakula Vinayagar Medical College and Hospital from May to August 2011. A total of 100 households from the 4 adjoining villages of our Institute were selected for operational and logistic feasibility. The household’s capacity to pay, out of pocket expenditure and catastrophic health expenditure were calculated. Data collection was done using a pretested questionnaire by the principal investigator and the analysis was done using SPSS (version 16. Results: The average income in the highest income quintile was Rs 51,885 but the quintile ratio was 14.98. The median subsistence expenditure was Rs 4,520. About 18% of households got impoverished paying for health care. About 81% of households were incurring out of pocket expenditure and 66% were facing catastrophic health expenses of 40%.Conclusion There was very high out of pocket spending and a high prevalence of catastrophic expenditure noted. Providing quality care at affordable cost and appropriate risk pooling mechanism are warranted to protect households from such economic threats.

Gasto de hogares durante la hospitalización de menores derechohabientes, con diagnóstico de leucemia, en dos hospitales en México Out-of-pocket expenditures during hospitalization of young leukemia patients with state medical insurance in two Mexican hospitals

Directory of Open Access Journals (Sweden)

Arnoldo Rocha-García

2003-08-01

two hospitals of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social -IMSS-. MATERIAL AND METHODS: A cross-sectional study was conducted in Mexico City and Leon, Guanajato, Mexico in 1997. The study population consisted of the parents of 51 children under 15 years of age diagnosed with leukemia, who were hospitalized for the first time in two IMSS hospitals. A questionnaire was applied to participants to obtain direct and indirect expenditures during that period. Consumer price indexes (1997-2002 were used to estimate expenditure prices for 2002. Average expenditures and catastrophic expenditures were estimated. Factors associated with expenditures were analyzed using a linear regression model in which the dependent variable was the total household expenditures during hospitalization. RESULTS: The average household cost per hospitalization was 7 318 pesos, 86% of which corresponded to medical care and 14% to indirect costs. Catastrophic expenditures occurred in 14% of households. In 47% of household expenditures exceeded 100% of the total household income during the hospitalization period. Expenditures during hospitalization were associated with place of residence, income level, and type of medical insurance. CONCLUSIONS: Being an IMSS policyholder decreased out-of-pocket expenditures, but not complementary expenditures, which may still be unaffordable for a large segment of the population. For more than a half of the households studied, continuity of care was compromised, as expenditures during the first hospitalization entailed using up savings, going into debt, and/or selling household property.

Comparative Analysis of the Consumer Protection, Considering the Globalisation and Technological Changes, within Member States of the European Union

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Iulian Viorel Braşoveanu

2014-05-01

Full Text Available Recent globalization and technological changes have produced significant changes in consumption patterns, shopping online becoming increasingly more important. Under these conditions, in this article we analyze the most important issues relating to the level and quality of consumer protection in the European Union countries for the period 2008-2012 . In this article we aimed to analyze the most important issues related to the level and quality of consumer protection in European Union 27 countries in the period 2008-2012. For this scope, we have chosen the most important five consumer indicators, which are the components of the Consumer Conditions Index, which provide information on both the level and the quality of consumer protection: the protection perceived by consumers (feeling protected as a consumer, illicit commercial practices, the product safety, the consumer complaints, and the redress measures. Initial data were collected from the European Commission for each Member State of the European Union 27, for the last five years, from 2008 to 2012. We have used statistical and econometric methods. For the year 2012, using the selected indicators, we have presented the descriptive statistics in order to observe their caracteristics, we have analysed the correlation matrix and we have determined the structure of four clusters, which reveals common features of countries in each cluster. In order to capture the impact of the variables illegal commercial practices and redress measures on the dependent variable protection perceived by the consumers, we have realized panel regressions with cross-section fixed effects, using data for the period 2008-2012. Also for this period, comparative statistical analyzes were performed (average, minimum, maximum, trend between Member States. The results reflect the correlations between the analyzed indicators during the period 2008-2012, and a comprehensive scan of how these indicators developed in territorial

Determinants of cruise passengers’ expenditures in the port of call

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Maršenka Marksel

2016-12-01

Full Text Available Cruise tourism generates different types of cruise consumption and related indirect, direct and induced expenditure effects, in homeports as well as in ports of call. Cruise passengers’ expenditures produce positive economic effects for destinations, from increasing the incomes and employment, to tax incomes, duties, etc. Therefore, it is no doubt that cruise stakeholders and local economies can benefit from increased cruise passenger consumption. To stimulate higher consumption and passengers’ satisfaction, it is necessary to design the supportive policy framework and build appropriate quality of products and services. Identifying influential variables of cruise passengers’ expenditures in this sense enables the design of appropriate policies and measures. In the current research, based on a survey of 357 cruise passengers, several variables included in a new theoretical model of the expenditures determinants, such as gender, nationality, frequency of cruising and frequency of visits, were found to be statistically significantly associated with cruise passengers’ expenditures. Several conclusions and suggestions to stimulate cruise passenger expenditures based on research findings are provided.

On the nature and properties of appeals used in direct-to-consumer advertising of prescription drugs.

Science.gov (United States)

Pinto, M B

2000-04-01

The past decade has seen a steady rise in expenditures for direct-to-consumer pharmaceutical advertising. While total revenues across all media are approaching the $1 billion dollar mark, surprisingly little is known about the effectiveness of these types of advertisements, including the appropriateness of various forms of emotional and informational appeal. A content analysis of direct-to-consumer advertising in 24 popular magazines shows that these advertisements are found in every category of magazine, the advertisements employ a mix of informational and emotional appeals, all types of emotional appeals are used, and to date, the type of appeal (emotional and/or informational) tends not to be based on the type of drug advertised. Implications of this content analysis are considered and directions for research on appeals used in direct-to-consumer advertising are suggested.

Half the Nation's R&D Concentrated in Six States. InfoBrief.

Science.gov (United States)

Bennof, Richard J.

This document presents research and development (R&D) expenditures reported by state based on data from the year 1999 in the United States. Information includes R&D expenditures by state, sector distribution of R&D performance by state, ratio of R&D to gross state product, and federal support for R&D by state. (YDS)

Local Health Department Food Safety and Sanitation Expenditures and Reductions in Enteric Disease, 2000–2010

Science.gov (United States)

Yip, Michelle Pui-Yan; Dunbar, Matthew D.; Whitman, Greg; Kwan-Gett, Tao

2015-01-01

Objectives. In collaboration with Public Health Practice–Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. Methods. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000–2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. Results. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Conclusions. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking. PMID:25689186

Convergence and determinants of health expenditures in OECD countries.

Science.gov (United States)

Nghiem, Son Hong; Connelly, Luke Brian

2017-08-17

This study examines the trend and determinants of health expenditures in OECD countries over the 1975-2004 period. Based on recent developments in the economic growth literature we propose and test the hypothesis that health care expenditures in countries of similar economic development level may converge. We hypothesise that the main drivers for growth in health care costs include: aging population, technological progress and health insurance. The results reveal no evidence that health expenditures among OECD countries converge. Nevertheless, there is evidence of convergence among three sub-groups of countries. We found that the main driver of health expenditure is technological progress. Our results also suggest that health care is a (national) necessity, not a luxury good as some other studies in this field have found.

Postprandial energy expenditure in whole-food and processed-food meals: implications for daily energy expenditure

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Sadie B. Barr

2010-07-01

Full Text Available Background: Empirical evidence has shown that rising obesity rates closely parallel the increased consumption of processed foods (PF consumption in USA. Differences in postprandial thermogenic responses to a whole-food (WF meal vs. a PF meal may be a key factor in explaining obesity trends, but currently there is limited research exploring this potential link. Objective: The goal was to determine if a particular PF meal has a greater thermodynamic efficiency than a comparable WF meal, thereby conferring a greater net-energy intake. Design: Subjective satiation scores and postprandial energy expenditure were measured for 5–6 h after isoenergetic meals were ingested. The meals were either ‘whole’ or ‘processed’ cheese sandwiches; multi-grain bread and cheddar cheese were deemed whole, while white bread and processed cheese product were considered processed. Meals were comparable in terms of protein (15–20%, carbohydrate (40–50%, and fat (33–39% composition. Subjects were healthy women (n=12 and men (n=5 studied in a crossover design. Results: There were no significant differences in satiety ratings after the two meals. Average energy expenditure for the WF meal (137±14.1 kcal, 19.9% of meal energy was significantly larger than for the PF meal (73.1±10.2 kcal, 10.7% of meal energy. Conclusion: Ingestion of the particular PF meal tested in this study decreases postprandial energy expenditure by nearly 50% compared with the isoenergetic WF meal. This reduction in daily energy expenditure has potential implications for diets comprised heavily of PFs and their associations with obesity.

FDA direct-to-consumer advertising for prescription drugs: what are consumer preferences and response tendencies?

Science.gov (United States)

Khanfar, Nile; Loudon, David; Sircar-Ramsewak, Feroza

2007-01-01

The effect of direct-to-consumer (DTC) television advertising of prescription medications is a growing concern of the United States (U.S.) Congress, state legislatures, and the Food and Drug Administration (FDA). This research study was conducted in order to examine consumers' perceived preferences of DTC television advertisement in relation to "reminder" "help-seeking," and "product-claim" FDA-approved advertisement categories. An additional objective was to examine the influence of DTC television advertising of prescription drugs on consumers' tendency to seek more information about the medication and/or the medical condition. The research indicates that DTC television drug ads appear to be insufficient for consumers to make informed decisions. Their mixed perception and acceptance of the advertisements seem to influence them to seek more information from a variety of medical sources.

EU pharmaceutical expenditure forecast.

Science.gov (United States)

Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

2014-01-01

With constant incentives for healthcare payers to contain their pharmaceutical budgets, forecasting has become critically important. Some countries have, for instance, developed pharmaceutical horizon scanning units. The objective of this project was to build a model to assess the net effect of the entrance of new patented medicinal products versus medicinal products going off-patent, with a defined forecast horizon, on selected European Union (EU) Member States' pharmaceutical budgets. This model took into account population ageing, as well as current and future country-specific pricing, reimbursement, and market access policies (the project was performed for the European Commission; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). In order to have a representative heterogeneity of EU Member States, the following countries were selected for the analysis: France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. A forecasting period of 5 years (2012-2016) was chosen to assess the net pharmaceutical budget impact. A model for generics and biosimilars was developed for each country. The model estimated a separate and combined effect of the direct and indirect impacts of the patent cliff. A second model, estimating the sales development and the risk of development failure, was developed for new drugs. New drugs were reviewed individually to assess their clinical potential and translate it into commercial potential. The forecast was carried out according to three perspectives (healthcare public payer, society, and manufacturer), and several types of distribution chains (retail, hospital, and combined retail and hospital). Probabilistic and deterministic sensitivity analyses were carried out. According to the model, all countries experienced drug budget reductions except Poland (+€41 million). Savings were expected to be the highest in the United Kingdom (-€9,367 million), France (-€5,589 million), and, far behind them

Price elasticity of expenditure across health care services.

Science.gov (United States)

Duarte, Fabian

2012-12-01

Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled from administrative records from the Chilean private health insurance market, I estimate the price elasticity of expenditures across a variety of health care services. I find elasticities that range between zero for the most acute service (appendectomy) and -2.08 for the most elective (psychologist visit). Moreover, the results show that at least one third of the elasticity is explained by the number of visits; the rest is explained by the intensity of each visit. Finally, I find that high-income individuals are five times more price sensitive than low-income individuals and that older individuals are less price-sensitive than young individuals. Copyright © 2012 Elsevier B.V. All rights reserved.

Multiple Sclerosis and Catastrophic Health Expenditure in Iran.

Science.gov (United States)

Juyani, Yaser; Hamedi, Dorsa; Hosseini Jebeli, Seyede Sedighe; Qasham, Maryam

2016-09-01

There are many disabling medical conditions which can result in catastrophic health expenditure. Multiple Sclerosis is one of the most costly medical conditions through the world which encounter families to the catastrophic health expenditures. This study aims to investigate on what extent Multiple sclerosis patients face catastrophic costs. This study was carried out in Ahvaz, Iran (2014). The study population included households that at least one of their members suffers from MS. To analyze data, Logit regression model was employed by using the default software STATA12. 3.37% of families were encountered with catastrophic costs. Important variables including brand of drug, housing, income and health insurance were significantly correlated with catastrophic expenditure. This study suggests that although a small proportion of MS patients met the catastrophic health expenditure, mechanisms that pool risk and cost (e.g. health insurance) are required to protect them and improve financial and access equity in health care.

Analysis of hospitalization expenditures and influencing factors for inpatients with coronary heart disease in a tier-3 hospital in Xi'an, China: A retrospective study.

Science.gov (United States)

Ding, Jing-Mei; Zhang, Xian-Zhi; Hu, Xue-Jun; Chen, Huo-Liang; Yu, Min

2017-12-01

The medical costs for inpatients with coronary heart disease (CHD) have risen to unprecedented levels, putting tremendous financial pressure on their families and the entire society. The objective of this study was to examine the actual direct medical costs of inpatients with CHD and to analyze the influencing factors of those costs, to provide advice on the prevention and control of high medical costs of patients with CHD. A retrospective descriptive analysis of hospitalization expenditures data examined 10,301 inpatients with coronary heart disease of a tier-3 hospital in Xi'an from January 1, 2015 to December 31, 2015. The data included demographic information, the average length of stay, and different types of expenses incurred during the hospitalization period. The difference between different groups was analyzed using a univariate analysis, and the influencing factors of hospitalization expenditures were explored by the multiple linear stepwise regression analysis. The average age of these patients was 60.0 years old, the average length of stay was 4.0 days, and the majority were males (7172, 69.6%). The average hospitalization expenses were $6791.38 (3294.16-9, 732.59), and the top 3 expenses were medical consumables, operation fees, and drugs. The influencing factors of hospitalization expenditures included the length of stay, the number of times of admission, the type of medical insurance schemes, whether have a surgery or not, the gender, the age, and the marriage status. The inpatients with CHD in this tier-3 hospital were mostly over 45 years old. The average medical cost of males was much higher than that of females. Our findings suggest that the solution for tremendous hospitalization expenditures should be that more attention is paid to controlling the high expense of medical consumables and that the traditional method of reducing medical expenses by shortening the length of stay is still important in nowadays. Furthermore, the type of medical

Health care expenditure in the Islamic Republic of Iran versus other high spending countries.

Science.gov (United States)

Khosravi, Bahman; Soltani, Shahin; Javan-Noughabi, Javad; Faramarzi, Ahmad

2017-01-01

Background: In all countries, health expenditures are a main part of government expenditure, and governments try to find policies and strategies to reduce this expenditure. Overall expenditure index has been raised 30 times during the past 20 years in Iran, while in the health sector, the growth in health expenditures index has been 71 times. The present study aimed at examining health care expenditure in the Islamic Republic of Iran versus other high spending countries. Methods: A comparative panel study was conducted in selected countries with the high mean of health expenditure per capita. Data were collected from the WORLD BANK. Out- of- pocket (OOP), health expenditure per capita, public and private health expenditure, and total health expenditure were compared among the selected counties. Results: Iran has the lowest health expenditure per capita compared to other countries and the USA has the highest health expenditures per capita. In Iran, out- of- pocket expenditure, with more than 50%, was the most cost, while in Luxembourg it was the least cost during 2004 to 2014, with less than 12%. Conclusion: Our findings revealed that politicians and health care executives should find a stable source to finance the health system. Stable sources of financing lead to having a steady trend in health expenditure.

Highway Expenditures and Associated Customer Satisfaction: A Case Study

Directory of Open Access Journals (Sweden)

Alexander Paz

2016-01-01

Full Text Available This study analyzes the satisfaction of the Nevadans with respect to their highway transportation system and the corresponding expenditures of Nevada Department of Transportation (NDOT. A survey questionnaire was designed to capture the opinions of the Nevadans (customers about a number of characteristics of their transportation system. Data from the financial data warehouse of the NDOT was used to evaluate expenditures. Multinomial probit models were estimated to study the correlations between customers’ opinion and the government expenditures in transportation. The results indicate the customer satisfaction is decreasing with respect to traffic safety throughout Northwestern and Southern Nevada highways. In addition, users of Northwestern highways are more likely to be satisfied, compared to their counterparts, with increasing construction spending to reduce the time taken to complete construction projects. In Southern Nevada highways, customers’ satisfaction increases with the expenditures associated with reduction of congestion. These insights are examples of the conclusions that were obtained as a consequence of simultaneously considering customer satisfaction and the corresponding expenditures in transportation.

Is Wagner’s theory relevant in explaining health expenditure dynamics in Botswana?

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Kunofiwa Tsaurai

2014-11-01

Full Text Available This study tests the relevance of the Wagner’s theory in explaining the health expenditure in Botswana. There is no consensus yet when it comes to the causality relationship between health expenditure and economy. At the moment, there are four dominant schools of thought explaining the causality relationship between health expenditure and economy. The first school of thought is that health expenditure spurs the economy whilst the second school of thought says that the economy drives health expenditure. The third school of thought maintains that there is a feedback effect between health expenditure and the economy whilst the fourth mentions that there is no causality at all between the two variables. However, this study found out that there is no causality relationship between health expenditure and GDP in Botswana thereby dismissing the relevance of the Wagner’s theory.

The retail market for electric power. Competition and consumer analysis; Denmark; Detailmarkedet for elektricitet. Konkurrence- og forbrugeranalyse

Energy Technology Data Exchange (ETDEWEB)

2011-12-15

The Danish Competition and Consumer Authority has examined the market for electricity to consumers. It is a market that has great importance for the Danish consumers, and it is a market where competition could make a difference for consumers, businesses and the settlement of the Danish climate objectives. An average Danish household spends over DKK 7,000 a year on electricity. Average household expenditures for electricity will probably increase with the electric cars and electric-powered heat pumps will constitute a larger share of the Danish electricity consumption in the future. Simultaneously, the electricity market is difficult to understand for consumers, and there is generally a weak market competition. The analyses in this report show that there is a large untapped potential for economic gains through innovation, increased competition and a more efficient use of resources in the electricity sector. A realization of the potential for economic gains can be beneficial to consumers, businesses and environment. If the potential for economic gains is to be realized, it is necessary to change the regulation of the market. (LN)

The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

OpenAIRE

Phillips, Charles D.

2015-01-01

Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large sta...

Predictors of regional Medicare expenditures for otolaryngology physician services.

Science.gov (United States)

Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N

2017-06-01

To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society

ENERGY EXPENDITURE AND INTENSITY OF PHYSICAL ACTIVITY IN SOCCER REFEREES DURING MATCH-PLAY

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Alberto Inácio da Silva

2008-09-01

Full Text Available The aim of this study was to determine the caloric expenditure and the intensity of physical activities performed by official soccer referees during a match expressed in Metabolic Equivalent (METs. The physical activity of referees accredited by CBF (Brazilian Confederation of Soccer was video-recorded during twenty-nine official games of Paraná Championship (Brasil, Series A and B of the 2005/2006. Computerized video analysis was used to determine the time spent in 6 locomotor activities (standing still, walking, jogging, backwards running, running and sprint. The frequency and duration of each activity were recorded and these data were utilized to calculate the distance covered by the referee. Energy expenditure values were estimated, utilizing specific equations, from the time players spent in each motor activity. The referees observed in this study had a mean age of 38.9 ± 3.8 years, body mass of 86.1 ± 7.1 kg, stature of 1.80 ± 0.07 m and a body mass index of 26.5 ± 0.6 kg·m-2. During match-play, referees covered an average distance of 9155.4 ± 70.3 meters (8411 - 9765, with a mean energy expenditure of 734.7 ± 65 kcal. This energy expenditure was significantly reduced in the second half: 359.9 ± 6.3 vs 374.7 ± 6.6 kcal (p = 0.006, and averaged to be moderate energy intensity (5 METs with predominant utilization of the aerobic energy system. In total, during 67% of match-play the intensity was equal or lower than 3.8 METs and in 33% it was higher than 9.8 METs. The pattern of movement observed in the present study confirms that soccer refereeing may be considered as a highly intermittent exercise mode. The high to low-intensity activity ratio may be defined as 1:7.1. In conclusion, referees officiating in professional soccer matches in Brazil should perform a physical conditioning regime that provides the stamina required at this level and consume appropriate and adequate nutrition to meet the energetic demands for match-play

Activity limitations predict health care expenditures in the general population in Belgium.

Science.gov (United States)

Van der Heyden, Johan; Van Oyen, Herman; Berger, Nicolas; De Bacquer, Dirk; Van Herck, Koen

2015-03-19

Disability and chronic conditions both have an impact on health expenditures and although they are conceptually related, they present different dimensions of ill-health. Recent concepts of disability combine a biological understanding of impairment with the social dimension of activity limitation and resulted in the development of the Global Activity Limitation Indicator (GALI). This paper reports on the predictive value of the GALI on health care expenditures in relation to the presence of chronic conditions. Data from the Belgian Health Interview Survey 2008 were linked with data from the compulsory national health insurance (n = 7,286). The effect of activity limitation on health care expenditures was assessed via cost ratios from multivariate linear regression models. To study the factors contributing to the difference in health expenditure between persons with and without activity limitations, the Blinder-Oaxaca decomposition method was used. Activity limitations are a strong determinant of health care expenditures. People with severe activity limitations (5.1%) accounted for 16.9% of the total health expenditure, whereas those without activity limitations (79.0%), were responsible for 51.5% of the total health expenditure. These observed differences in health care expenditures can to some extent be explained by chronic conditions, but activity limitations also contribute substantially to higher health care expenditures in the absence of chronic conditions (cost ratio 2.46; 95% CI 1.74-3.48 for moderate and 4.45; 95% CI 2.47-8.02 for severe activity limitations). The association between activity limitation and health care expenditures is stronger for reimbursed health care costs than for out-of-pocket payments. In the absence of chronic conditions, activity limitations appear to be an important determinant of health care expenditures. To make projections on health care expenditures, routine data on activity limitations are essential and complementary to data

Trends in Australian government health expenditure by age: a fiscal incidence analysis.

Science.gov (United States)

Tapper, Alan; Phillimore, John

2014-11-01

Australian government health expenditure per capita has grown steadily across the past few decades, but little is known about trends in the age distribution of health expenditure. In this paper, the Australian Bureau of Statistics (ABS) fiscal incidence studies, which track expenditure at the household level between 1984 and 2010, are used to shed light on this topic. The main finding was that spending has shifted focus from the younger half to the older half of the population. This shift is evident in three areas: (1) acute care (hospitals); (2) community health services (doctors); and (3) pharmaceuticals. Together, these areas account for approximately 88% of expenditure. The trend is independent of demographic aging. It is unlikely to reflect changes in population health. Its explanation is open to debate. Growth in expenditure per household has been more than threefold faster for elderly than young households. Across this period, expenditure per household per week has increased by 51% for the young, by 79% for the middle aged and by 179% for the elderly. This age-related growth is most prominent in expenditure on acute care, community health services and pharmaceuticals. WHAT IS KNOWN ABOUT THE TOPIC?: The Productivity Commission has published figures that relate age and Australian heath expenditure. However, there has been no published study of age-related trends in Australian health expenditure. WHAT DOES THIS PAPER ADD?: In addition to tracking age-related trends across 26 years, this paper adds a breakdown of those trends into four categories of expenditure, namely acute care, community health services, pharmaceutical benefits, and other. This breakdown shows that the trends vary by expenditure type. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS?: The paper shows that forward projections in health expenditure need to take into account age-related trends as well as demographic trends.

Physical activity, sleep pattern and energy expenditure in double-handed offshore sailing.

Science.gov (United States)

Galvani, C; Ardigò, L P; Alberti, M; Daniele, F; Capelli, C

2015-12-01

The aim of the present study was to quantify total energy expenditure, activity energy expenditure and time spent at three levels of physical activity (low, moderate, high intensity) in four two-person crews during a 500-mile double-handed sailing regatta. Physical activity intensity and energy expenditure were assessed during a 500-nautical-mile double-handed offshore competition in eight male sailors (46.3±3.4 years; 180±13 cm; 85.4±12.5 kg). During the whole regatta, they wore an activity monitor that estimated energy expenditure and minutes spent at each level of intensity (sedentary, 6.0 METs). The sailors spent longer periods (Penergy expenditure was 14.26±1.89 MJ/day and the activity energy expenditure was 5.06±1.42 MJ/day. Activity energy expenditure was significantly correlated with total sleep time, boat speed, and distance covered each day (Penergy expenditure was more likely a consequence of the short and rare periods of sleep during the competition rather than of the bouts of moderate and vigorous physical activities.

Physical activity recommendations: an alternative approach using energy expenditure.

Science.gov (United States)

Mudd, Lanay M; Rafferty, Ann P; Reeves, Mathew J; Pivarnik, James M

2008-10-01

Most adults do not meet the American College of Sports Medicine and Centers for Disease Control and Prevention (ACSM/CDC) physical activity recommendations. Even fewer meet the more extreme Institute of Medicine (IOM) physical activity recommendations. Compliance with either recommendation has been conventionally assessed by combining frequencies and durations of self-reported activities. Leisure-time energy expenditure is a cumulative measure of activity that offers an alternative method of defining compliance. To calculate the leisure-time energy expenditure of adults complying with the ACSM/CDC or the IOM physical activity recommendations determined by conventional measures and to reexamine compliance with the IOM recommendation using energy expenditure criteria. National, cross-sectional data from the 2000 Behavioral Risk Factor Surveillance System determined the mode, frequency, and duration of up to two leisure-time activities performed by adults. Four mutually exclusive activity groups (Non-, Low-, ACSM/CDC-, and IOM-Active) were defined on the basis of frequencies and durations of reported activities. Leisure-time energy expenditure (kcal x kg(-1) x wk(-1)) was calculated per respondent. The energy expenditure threshold for meeting the IOM recommendation was calculated as 21 kcal x kg(-1) x wk(-1). Of the 162,669 respondents included in the analyses, 29.9% were Nonactive, whereas 42.3%, 23.3%, and 4.5% were Low-, ACSM/CDC-, and IOM-Active, respectively. Median leisure-time energy expenditure values were 9.0, 27.4, and 63.0 kcal x kg(-1) x wk(-1) for Low-, ACSM/CDC-, and IOM-Active groups, respectively. When using energy expenditure criteria, compliance with the IOM recommendation rose to 27.7% of respondents. Compliance with the IOM physical activity recommendation dramatically increased when assessed by energy expenditure compared with conventional criteria, thereby highlighting the potential bias of conventional methods. A significant proportion of adults

Exploring the impact of network tariffs on household electricity expenditures using load profiles and socio-economic characteristics

Science.gov (United States)

Azarova, Valeriya; Engel, Dominik; Ferner, Cornelia; Kollmann, Andrea; Reichl, Johannes

2018-04-01

Growing self-generation and storage are expected to cause significant changes in residential electricity utilization patterns. Commonly applied volumetric network tariffs may induce imbalance between different groups of households and their respective contribution to recovering the operating costs of the grid. Understanding consumer behaviour and appliance usage together with socio-economic factors can help regulatory authorities to adapt network tariffs to new circumstances in a fair way. Here, we assess the effects of 11 network tariff scenarios on household budgets using real load profiles from 765 households. Thus we explore the possibly disruptive impact of applying peak-load-based tariffs on the budgets of households when they have been mainly charged for consumed volumes before. Our analysis estimates the change in household network expenditure for different combinations of energy, peak and fixed charges, and can help to design tariffs that recover the costs needed for the sustainable operation of the grid.

Tax expenditures and the efficiency of Croatian value added tax

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Petar Sopek

2012-09-01

Full Text Available The main aim of this paper is to provide a systematic overview of value added taxation in Croatia along with main changes in relevant legislation and to estimate total amount of tax expenditures. Results show that the proportion of tax expenditures in GDP in Croatia in 2010 amounted to less than 4%, a proportion lower than in any of the EU new member states, as well as almost twice as low as the EU-27 average. It can be concluded that the Croatian value added taxation system is efficient in this way, as was additionally shown by an analysis according to which Croatia in 2010 had better efficiency indicators than all the observed EU member states. The Croatian VAT system is mainly harmonized with EU directives, but abolition of the zero rate is still expected; this will increase government revenue by approximately 0.4-0.8% of GDP, depending on a chosen scenario. It has been suggested that a detailed analysis of the overall value added taxation system should be initiated, with the aim of optimizing cost-benefits. The main focus should be placed on the determination of the optimal VAT registration threshold, the costs and benefits of the introduced reliefs and exemptions in the tax system and the potential effects of the repeal of the zero rate.

Factors Affecting Tourist Expenditure Coming To Mugla Region

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Fehime Korkmaz Bingöl

2012-12-01

Full Text Available Increasing tourist expenditure is a means to increase tourism income, which is extremely important for local economies. The purpose of this study is to understand the expending pattern of tourists coming to Mugla Region and provide empirical background for the policies to increase per tourist expenditure. The survey conducted at Dalaman International Airport and the data has been analyzed using OLS method. Nationality, age, accommodation type, pension type, credit card usage, availability of shopping facilities, standard of night life and entertainment, quality of food and beverage, length of holiday and group size has been found as significant factors affecting tourist expenditure

Assessment of physical activity and energy expenditure: an overview of objective measures

Directory of Open Access Journals (Sweden)

Andrew P Hills

2014-06-01

Full Text Available The ability to assess energy expenditure and estimate physical activity in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity and diabetes. It is also important to appreciate that physical activity and energy expenditure are different constructs with physical activity defined as any bodily movement that results in energy expenditure and accordingly, energy is expended as a result of physical activity. However, total energy expenditure, best assessed using the criterion doubly labelled water technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate physical activity in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of physical activity and their relationship with energy expenditure. The measures discussed include those based on energy expenditure or oxygen uptake including doubly labelled water, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.

Heart rate during basketball game play and volleyball drills accurately predicts oxygen uptake and energy expenditure.

Science.gov (United States)

Scribbans, T D; Berg, K; Narazaki, K; Janssen, I; Gurd, B J

2015-09-01

There is currently little information regarding the ability of metabolic prediction equations to accurately predict oxygen uptake and exercise intensity from heart rate (HR) during intermittent sport. The purpose of the present study was to develop and, cross-validate equations appropriate for accurately predicting oxygen cost (VO2) and energy expenditure from HR during intermittent sport participation. Eleven healthy adult males (19.9±1.1yrs) were recruited to establish the relationship between %VO2peak and %HRmax during low-intensity steady state endurance (END), moderate-intensity interval (MOD) and high intensity-interval exercise (HI), as performed on a cycle ergometer. Three equations (END, MOD, and HI) for predicting %VO2peak based on %HRmax were developed. HR and VO2 were directly measured during basketball games (6 male, 20.8±1.0 yrs; 6 female, 20.0±1.3yrs) and volleyball drills (12 female; 20.8±1.0yrs). Comparisons were made between measured and predicted VO2 and energy expenditure using the 3 equations developed and 2 previously published equations. The END and MOD equations accurately predicted VO2 and energy expenditure, while the HI equation underestimated, and the previously published equations systematically overestimated VO2 and energy expenditure. Intermittent sport VO2 and energy expenditure can be accurately predicted from heart rate data using either the END (%VO2peak=%HRmax x 1.008-17.17) or MOD (%VO2peak=%HRmax x 1.2-32) equations. These 2 simple equations provide an accessible and cost-effective method for accurate estimation of exercise intensity and energy expenditure during intermittent sport.

11 CFR 110.20 - Prohibition on contributions, donations, expenditures, independent expenditures, and...

Science.gov (United States)

2010-01-01

... participate in the decision-making process of any person, such as a corporation, labor organization, political... activities, such as decisions concerning the making of contributions, donations, expenditures, or... party for the purchase or construction of an office building. See 11 CFR 300.10 and 300.35. (e...

Poison politics: a contentious history of consumer protection against dangerous household chemicals in the United States.

Science.gov (United States)

Jones, Marian Moser; Benrubi, Isidore Daniel

2013-05-01

The history of consumer protection against household poisons presents a key case study of the uniquely American struggle to balance public health and safety with the interests of business. By the late 19th century, package designs, warning labels, and state statutes had formed an uneven patchwork of protective mechanisms against accidental poisonings. As household chemicals proliferated in the early 20th century, physicians concerned with childhood poisonings pressured the federal government to enact legislation mandating warning labels on packaging for these substances. Manufacturers of household chemicals agreed to labeling requirements for caustic poisons but resisted broader regulation. Accidental poisonings of children continued to increase until the enactment of broad labeling and packaging legislation in the 1960s and 1970s. This history suggests that voluntary agreements between government agencies and manufacturers are inadequate to protect consumers against household poisonings and that, in the United States, protective household chemical regulation proceeds in a reactive rather than a precautionary manner.

18 CFR 367.1880 - Account 188, Research, development, or demonstration expenditures.

Science.gov (United States)

2010-04-01

... 188, Research, development, or demonstration expenditures. (a) This account must be charged with the cost of all expenditures coming within the meaning of research, development and demonstration (RD&D) of..., development, and demonstration expenditures that are nonrecurring and that would distort the annual research...

Testing the stability of travel expenditures in Nigeria

International Nuclear Information System (INIS)

Osula, D.O.A.; Adebisi, O.

2001-01-01

A report is presented on a study carried out to develop a functional form for travel money expenditure in a Nigerian setting, and test its stability against energy policy change, specifically the fuel price increase of October 1994. The Box-Cox transformation regression approach was adopted in the modelling exercise in order to evolve a data-defined functional form and ensure a more rational basis for the stability test. The results of the modelling exercise show that while statistically significant functional forms were estimated for the 'before' and 'after' fuel price increase periods, the functional forms estimated are not stable across the periods. Thus 'travel budget' is as yet not usable as a term for travel expenditures in Nigeria. The implication of this for travel demand modelling in Nigeria is that, at least till other evidences prove otherwise, there is as yet no basis for using the 'Universal Mechanism of Travel' model developed by Zahavi (The UMOT Project. Report No. DOT-RSPA-DPB-20-79-3; The UMOT Travel Model II Report No. DOT-RSPA-DPB-50-82-11). Of disposable income and total expenditure, the former has proved to be more appropriate for use as 'available money' for the estimation of travel expenditures in Nigeria in the 'before' energy policy change period, while total expenditure proved appropriate in the 'after' period. (author)

11 CFR 9035.1 - Campaign expenditure limitation; compliance and fundraising exemptions.

Science.gov (United States)

2010-01-01

... 11 Federal Elections 1 2010-01-01 2010-01-01 false Campaign expenditure limitation; compliance and... ELECTION CAMPAIGN FUND: PRESIDENTIAL PRIMARY MATCHING FUND EXPENDITURE LIMITATIONS § 9035.1 Campaign... campaign for nomination, which expenditures, in the aggregate, exceed $10,000,000 (as adjusted under 2 U.S...

Análisis del gasto en salud reproductiva en México, 2003 Analysis of reproductive health expenditures in Mexico, 2003

Directory of Open Access Journals (Sweden)

Lucero Cahuana-Hurtado

2006-11-01

estimate reproductive health expenditures in Mexico during 2003; analyze how costs were distributed across the main programs, funding entities, and providers of health goods and services; and evaluate the relationship between reproductive health expenditures and economic indicators in different states, using health accounts methods. METHODS: We estimated reproductive health expenditures between January and December 2003, at the national and state level. We used health accounts methods adjusted for the particular characteristics of Mexico on the basis of information from public and private sources. Expenditures were calculated for the four main reproductive health programs (maternal-perinatal health, family planning, cervical and uterine cancer, and breast cancer according to different funding entities, goods and services providers, and functions of health care, in both the public and private sector. We estimated public expenditures by state per beneficiary, and analyzed how these costs were related with pubic health care expenditures and annual per capita gross domestic product (GDP for each state. RESULTS: The reproductive health expenditures in Mexico during the year 2003 were US$ 2.912 6 billion, a figure that represented 0.5% of the national GDP in 2003 and slightly more than 8% of the total health care expenditures. Costs were higher for public entities (53.5% than for private entities (46.5%. The maternal-perinatal health program accounted for the highest costs, mainly from deliveries and complications; direct payments from households accounted for nearly 50% of the total figure. Costs for family planning were accrued mainly in the public sector, and represented 5.9% of the total expenditure. Of the total spending on reproductive health, 7.9% was devoted to cervical and uterine cancer and breast cancer programs. Mean public expenditures on reproductive health per beneficiary were US$ 680.03, and differences between states were associated with differences in public

Automatic energy expenditure measurement for health science.

Science.gov (United States)

Catal, Cagatay; Akbulut, Akhan

2018-04-01

It is crucial to predict the human energy expenditure in any sports activity and health science application accurately to investigate the impact of the activity. However, measurement of the real energy expenditure is not a trivial task and involves complex steps. The objective of this work is to improve the performance of existing estimation models of energy expenditure by using machine learning algorithms and several data from different sensors and provide this estimation service in a cloud-based platform. In this study, we used input data such as breathe rate, and hearth rate from three sensors. Inputs are received from a web form and sent to the web service which applies a regression model on Azure cloud platform. During the experiments, we assessed several machine learning models based on regression methods. Our experimental results showed that our novel model which applies Boosted Decision Tree Regression in conjunction with the median aggregation technique provides the best result among other five regression algorithms. This cloud-based energy expenditure system which uses a web service showed that cloud computing technology is a great opportunity to develop estimation systems and the new model which applies Boosted Decision Tree Regression with the median aggregation provides remarkable results. Copyright © 2018 Elsevier B.V. All rights reserved.

Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State.

Science.gov (United States)

Ahmed, Selena; Byker Shanks, Carmen

2017-08-17

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores ( p vegetable TP scores ( p vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health.

The Effect of Corruption on Government Expenditure Allocation in OECD Countries

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Ondřej Jajkowicz

2015-01-01

Full Text Available This paper empirically examines the effect of corruption on the allocation of government expenditures by function. Equations using pooled panel dataset for 21 OECD countries between 1998 and 2011 were tested, and the findings show that government expenditure on defense and general public services increase, while government expenditures on education, health, recreation, culture and religion decline with higher levels of corruption. This paper presents new results and new evidence on the link between corruption and allocation of government expenditures in OECD countries.

All States Guide to Consumer Laws.

Science.gov (United States)

1986-09-01

control with the card issuer; - Is a franchised dealer in the card issuer’s products or services; or - Obtained the order for the transaction through...1973). Certificate of Title; Application for Certifi- plication for Certificate of Title and Registration. cafe of Ownership. TEXAS-TEX. REV. Civ. STAT...distribution, or b lease of any goods, including real estate and franchises , services or things of value. Most violations must involve consumer

Food Marketing Expenditures Aimed at Youth Putting the Numbers in Context

Science.gov (United States)

Powell, Lisa M.; Harris, Jennifer L.; Fox, Tracy

2013-01-01

In response to concerns about childhood obesity, the Federal Trade Commission (FTC) released two reports documenting food and beverage marketing expenditures to children and adolescents. The recently released 2012 report found an inflation-adjusted 19.5% reduction in marketing expenditures targeted to youth from $2.1 billion in 2006 to $1.8 billion in 2009. The current article highlights features of the FTC’s analysis, examines how expenditures relate to youth exposure to food marketing, and assesses changes in the nutritional content of marketed products. Of the $304.0 million decline in expenditures, $117.8 million (38.7%) was from a decline in premium (i.e., restaurant children’s meal toys) expenditures rather than direct marketing. Although inflation-adjusted TV expenditures fell by 19.4%, children and teens still see 12–16 TV advertisements (ads)/day for products generally high in saturated fat, sugar or sodium. In addition, newer digital forms of unhealthy food and beverage marketing to youths are increasing; the FTC reported an inflation-adjusted 50.7% increase in new media marketing expenditures. The self-regulatory Children’s Food and Beverage Advertising Initiative (CFBAI) is limited in scope and effectiveness: expenditures increased for many noncovered marketing techniques (i.e., product placement, movie/video, cross-promotion licenses, athletic sponsorship, celebrity fees, events, philanthropy, and other); only two restaurants are members of CFBAI, and nonpremium restaurant marketing expenditures were up by $86.0 million (22.5% inflation-adjusted increase); industry pledges do not protect children aged >11 years, and some marketing appears to have shifted to older children; and, nutritional content remains poor. Continued monitoring of and improvements to food marketing to youth are needed. PMID:24050422

Food marketing expenditures aimed at youth: putting the numbers in context.

Science.gov (United States)

Powell, Lisa M; Harris, Jennifer L; Fox, Tracy

2013-10-01

In response to concerns about childhood obesity, the Federal Trade Commission (FTC) released two reports documenting food and beverage marketing expenditures to children and adolescents. The recently released 2012 report found an inflation-adjusted 19.5% reduction in marketing expenditures targeted to youth from $2.1 billion in 2006 to $1.8 billion in 2009. The current article highlights features of the FTC's analysis, examines how expenditures relate to youth exposure to food marketing, and assesses changes in the nutritional content of marketed products. Of the $304.0 million decline in expenditures, $117.8 million (38.7%) was from a decline in premium (i.e., restaurant children's meal toys) expenditures rather than direct marketing. Although inflation-adjusted TV expenditures fell by 19.4%, children and teens still see 12-16 TV advertisements (ads)/day for products generally high in saturated fat, sugar, or sodium. In addition, newer digital forms of unhealthy food and beverage marketing to youths are increasing; the FTC reported an inflation-adjusted 50.7% increase in new media marketing expenditures. The self-regulatory Children's Food and Beverage Advertising Initiative (CFBAI) is limited in scope and effectiveness: expenditures increased for many noncovered marketing techniques (i.e., product placement, movie/video, cross-promotion licenses, athletic sponsorship, celebrity fees, events, philanthropy, and other); only two restaurants are members of CFBAI, and nonpremium restaurant marketing expenditures were up by $86.0 million (22.5% inflation-adjusted increase); industry pledges do not protect children aged >11 years, and some marketing appears to have shifted to older children; and, nutritional content remains poor. Continued monitoring of and improvements to food marketing to youth are needed. © 2013 American Journal of Preventive Medicine.

Medical Expenditures and Earnings Losses Among US Adults With Arthritis in 2013.

Science.gov (United States)

Murphy, Louise B; Cisternas, Miriam G; Pasta, David J; Helmick, Charles G; Yelin, Edward H

2018-06-01

We estimated the economic impact of arthritis using 2013 US Medical Expenditure Panel Survey (MEPS) data. We calculated arthritis-attributable and all-cause medical expenditures for adults age ≥18 years and arthritis-attributable earnings losses among those ages 18-64 years who had ever worked. We calculated arthritis-attributable costs using multistage regression-based methods, and conducted sensitivity analyses to estimate costs for 2 other arthritis definitions in MEPS. In 2013, estimated total national arthritis-attributable medical expenditures were $139.8 billion (range $135.9-$157.5 billion). Across expenditure categories, ambulatory care expenditures accounted for nearly half of arthritis-attributable expenditures. All-cause expenditures among adults with arthritis represented 50% of the $1.2 trillion national medical expenditures among all US adults in MEPS. Estimated total national arthritis-attributable earning losses were $163.7 billion (range $163.7-$170.0 billion). The percentage with arthritis who worked in the past year was 7.2 percentage points lower than those without arthritis (76.8% [95% confidence interval (95% CI)] 75.0-78.6 and 84.0% [95% CI 82.5-85.5], respectively, adjusted for sociodemographics and chronic conditions). Total arthritis-attributable medical expenditures and earnings losses were $303.5 billion (range $303.5-$326.9 billion). Total national arthritis-attributable medical care expenditures and earnings losses among adults with arthritis were $303.5 billion in 2013. High arthritis-attributable medical expenditures might be reduced by greater efforts to reduce pain and improve function. The high earnings losses were largely attributable to the substantially lower prevalence of working among those with arthritis compared to those without, signaling the need for interventions that keep people with arthritis in the workforce. © 2017, American College of Rheumatology.

Summary of expenditures of rebates from the low-level radioactive waste surcharge escrow account for calendar year 1993: Report to Congress

International Nuclear Information System (INIS)

1994-06-01

This is the eighth report submitted to Congress in accordance with section 5(d)(2)(E)(ii)(II) of the Low-Level Radioactive Waste Policy Act (the Act). This section of the Act directs the Department of Energy (DOE) to summarize the annual expenditures of funds disbursed from the DOE surcharge escrow account and to assess compliance of these expenditures with the following limitations specified in the Act: establish low-level radioactive waste disposal facilities; mitigate the impact of low-level radioactive waste disposal facilities on the host State; regulate low-level radioactive waste disposal facilities; or ensure the decommissioning, closure, and care during the period of institutional control of low-level radioactive waste disposal facilities. In addition to placing these limitations on the use of these funds, the Act also requires all nonsited compact regions and nonmember States to provide DOE with an itemized report of their expenditures on December 31 of each year in which funds are expended. Within six months after receiving the individual reports, the Act requires the Secretary of Energy to furnish Congress with a summary of the reported expenditures and an assessment of compliance with the specified usage limitations. This report fulfills that requirement

Estimating energy expenditure during front crawl swimming using accelerometers

DEFF Research Database (Denmark)

Nordsborg, Nikolai Baastrup; Espinosa, Hugo G.; Van Thiel, David H

2014-01-01

The determination of energy expenditure is of major interest in training load and performance assessment. Small, wireless accelerometer units have the potential to characterise energy expenditure during swimming. The correlation between absorbed oxygen versus flume swimming speed and absorbed oxy...

Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

Science.gov (United States)

Long, Qian; Xu, Ling; Bekedam, Henk; Tang, Shenglan

2013-06-13

China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000-2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990-2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick

Moving from Outsider to Insider: Peer Status and Partnerships between Electricity Utilities and Residential Consumers

Science.gov (United States)

Morris, Peter; Buys, Laurie; Vine, Desley

2014-01-01

An electricity demand reduction project based on comprehensive residential consumer engagement was established within an Australian community in 2008. By 2011, both the peak demand and grid supplied electricity consumption had decreased to below pre-intervention levels. This case study research explored the relationship developed between the utility, community and individual consumer from the residential customer perspective through qualitative research of 22 residential households. It is proposed that an energy utility can be highly successful at peak demand reduction by becoming a community member and a peer to residential consumers and developing the necessary trust, access, influence and partnership required to create the responsive environment to change. A peer-community approach could provide policymakers with a pathway for implementing pro-environmental behaviour for low carbon communities, as well as peak demand reduction, thereby addressing government emission targets while limiting the cost of living increases from infrastructure expenditure. PMID:24979234

78 FR 73753 - Partnerships; Start-Up Expenditures; Organization and Syndication Fees

Science.gov (United States)

2013-12-09

... deduct start-up expenditures in the taxable year in which the active trade or business begins. The amount... begins. All start-up expenditures that relate to the active trade or business are considered in...(b) to amortize start-up expenditures for the taxable year in which the active trade or business to...

Pharmaceutical expenditure on drugs for rare diseases in Canada: a historical (2007-13) and prospective (2014-18) MIDAS sales data analysis.

Science.gov (United States)

Divino, Victoria; DeKoven, Mitch; Kleinrock, Michael; Wade, Rolin L; Kim, Tony; Kaura, Satyin

2016-05-21

Health Canada has defined rare diseases as life-threatening, seriously debilitating, or serious chronic conditions affecting a very small number of patients (~1 in 2,000 persons). An estimated 9 % of Canadians suffer from a rare disease. Drugs treating rare diseases (DRDs) are also known as orphan drugs. While Canada is currently developing an orphan drug framework, in the United States (US), the Orphan Drug Act (ODA) of 1983 established incentives for the development of orphan drugs. This study measured total annual expenditure of orphan drugs in Canada (2007-13) and estimated future (2014-18) orphan drug expenditure. Orphan drugs approved by the US Food and Drug Administration (FDA) in the US were used as a proxy for the orphan drug landscape in Canada. Branded, orphan drugs approved by the FDA between 1983 through 2013 were identified (N = 356 unique products). Only US orphan drugs with the same orphan indication(s) approved in Canada were included in the analysis. Adjustment via an indication factoring was applied to products with both orphan and non-orphan indications using available data sources to isolate orphan-indication sales. The IMS Health MIDAS database of audited biopharmaceutical sales was utilized to measure total orphan drug expenditure, calculated annually from 2007-2013 and evaluated as a proportion of total annual pharmaceutical drug expenditure (adjusted to 2014 CAD). Between 2007 and 2013, expenditure was measured for a final N = 147 orphan drugs. Orphan drug expenditure totaled $610.2 million (M) in 2007 and $1,100.0 M in 2013, representing 3.3- 5.6 % of total Canadian pharmaceutical drug expenditure in 2007-2013, respectively. Future trend analysis suggests orphan drug expenditure will remain under 6 % of total expenditure in 2014-18. While the number of available orphan drugs and associated expenditure increased over time, access remains an issue, and from the perspectives of society and equity, overall spending on orphan drugs

Testing the stability of travel expenditures in Nigeria

Energy Technology Data Exchange (ETDEWEB)

Osula, D.O.A.; Adebisi, O. [Ahmadu Bello University, Zaria (Nigeria). Department of Civil Engineering

2001-07-01

A report is presented on a study carried out to develop a functional form for travel money expenditure in a Nigerian setting, and test its stability against energy policy change, specifically the fuel price increase of October 1994. The Box-Cox transformation regression approach was adopted in the modelling exercise in order to evolve a data-defined functional form and ensure a more rational basis for the stability test. The results of the modelling exercise show that while statistically significant functional forms were estimated for the 'before' and 'after' fuel price increase periods, the functional forms estimated are not stable across the periods. Thus 'travel budget' is as yet not usable as a term for travel expenditures in Nigeria. The implication of this for travel demand modelling in Nigeria is that, at least till other evidences prove otherwise, there is as yet no basis for using the 'Universal Mechanism of Travel' model developed by Zahavi (The UMOT Project. Report No. DOT-RSPA-DPB-20-79-3; The UMOT Travel Model II Report No. DOT-RSPA-DPB-50-82-11). Of disposable income and total expenditure, the former has proved to be more appropriate for use as 'available money' for the estimation of travel expenditures in Nigeria in the 'before' energy policy change period, while total expenditure proved appropriate in the 'after' period. (author)

The Impact of HbA1c Testing on Total Annual Healthcare Expenditures Among Newly Diagnosed Patients with Diabetes.

Science.gov (United States)

Bhounsule, Prajakta; Peterson, Andrew M

2015-09-01

In 2010, diabetes was the seventh leading cause of death in the United States. Diabetes also imposes a huge financial burden on the US economy. In 2009, the American Diabetes Association International Expert Committee recommended the use of the glycated hemoglobin (HbA1c) test as a uniform diagnostic measure to identify patients with diabetes. Although HbA1c is a convenient diagnostic test, it is also more expensive than older tests and could, therefore, have an impact on patients' healthcare expenditures. To determine if HbA1c testing has an impact on total annual healthcare expenditures among newly diagnosed patients with diabetes and to analyze the factors that are associated with the total healthcare expenditures among diabetic patients before and after HbA1c was implemented as a standard diagnostic factor. This was an observational, retrospective, cross-sectional study. The Medical Expenditure Panel Survey-Household Component 2009 and 2011 databases were used to form the study cohort of patients with diabetes. The total mean healthcare expenditures among patients with diabetes formed the dependent variable. A proxy variable representing a diagnosis of diabetes with and without the use of HbA1c testing in 2009 and in 2011, respectively, formed the main independent variable along with demographic factors, comorbidities, and healthcare services utilization in both years. A generalized linear regression was conducted to determine the association of HbA1c testing with total diabetes-related healthcare expenditures. The mean total healthcare expenditure decreased in 2011 compared with 2009. The HbA1c test did not show an association with the total healthcare expenditures versus earlier diabetes-related diagnostic factors. The total expenditures were associated with private insurance, the incidence of a previous heart attack, prescription drug refills, inpatient hospital stays, home care, hospital discharges, and visits to outpatient providers and physicians in both

EFFECT OF FISCAL DECENTRALIZATION ON CAPITAL EXPENDITURE, GROWTH, AND WELFARE

OpenAIRE

Badrudin, Rudy

2013-01-01

This research analyzes the influence of fiscal decentralization on capital expenditure, economic growth, and social welfare of 29 regencies and 6 cities in Central Java Province based on the data of year 2004 to 2008. The method used to analyze the hypotheses is the Partial Least Square. The results showes that fiscal decentralization has no significant effect on capital expenditure; fiscal decentralization has significant effect on economic growth and social welfare; capital expenditure has ...

The Behaviour of Disaggregated Public Expenditures and Income in Malaysia

OpenAIRE

Tang, Chor-Foon; Lau, Evan

2011-01-01

The present study attempts to re-investigate the behaviour of disaggregated public expenditures data and national income for Malaysia. This study covers the sample period of annual data from 1960 to 2007. The Bartlett-corrected trace tests proposed by Johansen (2002) were used to ascertain the presence of long run equilibrium relationship between public expenditures and national income. The results show one cointegrating vector for each specification of public expenditures. The relatively new...

Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

Science.gov (United States)

Gupt, Anadi; Kaur, Prabhdeep; Kamraj, P; Murthy, B N

2016-01-01

Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY), should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE) for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL) families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013. We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains. Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%). The median overall OOPE was $39 (Rs 2567) in the non-beneficiaries group as compared to $11 (Rs 713) in the beneficiaries group (p<0.01). Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500) in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01). Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3)] with OOPE above median independently and also after adjusting for various covariates. RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

Directory of Open Access Journals (Sweden)

Anadi Gupt

Full Text Available Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY, should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013.We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains.Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%. The median overall OOPE was $39 (Rs 2567 in the non-beneficiaries group as compared to $11 (Rs 713 in the beneficiaries group (p<0.01. Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500 in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01. Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3] with OOPE above median independently and also after adjusting for various covariates.RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

Public health and the economy could be served by reallocating medical expenditures to social programs

Directory of Open Access Journals (Sweden)

Linda Diem Tran

2017-12-01

Full Text Available As much as 30% of US health care spending in the United States does not improve individual or population health. To a large extent this excess spending results from prices that are too high and from administrative waste. In the public sector, and particularly at the state level, where budget constraints are severe and reluctance to raise taxes high, this spending crowds out social, educational, and public-health investments. Over time, as spending on medical care increases, spending on improvements to the social determinants of health are starved. In California the fraction of General Fund expenditures spent on public health and social programs fell from 34.8% in fiscal year 1990 to 21.4% in fiscal year 2014, while health care increased from 14.1% to 21.3%. In spending more on healthcare and less on other efforts to improve health and health determinants, the state is missing important opportunities for health-promoting interventions with a strong financial return. Reallocating ineffective medical expenditures to proven and cost-effective public health and social programs would not be easy, but recognizing its potential for improving the public's health while saving taxpayers billions of dollars might provide political cover to those willing to engage in genuine reform. National estimates of the percent of medical spending that does not improve health suggest that approximately $5 billion of California's public budget for medical spending has no positive effect on health. Up to 10,500 premature deaths could be prevented annually by reallocating this portion of medical spending to public health. Alternatively, the same expenditure could help an additional 418,000 high school students to graduate.

Public health and the economy could be served by reallocating medical expenditures to social programs.

Science.gov (United States)

Tran, Linda Diem; Zimmerman, Frederick J; Fielding, Jonathan E

2017-12-01

As much as 30% of US health care spending in the United States does not improve individual or population health. To a large extent this excess spending results from prices that are too high and from administrative waste. In the public sector, and particularly at the state level, where budget constraints are severe and reluctance to raise taxes high, this spending crowds out social, educational, and public-health investments. Over time, as spending on medical care increases, spending on improvements to the social determinants of health are starved. In California the fraction of General Fund expenditures spent on public health and social programs fell from 34.8% in fiscal year 1990 to 21.4% in fiscal year 2014, while health care increased from 14.1% to 21.3%. In spending more on healthcare and less on other efforts to improve health and health determinants, the state is missing important opportunities for health-promoting interventions with a strong financial return. Reallocating ineffective medical expenditures to proven and cost-effective public health and social programs would not be easy, but recognizing its potential for improving the public's health while saving taxpayers billions of dollars might provide political cover to those willing to engage in genuine reform. National estimates of the percent of medical spending that does not improve health suggest that approximately $5 billion of California's public budget for medical spending has no positive effect on health. Up to 10,500 premature deaths could be prevented annually by reallocating this portion of medical spending to public health. Alternatively, the same expenditure could help an additional 418,000 high school students to graduate.

Measuring Government Expenditure Efficiencies Towards Peace and Human Development

Directory of Open Access Journals (Sweden)

Ahmad Danu Prasetyo

2014-02-01

Full Text Available In this paper, we investigate the efficiency level of government expenditure in 82 countries towards the human development and peace index of the respective countries by using Data Envelopment Analysis (DEA approach during 2007-2011. We found that only few countries that always being positioned in the efficient frontier during the sample period, namely: Japan, Nigeria, and Norway.  By using Malmquist index approach, we also found that Cyprus has the largest government expenditure efficiency improvement.Keywords: Government Expenditure Efficiencies, Human Development Index, Global Peace Indexdoi:10.12695/ajtm.2013.6.2.3 How to cite this article:Prasetyo, A.D., and Pudjono, A.N.S. (2013. Measuring Government Expenditure Efficiencies Towards Peace and Human Development. The Asian Journal of Technology Management 6 (2: 82-91. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.3

Economic Differentiation as a Determinant of Higher Education Pricing and Expenditure Policies and State-wide Public Policy: Implications for Governance. ASHE 1983 Annual Meeting Paper.

Science.gov (United States)

Alfred, Richard L.

A study of the impact of economic differentiation on institutional pricing and expenditure policies, higher education public policy, and governance in public colleges and universities is described. It is suggested that economic differentiation is a likely determinant of variation in institutional expenditure and pricing policies and higher…

THE IMPACT OF EDUCATIONAL EXPENDITURES OF GOVERNMENT ON ECONOMIC GROWTH OF IRAN

Directory of Open Access Journals (Sweden)

FOZIEH JEYHOON TABAR

Full Text Available ABSTRACT Using the annual data of Iran’s economy from 1981-2012, this study examines Wagner’s law and the Keynesian hypothesis about the relationship between the real government expenditure and the real GDP. In this regard, this paper investigated the relationship between the total government expenditure, the GDP and the relationship between government educational expenditure and GDP using bivariate and multivariate models. The multivariate model is used to reduce the specified error issues that has not been considered in many studies. The co-integration was examined using the auto regressive distributive lag method (ARDL of both long-term and short-term relationships. In making the estimations of the Wagner’s view, the variables: real GDP, capital stock and labor force stock respectively, had a positive, a negative, and a positive impact on total government expenditure and the long-term relationship is true in this regard. Additionally, in the estimation of Keynesian model, the educational expenditures, unlike real expenditures of government, had a long-term relationship. In addition, the variable, capital, in both models had a similar effect on the real GDP, and the labor force coefficient in the presence of the total expenditures and educational expenditures were negative and positive respectively.

Disability Compensation and Patient Expenditures: FY2000 to FY2013

Data.gov (United States)

Department of Veterans Affairs — This report contains FY2000 through FY2013 data on disability compensation expenditures and recipients and on VA healthcare system patients and patient expenditures.

Variations in resting energy expenditure: impact on gestational weight gain.

Science.gov (United States)

Berggren, E K; O'Tierney-Ginn, P; Lewis, S; Presley, L; De-Mouzon, S Hauguel; Catalano, P M

2017-10-01

There are significant variations in gestational weight gain, with many women gaining in excess of the Institute of Medicine guidelines. Unfortunately, efforts to improve appropriate gestational weight gain have had only limited success. To date, interventions have focused primarily on decreasing energy intake and/or increasing physical activity. Maternal resting energy expenditure, which comprises ∼60% of total energy expenditure compared with the ∼20% that comes from physical activity, may be an important consideration in understanding variations in gestational weight gain. Our objective was to quantify the changes in resting energy expenditure during pregnancy and their relationship to gestational weight gain and body composition changes among healthy women. We hypothesized that greater gestational weight gain, and fat mass accrual in particular, are inversely related to variations in resting energy expenditure. We conducted a secondary analysis of a prospective cohort studied before conception and late pregnancy (34-36 weeks). Body composition (estimated using hydrodensitometry) and resting energy expenditure (estimated using indirect calorimetry) were measured. The relationship between the changes in resting energy expenditure and gestational weight gain and the change in fat mass and fat-free mass were quantified. Resting energy expenditure was expressed as kilocalories per kilogram of fat-free mass per day (kilocalories per kilogram of fat-free mass -1 /day -1 ) and kilocalories per day. Correlations are reported as r. Among 51 women, preconception body mass index was 23.0 (4.7) kg/m 2 ; gestational weight gain was 12.8 (4.7) kg. Preconception and late pregnancy resting energy expenditure (kilocalories per day) correlated positively with the change in fat-free mass (r = 0.37, P = .008; r = 0.51, P = .001). Late-pregnancy resting energy expenditure (kilocalories per kilogram of fat-free mass -1 /day -1 ) was inversely associated with the change in fat

Energy consumption, energy efficiency, and consumer perceptions: A case study for the Southeast United States

International Nuclear Information System (INIS)

Craig, Christopher A.

2016-01-01

Highlights: • Interaction between climate, efficiency, and electricity consumption were examined. • 2450 state residents were surveyed about clean energy and subsidy policies. • Indirect energy efficiency costs negatively influenced electricity consumption. • Cooling degree days were positively related to electricity consumption. • Resident awareness influenced policy perceptions about clean energy and subsidies. - Abstract: This study examined the interaction between climatic variability and residential electricity consumption in a Southeast US state. Residential electricity consumers were surveyed to better understand how to diffuse positive attitudes and behaviors related to energy efficiency (EE) into households. The study found that 16.8% of the variability in residential electricity consumption for heating applications was explained by indirect EE costs. 36.6% of the variability in residential electricity consumption for cooling applications was explained by indirect EE costs and cooling degree days (CDD). A survey of 2450 residential electricity consumers was analyzed using the theory of planned behavior (TPB). Significant findings suggest that those residents are aware of utility EE programs are more likely to participate, view utility company motives more favorably, to support governmental subsidies for EE programs, and to support the use of clean energy by utility companies.

Daily energy expenditure, physical activity, and weight loss in Parkinson's disease patients

Science.gov (United States)

Patients with Parkinson's disease (PD) commonly exhibit weight loss (WL) which investigators attribute to various factors, including elevated energy expenditure. We tested the hypothesis that daily energy expenditure (DEE) and its components, resting energy expenditure (REE) and physical activity (P...

Light quality and efficiency of consumer grade solid state lighting products

Science.gov (United States)

Dam-Hansen, Carsten; Corell, Dennis Dan; Thorseth, Anders; Poulsen, Peter Behrensdorff

2013-03-01

The rapid development in flux and efficiency of Light Emitting Diodes (LED) has resulted in a flooding of the lighting market with Solid State Lighting (SSL) products. Many traditional light sources can advantageously be replaced by SSL products. There are, however, large variations in the quality of these products, and some are not better than the ones they are supposed to replace. A lack of quality demands and standards makes it difficult for consumers to get an overview of the SSL products. Here the results of a two year study investigating SSL products on the Danish market are presented. Focus has been on SSL products for replacement of incandescent lamps and halogen spotlights. The warm white light and good color rendering properties of these traditional light sources are a must for lighting in Denmark and the Nordic countries. 266 SSL replacement lamps have been tested for efficiency and light quality with respect to correlated color temperature and color rendering properties. This shows a trade-off between high color rendering warm white light and energy efficiency. The lumen and color maintenance over time has been investigated and results for products running over 11000 h will be presented. A new internet based SSL product selection tool will be shown. Here the products can be compared on efficiency, light quality parameters, thus providing a better basis for the selection of SSL products for consumers.

The effect of pharmaceutical innovation on longevity, hospitalization and medical expenditure in Turkey, 1999-2010.

Science.gov (United States)

Lichtenberg, Frank R; Tatar, Mehtap; Çalışkan, Zafer

2014-09-01

We investigate the impact of pharmaceutical innovation on longevity, hospitalization and medical expenditure in Turkey during the period 1999-2010 using longitudinal, disease-level data. From 1999 to 2008, mean age at death increased by 3.6 years, from 63.0 to 66.6 years. We estimate that in the absence of any pharmaceutical innovation, mean age at death would have increased by only 0.6 years. Hence, pharmaceutical innovation is estimated to have increased mean age at death in Turkey by 3.0 years during the period 1999-2008. We also examine the effect of pharmaceutical innovation on hospital utilization. We estimate that pharmaceutical innovation has reduced the number of hospital days by approximately 1% per year. We use our estimates of the effect of pharmaceutical innovation on age at death, hospital utilization and pharmaceutical expenditure to assess the incremental cost-effectiveness of pharmaceutical innovation, i.e., the cost per life-year gained from the introduction of new drugs. The baseline estimate of the cost per life-year gained from pharmaceutical innovation is $2776. Even the latter figure is a very small fraction of leading economists' estimates of the value of (or consumers' willingness to pay for) a one-year increase in life expectancy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Ecological Settings and State Economies as Factor Inputs in the Provision of Outdoor Recreation

Science.gov (United States)

Siderelis, Christos; Smith, Jordan W.

2013-09-01

State parks play a substantial role in the provision of outdoor recreation opportunities within the United States. Park operators must make crucial decisions in how they allocate capital expenditures, labor, and parkland to maintain recreation opportunities. Their decisions are influenced, in part, by the ecological characteristics of their state's park system as well as the vitality of their state's economy. In this research, we incorporate the characteristics of states' ecosystems and their local economies into a formal production analysis of the states' park systems from the years 1986 to 2011. Our analysis revealed all three factors of production were positive and inelastic. Expenditures on labor had the largest effect on both park utilization and operational expenditures. Our analysis also found a large degree of variability in the effects of ecological characteristics on both utilization and operating expenditures. Parkland utilization and operational expenditures were more elastic in areas such as Oceania and Mediterranean California relative to other ecological regions. These findings lead us to conclude that state park operators will experience variable levels of difficulty in both accommodating increasing demands for recreation from state parks and maintaining the existing quality of outdoor recreation provided within their system.

Food Consumption, Prices, and Expenditures, 1960-81

OpenAIRE

Anonymous

1982-01-01

This bulletin presents 1960-81 data on per capita food consumption, prices, nutrient availability, food expenditures and marketing costs, and U.S. income and population. Retail food prices rose 7.9 percent, aggregate food consumption fell 1.0 percent, and personal consumption expenditures for food rose 9.7 percent. Per capita meat consumption was down 2.5 pounds in 1981, hut poultry usage rose 1.8 pounds. Dairy consumption per person was lower. Fresh fruit consumption rose 1.6 pounds per pers...

Food Consumption, Prices, and Expenditures, 1962-82

OpenAIRE

Anonymous

1983-01-01

This bulletin ,presents 1962-82 data on per capita food consumption, prices, nutrient availability,food expenditures and marketing costs, and U.S. income and population. Retail food prices in 1982 rose 4.0 percent, aggregate food consumption fell 0.4 percent, and personal food, consumption expenditures rose 6.3 percent from 1981. Per, capita red meat consumption was down 5.8 pounds, but poultry use rose 1.3 pounds. Dairy product consumption per person decreased. Fresh fruit consumption fell 3...

25 CFR 214.13 - Diligence; annual expenditures; mining records.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Diligence; annual expenditures; mining records. 214.13... OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS § 214.13 Diligence; annual expenditures; mining records. (a) Lessees shall exercise diligence in the conduct of prospecting and mining...

26 CFR 1.617-3 - Recapture of exploration expenditures.

Science.gov (United States)

2010-04-01

... property which is neither a capital asset nor property described in section 1231. (iii) If a taxpayer pays...) Allocation of certain expenditures. A project area consists of that territory which the taxpayer has... available) can be explored advantageously as a single integrated operation. If exploration expenditures are...

Issue Papers To Consumer Protection in Postsecondary Education.

Science.gov (United States)

1974

This document is intended to present background information on the basic consumer protection issues in postsecondary education. Topics discussed are: (1) recruitment practices of postsecondary schools; (2) the role of a state agency in consumer protection; (3) consumer rights, responsibilities and redress of consumer protection; (4) advertising…

Slovenian income taxes and analysis of their tax expenditure in 2006-2010

Directory of Open Access Journals (Sweden)

Maja Klun

2012-09-01

Full Text Available Tax expenditure analyses have been an important element in the supervision of reform processes linked to implementing different kinds of tax incentive and the management of a correct tax policy. The paper provides an evaluation of tax expenditure in Slovenia relating to personal income tax and corporate income tax. Four consecutive tax years were selected for the calculation of the tax expenditure on personal income tax (2006-09, while three consecutive years were selected for the corporate income tax calculation (2008-10. The tax expenditure calculated for personal income tax was highest in 2006 and reached 5.2% of GDP. After several changes in personal income tax, expenditures decreased to around 3% of GDP in the following three years. The tax expenditure calculated for corporate income tax was much lower as compared to GDP than for personal income tax, reaching around 0.2% of GDP.

An analytical guidance law of planetary landing mission by minimizing the control effort expenditure

International Nuclear Information System (INIS)

Afshari, Hamed Hossein; Novinzadeh, Alireza Basohbat; Roshanian, Jafar

2009-01-01

An optimal trajectory design of a module for the planetary landing problem is achieved by minimizing the control effort expenditure. Using the calculus of variations theorem, the control variable is expressed as a function of costate variables, and the problem is converted into a two-point boundary-value problem. To solve this problem, the performance measure is approximated by employing a trigonometric series and subsequently, the optimal control and state trajectories are determined. To validate the accuracy of the proposed solution, a numerical method of the steepest descent is utilized. The main objective of this paper is to present a novel analytic guidance law of the planetary landing mission by optimizing the control effort expenditure. Finally, an example of a lunar landing mission is demonstrated to examine the results of this solution in practical situations

Reconciling medical expenditure estimates from the MEPS and NHEA, 2007.

Science.gov (United States)

Bernard, Didem; Cowan, Cathy; Selden, Thomas; Cai, Liming; Catlin, Aaron; Heffler, Stephen

2012-01-01

Provide a comparison of health care expenditure estimates for 2007 from the Medical Expenditure Panel Survey (MEPS) and the National Health Expenditure Accounts (NHEA). Reconciling these estimates serves two important purposes. First, it is an important quality assurance exercise for improving and ensuring the integrity of each source's estimates. Second, the reconciliation provides a consistent baseline of health expenditure data for policy simulations. Our results assist researchers to adjust MEPS to be consistent with the NHEA so that the projected costs as well as budgetary and tax implications of any policy change are consistent with national health spending estimates. The Medical Expenditure Panel Survey produced by the Agency for Healthcare Research and Quality, and the National Health Center for Health Statistics and the National Health Expenditures produced by the Centers for Medicare & Medicaid Service's Office of the Actuary. In this study, we focus on the personal health care (PHC) sector, which includes the goods and services rendered to treat or prevent a specific disease or condition in an individual. The official 2007 NHEA estimate for PHC spending is $1,915 billion and the MEPS estimate is $1,126 billion. Adjusting the NHEA estimates for differences in underlying populations, covered services, and other measurement concepts reduces the NHEA estimate for 2007 to $1,366 billion. As a result, MEPS is $240 billion, or 17.6 percent, less than the adjusted NHEA total.

Medical Care Expenditure in Suicides From Non-illness-related Causes

Directory of Open Access Journals (Sweden)

Jungwoo Sohn

2014-11-01

Full Text Available Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

The effect of the downturn in oil prices on the relative efficiency of government expenditure in the GCC countries

International Nuclear Information System (INIS)

Metwally, M.M.; Perera, N.

1995-01-01

This paper tests a control model to discover the effect of the decline in oil prices on the relative efficiency of government expenditure in the member states of the Gulf Cooperation Council. The econometric analysis shows that as a consequence of the decline in oil prices, the GCC countries need a relatively higher proportional rate of growth in their government expenditure to maintain a given percentage of income growth in the long run. This may, however, prove difficult, which necessitates greater reliance on other means of control. (author)

Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from Quebec, Canada.

Science.gov (United States)

Contoyannis, Paul; Hurley, Jeremiah; Grootendorst, Paul; Jeon, Sung-Hee; Tamblyn, Robyn

2005-09-01

The price elasticity of demand for prescription drugs is a crucial parameter of interest in designing pharmaceutical benefit plans. Estimating the elasticity using micro-data, however, is challenging because insurance coverage that includes deductibles, co-insurance provisions and maximum expenditure limits create a non-linear price schedule, making price endogenous (a function of drug consumption). In this paper we exploit an exogenous change in cost-sharing within the Quebec (Canada) public Pharmacare program to estimate the price elasticity of expenditure for drugs using IV methods. This approach corrects for the endogeneity of price and incorporates the concept of a 'rational' consumer who factors into consumption decisions the price they expect to face at the margin given their expected needs. The IV method is adapted from an approach developed in the public finance literature used to estimate income responses to changes in tax schedules. The instrument is based on the price an individual would face under the new cost-sharing policy if their consumption remained at the pre-policy level. Our preferred specification leads to expenditure elasticities that are in the low range of previous estimates (between -0.12 and -0.16). Naïve OLS estimates are between 1 and 4 times these magnitudes. (c) 2005 John Wiley & Sons, Ltd.

Households' incidence on malaria and expenditures to treat malaria ...

African Journals Online (AJOL)

CONCLUSION: The relationship between expenditure and use of different vector control depends on the geographic location of respondents. People living in the rural areas spend more to have access to malaria control tools. Location of respondent has a positive effect on expenditures and use of malaria control tools.

Effect of 3 modified fats and a conventional fat on appetite, energy intake, energy expenditure, and substrate oxidation in healthy men

DEFF Research Database (Denmark)

Bendixen, H.; Flint, A.; Raben, A.

2002-01-01

energy intake, meal-induced thermogenesis, and postprandial substrate oxidation.Design: Eleven healthy, normal-weight men (mean age: 25.1 +/-0.5 y) consumed 4 different test fats [conventional fat (rapeseed oil) and 3 modified fats (lipase-structured fat, chemically structured fat, and physically mixed...... fat)] in a randomized, double-blind, crossover design.Results: No significant differences in appetite sensations or ad libitum energy intakes were observed between the 4 test fats. Overall, the 4 fats exerted different effects on energy expenditure (meal effect: P...

Main drivers of health expenditure growth in China: a decomposition analysis.

Science.gov (United States)

Zhai, Tiemin; Goss, John; Li, Jinjing

2017-03-09

In past two decades, health expenditure in China grew at a rate of 11.6% per year, which is much faster than the growth of the country's economy (9.9% per year). As cost containment is a key aspect of China's new health system reform agenda, this study aims to identify the main drivers of past growth so that cost containment policies are focussed in the right areas. The analysis covered the period 1993-2012. To understand the drivers of past growth during this period, Das Gupta's decomposition method was used to decompose the changes in health expenditure by disease into five main components that include population growth, population ageing, disease prevalence rate, expenditure per case of disease, and excess health price inflation. Demographic data on population size and age-composition were obtained from the Department of Economic and Social Affairs of the United Nations. Age- and disease- specific expenditure and prevalence rates by age and disease were extracted from China's National Health Accounts studies and Global Burden of Disease 2013 studies of the Institute for Health Metrics and Evaluation, respectively. Growth in health expenditure in China was mainly driven by a rapid increase in real expenditure per prevalent case, which contributed 8.4 percentage points of the 11.6% annual average growth. Excess health price inflation and population growth contributed 1.3 and 1.3% respectively. The effect of population ageing was relatively small, contributing 0.8% per year. However, reductions in disease prevalence rates reduced the growth rate by 0.3 percentage points. Future policy in optimising growth in health expenditure in China should address growth in expenditure per prevalent case. This is especially so for neoplasms, and for circulatory and respiratory disease. And a focus on effective interventions to reduce the prevalence of disease in the country will ensure that changing disease rates do not lead to a higher growth in future health expenditure

An inspection on the Gini coefficient of the budget educational public expenditure per student for China's basic education

Institute of Scientific and Technical Information of China (English)

Yang Yingxiu

2006-01-01

Using statistical data on the implementing conditions Of China's educational expenditure pubhshed by the state.this paper studies the Gini coefficient of the budget educational pubic expenditure per student in order to examine the concentration degree of the educational expenditure for China's basic education and analyze its balanced development condition.As the research shows,China's basic education is undergoing an unbalanced development due to diversified factors,which is mainly reflected as follows:firstly.the budget educational pubic expenditure presents a four-tiered appearance of the strong,the less strong,the less weak and the weak,which lead to a great discrepancy between the two opposing extremes:secondly,the compulsory education in rural areas is still confronted with great difficulties;thirdly.the general senior secondary education is loaded with the crisis of unbalance.Therefore,it is necessary to construct a balanced development policy framework of the basic education and Pay close aaention to the benefit and effectiveness of the educational input.In addition.it is also important to clearly stipulate the criteflon ofthe government's educational allocation and to support the disadvantaged areas in order to promote the baianced development of the basic education.

Carbon taxes, consumer demand and carbon dioxide emission: a simulation analysis for the UK

International Nuclear Information System (INIS)

Symons, E.J.; Proops, J.L.R.; Gay, P.W.

1991-01-01

This paper examines a policy instrument that has been proposed as a means of reducing 'greenhouse gases', the introduction of a carbon tax on fossil fuels. It investigates the implication of a carbon tax for consumer prices using an input-output framework. Thus the effect of a tax on use of fossil fuels is allowed to affect consumer prices. These are then used in a micro-simulation program that features estimates of a system of demand equations obtained using 116,000 observations from the Family Expenditure System. This predicts the behavioural reaction of each household to the tax changes and the consequent effect on CO 2 emission, government revenue and any distributional effects. We illustrate the impact of a variety of carbon taxes, changes to indirect tax rates and lump-sum compensatory payments. (author)

MARKETING EXPENDITURES IN THE INDONESIAN CONSTRUCTION INDUSTRY

OpenAIRE

Krishna Mochtar

2004-01-01

In the 1960s, a ânewâ marketing concept known as "four Ps marketing mix" appeared and shifted the focus from the product to the customer. The objective of the new concept was not only profit, and the means of achieving the objective expanded to include the entire âmarketing mixâ: product, price, promotion, and place (channels and distribution). Expenditures of marketing in a company should be explored from these mixes, because each mix would have an impact on the total marketing expenditures....

US military expenditures to protect the use of Persian Gulf oil for motor vehicles

International Nuclear Information System (INIS)

Delucchi, Mark A.; Murphy, James J.

2008-01-01

Analyses of the full social cost of motor vehicle use in the US often estimate an 'oil import premium' that includes the military cost of defending oil supplies from the Persian Gulf. Estimates of this cost have ranged from essentially zero to upwards of a $1 per gallon (about $0.25 per liter). In this paper, we attempt to narrow this range, by carefully answering the question: 'If the US highway transportation sector did not use oil, how much would the US federal government reduce its military commitment in the Persian Gulf?' We work towards our answer in five steps, accounting for interests not related to oil, the interests of other oil-consuming countries, the interests of producers apart from the interests of consumers, and the interests of non-highway users of oil. We estimate that were there no oil in the Persian Gulf, then US combined peacetime and wartime defense expenditures might be reduced in the long run by roughly $27-$73 billion per year (in 2004 dollars), of which roughly $6-$25 billion annually ($0.03-$0.15 per gallon or $0.01-$0.04 per liter) is attributable to motor-vehicle use

Catastrophic Health Expenditure and Household Impoverishment: a case of NCDs prevalence in Kenya

Directory of Open Access Journals (Sweden)

Daniel Mwai

2016-03-01

Full Text Available Introduction and problem: Non-Communicable Diseases (NCDs have become one of the leading causes of morbidity and mortality in Kenya. Their claim on financial and time resources adversely affects household welfare. Health care cost for NCDs in Kenya is predominantly paid by households as OOP. Health expenditure on NCD stands at 6.2% of Total Health Expenditure which is 0.4 % of the total gross domestic product of the country. This expenditure scenario could have implications on household welfare through catastrophic expenditure in Kenya. Most studies done on catastrophic expenditure in Kenya have not looked at the effect of NCD on poverty. Methodology: The paper has investigated the determinants of catastrophic health spending in a household with special focus on the NCDs. It has also investigated the effect of catastrophic expenditure on household welfare.A National household level survey data on expenditure and utilization is used. Controlling for endogeneity, the results revealed that NCDs and communicable diseases contribute significantly to the likelihood of a household incurring catastrophic expenditure. Results: Although all types of sicknesses have negative effects on household welfare, NCDs have more severe impacts on impoverishment. Policy wise, government and development partners should put in place a health financing plan entailing health insurance and resource pooling as a mean towards social protection. Key words:  Non-Communicable Diseases (NCD, Catastrophic Health Expenditure, endogeneity Impoverishment

Influence of Brettanomyces ethylphenols on red wine aroma evaluated by consumers in the United States and Portugal.

Science.gov (United States)

Schumaker, Megan R; Chandra, Mahesh; Malfeito-Ferreira, Manuel; Ross, Carolyn F

2017-10-01

Brettanomyces may add complexity to wine at low concentrations but at high concentrations, can result in objectionable wines. The objective of this study was to determine the concentrations at which consumers from two different locations were able to detect Brettanomyces volatile compounds present in a red wine. A red wine blend, used in both countries, was spiked to create five treatments containing different concentrations of 4-ethylphenol (4-EP), 4-ethylguiacol (4-EG), and 4-ethylcatechol (4-EC) in a 5:1:1 ratio, respectively. These treatments were evaluated by consumers in the United States and Portugal (n=121) using a difference from control test. Consumers were also classified as having low, medium, or high wine knowledge. Among the spiked samples, the greatest degree of difference was found between the second and third treatments, corresponding to reported detection and recognition threshold ranges of 4-EP and 4-EG. For some treatments, consumers from Portugal classified in the medium or high knowledge level reported significantly higher mean differences from the control than those in the low knowledge group (p<0.05). Results demonstrated consumers' ability to detect differences in red wines due to Brettanomyces volatile compounds. Results provide useful context on how wine knowledge and cultural variants may affect the detection of Brettanomyces. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sensitivity analysis and comparison of two methods of using heart rate to represent energy expenditure during walking.

Science.gov (United States)

Karimi, Mohammad Taghi

2015-01-01

Heart rate is an accurate and easy to use method to represent the energy expenditure during walking, based on physiological cost index (PCI). However, in some conditions the heart rate during walking does not reach to a steady state. Therefore, it is not possible to determine the energy expenditure by use of the PCI index. The total heart beat index (THBI) is a new method to solve the aforementioned problem. The aim of this research project was to find the sensitivity of both the physiological cost index (PCI) and total heart beat index (THBI). Fifteen normal subjects and ten patients with flatfoot disorder and two subjects with spinal cord injury were recruited in this research project. The PCI and THBI indexes were determined by use of heart beats with respect to walking speed and total distance walked, respectively. The sensitivity of PCI was more than that of THBI index in the three groups of subjects. Although the PCI and THBI indexes are easy to use and reliable parameters to represent the energy expenditure during walking, their sensitivity is not high to detect the influence of some orthotic interventions, such as use of insoles or using shoes on energy expenditure during walking.

Health expenditure and economic growth - a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries.

Science.gov (United States)

Piabuo, Serge Mandiefe; Tieguhong, Julius Chupezi

2017-12-01

African leaders accepted in the year 2001 through the Abuja Declaration to allocate 15% of their government expenditure on health but by 2013 only five (5) African countries achieved this target. In this paper, a comparative analysis on the impact of health expenditure between countries in the CEMAC sub-region and five other African countries that achieved the Abuja declaration is provided. Data for this study was extracted from the World Development Indicators (2016) database, panel ordinary least square (OLS), fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) were used as econometric technic of analysis. Results showed that health expenditure has a positive and significant effect on economic growth in both samples. A unit change in health expenditure can potentially increase GDP per capita by 0.38 and 0.3 units for the five other African countries that achieve the Abuja target and for CEMAC countries respectively, a significant difference of 0.08 units among the two samples. In addition, a long-run relationship also exist between health expenditure and economic growth for both groups of countries. Thus African Economies are strongly advised to achieve the Abuja target especially when other socio-economic and political factors are efficient.

Uranium exploration expenditures in 1980 and plans for 1981-1982

International Nuclear Information System (INIS)

Sanders, L.R. Jr.

1981-05-01

The Grand Junction Office of the US Department of Energy has conducted annual surveys of actual and planned uranium exploration activities since 1971. This report summarizes the aggregated proprietary information which has been furnished by the industry on a confidential basis. This work is part of an overall program to evaluate future supplies of nuclear fuel. The annual surveys have covered: (1) land acquired for exploration and cost of acquisition (since 1966); (2) surface drilling footage and cost (since 1966); (3) all other exploration expenditures (since 1966); (4) estimates of exploration activities and costs for the next 2 years (since 1971), this year's survey covered estimates for 1981 to 1982; (5) year-end total of lands held for uranium exploration (since 1972); (6) exploration for nonsandstone deposits (since 1974); (7) exploration in nonestablished areas (since 1974); (8) foreign uranium exploration expenditures by US companies (since 1966); (9) foreign participation in exploration activities in the United States (since 1975); (10) aerial radiometric exploration activities (since 1977); and (11) solution mining production drilling (since 1976). This report presents a compilation of data from the replies of 147 companies

Relating the environmental impact of consumption to household expenditures. An input-output analysis