scholarly journals Assessing the Impact of Insurance Type on COVID-19 Mortality in Black and White Patients in the Largest Healthcare System in the State of Georgia

2022 ◽  
Author(s):  
Jessica L. McCain ◽  
Xinyue Wang ◽  
Kate Connell ◽  
Jayne Morgan
Keyword(s):  
Healthcare System ◽  
The State ◽  
Black And White ◽  
Insurance Type ◽  
The Impact ◽  
White Patients

scholarly journals Distributed Counterfactual Modeling Approach for Investigating Hospital-Associated Racial Disparities in COVID-19 Mortality

2021 ◽  
Author(s):  
Mackenzie J Edmondson ◽  
Chongliang Luo ◽  
Nazmul Islam ◽  
David Asch ◽  
Jiang J Bian ◽  
...  
Keyword(s):  
Racial Differences ◽  
Hospital System ◽  
Black And White ◽  
Patient Level ◽  
Modeling Approach ◽  
Black Patients ◽  
The Difference ◽  
Using Data ◽  
The Impact ◽  
White Patients

Several studies have found that black patients are more likely than white patients to test positive for or be hospitalized with COVID-19, but many of these same studies have found no difference in in-hospital mortality. These studies may have underestimated racial differences due to reliance on data from a single hospital system, as adequate control of patient-level characteristics requires aggregation of highly granular data from several institutions. Further, one factor thought to contribute to disparities in health outcomes by race is site of care. Several differences between black and white patient populations, such as access to care and referral patterns among clinicians, can lead to patients of different races largely attending different hospitals. We sought to develop a method that could study the potential association between attending hospital and racial disparity in mortality for COVID-19 patients without requiring patient-level data sharing among collaborating institutions. We propose a novel application of a distributed algorithm for generalized linear mixed modeling (GLMM) to perform counterfactual modeling and investigate the role of hospital in differences in COVID-19 mortality by race. Our counterfactual modeling approach uses simulation to randomly assign black patients to hospitals in the same distribution as those attended by white patients, quantifying the difference between observed mortality rates and simulated mortality risk following random hospital assignment. To illustrate our method, we perform a proof-of-concept analysis using data from four hospitals within the OneFlorida Clinical Research Consortium. Our approach can be used by investigators from several institutions to study the impact of admitting hospital on COVID-19 mortality, a critical step in addressing systemic racism in modern healthcare.

scholarly journals Socioeconomic and Racial Determinants of Brachytherapy Utilization for Cervical Cancer: Concerns for Widening Disparities

2021 ◽  
pp. OP.21.00291
Author(s):  
David Boyce-Fappiano ◽  
Kevin A. Nguyen ◽  
Olsi Gjyshi ◽  
Gohar Manzar ◽  
Chike O. Abana ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Stage I ◽  
Oncologic Outcomes ◽  
External Beam Radiation ◽  
Insurance Status ◽  
Beam Radiation ◽  
Black And White ◽  
Survival Differences ◽  
The Impact ◽  
White Patients

PURPOSE: Cervical cancer (CC) disproportionately affects minorities who have higher incidence and mortality rates. Standard of care for locally advanced CC involves a multimodality approach including brachytherapy (BT), which independently improves oncologic outcomes. Here, we examine the impact of insurance status and race on BT utilization with the SEER database. MATERIALS AND METHODS: In total, 7,266 patients with stage I-IV CC diagnosed from 2007 to 2015 were included. BT utilization, overall survival (OS), and disease-specific survival (DSS) were compared. RESULTS: Overall, 3,832 (52.7%) received combined external beam radiation therapy (EBRT) + BT, whereas 3,434 (47.3%) received EBRT alone. On multivariate logistic regression analysis, increasing age (OR, 0.98; 95% CI, 0.98 to 0.99; P < .001); Medicaid (OR, 0.80; 95% CI, 0.72 to 0.88; P < .001), uninsured (OR, 0.67; 95% CI, 0.56 to 0.80; P < .001), and unknown versus private insurance (OR, 0.61; 95% CI, 0.43 to 0.86; P < .001); Black (OR, 0.68; 95% CI, 0.60 to 0.77; P < .001) and unknown versus White race (OR, 0.30; 95% CI, 0.13 to 0.77; P = .047); and American Joint Committee on Cancer stage II (OR, 1.07; 95% CI, 0.93 to 1.24; P = .36), stage III (OR, 0.82; 95% CI, 0.71 to 0.94; P = .006), stage IV (OR, 0.30; 95% CI, 0.23 to 0.40; P < .001), and unknown stage versus stage I (OR, 0.36; 95% CI, 0.28 to 0.45; P < .001) were associated with decreased BT utilization. When comparing racial survival differences, the 5-year OS was 44.2% versus 50.9% ( P < .0001) and the 5-year DSS was 55.6% versus 60.5% ( P < .0001) for Black and White patients, respectively. Importantly, the racial survival disparities resolved when examining patients who received combined EBRT + BT, with the 5-year OS of 57.3% versus 58.5% ( P = .24) and the 5-year DSS of 66.3% versus 66.6% ( P = .53) for Black and White patients, respectively. CONCLUSION: This work demonstrates notable inequities in BT utilization for CC that particularly affects patients of lower insurance status and Black race, which translates into inferior oncologic outcomes. Importantly, the use of BT was able to overcome racial survival differences, thus highlighting its essential value.

Russia - European Union: The continuation ofthe sanctions standoff

2017 ◽  
pp. 114-127
Author(s):  
M. Klinova ◽  
E. Sidorova
Keyword(s):  
European Union ◽  
Economic Recession ◽  
Economic Sanctions ◽  
Current Data ◽  
The State ◽  
The European Union ◽  
The Impact ◽  
The Eu ◽  
Year 2013

The article deals with economic sanctions and their impact on the state and prospects of the neighboring partner economies - the European Union (EU) and Russia. It provides comparisons of current data with that of the year 2013 (before sanctions) to demonstrate the impact of sanctions on both sides. Despite the fact that Russia remains the EU’s key partner, it came out of the first three partners of the EU. The current economic recession is caused by different reasons, not only by sanctions. Both the EU and Russia have internal problems, which the sanctions confrontation only exacerbates. The article emphasizes the need for a speedy restoration of cooperation.

PERTANGGUNGJAWABAN KERUGIAN NEGARA DALAM PENGELOLAAN KEUANGAN DAERAH

EDUKASI ◽  
2018 ◽  
Vol 16 (1) ◽  
Author(s):  
Hendra Karianga
Keyword(s):  
Financial Management ◽  
Criminal Liability ◽  
The State ◽  
Legal Proceedings ◽  
Regional Finance ◽  
Regional Budget ◽  
State Finance ◽  
Budget Policy ◽  
Definition Of ◽  
The Impact

Sources of revenue and expenditure of APBD (regional budget) can be allocated to finance the compulsory affairs and optional affairs in the form of programs and activities related to the improvement of public services, job creation, poverty alleviation, improvement of environmental quality, and regional economic growth. The implications of these policies is the need for funds to finance the implementation of the functions, that have become regional authority, is also increasing. In practice, regional financial management still poses a complicated issue because the regional head are reluctant to release pro-people regional budget policy, even implication of regional autonomy is likely to give birth to little kings in region causing losses to state finance and most end up in legal proceedings. This paper discusses the loss of state finance and forms of liability for losses to the state finance. The result of the study can be concluded firstly,  there are still many differences in giving meaning and definition of the loss of state finace and no standard definition of state losses, can cause difficulties. The difficulty there is in an effort to determine the amount of the state finance losses. The calculation of state/regions losses that occur today is simply assessing the suitability of the size of the budget and expenditure without considering profits earned by the community and the impact of the use of budget to the community. Secondly, the liability for losses to the state finance is the fulfillment of the consequences for a person to give or to do something in the regional financial management by giving birth to three forms of liability, namely the Criminal liability, Civil liability, and Administrative liability.Keywords: state finance losses, liability, regional finance.

Financial and monetary policy of the State and its impact on the income level and poverty reduction in Russia

2020 ◽  
Vol 26 (5) ◽  
pp. 964-990
Author(s):  
N.I. Kulikov ◽  
V.L. Parkhomenko ◽  
Akun Anna Stefani Rozi Mobio
Keyword(s):  
Monetary Policy ◽  
Household Income ◽  
Poverty Reduction ◽  
The State ◽  
Financial Policy ◽  
Gdp Growth ◽  
Tax Rate ◽  
Gdp Growth Rate ◽  
The Government ◽  
The Impact

Subject. We assess the impact of tight financial and monetary policy of the government of the Russian Federation and the Bank of Russia on the level of household income and poverty reduction in Russia. Objectives. The purpose of the study is to analyze the results of financial and monetary policy in Russia and determine why the situation with household income and poverty has not changed for the recent six years, and the GDP growth rate in Russia is significantly lagging behind the global average. Methods. The study employs methods of analysis of scientific and information base, and synthesis of obtained data. The methodology and theoretical framework draw upon works of domestic and foreign scientists on economic and financial support to economy and population’s income. Results. We offer measures for liberalization of the financial and monetary policy of the government and the Central Bank to ensure changes in the structure of the Russian economy. The proposed alternative economic and financial policy of the State will enable the growth of real incomes of the population, poverty reduction by half by 2024, and annual GDP growth up to 6 per cent. Conclusions. It is crucial to change budget priorities, increase the salaries of public employees, introduce a progressive tax rate for individuals; to reduce the key rate to the value of annual inflation and limit the bank margin. The country needs a phased program to increase the population's income, which will ensure consumer demand.

The impact of business tourism clustering on the regional economy's development: A Greater Moscow case study

2020 ◽  
Vol 18 (7) ◽  
pp. 1397-1414
Author(s):  
K.S. Golondarev
Keyword(s):  
Multivariate Analysis ◽  
The State ◽  
Investment Climate ◽  
Private Investors ◽  
The Impact

Subject. This article explores the issues of business tourism clustering in Greater Moscow. Objectives. The article intends to justify the need to create a business tourism cluster in Greater Moscow to improve the investment climate in the region. Methods. For the study, I used a multivariate analysis, forecasting, and extrapolation. Results. The article shows a certain relationship between the efficient functioning of the business tourism cluster and the economy's development. Conclusions and Relevance. Certain types of tourist clusters can serve as platforms for attracting investors and implementing marketing plans. The business tourism cluster is a link between buyers and sellers in various industries. The results of the study can be used to improve the effectiveness of the cluster initiative in business tourism, as well as find ways of cooperation between the State and private investors when creating the business tourism cluster in Greater Moscow.

A PROPOSED EVALUATION PLAN TO ASSESS THE IMPACT OF A YOUTH DEVELOPMENT PROGRAMME FACILITATED BY THE STATE INFORMATION TECHNOLOGY AGENCY (SITA) IN RURAL SOUTH AFRICA

2017 ◽  
Vol 14 (1) ◽  
pp. 174-181
Author(s):  
Maura Mbunyuza-deHeer Menlah
Keyword(s):  
Information Technology ◽  
Youth Development ◽  
Rural Areas ◽  
Secondary Data ◽  
The State ◽  
State Information ◽  
Evaluation Plan ◽  
Lessons Learnt ◽  
Slow Development ◽  
The Impact

This article reports on a proposed evaluation plan that has been developed to assess the work done by the State Information Technology Agency (SITA). The SITA programme was implemented in response to the South African government’s call to improve the lives of the populations in some rural areas through technology. The programme was meant to address slow development in  rural  areas  that  lack  technological  innovations  and  advances.  In  the proposed evaluation plan a review is made of secondary data, deciding how strategic priorities are to be determined, as well as analysis of the rural context environment. The researcher gives an account of how the evaluation strategies are to be piloted and rolled out thereafter. Lessons learnt are recorded and reported upon. A proposed evaluation plan will be developed, based on the lessons learnt in line with the objectives of the project.

The Right to Housing: Challenges Associated with the ‘Waiting List System’ Ekurhuleni Metropolitan Municipality V Various Occupiers, Eden Park Extension 5 2014 3 SA 23 (SCA)

2017 ◽  
Vol 30 (1) ◽  
pp. 112-121
Author(s):  
Shamier Ebrahim
Keyword(s):  
Supreme Court ◽  
Waiting Lists ◽  
The State ◽  
Waiting List ◽  
Allocation Process ◽  
The Supreme Court ◽  
The Right ◽  
The Impact ◽  
Court Of Appeal

The right to adequate housing is a constitutional imperative which is contained in section 26 of the Constitution. The state is tasked with the progressive realisation of this right. The allocation of housing has been plagued with challenges which impact negatively on the allocation process. This note analyses Ekurhuleni Metropolitan Municipality v Various Occupiers, Eden Park Extension 51 which dealt with a situation where one of the main reasons provided by the Supreme Court of Appeal for refusing the eviction order was because the appellants subjected the unlawful occupiers to defective waiting lists and failed to engage with the community regarding the compilation of the lists and the criteria used to identify beneficiaries. This case brings to the fore the importance of a coherent (reasonable) waiting list in eviction proceedings. This note further analyses the impact of the waiting list system in eviction proceedings and makes recommendations regarding what would constitute a coherent (reasonable) waiting list for the purpose of section 26(2) of the Constitution.

IMPACT OF GOVERNMENT DEBT ON FINANCIAL SECURITY OF UKRAINE

2017 ◽  
Author(s):  
Olena Pikaliuk ◽  
◽  
Dmitry Kovalenko ◽  
Keyword(s):  
Economic Development ◽  
Public Debt ◽  
Positive Impact ◽  
The State ◽  
Financial Security ◽  
State Budget ◽  
The Public ◽  
Debt Security ◽  
The Stability ◽  
The Impact

One of the main criteria for economic development is the size of the public debt and its dynamics. The article considers the impact of public debt on the financial security of Ukraine. The views of scientists on the essence of public debt and financial security of the state are substantiated. An analysis of the dynamics and structure of public debt of Ukraine for 2014-2019. It is proved that one of the main criteria for economic development is the size of public debt and its dynamics. State budget deficit, attracting and using loans to cover it have led to the formation and significant growth of public debt in Ukraine. The volume of public debt indicates an increase in the debt security of the state, which is a component of financial security. Therefore, the issue of the impact of public debt on the financial security of Ukraine is becoming increasingly relevant. The constant growth and large amounts of debt make it necessary to study it, which will have a positive impact on economic processes that will ensure the stability of the financial system and enhance its security.

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