scholarly journals Charging of overseas visitors in England and universal health coverage: a cross-sectional analysis of NHS trusts

2020 ◽  
Author(s):  
Joanna Dobbin ◽  
Adrienne Milner ◽  
Alexander Dobbin ◽  
Jessica Potter
Keyword(s):  
Reproductive Age ◽  
Urgent Care ◽  
Freedom Of Information ◽  
European Economic Area ◽  
Health Coverage ◽  
Cross Sectional ◽  
Data Set ◽  
The Cost ◽  
Sectional Analysis ◽  
The Relationship

Abstract Background In 2017, new regulations in England introduced upfront charging for non-urgent care within the National Health Service (NHS). Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. Methods A freedom of information (FOI) request was sent to 135 acute non-specialist NHS trusts in England to create a database of overseas visitors charges. This was analysed using multiple linear regression to explore the relationship between sex, age, nationality, ethnicity, urgency and the cost of healthcare. Results Of 135 acute non-specialist trusts in England 64 replied, providing a data set of 13 484 patients. Women were found to be invoiced higher amounts than men (P = 0.002). Patients were more likely to be women (63 versus 37% men), and within this group, almost half of patients were of reproductive age, with 47.9% (3165) aged 16–40 years old. Only seven trusts supplied data on urgency, and within these trusts the urgency of treatment was significantly related to cost, with the most urgent (immediately necessary) treatment costing the most (P < 0.001). Conclusion This research reflects that that migrant women, and particularly undocumented women, are disproportionately impacted by the NHS charging policies in England.

Charging of overseas visitors within England and achieving Universal Health Coverage: A cross sectional analysis of a freedom of information request of NHS trusts in England

2019 ◽  
Author(s):  
Joanna Dobbin ◽  
Adrienne Milner ◽  
Alexander Dobbin ◽  
Jessica Potter
Keyword(s):  
Health Care ◽  
Linear Regression ◽  
Reproductive Age ◽  
Freedom Of Information ◽  
Health Coverage ◽  
Cross Sectional ◽  
Information Request ◽  
Cost Of Health Care ◽  
The Cost ◽  
Universal Health

Abstract Background Not everybody living in or visiting the UK is eligible for free NHS care. Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. In 2017, new regulations introduced upfront charging for non-urgent care. Following this, reports of individuals being denied treatment – in particular British people from the Windrush generation appeared. This research provides the first large scale dataset examining the demographics of those charged. Methods A freedom of information request was sent to 135 acute non-specialist NHS trusts in England to create a database of non-EEA overseas visitors charges from 2016/17 and 2017/18. This cross sectional survey was analysed using multiple linear regression to explore the relationship between sex, age, nationality, ethnicity, urgency and the cost of health care. Results Of 135 acute non-specialist trusts in England 64 replied, providing a data set of 13,484 patients. Women were found to be invoiced higher amounts than men (p=0.002). Patients were more likely to be women (63% vs. 37% men), and within this group, almost half of patients were of reproductive age, with 47.9% (3165) aged 16 to 40 years old. Multiple linear regression by age group showed that age is significantly related to the cost of health care with patients over 65 paying more than those aged 16-40, and 41-64 (p=0.011), and children under 16 paying less (p<0.001). The urgency of treatment was significantly related to cost, with the most urgent (immediantly necessary) treatment costing the most (p<0.001). Conclusions The demographics of those charged as overseas visitors alligns with the pattern of estimated costs of care for NHS care overall, where women of reproductive age and older patients require a higher amount of medical care. This research reflects current concerns of migrants being left behind in the strive towards universal health coverage which should be based upon quality, equality, and financial protection for patients. A key limitation was the low response rate.. The limitation of missing data has meant that questions surrounding possible charging discrimination of ethnic grounds cannot be answered.

scholarly journals The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajing Jia ◽  
Ying Yang ◽  
Fangchao Liu ◽  
Minjin Zhang ◽  
Qin Xu ◽  
...  
Keyword(s):  
Alanine Aminotransferase ◽  
Elevated Serum ◽  
Population Based ◽  
Reproductive Age ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Serum Alanine Aminotransferase ◽  
Cross Sectional Analysis ◽  
Registration Data ◽  
Sectional Analysis

Abstract Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.

The Opioid Epidemic and Homicide in the United States

2021 ◽  
pp. 002242782098684
Author(s):  
Richard Rosenfeld ◽  
Joel Wallman ◽  
Randolph Roth
Keyword(s):  
United States ◽  
Death Rate ◽  
The United States ◽  
Opioid Epidemic ◽  
Drug Markets ◽  
Cross Sectional ◽  
Homicide Rates ◽  
Overdose Death ◽  
Sectional Analysis ◽  
The Relationship

Objectives: Evaluate the relationship between the opioid epidemic and homicide rates in the United States. Methods: A county-level cross-sectional analysis covering the period 1999 to 2015. The race-specific homicide rate and the race-specific opioid-related overdose death rate are regressed on demographic, social, and economic covariates. Results: The race-specific opioid-related overdose death rate is positively associated with race-specific homicide rates, net of controls. The results are generally robust across alternative samples and model specifications. Conclusions: We interpret the results as reflecting the violent dynamics of street drug markets, although more research is needed to draw definitive conclusions about the mechanisms linking opioid demand and homicide.

scholarly journals Gender Differences in Phytoestrogens and the Relationship with Speed of Processing in Older Adults: A Cross-Sectional Analysis of NHANES, 1999–2002

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1780 ◽  
Author(s):  
Alwerdt ◽  
Patterson ◽  
Sliwinski
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Cognitive Aging ◽  
Linear Models ◽  
Speed Of Processing ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Performance Results ◽  
Sectional Analysis ◽  
The Relationship

Sex hormone changes in adults are known to play a part in aging, including cognitive aging. Dietary intake of phytoestrogens can mimic estrogenic effects on brain function. Since sex hormones differ between genders, it is important to examine gender differences in the phytoestrogen–cognition association. Therefore, the goal of this study is to examine the relationship between urinary phytoestrogens and speed of processing (SOP) and the variation of the association between genders in older adults. Participants were drawn from the 1999–2002 National Health and Nutrition Examination Survey and included 354 individuals aged 65–85 years old. General linear models (GLMs) were used to test for significant gender differences in the relationship between phytoestrogens and SOP. Results from the GLMs showed significant gender differences in the relationship between genistein and SOP. Higher levels of genistein were associated with better SOP in women. This relationship was reversed in men: higher genistein levels were associated with worse performance. Results indicate that there are distinct gender differences in the relationship between genistein and SOP. These results emphasize the importance of considering gender differences when devising dietary and pharmacologic interventions that target phytoestrogens to improve brain health.

Leader positive humor and organizational cynicism: LMX as a mediator

2014 ◽  
Vol 35 (4) ◽  
pp. 305-315 ◽  
Author(s):  
Panagiotis Gkorezis ◽  
Eugenia Petridou ◽  
Panteleimon Xanthiakos
Keyword(s):  
Mediating Effect ◽  
Hierarchical Regression ◽  
Public Employees ◽  
Cross Sectional ◽  
Content Type ◽  
Organizational Cynicism ◽  
Member Exchange ◽  
Sectional Analysis ◽  
The Impact ◽  
The Relationship

Purpose – Leader-member exchange (LMX) has been proposed as a core mechanism which accounts for the impact of various antecedents on employee outcomes. As such, the purpose of this paper is to examine the mediating effect of LMX regarding the relationship between leader positive humor and employees’ perceptions of organizational cynicism. Design/methodology/approach – Data were collected from 114 public employees. In order to examine the authors’ hypotheses hierarchical regression analysis was conducted. Findings – As hypothesized, results demonstrated that LMX mediates the relationship between leader positive humor and organizational cynicism. Research limitations/implications – Data were drawn from public employees and, therefore, this may constrain the generalizability of the results. Also, the cross-sectional analysis of the data cannot directly assess causality. Originality/value – This is the first empirical study to examine the mediating effect of LMX in the relationship between leader humor and employees’ perceptions of organizational cynicism.

scholarly journals Daily Sitting for Long Periods Increases the Odds for Subclinical Atheroma Plaques

2021 ◽  
Vol 10 (6) ◽  
pp. 1229
Author(s):  
Jose Luis Perez-Lasierra ◽  
Martin Laclaustra ◽  
Pilar Guallar-Castillón ◽  
Jose Antonio Casasnovas ◽  
Jose Antonio Casajús ◽  
...  
Keyword(s):  
Physical Activity ◽  
Subclinical Atherosclerosis ◽  
Sitting Time ◽  
Health Study ◽  
Activity Levels ◽  
Cross Sectional ◽  
Trained Personnel ◽  
Atherosclerosis Development ◽  
Sectional Analysis ◽  
The Relationship

Sedentarism is a risk factor for cardiovascular disease (CVD), but currently it is not clear how a sedentary behavior such as long sitting time can affect atherosclerosis development. This study examined the relationship between sitting time and the prevalence of carotid and femoral subclinical atherosclerosis. A cross-sectional analysis based on a subsample of 2082 participants belonging to the Aragon Workers’ Health Study was carried out. Ultrasonography was used to assess the presence of plaques in carotid and femoral territories; the validated Spanish version of the questionnaire on the frequency of engaging in physical activity used in the Nurses’ Health Study and the Health Professionals’ was used to assess physical activity and sitting time; and demographic, anthropometric, and clinical data were obtained by trained personnel during the annual medical examination. Participants were categorized into <9 h/day and ≥9 h/day sitting time groups. After adjusting for several confounders, compared with participants that remain seated <9 h/day, those participants who remain seated ≥9 h/day had, respectively, OR = 1.25 (95%CI: 1.01, 1.55, p < 0.05) and OR = 1.38 (95%CI: 1.09, 1.74, p < 0.05) for carotid and any-territory plaque presence. Remaining seated ≥9 h/day is associated with higher odds for carotid and any-territory plaque presence independently of physical activity levels and other cardiovascular risk factors.

A Cross Sectional Analysis of Tourism Development and Social Development

2021 ◽  
Vol 12 (2) ◽  
pp. 487
Author(s):  
Tauseef AMAN ◽  
Mussawar SHAH ◽  
Humera JAMAL ◽  
Younas KHAN ◽  
Muhammad ARIF ◽  
...  
Keyword(s):  
Social Development ◽  
Local Community ◽  
Tourism Development ◽  
Chi Square ◽  
Cross Sectional ◽  
Close Proximity ◽  
Chi Square Test ◽  
The Government ◽  
Sectional Analysis ◽  
The Relationship

The major objective of this study was to measure the association between various interventions and Chitral Gole National Park (CGNP) role in preservation of bio-diversity and socio-economic uplift. A sample size of 346 respondents was randomly selected from total population of 3326 from the 4 selected villages on the basis of close proximity. A conceptual framework including dependent variable social development and independent variable tourism development were taken. The data were analyzed through frequency and percentage distribution. Moreover, Chi-square test was applied to know the relationship between dependent and independent variables at bi-variate level. In bi-variate analysis a highly significant (P=0.000) relation was found between CGNP is main source of promoting tourism in Chitral,tourists do any impacts upon local community in terms of increased business activities, local culture is safeguarded despite influx of tourists in the area, tourism produced employment opportunities, and social development. Qualitative data supported the empirical findings, however tourism brings economic opportunities at micro and macro level, but unfortunately CGNP is not as satisfactory regarding generating income since its establishment. The government should ensure to make such polices pertaining to the entrance fee, provides accommodation services on payment to the tourists and to reserve the entrance fee or any other form of taxes to ensure CGNP to spend on self-sustaining basis by ensuring refinement in the procedures as well.

Dead Hand Proxy Puts and Hedge Fund Activism

2018 ◽  
Vol 54 (4) ◽  
pp. 1615-1642
Author(s):  
Sean J. Griffith ◽  
Natalia Reisel
Keyword(s):  
Cash Flow ◽  
Hedge Fund ◽  
Cost Benefit ◽  
Free Cash Flow ◽  
Cross Sectional ◽  
Flow Problems ◽  
Banking Relationships ◽  
Hedge Fund Activism ◽  
The Cost ◽  
Sectional Analysis

We investigate the Dead Hand Proxy Put, a contractual innovation in corporate debt agreements that may impact hedge fund activism. We find the provision principally in loans, not bonds, and provide evidence linking the adoption of the provision to hedge fund activism. Furthermore, controlling for endogeneity, we find that the provision significantly reduces the cost of loans. Bondholder wealth also increases. Moreover, cross-sectional analysis of share returns reveals that the provision is positively associated with repeat banking relationships and negatively associated with free cash flow problems, suggesting a cost-benefit tradeoff.

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