scholarly journals Parents and offspring in an evolutionary game: the effect of supply on demand when costs of care vary

2011 ◽  
Vol 279 (1726) ◽  
pp. 109-115 ◽  
Author(s):  
Uri Grodzinski ◽  
Rufus A. Johnstone
Keyword(s):  
Evolutionary Game ◽  
Cost Of Care ◽  
Quantitative Relation ◽  
Costs And Benefits ◽  
Parental Responsiveness ◽  
Opposite Case ◽  
On Demand ◽  
The Cost ◽  
The Impact ◽  
Care Costs

Current models of parent–offspring communication do not explicitly predict the effect of parental food supply on offspring demand (ESD). However, existing theory is frequently interpreted as predicting a negative ESD, such that offspring beg less when parental supply is high. While empirical evidence largely supports this interpretation, several studies have identified the opposite case, with well-fed offspring begging more than those in poorer condition. Here, we show that signalling theory can give rise to either a negative or a positive ESD depending on the precise form of costs and benefits. Introducing variation among parents in the cost of care, we show that the ESD may change sign depending upon the quantitative relation between two effects: (i) decreased supply leads to increased begging because of an increase in marginal fitness benefit of additional resources to offspring, (ii) decreased supply leads to reduced begging because it is associated with a decrease in parental responsiveness, rendering begging less effective. To illustrate the interplay between these two effects, we show that Godfray's seminal model of begging yields a negative ESD when care is generally cheap, because the impact of supply on the marginal benefits of additional resources then outweighs the associated changes in parental responsiveness to begging. By contrast, the same model predicts a positive ESD when care is generally costly, because the impact of care costs on parental responsiveness then outweighs the change in marginal benefits.

Impact of new technologies on health-care costs and on the nation's "health"

1990 ◽  
Vol 36 (8) ◽  
pp. 1612-1616 ◽  
Author(s):  
T A Massaro
Keyword(s):  
Health Care ◽  
New Technologies ◽  
Well Being ◽  
Cost Of Care ◽  
American Health Care System ◽  
The Public ◽  
American Health Care ◽  
The Cost ◽  
The Impact ◽  
Care Costs

Abstract By virtually all criteria, the American health-care system has the largest and most widely distributed technology base of any in the world. The impact of this emphasis on technology on the cost of care, the rate of health-care inflation, and the well-being of the population is reviewed from the perspective of the patient, the provider, and the public health analyst.

GSS 2011 Linked with TIFF: Exploring the Cost of Child Care in Canada and the Use of the Child Care Tax Benefit

2019 ◽  
Vol 12 (1) ◽  
pp. 81-103
Author(s):  
Leanne Findlay ◽  
Dafna Kohen
Keyword(s):  
Child Care ◽  
General Social Survey ◽  
Cost Of Care ◽  
Indigenous Identity ◽  
Social Survey ◽  
The Cost ◽  
Care Costs ◽  
Compare And Contrast ◽  
Employment Characteristics ◽  
Different Sources

Affordability of child care is fundamental to parents’, in particular, women’s decision to work. However, information on the cost of care in Canada is limited. The purpose of the current study was to examine the feasibility of using linked survey and administrative data to compare and contrast parent-reported child care costs based on two different sources of data. The linked file brings together data from the 2011 General Social Survey (GSS) and the annual tax files (TIFF) for the corresponding year (2010). Descriptive analyses were conducted to examine the socio-demographic and employment characteristics of respondents who reported using child care, and child care costs were compared. In 2011, parents who reported currently paying for child care (GSS) spent almost $6700 per year ($7,500 for children age 5 and under). According to the tax files, individuals claimed just over $3900 per year ($4,700). Approximately one in four individuals who reported child care costs on the GSS did not report any amount on their tax file; about four in ten who claimed child care on the tax file did not report any cost on the survey. Multivariate analyses suggested that individuals with a lower education, lower income, with Indigenous identity, and who were self-employed were less likely to make a tax claim despite reporting child care expenses on the GSS. Further examination of child care costs by province and by type of care are necessary, as is research to determine the most accurate way to measure and report child care costs.

scholarly journals Research on Cooperative Innovation Behavior of Industrial Cluster Based on Subject Adaptability

2016 ◽  
Vol 2016 ◽  
pp. 1-19 ◽  
Author(s):  
Xiaohui Jia ◽  
Minghui Jiang ◽  
Lei Shi
Keyword(s):  
Steady State ◽  
Evolutionary Game ◽  
Industrial Cluster ◽  
Industrial Clusters ◽  
Government Support ◽  
Correlated Equilibrium ◽  
Game Model ◽  
Cooperative Innovation ◽  
The Cost ◽  
The Impact

From the perspective of the interactive cooperation among subjects, this paper portrays the process of cooperative innovation in industrial cluster, in order to capture the correlated equilibrium relationship among them. Through the utilization of two key tools, evolutionary stable strategy and replicator dynamics equations, this paper considers the cost and gains of cooperative innovation and the amount of government support as well as other factors to build and analyze a classic evolutionary game model. On this basis, the subject’s own adaptability is introduced, which is regarded as the system noise in the stochastic evolutionary game model so as to analyze the impact of adaptability on the game strategy selection. The results show that, in the first place, without considering subjects’ adaptability, their cooperation in industrial clusters depends on the cost and gains of innovative cooperation, the amount of government support, and some conditions that can promote cooperation, namely, game steady state. In the second place after the introduction of subjects’ adaptability, it will affect both game theory selection process and time, which means that the process becomes more complex, presents the nonlinear characteristics, and helps them to make faster decisions in their favor, but the final steady state remains unchanged.

Consumer Cost-Sharing as a Means to Reduce Health Care Costs

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 168-170
Author(s):  
Stephen M. Davidson ◽  
John P. Connelly ◽  
R. Don Blim ◽  
James E. Strain ◽  
H. Doyl Taylor
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Cost Sharing ◽  
Cost Of Care ◽  
National Commission ◽  
Insurance Policies ◽  
National Medical ◽  
Use Of Services ◽  
The Cost ◽  
Care Costs

The National Commission on the Cost of Medical Care1 states in part (Recommendation 2) that "insurance policies should include provisions through which the consumer shares in the cost of care received, at the time of service, for selected benefits and for selected groups...." These cost-sharing provisions are expected to reduce national medical care expenditures by encouraging consumers to reduce their use of services in order to avoid paying additional money out of their own pockets. They will thus moderate the demand-inducing tendency of insurance, leading the rational consumer to seek only necessary services and to forego those services contributing to what is believed to be over-utilization. As the Commission states in its supporting statement:

scholarly journals Jual Beli Dengan Hak Membeli Kembali (Studi Komparasi Antara Kitab Undang-Undang Hukum Perdata dan Fikih Syafi’i)

JURISDICTIE ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 50
Author(s):  
Dewi Wulan Fasya
Keyword(s):  
Civil Law ◽  
Supreme Court Decision ◽  
Cost Of Care ◽  
The Supreme Court ◽  
Buy Back ◽  
The Right ◽  
The Cost ◽  
Care Costs ◽  
Right To Buy

This article seeks to examine the concept of buying and selling the right to buy back the book review law and civil law bai 'al-Wafa, according to the Shafi'i fiqh. In addition, this article also aims to determine the ratio of the purchase with repurchase review the statute books of civil law and bai al-Wafa, according to the Shafi'i fiqh. Based on the discussion of this article indicates that the purchase is a period of time agreed to recall goods that have been sold and the sale can not be more than five years. While bai 'al-Wafa, according to the Shafi'i fiqh of buying and selling that took sides coupled with the condition that the sale could be bought back by the seller, when the time limit has been determined arrive, while the goods sold are free to be used by the buyer. In sale and purchase of the right to buy back also set about replacement care costs of goods and so forth, while bai 'alWafa there is no mention of the replacement cost of care, which is paid only the cost of the initial purchase, the last of the law of sale and purchase with a repurchase in KUHPerdata much contested in the Supreme court decision which MA. No. 1729 K / Pdt / 2004, which stated that the purchase of the right to buy back is not allowed, while bai 'al-Wafa laws in Shafi'i fiqh books Raghibin Kanz al-Minhaj Fi Sharh al-Thalibin a transaction is fasid. <br />Artikel ini bertujuan mengetahui konsep jual beli dengan hak membeli kembali tinjauan kitab undang-undang hukum perdata dan bai` al-wafâ menurut fikih Syafi’i. Selain itu, artikel ini juga bertujuan untuk mengetahui perbandingan dari jual beli dengan hak membeli kembali tinjauan kitab undang-undang hukum perdata dan bai` al-wafâ menurut fikih Syafi’i. Berdasarkan uraian pembahasan artikel ini menunjukkan bahwa dalam jual beli ini ada suatu jangka waktu tertentu yang diperjanjikan untuk menebus kembali barang yang telah dijual dan jangka waktu jual beli ini tidak boleh lebih dari lima tahun. Sedangkan bai’ al-wafâ menurut fikih Syafi’i yaitu jual beli yang dilangsungkan dua pihak yang dibarengi dengan syarat bahwa yang dijual itu dapat dibeli kembali oleh penjual, apabila tenggang waktu yang telah ditentukan tiba, sedangkan barang yang dijual tersebut bebas dipergunakan oleh pembeli. Dalam jual beli dengan hak membeli kembali juga mengatur tentang penggantian biaya perawatan barang dan lain sebagainya, sedangkan bai’ al-wafâ tidak ada menyinggung tentang penggantian biaya perawatan, yang dibayarkan hanya harga awal pembelian, terakhir mengenai hukum dari jual beli dengan hak membeli kembali dalam KUHPerdata banyak dipertentangkan dalam putusan Mahkamah Agung diantaranya Putusan MA. No. 1729 K/Pdt/2004 yang menyatakan bahwa jual beli dengan hak membeli kembali tidak diperbolehkan, sedangkan bai’ al-wafâ hukumnya dalam fikih Syafi’i kitab Kanz al-Râghibin Fi Syarh Minhaj al-Thâlibin merupakan jual beli yang fasid

scholarly journals The challenge of determining appropriate care in the era of patient-centered care and rising health care costs

2018 ◽  
Vol 24 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Ian Coulter ◽  
Patricia Herman ◽  
Gery Ryan ◽  
Lara Hilton ◽  
Ron D. Hays ◽  
...  
Keyword(s):  
Patient Preferences ◽  
The United States ◽  
Patient Centered Care ◽  
Cost Of Care ◽  
Patient Centered ◽  
Inappropriate Care ◽  
Appropriateness Of Care ◽  
Centered Care ◽  
The Cost ◽  
Care Costs

Appropriateness of care is typically determined in the United States by evidence on efficacy and safety, combined with the judgments of experts in research and clinical practice, but without consideration of the cost of care or patient preferences. The shift in focus towards patient-centered care calls for consideration of outcomes that are important to patients, accommodation of patient preferences, and incorporation of the costs of care in patient-provider shared clinical decisions. The RAND/UCLA Appropriateness method was designed to determine rates of appropriate or inappropriate care, but the method did not include patient preferences or costs. This essay examines how methods of studying appropriateness can be made more patient-centered by describing a modification of the RAND/UCLA method by including patient outcomes, preferences, and costs.

Computing the cost of care per day of breast cancer survivor care.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 10-10 ◽  
Author(s):  
Douglas W. Blayney ◽  
Craig Lindquist ◽  
Tina Seto ◽  
Nhat Minh Hoang ◽  
Allison W. Kurian
Keyword(s):  
Breast Cancer ◽  
Cancer Survivor ◽  
Breast Cancer Survivor ◽  
Radiation Treatment ◽  
Cost Of Care ◽  
Survivorship Care ◽  
Co Morbidity ◽  
Social Security Death Index ◽  
The Cost ◽  
The Impact

10 Background: Cost of breast cancer survivor surveillance, of survivorship care and of variation in care practices are unknown. Furthermore, it is not known whether intense surveillance care adds value. We developed a method to measure the cost of surveillance to account for varying follow-up duration [cost of care per day (CCPD)], and explored the impact of surveillance cost on survival. Methods: We queried the Oncoshare database {Kurian et al Cancer 2014}, which amalgamates data from Stanford Health Care’s (SHC) electronic health record (EHR) (imaging, infused drugs, inpatient and outpatient facility and professional services), from the California Cancer Registry, and the Social Security Death Index. We included breast cancer patients diagnosed 2000-2014, Stages 0-III who had surgery, chemotherapy or radiation treatment at SHC, and who had more than two visits at SHC within 3 years of their treatment completion. We tallied Common Procedural Terminology (CPT©) codes assigned to each service, and mapped each CPT code to the corresponding code and date in the CMS Medicare fee schedule. For patients with breast cancer relapse, we explored the post-relapse survival of the costliest 20% compared with the other patients. Results: CCPD was $2.45 for care delivered at SHC. Among the three breast cancer subtypes (luminal, Her-2 over-expressed and triple negative) there was no difference in cost. Among patients who relapsed, those in the most expensive 20% CCPD had significantly shorter survival than other patients. The high-cost patients had more co-morbidity [cerebrovascular disease (4% for low cost vs 7% for high), chronic pulmonary disease (5% vs 10%), CHF (2% vs 7%), diabetes (4% vs 7%), liver disease (4% vs 9%)]. Conclusions: Cost of care per day (CCPD) is a useful metric to assess value of surveillance and survivorship care, and is also applicable to initial treatment and post-relapse care, to identify “positive deviants” ( those who have developed best practices) in high value care delivery. We captured only costs for treatment at SHC, and merging our data with claims data from 3rd party carriers could increase the accuracy and validity of the CCPD. We identified a model for further testing to reduce total spending for high-quality oncology care.

Abstract MP76: Assessing the Impact of the "Health Bucks" Program on Cardiovascular Disease in New York City: A Modeling Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Heesun Eom ◽  
Stella S Yi ◽  
Daniel Bu ◽  
Rienna Russo ◽  
Brandon Bellows ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
New York ◽  
New York City ◽  
Health Care Costs ◽  
York City ◽  
Fruits And Vegetables ◽  
The Cost ◽  
The Impact ◽  
Care Costs

Background: Low fruit and vegetable (FV) consumption is considered one of the leading causes of deteriorating health outcomes, and has been linked to obesity, diabetes, and cardiovascular disease. Yet, few adults in New York City (NYC) consume the daily recommended amounts. In order to address the need for fresh and affordable fruits and vegetables, the NYC Department of Health and Mental Hygiene has implemented the “Health Bucks” program, which provides low-income population with coupons that can be used to purchase fruits and vegetetabls. Previous studies have shown the impact of the Health Bucks program on fruit and vegetable consumption; however, it is unclear how the program would influence cardiovascular health and the associated health care costs in the long term. Objective: To estimate the health and economic impact of the Health Bucks program using a validated microsimulation model of cardiovascular disease (CVD) in NYC. Methods: We used the Simulations for Health Improvement and Equity (SHINE) CVD Model to estimate the impact of the Health Bucks program on lifetime CVD events and direct medical costs (2019 USD). We considered different program strengths by assuming the program can reduce the cost of fruits and vegetables by 20%, 30%, and 40%. Population characteristics were estimated based on data from the 2013-2014 NYC Health and Nutrition Examination Survey. CVD risk factor trajectories and risk of incident CVD events were derived from six pooled longitudinal US cohorts. Policy effects were derived from the literature. We run 1,000 simulations to account for uncertainties in the parameter. We discounted costs by 3% and reported health care costs in 2019 dollars. Results: A Health Bucks program that can reduce the cost of fruits and vegetables by 20%, 30%, and 40% would prevent 2,690 (95% CI: -14,793, 20,173), 27,386 (95% CI: 9,967, 44,805), and 50,014 (95% CI: 15,227, 50,014) coronary heart disease events, respectively, over the simulated lifetimes of the NYC population. The program would also prevent 47,469 (95% CI: 35,008, 59,931), 59,127 (95% CI: 46,676, 71,579), and 85,359 (95% CI: 72,902, 97,815) stroke events based on the price reduction level. The program would result in savings in health care costs, ranged from $937 million to $1.8 billion based on the price reduction level over the lifetime or from $19 million to $37 million annually. Conclusions: We projected that the Health Bucks program could prevent a significant number of CVD events among adults in NYC and yield substantial health care cost savings. Public health practitioners and policymakers may consider adopting this program in other locations.

scholarly journals Impact of Dispensing Services in an Independent Community Pharmacy

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 44
Author(s):  
Kaleb Payne ◽  
Elizabeth J. Unni ◽  
Benjamin Jolley
Keyword(s):  
Cost Saving ◽  
Community Pharmacy ◽  
Adverse Drug Events ◽  
Minimum Cost ◽  
Improve Medication Adherence ◽  
Potential Harm ◽  
Medication Therapy ◽  
The Cost ◽  
The Impact ◽  
Care Costs

With approximately 300 prescriptions dispensed per day in a typical community pharmacy, several activities take place to ensure the safe dispensing of medicines. While some of these activities are common for all prescriptions, others need further activities such as prescription clarification. These activities are important to avoid any potential harm to the patient and improve medication adherence. The objective of this study was to measure the impact of these additional dispensing services in a community pharmacy by evaluating the documented patient notes. Two-hundred patients with annotations on their profiles between 1 July and 31 August 2018 were randomly selected and 322 notes were analyzed. The average number of notes per patient was 1.6. The majority of the notes were about contacting the patient/caregiver for prescription clarification (86.8%). When analyzed based on Medication Therapy Problems, 54.7% were related to adherence and 35.4% to safety. Using the cost saving estimate from the literature for each averted adverse event, these activities resulted in a minimum cost saving of $10,458. This study was able to show the positive impacts that everyday dispensing services in an independent community pharmacy have on ensuring the safe use of medication, thus potentially preventing adverse drug events and reducing health care costs.

Time to Clinical Response: An Outcome of Antibiotic Therapy of Febrile Neutropenia With Implications for Quality and Cost of Care

2000 ◽  
Vol 18 (21) ◽  
pp. 3699-3706 ◽  
Author(s):  
Linda S. Elting ◽  
Edward B. Rubenstein ◽  
Kenneth Rolston ◽  
Scott B. Cantor ◽  
Charles G. Martin ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Antibiotic Therapy ◽  
Clinical Response ◽  
Median Time ◽  
Early Discharge ◽  
Cost Of Care ◽  
Predictive Values ◽  
The Cost ◽  
The Impact ◽  
Time Point

PURPOSE: To determine whether antibiotic regimens with similar rates of response differ significantly in the speed of response and to estimate the impact of this difference on the cost of febrile neutropenia. METHODS: The time point of clinical response was defined by comparing the sensitivity, specificity, and predictive values of alternative objective and subjective definitions. Data from 488 episodes of febrile neutropenia, treated with either of two commonly used antibiotics (coded A or B) during six clinical trials, were pooled to compare the median time to clinical response, days of antibiotic therapy and hospitalization, and estimated costs. RESULTS: Response rates were similar; however, the median time to clinical response was significantly shorter with A-based regimens (5 days) compared with B-based regimens (7 days; P = .003). After 72 hours of therapy, 33% of patients who received A but only 18% of those who received B had responded (P = .01). These differences resulted in fewer days of antibiotic therapy and hospitalization with A-based regimens (7 and 9 days) compared with B-based regimens (9 and 12 days, respectively; P < .04) and in significantly lower estimated median costs ($8,491 v $11,133 per episode; P = .03). Early discharge at the time of clinical response should reduce the median cost from $10,752 to $8,162 (P < .001). CONCLUSION: Despite virtually identical rates of response, time to clinical response and estimated cost of care varied significantly among regimens. An early discharge strategy based on our definition of the time point of clinical response may further reduce the cost of treating non–low-risk patients with febrile neutropenia.

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