scholarly journals The effect of face mask mandates during the COVID-19 pandemic on the rate of mask use in the United States

2020 ◽  
Author(s):  
Michael J. Maloney
Keyword(s):  
United States ◽  
Economic Impact ◽  
Cost Effective ◽  
Face Mask ◽  
Public Spaces ◽  
The United States ◽  
State Governments ◽  
Strongly Correlated ◽  
Effective Measure ◽  
Cost Effective Measure

ABSTRACTAs COVID-19 continues to spread throughout the United States, there has been a search for policies to prevent individual infections, to slow the spread of the virus in general, and to mitigate the economic impact of the pandemic. Masks have proven to be a cost-effective measure in all regards, and as such some state governments have begun to mandate their use. However, while the efficacy of masks has been demonstrated, the efficacy of public policies which mandate the use of masks has not been demonstrated. This paper compares the rates of mask use in counties as defined by state policy. It finds that state mandates are strongly correlated with higher rates of mask use, and that mandating use by all individuals in public spaces is more effective than a less comprehensive mandate for mask use by all public facing employees.

scholarly journals Intra-articular Hyaluronic Acid for Osteoarthritis of the Knee in the United States: A Systematic Review of Economic Evaluations

2021 ◽  
Vol 14 ◽  
pp. 117954412110472
Author(s):  
Margaret Mordin ◽  
William Parrish ◽  
Catherine Masaquel ◽  
Brad Bisson ◽  
Catherine Copley-Merriman
Keyword(s):  
United States ◽  
Hyaluronic Acid ◽  
Literature Review ◽  
Economic Impact ◽  
Cost Effective ◽  
The United States ◽  
Economic Evaluations ◽  
Knee Oa ◽  
Pain Medications ◽  
Number Of Patients

Background: The economic impact of intra-articular hyaluronic acid (IAHA) for the treatment of knee pain associated with osteoarthritis (OA) has been evaluated in the United States, but not systematically summarized. Objective: We reviewed the literature to determine the economic impact of IAHA for pain associated with knee OA in the United States. Methods: A literature review was performed in PubMed (including MEDLINE and MEDLINE In-Process), Embase, the Cochrane Database of Systematic Reviews, and National Health Service Economic Evaluation Database and was limited to English language human studies published from January 2000 to October 2020. Results: The literature search identified 215 unique abstracts; of these, 47 were selected for full-text review and 21 studies met the inclusion criteria. Intra-articular hyaluronic acid injections delayed progression to total knee arthroplasty (TKA), and repeated courses of treatment successfully delayed TKA by more than 5 years. Intra-articular hyaluronic acid was found to reduce the use of pain medications overall and reduce the number of patients receiving opioid prescriptions by 6% ( P < .001). Several studies showed that IAHA is more cost-effective in treating pain associated with knee OA compared with conventional care with nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, and corticosteroids, and several authors concluded that IAHA should be the dominant treatment strategy. Conclusions: Current studies suggest that IAHA may reduce the use of pain medications, such as NSAIDs and opioids, and impact time to TKA procedures, thus potentially decreasing overall treatment costs of knee OA over time. Furthermore, IAHA was determined to be cost-effective against NSAIDs, corticosteroids, analgesics, and conservative treatment. As the safety and efficacy of IAHA for knee OA have been well established, the findings from our literature review may be used to inform future economic evaluations.

The Economic Impact of Acetabular Labral Tears

2016 ◽  
Vol 44 (7) ◽  
pp. 1771-1780 ◽  
Author(s):  
Parth Lodhia ◽  
Chengcheng Gui ◽  
Sivashankar Chandrasekaran ◽  
Carlos Suarez-Ahedo ◽  
Douglas R. Dirschl ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Economic Impact ◽  
Arthroscopic Surgery ◽  
Cost Effective ◽  
The United States ◽  
Harris Hip Score ◽  
Health States ◽  
Lifetime Horizon ◽  
Labral Tears

Background: Hip arthroscopic surgery has emerged as a successful procedure to manage acetabular labral tears and concurrent hip injuries, which if left untreated, may contribute to hip osteoarthritis (OA). Therefore, it is essential to analyze the economic impact of this treatment option. Purpose: To investigate the cost-effectiveness of hip arthroscopic surgery versus structured rehabilitation alone for acetabular labral tears, to examine the effects of age on cost-effectiveness, and to estimate the rate of symptomatic OA and total hip arthroplasty (THA) in both treatment arms over a lifetime horizon. Study Design: Economic and decision analysis; Level of evidence, 2. Methods: A cost-effectiveness analysis of hip arthroscopic surgery compared with structured rehabilitation for symptomatic labral tears was performed using a Markov decision model constructed over a lifetime horizon. It was assumed that patients did not have OA. Direct costs (in 2014 United States dollars), utilities of health states (in quality-adjusted life years [QALYs] gained), and probabilities of transitioning between health states were estimated from a comprehensive literature review. Costs were estimated using national averages of Medicare reimbursements, adjusted for all payers in the United States from a societal perspective. Utilities were estimated from the Harris Hip Score. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to determine the effect of uncertainty on the model outcomes. Results: For a cohort representative of patients undergoing hip arthroscopic surgery at our facility, arthroscopic surgery was more costly (additional $2653) but generated more utility (additional 3.94 QALYs) compared with rehabilitation over a lifetime. The mean ICER was $754/QALY, well below the conventional willingness to pay of $50,000/QALY. Arthroscopic surgery was cost-effective for 94.5% of patients. Although arthroscopic surgery decreased in cost-effectiveness with increasing age, arthroscopic surgery remained more cost-effective than rehabilitation for patients in the second to seventh decades of life. The lifetime incidence of symptomatic hip OA was over twice as high for patients treated with rehabilitation compared with arthroscopic surgery. The preferred treatment was sensitive to the utility after successful hip arthroscopic surgery, although the utility at which arthroscopic surgery becomes less cost-effective than rehabilitation is far below our best estimate. For older patients, the lifetime cost of arthroscopic surgery was greater, while the lifetime utility of arthroscopic surgery was less, approaching that of the rehabilitation arm. Conclusion: Hip arthroscopic surgery is more cost-effective and results in a considerably lower incidence of symptomatic OA than structured rehabilitation alone in treating symptomatic labral tears of patients in the second to seventh decades of life without pre-existing OA.

scholarly journals Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010

2021 ◽  
Vol 18 (15) ◽  
pp. 7864
Author(s):  
Minaal Farrukh ◽  
Haneen Khreis
Keyword(s):  
United States ◽  
Air Pollution ◽  
Economic Impact ◽  
Childhood Asthma ◽  
Ambient Air ◽  
The United States ◽  
The State ◽  
Cost Calculation ◽  
Cost Burden ◽  
Incident Cases

Background: Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers. Objective: The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO2), a common traffic-related air pollutant in urban areas, in the United States at the state level. Methods: We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO2 using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO2-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO2 in the United States. Results: The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO2 in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20–$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62–$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06–$144,269.18). Conclusion: This study estimates the annual costs of childhood asthma incident cases attributable to NO2 and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP’s impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population’s exposure.

scholarly journals Economic Impact from Unrestricted Spread of Potato Cyst Nematodes in Australia

2009 ◽  
Vol 99 (12) ◽  
pp. 1387-1393 ◽  
Author(s):  
M. Hodda ◽  
D. C. Cook
Keyword(s):  
United States ◽  
Confidence Interval ◽  
Economic Impact ◽  
Annual Cost ◽  
The United States ◽  
Economic Consequences ◽  
Potato Cyst Nematodes ◽  
Cyst Nematodes ◽  
Model Predictions ◽  
Alternative Responses

Potato cyst nematodes (PCN) (Globodera spp.) are quarantine pests with serious potential economic consequences. Recent new detections in Australia, Canada, and the United States have focussed attention on the consequences of spread and economic justifications for alternative responses. Here, a full assessment of the economic impact of PCN spread from a small initial incursion is presented. Models linking spread, population growth, and economic impact are combined to estimate costs of spread without restriction in Australia. Because the characteristics of the Australian PCN populations are currently unknown, the known ranges of parameters were used to obtain cost scenarios, an approach which makes the model predictions applicable generally. Our analysis indicates that mean annual costs associated with spread of PCN would increase rapidly initially, associated with increased testing. Costs would then increase more slowly to peak at over AUD$20 million per year ≈10 years into the future. Afterward, this annual cost would decrease slightly due to discounting factors. Mean annual costs over 20 years were $18.7 million, with a 90% confidence interval between AUD$11.9 million and AUD$27.0 million. Thus, cumulative losses to Australian agriculture over 20 years may exceed $370 million without action to prevent spread of PCN and entry to new areas.

scholarly journals The Effect of Partisan Representation at Different Levels of Government on Satisfaction with Democracy in the United States

2021 ◽  
pp. 1-27 ◽  
Author(s):  
Julie VanDusky-Allen ◽  
Stephen M. Utych
Keyword(s):  
United States ◽  
State Government ◽  
The United States ◽  
State Governments ◽  
Satisfaction With Democracy ◽  
National Election Study ◽  
American National Election Study ◽  
Respective State ◽  
Different Levels ◽  
Analyze Data

AbstractIn this paper, we analyze how variations in partisan representation across different levels of government influence Americans’ satisfaction with the democracy in the United States. We conduct two survey experiments and analyze data from the 2016 American National Election Study postelection survey. We find that Americans are the most satisfied with democracy when their most preferred party controls both the federal and their respective state governments. However, we also find that even if an individual’s least preferred party only controls one level of government, they are still more satisfied with democracy than if their most preferred party controls no levels of government. These findings suggest that competition in elections across both the national and state government, where winning and losing alternates between the two parties, may have positive outcomes for attitudes toward democracy.

Comment

1980 ◽  
Vol 2 (2-3) ◽  
pp. 108-109
Author(s):  
Mark Kesselman
Keyword(s):  
United States ◽  
Local Government ◽  
Federal Government ◽  
The United States ◽  
State Governments ◽  
Local Autonomy ◽  
Fundamental Change ◽  
Local Expenditures

Acentral ingredient of democracy in the United States, according to Tocqueville, was local autonomy – yet the data presented by Professor Austin suggests a fundamental change in the United States since Tocquevilles time. Most local expenditures are now provided by the federal and state governments, most “local” programs are not local at all, for many (if not most) purposes the local government has become an extension of the federal government, and it is often replaced altogether by federally created field agencies (what the French call deconcentrated administration).

scholarly journals Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

2015 ◽  
Vol 4 (6) ◽  
pp. 82 ◽  
Author(s):  
Julie M. Mhlaba ◽  
Emily W. Stockert ◽  
Martin Coronel ◽  
Alexander J. Langerman
Keyword(s):  
United States ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Waste Reduction ◽  
Significant Cost ◽  
Instrument Type ◽  
Hospital Revenue ◽  
Potential Strategy ◽  
The Cost

Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

Comparative Environmental Federalism: Subsidiarity and Central Regulation in the United States and China

2017 ◽  
Vol 6 (3) ◽  
pp. 531-549 ◽  
Author(s):  
Huiyu Zhao ◽  
Robert Percival
Keyword(s):  
United States ◽  
Environmental Protection ◽  
Environmental Governance ◽  
The United States ◽  
Conclusive Evidence ◽  
State Governments ◽  
Race To The Bottom ◽  
Environmental Laws ◽  
National Governments ◽  
National Environmental

AbstractThe proper division of responsibility for environmental protection between national and state governments has long been the subject of fierce debate. During the 1970s the United States Congress decided to shift the most important environmental responsibilities from state governments to the federal government. The main reason for this decision was to prevent a ‘race to the bottom’ in that states competing for industries could otherwise be lax in implementing and enforcing federal environmental standards. Yet, some scholars have argued that there could just as easily be a ‘race to the top’ among states as they compete to attract people and businesses concerned with environmental protection. China, in turn, is plagued with severe air and water pollution and soil contamination, which is attributed largely to ineffective enforcement of its national environmental laws. This article investigates whether China’s experience confirms the race-to-the-bottom theory. It demonstrates that devolution of responsibility for environmental protection to lower levels of government tends to result in lax implementation and enforcement of national environmental laws, particularly where national governments also create strong incentives for economic growth. It concludes that China’s highly devolved system of environmental governance is consistent with this theory, even if it does not provide conclusive evidence of its correctness.

Pension Enhancements and the Retention of Public Employees

ILR Review ◽  
2016 ◽  
Vol 70 (2) ◽  
pp. 519-551 ◽  
Author(s):  
Cory Koedel ◽  
P. Brett Xiang
Keyword(s):  
United States ◽  
Public Sector ◽  
Employee Retention ◽  
Cost Effective ◽  
The United States ◽  
Pension Plans ◽  
Public Employees ◽  
Public School Teachers ◽  
School Teachers ◽  
Public Pension Plans

The authors use data from workers in the largest public-sector occupation in the United States—teaching—to examine the effect of pension enhancements on employee retention. Specifically, they study a 1999 enhancement to the benefit formula for public school teachers in St. Louis, Missouri, that resulted in an immediate and dramatic increase in their incentives to remain in covered employment. To identify the effect of the enhancement on teacher retention, the analysis leverages the fact that the strength of the incentive increase varied across the workforce depending on how far teachers were from retirement eligibility when it was enacted. The results indicate that the St. Louis enhancement—which was structurally similar to enhancements that were enacted in other public pension plans across the United States in the late 1990s and early 2000s—was not a cost-effective way to increase employee retention.

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