The Impact of Medical and Nursing Home Expenses on Savings

2014 ◽  
Vol 6 (3) ◽  
pp. 29-72 ◽  
Author(s):  
Karen A. Kopecky ◽  
Tatyana Koreshkova
Keyword(s):  
Nursing Home ◽  
Social Insurance ◽  
The United States ◽  
Idiosyncratic Risk ◽  
Cycle Model ◽  
Cross Sectional ◽  
Aggregate Wealth ◽  
Out Of Pocket Expenses ◽  
The Impact ◽  
Wealth Decumulation

We consider a life-cycle model with idiosyncratic risk in earnings, out-of-pocket medical and nursing home expenses, and survival. Partial insurance is available through welfare, Medicaid, and social security. Calibrating the model to the United States we show that savings for old-age, out-of-pocket expenses account for 13.5 percent of aggregate wealth, half of which is due to nursing home expenses; cross-sectional out-of-pocket nursing home risk accounts for 3 percent of aggregate wealth and substantially slows down wealth decumulation at older ages; and all newborns would benefit if social insurance for nursing home stays was made more generous. (JEL D91, E21, E62, H51, I13, I18, I38, J14)

scholarly journals Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043863
Author(s):  
Jingyuan Wang ◽  
Ke Tang ◽  
Kai Feng ◽  
Xin Lin ◽  
Weifeng Lv ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Relative Humidity ◽  
Human Mobility ◽  
The United States ◽  
Reproductive Number ◽  
Cross Sectional ◽  
The Usa ◽  
Higher Temperature ◽  
Potential Impact ◽  
The Impact

ObjectivesWe aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.DesignA retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.SettingWe use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.ParticipantsA total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.Primary outcome measuresRegression analysis of the impact of temperature and relative humidity on the effective reproductive number (R value).ResultsStatistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (R value) in both China and the USA.ConclusionsHigher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in the R value of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in the R value by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.

scholarly journals Debt Relief and Debtor Outcomes: Measuring the Effects of Consumer Bankruptcy Protection

2015 ◽  
Vol 105 (3) ◽  
pp. 1272-1311 ◽  
Author(s):  
Will Dobbie ◽  
Jae Song
Keyword(s):  
United States ◽  
Social Insurance ◽  
The United States ◽  
Debt Relief ◽  
Random Assignment ◽  
Percentage Points ◽  
Consumer Bankruptcy ◽  
Annual Earnings ◽  
The Impact

Consumer bankruptcy is one of the largest social insurance programs in the United States, but little is known about its impact on debtors. We use 500,000 bankruptcy filings matched to administrative tax and foreclosure data to estimate the impact of Chapter 13 bankruptcy protection on subsequent outcomes. Exploiting the random assignment of bankruptcy filings to judges, we find that Chapter 13 protection increases annual earnings by $5,562, decreases five-year mortality by 1.2 percentage points, and decreases five-year foreclo-sure rates by 19.1 percentage points. These results come primarily from the deterioration of outcomes among dismissed filers, not gains by granted filers. (JEL D14, I12, J22, J31, K35)

OHNS Residency Program and Applicant Social Media Presence During the COVID-19 Pandemic

2021 ◽  
pp. 000348942098797
Author(s):  
Shadi Ahmadmehrabi ◽  
Deborah X. Xie ◽  
Bryan K. Ward ◽  
Paul C. Bryson ◽  
Patrick Byrne
Keyword(s):  
Social Media ◽  
The United States ◽  
Cross Sectional Study ◽  
Application Process ◽  
Cross Sectional ◽  
Residency Programs ◽  
Social Media Presence ◽  
Residency Application ◽  
The Impact ◽  
Residency Match

Objectives: In addition to clinical and social disruption, the Coronavirus Disease 2019 (COVID-19) pandemic has affected many aspects of the otolaryngology residency application process. With delays in the 2021 Electronic Residency Applications Service (ERAS) timeline, students and programs have had more time to interact prior to the formal application process. This communication will report recent trends in social media presence by OHNS residency programs, and discuss mechanisms to compensate for decreased applicant-program interactions using social media ahead of the 2021 Match. Methods: In a cross-sectional study of the accredited otolaryngology residency programs in the United States, the number of social media profiles on Twitter, Instagram, and Facebook from 2009 to 2019 were recorded and compared. Results: Most programs (61%) have at least 1 social media profile. Over the past 10 years, the number of programs on social media has increased. During the COVID-19 pandemic, Twitter and Instagram showed higher rates of growth compared to Facebook. With the reduction of in-person opportunities for interactions, both applicants and programs are utilizing social media to showcase their values and their research. Twitter, in particular, also serves as a platform for professional networking. Conclusion: Both Twitter and Instagram are growing in popularity among programs and applicants to enhance networking. Social media is a powerful tool for networking and may help compensate for limitations imposed on the residency match process by the COVID-19 pandemic while maintaining professionalism considerations. The impact of social media on the 2021 otolaryngology residency match is an evolving phenomenon.

scholarly journals Physician beliefs about the impact of meaningful use of the EHR

2014 ◽  
Vol 05 (03) ◽  
pp. 789-801 ◽  
Author(s):  
D.Y. Ting ◽  
M. Healey ◽  
S.R. Lipsitz ◽  
A.S. Karson ◽  
J. S. Einbinder ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Primary Care Physicians ◽  
Meaningful Use ◽  
The United States ◽  
Improve Quality ◽  
Cross Sectional ◽  
Incentive Program ◽  
Physician Beliefs ◽  
The Impact

SummaryBackground: As adoption and use of electronic health records (EHRs) grows in the United States, there is a growing need in the field of applied clinical informatics to evaluate physician perceptions and beliefs about the impact of EHRs. The meaningful use of EHR incentive program provides a suitable context to examine physician beliefs about the impact of EHRs.Objective: Contribute to the sparse literature on physician beliefs about the impact of EHRs in areas such as quality of care, effectiveness of care, and delivery of care.Methods: A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who were preparing to qualify for the meaningful use of EHR incentive program.Results: Of the 1,797 physicians at both AMCs who were preparing to qualify for the incentive program, 967 completed the survey for an overall response rate of 54%. Only 23% and 27% of physicians agreed or strongly agreed that meaningful use of the EHR will help them improve the care they personally deliver and improve quality of care respectively. Physician specialty was significantly associated with beliefs; e.g., 35% of primary care physicians agreed or strongly agreed that meaningful use will improve quality of care compared to 26% of medical specialists and 21% of surgical specialists (p=0.009). Satisfaction with outpatient EHR was also significantly related to all belief items.Conclusions: Only about a quarter of physicians in our study responded positively that meaningful use of the EHR will improve quality of care and the care they personally provide. These findings are similar to and extend findings from qualitative studies about negative perceptions that physicians hold about the impact of EHRs. Factors outside of the regulatory context, such as physician beliefs, need to be considered in the implementation of the meaningful use of the EHR incentive program.Citation: Emani S, Ting DY, Healey M, Lipsitz SR, Karson AS, Einbinder JS, Leinen L, Suric V, Bates DW. Physician beliefs about the impact of meaningful use of the EHR: A cross-sectional study. Appl Clin Inf 2014; 5: 789–801http://dx.doi.org/10.4338/ACI-2014-05-RA-0050

scholarly journals HUBUNGAN PANDEMI COVID-19 DAN PSBB DENGAN GANGGUAN DEPRESI PADA LANSIA DI PANTI WREDA HANA CIPUTAT JAKARTA

2021 ◽  
Vol 1 (1) ◽  
pp. 66
Author(s):  
Anggun Tsabitah Rachmah ◽  
Noer Saelan Tadjudin
Keyword(s):  
Nursing Home ◽  
Large Scale ◽  
Depressive Disorders ◽  
The Elderly ◽  
Elderly Subjects ◽  
Research Subjects ◽  
Chi Square ◽  
Cross Sectional ◽  
The Government ◽  
The Impact

Pemerintah Indonesia selama pandemi COVID-19 menerapkan PSBB (Pembatasan Sosial Berskala Besar) dimana PSBB tersebut membuat aktivitas masyarakat dibatasi, dampaknya juga bisa dirasakan pada lansia di Panti Wreda sehingga dapat menyebabkan timbulnya gangguan depresi. Penelitian ini bertujuan untuk mengetahui hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. Penelitian ini menggunakan metode analitik observational dengan desain studi cross sectional. Penelitian ini dilakukan di Panti Wreda Hana Ciputat Jakarta terhadap lansia sejumlah 56 subjek penelitian yang terdiri dari perempuan 48 orang dan laki-laki 8 orang. Dari 56 subjek penelitian jumlah laki-laki 8 (14,3%) dan perempuan 48 (85,7%). Sebelum terjadinya pandemi COVID-19 dan PSBB, subjek penelitian yang tidak depresi sejumlah 49 subjek (87,5 %), kemungkinan besar depresi 6 subjek (10,7%), dan yang mengalami depresi 1 subjek (1,8%). Selama pandemi COVID19 dan PSBB, subjek penelitian yang tidak depresi 38 subjek (67,9%), kemungkinan besar depresi 14 subjek (25%), dan yang mengalami depresi 4 subjek (7,1%). Berdasarkan hasil uji Chi-square nilai p= 0,000. Dapat disimpulkan terdapat hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. The Government of Indonesia during the COVID-19 pandemic implemented PSBB (Large-Scale Social Restrictions) where the PSBB made community activities restricted, the impact can also be felt on the elderly in nursing home so that it can cause depressive disorders. This research was done in order to determine the relationship of the COVID-19 pandemic and PSBB with depressive disorders in the elderly at the Ciputat Hana Nursing Home in Jakarta. This study used an observational analytic method with a cross sectional study design. The research was conducted at the Ciputat Hana Nursing Home in Jakarta for 56 elderly subjects. In the nursing home consist of 48 women and 8 men. In 56 research subjects, there were 8 (14,3%) men and 48 (85,7%) women. Before the Pandemic of COVID-19 and PSBB, there were 49 (87,5%) research subjects who were not depressed, 6 (10,7%) research subjects who were most likely depressed, and 1 (1,8%) research subject who were depressed. During the Pandemic of COVID-19 and PSBB, there were 38 (67,9%) research subjects who were not depressed, 14 (25%) research subjects who were most likely depressed, and 4 (7,1%) research subjects who were depressed. Based on Chi-Square test result, the value of P = 0,000. In conclusion, there is a correlation between the pandemic of COVID-19 and PSBB with depression disorder in the elderly at Ciputat Hana Nursing Home in Jakarta.

scholarly journals Timing and Reasons Behind Single-Sport Specialization in Soccer: A Survey of 64 Major League Soccer Athletes

2020 ◽  
Vol 12 (4) ◽  
pp. 355-360
Author(s):  
Derrick M. Knapik ◽  
Katherine H. Rizzone ◽  
James E. Voos
Keyword(s):  
High School ◽  
The United States ◽  
Injury Incidence ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Advanced Level ◽  
School Location ◽  
Major League Soccer ◽  
Major League ◽  
The Impact

Background: Single-sport specialization at the exclusion of other sports has become increasingly popular in youth sporting culture. The purpose of this study was to survey Major League Soccer (MLS) athletes to examine factors influencing the timing of single-sport specialization in soccer. Hypothesis: The majority of surveyed athletes will have participated in multiple sports prior to specialization and specialized primarily as a result of a coach’s recommendation, with no significant impact on specialization timing stemming from birth or high school location, obtaining a collegiate scholarship, MLS experience, or position. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: Anonymous surveys were distributed to 3 MLS organizations and completed by MLS athletes during preseason physicals. Surveys evaluated the age and reason(s) behind an athlete’s decision to specialize in soccer, birth location, geographic high school location for US-born athletes, participation in a developmental league, college scholarship, years in the MLS, and position played. Results: Approximately 74% (64/86) of athletes returned completed surveys. Athletes reported beginning soccer at a mean age of 5.1 ± 2.1 years and specializing at age 12.6 ± 4.3 years. Athletes who participated in no other sports prior to specialization ( P < 0.001), athletes reporting soccer to be their first sport played at an advanced level ( P < 0.001), and athletes receiving a college scholarship ( P = 0.02) specialized at a significantly younger age. Internationally born athletes specialized at significantly younger ages when compared with US-born athletes ( P < 0.001). Conclusion: The majority of athletes participated in multiple sports prior to specialization and eventually specialized to focus exclusively on soccer. The timing of sport specialization in professional MLS athletes was not associated with multisport participation prior to specialization, playing soccer at an advanced level prior to other sports, receiving a college scholarship, or being born outside the United States. Clinical Relevance: Timing of sport specialization is associated with multiple factors prior to athlete promotion to the MLS that warrant further investigation to better understand the impact of specialization on injury incidence, performance, and career length.

scholarly journals Game-Related Impacts in High School Boys’ Lacrosse

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983558 ◽  
Author(s):  
Shane V. Caswell ◽  
Patricia Kelshaw ◽  
Andrew E. Lincoln ◽  
Lisa Hepburn ◽  
Reginald Dunn ◽  
...  
Keyword(s):  
High School ◽  
Rotational Velocity ◽  
Linear Acceleration ◽  
The United States ◽  
Head Impact ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Head Impacts ◽  
Direct Head ◽  
The Impact

Background: The rate of concussions in boys’ lacrosse is reported to be the third highest among high school sports in the United States, but no studies have described game-related impacts among boys’ lacrosse players. Purpose: To characterize verified game-related impacts, both overall and those directly to the head, in boys’ varsity high school lacrosse. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 77 male participants (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.05 m; mean weight, 73.4 ± 12.2 kg) were instrumented with sensors and were videotaped during 39 games. All verified game-related impacts ≥20 g were summarized in terms of frequency, peak linear acceleration (PLA), and peak rotational velocity (PRV). Descriptive statistics and impact rates per player-game (PG) with corresponding 95% CIs were calculated. Results: Overall, 1100 verified game-related impacts were recorded (PLA: median, 33.5 g [interquartile range (IQR), 25.7-51.2]; PRV: median, 1135.5 deg/s [IQR, 790.0-1613.8]) during 795 PGs. The rate for all verified game-related impacts was 1.38 impacts per PG (95% CI, 1.30-1.47). Of these, 680 (61.8%) impacts (PLA: median, 35.9 g [IQR, 26.7-55.5]; PRV: 1170.5 deg/s [IQR, 803.2-1672.8]) were directly to the head (impact rate, 0.86 impacts/PG [95% CI, 0.79-0.92]). Overall, midfielders (n = 514; 46.7%) sustained the most impacts, followed by attackers (n = 332; 30.2%), defenders (n = 233; 21.2%), and goalies (n = 21; 1.9%). The most common mechanisms for overall impacts and direct head impacts were contact with player (overall: n = 706 [64.2%]; head: n = 397 [58.4%]) and stick (overall: n = 303 [27.5%]; head: n = 239 [35.1%]), followed by ground (overall: n = 73 [6.6%]; head: n = 26 [3.8%]) and ball (overall: n = 15 [1.4%]; head: n = 15 [2.2%]). Direct head impacts were associated with a helmet-to-helmet collision 31.2% of the time, and they were frequently (53.7%) sustained by the players delivering the impact. Nearly half (48.8%) of players delivering contact used their helmets to initiate contact that resulted in a helmet-to-helmet impact. Players receiving a head impact from player contact were most often unprepared (75.9%) for the collision. Conclusion: The helmet is commonly used to initiate contact in boys’ high school lacrosse, often targeting defenseless opponents. Interventions to reduce head impacts should address rules and coaching messages to discourage intentional use of the helmet and encourage protection of defenseless opponents.

scholarly journals Declining mental health among disadvantaged Americans

2018 ◽  
Vol 115 (28) ◽  
pp. 7290-7295 ◽  
Author(s):  
Noreen Goldman ◽  
Dana A. Glei ◽  
Maxine Weinstein
Keyword(s):  
Mental Health ◽  
Psychological Health ◽  
Positive Emotions ◽  
Well Being ◽  
The United States ◽  
Opioid Epidemic ◽  
Cross Sectional ◽  
Modest Improvement ◽  
The Us ◽  
The Impact

Although there is little dispute about the impact of the US opioid epidemic on recent mortality, there is less consensus about whether trends reflect increasing despair among American adults. The issue is complicated by the absence of established scales or definitions of despair as well as a paucity of studies examining changes in psychological health, especially well-being, since the 1990s. We contribute evidence using two cross-sectional waves of the Midlife in the United States (MIDUS) study to assess changes in measures of psychological distress and well-being. These measures capture negative emotions such as sadness, hopelessness, and worthlessness, and positive emotions such as happiness, fulfillment, and life satisfaction. Most of the measures reveal increasing distress and decreasing well-being across the age span for those of low relative socioeconomic position, in contrast to little decline or modest improvement for persons of high relative position.

The Impact of Custodial Grandparenting on Cognitive Performance in a Longitudinal Sample of Grandparents Raising Grandchildren

2020 ◽  
pp. 0192513X2097672
Author(s):  
Ian T. McKay ◽  
Danielle K. Nadorff
Keyword(s):  
Cognitive Performance ◽  
Longitudinal Research ◽  
The United States ◽  
Word Recall ◽  
Grandparents Raising Grandchildren ◽  
Custodial Grandparents ◽  
Cross Sectional ◽  
Custodial Grandparenting ◽  
Sectional Analysis ◽  
The Impact

There are currently 2.7 million grandparents raising grandchildren in the United States. As grandparent caregiving has become more prevalent, concerns have surfaced regarding the effect of additional caregiving responsibilities placed on an aging population. The following study uses an existing dataset of individuals who graduated from Wisconsin high schools in 1957. The present study examined the impact of grandparenting on measures of cognition, both cross-sectionally and longitudinally. Findings from the cross-sectional analysis show that custodial grandparents outperformed their noncustodial grandparent counterparts on the cognitive tests of word recall, category fluency, letter fluency, and cognitive similarities. Findings from the longitudinal analysis show that though custodial grandparents had initially performed worse on the digit ordering task, their scores declined at a much slower rate than non-custodial grandparents. By using a cross-sectional and longitudinal research design, this study provides a unique opportunity to examine the impact of grandparenting on cognitive performance.

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