Variation in the Cost of Care for Different Types of Joint Arthroplasty

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.

Download Full-text

AGRICULTURAL PERIODICALS OF RUSSIA IN THE EARLY XX CENTURY

АГРАРНЫЙ ВЕСТНИК ВЕРХНЕВОЛЖЬЯ ◽

10.35523/2307-5872-2019-28-3-105-117 ◽

2019 ◽

Keyword(s):

Statistical Data ◽

Soil Science ◽

Agriculture Soil ◽

Agricultural Knowledge ◽

Horse Breeding ◽

Different Types ◽

Fruit Growing ◽

Advanced Knowledge ◽

The Cost ◽

The Upper Volga Region

The article deals with the distribution of agricultural periodicals on the territory of the Russian Em-pire in the early twentieth century. Before that there were practically no publications on the pages of sci-entific magazines. Great emphasis is placed on the analysis of agricultural magazines published before 1917 in the Upper Volga region, namely in Vladimir, Kostroma, Tver and Yaroslavl provinces. Thanks to existed in pre-revolutionary Russian periodicals on agricultural subjects advanced knowledge of agron-omy, agriculture, soil science, horticulture, fruit growing, vegetable growing, winemaking, viticulture, 135 tobacco growing, livestock, poultry, bee-keeping, veterinary medicine, forestry, and hunting, land man-agement, irrigation, horse breeding were promoted. On the basis of statistical data, office documentation and other published sources, the author draws conclusions about the degree of accessibility of agricul-tural periodicals for the population, including the peasantry. Availability of agricultural periodicals largely depended on its price, so the author studied the situation with the cost of the annual subscription fee of these publications. The article investigates the issues of periodicity of agricultural magazines and newspapers, the exact number of such publications, as well as their subject matter. Existence duration of different types of periodicals is analyzed, the main publishers of magazines and newspapers, places of their publication are revealed. A prominent place is given to the publishing activities of agricultural pub-lic organizations and zemstvo self-government bodies. It is concluded that natural process of agricultural knowledge distribution among the population of Russia through publications on the pages of periodicals was disrupted by revolutionary events of 1917.

Download Full-text

Budget Impact Analysis of Anticoagulation Clinics in Patients with Atrial Fibrillation under Chronic Therapy with Oral Anticoagulants

Journal of Primary Care & Community Health ◽

10.1177/21501327211000213 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110002

Author(s):

William Uribe-Arango ◽

Juan Manuel Reyes Sánchez ◽

Natalia Castaño Gamboa

Keyword(s):

Atrial Fibrillation ◽

Impact Analysis ◽

Budget Impact ◽

Oral Anticoagulants ◽

Anticoagulation Therapy ◽

Group Versus ◽

Cost Of Care ◽

Chronic Therapy ◽

Colombian Government ◽

The Cost

Objectives To assess budget impact of the implementation of an anticoagulation clinic (AC) compared to usual care (UC), in patients with non-valvular atrial fibrillation (NVAF). Method A decision tree was designed to analyze the cost and events rates over a 1-year horizon. The patients were distributed according to treatment, 30% Direct Oral Anticoagulant (DOAC) regimens and the rest to warfarin. The thromboembolism and bleeding were derived from observational studies which demonstrated that ACs had important impact in reducing the frequency of these events compared with UC, due to higher adherence with DOACs and proportion of time in therapeutic range (TTR) with warfarin. Costs were derived from the transactional platform of Colombian government, healthcare authority reimbursement and published studies. The values were expressed in American dollars (USD). The exchanged rate used was COP $3.693 per dollar. Results During 1 year of follow-up, in a cohort of 228 patients there were estimated 48 bleedings, 6 thromboembolisms in AC group versus 84 bleedings, and 12 thromboembolisms events in patients receiving UC. Total costs related to AC were $126 522 compared with $141 514 in UC. The AC had an important reduction in the cost of clinical events versus UC ($52 085 vs $110 749) despite a higher cost of care facilities ($74 436 vs $30 765). A sensibility analysis suggested that in the 83% of estimations, the AC produced savings varied between $27 078 and $135 391. Conclusions This study demonstrated that AC compared with UC, produced an important savings in the oral anticoagulation therapy for patients with NVAF.

Download Full-text

Game-Theoretic Decision Support for Cyber Forensic Investigations

Sensors ◽

10.3390/s21165300 ◽

2021 ◽

Vol 21 (16) ◽

pp. 5300

Author(s):

Antonia Nisioti ◽

George Loukas ◽

Stefan Rass ◽

Emmanouil Panaousis

Keyword(s):

Cyber Security ◽

Strategic Decisions ◽

Bayesian Games ◽

Bayesian Game ◽

Cyber Forensics ◽

Detection And Attribution ◽

Different Types ◽

Game Theoretic ◽

The Cost

The use of anti-forensic techniques is a very common practice that stealthy adversaries may deploy to minimise their traces and make the investigation of an incident harder by evading detection and attribution. In this paper, we study the interaction between a cyber forensic Investigator and a strategic Attacker using a game-theoretic framework. This is based on a Bayesian game of incomplete information played on a multi-host cyber forensics investigation graph of actions traversed by both players. The edges of the graph represent players’ actions across different hosts in a network. In alignment with the concept of Bayesian games, we define two Attacker types to represent their ability of deploying anti-forensic techniques to conceal their activities. In this way, our model allows the Investigator to identify the optimal investigating policy taking into consideration the cost and impact of the available actions, while coping with the uncertainty of the Attacker’s type and strategic decisions. To evaluate our model, we construct a realistic case study based on threat reports and data extracted from the MITRE ATT&CK STIX repository, Common Vulnerability Scoring System (CVSS), and interviews with cyber-security practitioners. We use the case study to compare the performance of the proposed method against two other investigative methods and three different types of Attackers.

Download Full-text

Use of past care markers in risk-adjustment: accounting for systematic differences across providers

The European Journal of Health Economics ◽

10.1007/s10198-021-01350-9 ◽

2021 ◽

Author(s):

Laura Anselmi ◽

Yiu-Shing Lau ◽

Matt Sutton ◽

Anna Everton ◽

Rob Shaw ◽

...

Keyword(s):

Risk Adjustment ◽

Fixed Effects ◽

Goodness Of Fit ◽

Reporting Quality ◽

Cost Of Care ◽

Local Health ◽

Administrative Records ◽

Practice Level ◽

Improve Model ◽

The Cost

AbstractRisk-adjustment models are used to predict the cost of care for patients based on their observable characteristics, and to derive efficient and equitable budgets based on weighted capitation. Markers based on past care contacts can improve model fit, but their coefficients may be affected by provider variations in diagnostic, treatment and reporting quality. This is problematic when distinguishing need and supply influences on costs is required.We examine the extent of this bias in the national formula for mental health care using administrative records for 43.7 million adults registered with 7746 GP practices in England in 2015. We also illustrate a method to control for provider effects.A linear regression containing a rich set of individual, GP practice and area characteristics, and fixed effects for local health organisations, had goodness-of-fit equal to R2 = 0.007 at person level and R2 = 0.720 at GP practice level. The addition of past care markers changed substantially the coefficients on the other variables and increased the goodness-of-fit to R2 = 0.275 at person level and R2 = 0.815 at GP practice level. The further inclusion of provider effects affected the coefficients on GP practice and area variables and on local health organisation fixed effects, increasing goodness-of-fit at GP practice level to R2 = 0.848.With adequate supply controls, it is possible to estimate coefficients on past care markers that are stable and unbiased. Nonetheless, inconsistent reporting may affect need predictions and penalise populations served by underreporting providers.

Download Full-text