scholarly journals Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany

2020 ◽  
Vol 17 (11) ◽  
pp. 4113 ◽  
Author(s):  
Katharina E. Blankart ◽  
Friederike Arndt
Keyword(s):  
Regional Variation ◽  
Fixed Effects ◽  
Cost Control ◽  
Control Measures ◽  
Biologic Drugs ◽  
Considerable Uncertainty ◽  
Panel Regressions ◽  
Spending Growth ◽  
German Physician

Biologic drugs represent a large and growing portion of health expenditures. Increasing the use of biosimilars is a promising option for controlling spending growth in pharmaceutical care. Amid the considerable uncertainty concerning physicians’ decision to prescribe biosimilars, explicit cost control measures may help increase biosimilar use. We analyze the role of regional cost control measures for biosimilars and their association with physician prescriptions in ambulatory care in Germany. We collect data on cost control measures implemented by German physician associations and national claims data on statutory health insurance covering 2009 to 2015. We perform panel regressions that include time and physician fixed effects to identify the average associations between cost control measures and biosimilar share/use while controlling for unobserved physician heterogeneity, patient structure, and socioeconomic factors. We identify 44 measures (priority prescribing, biosimilar quota) for erythropoiesis-stimulating substances, filgrastim, and somatropin. Estimates of cost control measures and their consequences for biosimilar share and use are heterogeneous by drug, measure type, and physician group. Across specialists, biosimilar quotas accounted for 5.13% to 9.75% of the total average biosimilar share of erythropoiesis-stimulating substances. Explicit quota regulations are more effective than priority prescribing. Regional variation in biosimilar use can be partly attributed to the presence of cost control measures.

The Role of Health Management in Commercial Medical Insurance Cost Control

2014 ◽  
Vol 955-959 ◽  
pp. 1078-1081
Author(s):  
Huang Ying ◽  
Ting Shen ◽  
Wan Ran Gu ◽  
Qun Li
Keyword(s):  
Medical Service ◽  
Cost Control ◽  
Health Management ◽  
Medical Insurance ◽  
Control Measures ◽  
Insurance Cost ◽  
Usage Patterns ◽  
The Cost ◽  
Commercial Medical Insurance

The sharp increase in medical insurance cost has become a common concern of the world. In the process of commercial health insurance, academics, government and related departments usually lamented that medical service institutions don’t cooperate on the implementation of risk control measures. They often complained that the insured's moral hazard problem at the medical process. The control measures of the medical insurance cost mostly focused on internal underwriting and claims assessment, rarely focused on mobilization the initiative of the medical service provider and the recipient controlling the expenses. Combination of the cost control management of commercial medical insurance and health management is an effective method. We can shift funds usage patterns to a certain extent and strengthen preventive health input to the insured, in order to achieve the multi-effective cooperation and win-win.

scholarly journals The Role of Embeddedness on Regional Economic Resilience: Evidence from the UK

2019 ◽  
Vol 11 (14) ◽  
pp. 3800 ◽  
Author(s):  
Anastasios Kitsos ◽  
André Carrascal-Incera ◽  
Raquel Ortega-Argilés
Keyword(s):  
Fixed Effects ◽  
Economic Resilience ◽  
Regional Heterogeneity ◽  
Panel Regressions ◽  
Local Embeddedness ◽  
The 2008 Financial Crisis ◽  
The Uk ◽  
Lock In ◽  
Positive Effect

This paper examines the role of local industrial embeddedness on economic resilience in UK Nomenclature of Territorial Units for Statistics (NUTS2) regions. The 2008 financial crisis had a profound effect on the socioeconomic conditions of different places. UK regions had significantly divergent experiences based on their capacity to avoid or overcome the shock. Research has shed light on some potential drivers behind this differential resilience performance such as skills, but others, such as the degree of a production system’s local embeddedness, are largely underexplored. This paper aims at filling this gap. We hypothesise that the combination of positive external economies of complexity and negative lock-in effects lead to an inverted U-shaped relationship between embeddedness and resilience. We use a novel dataset and method for approximating embeddedness and fixed-effects panel regressions for the period 2000–2010 to control for regional heterogeneity. The results support our hypothesis and suggest that embeddedness has a positive effect on resilience up to a point, after which more embeddedness leads to negative resilience effects. The results call for greater attention on the relationships among local industries, particularly with regards to the recent development of local industrial strategies.

scholarly journals Ernst von Leyden (1832–1910): a pioneer in making oncology a respected medical discipline

2021 ◽  
Author(s):  
Peter Voswinckel ◽  
Nils Hansson
Keyword(s):  
International Association ◽  
German Society ◽  
Scientific Discipline ◽  
Strong Impact ◽  
Medical Discipline ◽  
History Of ◽  
National Socialists ◽  
New Research ◽  
German Physician

Abstract Purpose This article presents new research on the role of the renowned German physician Ernst von Leyden (1832–1910) in the emergence of oncology as a scientific discipline. Methods The article draws on archival sources from the archive of the German Society of Haematology and primary and secondary literature. Results Leyden initiated two important events in the early history of oncology: the first international cancer conference, which took place in Heidelberg, Germany, in 1906, and the founding of the first international association for cancer research (forerunner of today's UICC) in Berlin in 1908. Unfortunately, these facts are not mentioned in the most recent accounts. Both had a strong impact on the professionalization of oncology as a discipline in its own right. Conclusion Although not of Jewish origin, von Leyden was considered by the National Socialists to be “Jewish tainted”, which had a lasting effect on his perception at home and abroad.

scholarly journals Tourism Impacts, Tourism-Phobia and Gentrification in Historic Centers: The Cases of Málaga (Spain) and Gdansk (Poland)

2021 ◽  
Vol 13 (1) ◽  
pp. 408
Author(s):  
Fernando Almeida-García ◽  
Rafael Cortés-Macías ◽  
Krzysztof Parzych
Keyword(s):  
Comparative Research ◽  
Control Measures ◽  
Tourism Impacts ◽  
Tourist Destinations ◽  
Tourist Flows ◽  
Tourist Accommodation ◽  
And Control ◽  
The Impact ◽  
Urban Characteristics

This study analyzes the role of residents in urban tourist destinations affected by the increase in tourist flows, which have generated various problems such as tourism, gentrification and the emergence of tourism as a threat to residents. The role of residents in tourist destinations has not been analyzed regularly during the development process of destinations. We study two cases of historic centers in European cities, with the aim of comparing tourism problems, which are common to most European urban destinations. This study was conducted by administering surveys amongst residents of these historic centers (378 in Málaga, Spain, and 380 in Gdansk, Poland). These cities show a similar demographic size and urban characteristics. This is the first comparative research on tourism-phobia and gentrification in destinations, a field of analysis that is still not studied much. We develop specific scales to measure gentrification and tourism-phobia; moreover, we study the impact of some tourist problems that affect residents (noise, dirt, occupation of public spaces, etc.), and we show the spatial distribution of tourism-phobia. The same analysis instruments are used for both cities. The results of this study show that the tourism-phobia situation is different in the analyzed destinations. It is more intense in the case of Málaga than in Gdansk. The two historic centers are especially affected by the processes of increased tourist flows and the growth of new forms of tourist accommodation. The research results show that the residents’ annoyance caused by tourism gentrification is more intense than tourism-phobia. Both case studies highlight the residents’ complaints regarding the inadequate management of problems by public stakeholders and control measures.

The role of social support in protecting mental health when employed and unemployed: A longitudinal fixed-effects analysis using 12 annual waves of the HILDA cohort

2016 ◽  
Vol 153 ◽  
pp. 20-26 ◽  
Author(s):  
Allison Milner ◽  
Lauren Krnjacki ◽  
Peter Butterworth ◽  
Anthony D. LaMontagne
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Fixed Effects

scholarly journals Using genetic variants to evaluate the causal effect of serum vitamin D concentration on COVID-19 susceptibility, severity and hospitalization traits: a Mendelian randomization study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhiyong Cui ◽  
Yun Tian
Keyword(s):  
Vitamin D ◽  
Fixed Effects ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Serum Vitamin ◽  
Vitamin D Supplementation ◽  
Sensitivity Analyses ◽  
Global Test ◽  
Serum Vitamin D

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has struck globally and is exerting a devastating toll on humans. The pandemic has led to calls for widespread vitamin D supplementation in public. However, evidence supporting the role of vitamin D in the COVID-19 pandemic remains controversial. Methods We performed a two-sample Mendelian randomization (MR) analysis to analyze the causal effect of the 25-hydroxyvitamin D [25(OH)D] concentration on COVID-19 susceptibility, severity and hospitalization traits by using summary-level GWAS data. The causal associations were estimated with inverse variance weighted (IVW) with fixed effects (IVW-fixed) and random effects (IVW-random), MR-Egger, weighted edian and MR Robust Adjusted Profile Score (MR.RAPS) methods. We further applied the MR Steiger filtering method, MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) global test and PhenoScanner tool to check and remove single nucleotide polymorphisms (SNPs) that were horizontally pleiotropic. Results We found no evidence to support the causal associations between the serum 25(OH)D concentration and the risk of COVID-19 susceptibility [IVW-fixed: odds ratio (OR) = 0.9049, 95% confidence interval (CI) 0.8197–0.9988, p = 0.0473], severity (IVW-fixed: OR = 1.0298, 95% CI 0.7699–1.3775, p = 0.8432) and hospitalized traits (IVW-fixed: OR = 1.0713, 95% CI 0.8819–1.3013, p = 0.4878) using outlier removed sets at a Bonferroni-corrected p threshold of 0.0167. Sensitivity analyses did not reveal any sign of horizontal pleiotropy. Conclusions Our MR analysis provided precise evidence that genetically lowered serum 25(OH)D concentrations were not causally associated with COVID-19 susceptibility, severity or hospitalized traits. Our study did not provide evidence assessing the role of vitamin D supplementation during the COVID-19 pandemic. High-quality randomized controlled trials are necessary to explore and define the role of vitamin D supplementation in the prevention and treatment of COVID-19.

scholarly journals Thermodynamic Control on the Poleward Shift of the Extratropical Jet in Climate Change Simulations: The Role of Rising High Clouds and Their Radiative Effects

2019 ◽  
Vol 32 (3) ◽  
pp. 917-934 ◽  
Author(s):  
Ying Li ◽  
David W. J. Thompson ◽  
Sandrine Bony ◽  
Timothy M. Merlis
Keyword(s):  
Climate Change ◽  
Radiative Effects ◽  
Considerable Uncertainty ◽  
Surface Warming ◽  
Thermodynamic Constraint ◽  
Poleward Shift ◽  
Cloud Radiative Effects ◽  
Underlying Mechanisms ◽  
High Clouds

Extratropical eddy-driven jets are predicted to shift poleward in a warmer climate. Recent studies have suggested that cloud radiative effects (CRE) may enhance the amplitude of such shifts. But there is still considerable uncertainty about the underlying mechanisms, whereby CRE govern the jet response to climate change. This study provides new insights into the role of CRE in the jet response to climate change by exploiting the output from six global warming simulations run with and without atmospheric CRE (ACRE). Consistent with previous studies, it is found that the magnitude of the jet shift under climate change is substantially increased in simulations run with ACRE. It is hypothesized that ACRE enhance the jet response to climate change by increasing the upper-tropospheric baroclinicity due to the radiative effects of rising high clouds. The lifting of the tropopause and high clouds in response to surface warming arises from the thermodynamic constraints placed on water vapor concentrations. Hence, the influence of ACRE on the jet shift in climate change simulations may be viewed as an additional “robust” thermodynamic constraint placed on climate change by the Clausius–Clapeyron relation. The hypothesis is tested in simulations run with an idealized dry GCM, in which the model is perturbed with a thermal forcing that resembles the ACRE response to surface warming. It is demonstrated that 1) the enhanced jet shifts found in climate change simulations run with ACRE are consistent with the atmospheric response to the radiative warming associated with rising high clouds, and 2) the amplitude of the jet shift scales linearly with the amplitude of the ACRE forcing.

scholarly journals Depletion of CD8αβ+ T Cells in Chickens Demonstrates Their Involvement in Protective Immunity towards Marek’s Disease with Respect to Tumor Incidence and Vaccinal Protection

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 557
Author(s):  
Supawadee Umthong ◽  
John R. Dunn ◽  
Hans H. Cheng
Keyword(s):  
T Cells ◽  
Cd8 T Cells ◽  
Protective Immunity ◽  
Lymphoproliferative Disease ◽  
Tumor Formation ◽  
Marek's Disease ◽  
Control Measures ◽  
Marek’S Disease ◽  
Cell Mediated Immune Response

Marek’s disease (MD) is a lymphoproliferative disease in chickens caused by Marek’s disease virus (MDV), a highly oncogenic alphaherpesvirus. Since 1970, MD has been controlled through widespread vaccination of commercial flocks. However, repeated and unpredictable MD outbreaks continue to occur in vaccinated flocks, indicating the need for a better understanding of MDV pathogenesis to guide improved or alternative control measures. As MDV is an intracellular pathogen that infects and transforms CD4+ T cells, the host cell-mediated immune response is considered to be vital for controlling MDV replication and tumor formation. In this study, we addressed the role of CD8+ T cells in vaccinal protection by widely-used monovalent (SB-1 and HVT) and bivalent (SB-1+HVT) MD vaccines. We established a method to deplete CD8+ T cells in chickens and found that their depletion through injection of anti-CD8 monoclonal antibodies (mAb) increased tumor induction and MD pathology, and reduced vaccinal protection to MD, which supports the important role of CD8+ T cells for both MD and vaccinal protection.

scholarly journals Islamic Bank Financing and Its Effects on Economic Growth: A Cross Province Analysis

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Muhammad Anif Afandi ◽  
Muhammad Amin
Keyword(s):  
Economic Growth ◽  
Fixed Effects ◽  
Islamic Banking ◽  
Fixed Effects Model ◽  
Islamic Bank ◽  
Bank Financing ◽  
Panel Data Regression ◽  
Data Regression ◽  
Almost All

Islamic banking industry shows a reasonably good development, one of which is marked by an increase in service coverage in almost all provinces in Indonesia. However, the question is how far Islamic banking capable of contributing to the improvement of Indonesia's economic growth? The purpose of this research is to examine the role of Islamic banking in promoting inclusive economic growth with a sample of 33 provinces in Indonesia. The method used in this research is panel data regression using the fixed effects model. The results show that Islamic bank financing does not have an impact on Indonesia's economic growth. In other words, the results of the research provide information that the existence of Islamic banking in Indonesia has not yet give a significant impact on the welfare of Indonesian society

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