Acute Coronary Syndrome Treatment Costs from the Perspective of the Supplementary Health System

AbstractBackground:Acute coronary syndrome (ACS) is defined as a “group of clinical symptoms compatible with acute myocardial ischemia”, representing the leading cause of death worldwide, with a high clinical and financial impact. In this sense, the development of economic studies assessing the costs related to the treatment of ACS should be considered.Objective:To evaluate costs and length of hospital stay between groups of patients treated for ACS undergoing angioplasty with or without stent implantation (stent+ / stent-), coronary artery bypass surgery (CABG) and treated only clinically (Clinical) from the perspective of the Brazilian Supplementary Health System (SHS).Methods:A retrospective analysis of medical claims of beneficiaries of health plans was performed considering hospitalization costs and length of hospital stay for management of patients undergoing different types of treatment for ACS, between Jan/2010 and Jun/2012.Results:The average costs per patient were R$ 18,261.77, R$ 30,611.07, R$ 37,454.94 and R$ 40,883.37 in the following groups: Clinical, stent-, stent+ and CABG, respectively. The average costs per day of hospitalization were R$ 1,987.03, R$ 4,024.72, R$ 6,033.40 and R$ 2,663.82, respectively. The average results for length of stay were 9.19 days, 7.61 days, 6.19 days and 15.20 days in these same groups. The differences were significant between all groups except Clinical and stent- and between stent + and CABG groups for cost analysis.Conclusion:Hospitalization costs of SCA are high in the Brazilian SHS, being significantly higher when interventional procedures are required.

Nutrição mineral de hortaliças: XXXII. marcha de absorção dos nutrientes pelo tomateiro (Lycopersicon esculentum Mill,) destinado ao processamento industrial

Reveste-se de grande importância o conhecimento da marcha de absorção de nutrientes pelas culturas, principalmente visando uma aplicação racional dos fertilizantes. Utilizou-se no presente experimento a cultivar Roma VF, de porte determinado, que tem tido grande aceitação tanto pelos tomaticultores como pelas industrias processadoras. As amostras para analise foram coletadas no período junho a outubro de 1977, em uma área experimental instalada num solo representativo da região oeste do Estado de São Paulo (Latossol Vermelho Amarelo), no município de Narandiba (DIRA de Presidente Prudente)· A cultura recebeu uma adubação de 85--300-100 kg/ha de NPK, sendo 1/3 do N aplicado juntamente com todo o P e K no plantio e os 2/3 restantes aplicados em cobertura aos 30 e 35 dias após a germinação. A área foi de 1,25 x 0,30 m (26,666 covas/ha), com culturais foram os normalmente recomendados para a cultura na região. As amostras (4 repetições) foram coletadas aos 15, 30, 45, 60, 75, 90 e 105 dias após a germinação. As plantas foram separadas em folhas cotiledonares, folhas, caule e frutos. Determinou-se o peso de matéria seca e analisou-se para N, P, K, Ca, Mg, S, B, Cu, Fe, Mo e Zn. Os resultados analíticos obtidos revelaram um crescimento lento ate aos 30 dias, após o que houve um crescimento acelerado, com o peso da materia seca praticamente dobrando a cada quinzena no período dos 45 aos 75 dias, atingindo o máximo aos 105 dias (5.706,61 kg/ha). Quanto ao crescimento dos frutos, expresso em peso de materia seca, houve um aumento de cerca de 20 vezes no intervalo dos 45 aos 75 dias, praticamente duplicando o peso no período dos 75 aos 90 dias e estabilizando-se aos 105 dias (2.708,6 kg/ha). Na época de floração, as folhas apresentavam, em função da materia seca, 3,7% N; 0,50% P; 4,44% K; 3,24% Ca; 0,99% Mg; 0,46% S; 72 ppm B; 15 ppm Cu; 434 ppm Fe; 375 ppm Mn; 0,18 ppm Mo; 148 ppm Zn. A produção efetiva de 65 ton/ha obtida na área experimental, contem as seguintes quantidades de nutrientes nos frutos: 67,8 g N; 8,9 g P; 112,2g K; 7,7 g Ca; 6,0 g Mg; 3,1 g S; 93 g B; 45 g Cu; 547 g Fe; 163 g Mn; 485 mg Mo.

Verkehrswertermittlung von Industrieimmobilien unter besonderer Betrachtung des Bodenwertes

Setting: There exists very little supportive valuation literature for the valuation of industrial properties and the present state of research is capable of improvement. Objective: A critical examination of the procedure for the determination of the market value of industrial properties in accordance with § 194 Building Code will be made on the basis of the relevant valuation literature. Based on using standard valuation practices there should be a ground value derived for an industrial estate. Conclusion: When valuing industrial properties economic use is crucial, therefore the income approach is applied in order to attain the market value of the property. Difficulties which may arise include customary approaches for rent, property management costs and interest rates. Based on a Germany-wide cross-comparison with other automobile-producing properties a plausible range for the derivation of the groundvalue was determined. At the time of submission, the determination of the ground value by the expert Committee was unfinished.

Estudo sobre perdas no processamento industrial do tomate

Neste trabalho foram propostas fórmulas para se calcular o rendimento esperado, em polpa concentrada, em industrias de processamento de tomate, comparando-o com o rendimento realmente obtido, e visando controlar o desempenho da indústria. Para testar estas fórmulas foi feito um estudo comparativo entre o rendimento esperado calculado e o rendimento real, tomando por base os assentamentos de uma indústria, de porte médio, de processamento de tomates, do Estado de São Paulo, nos anos agrícolas de 1981 e 1982. Concomitantemente foi feita uma análise das perdas, na forma de descartes, na esteira de seleção e de sementes e pele, nas despolpadeiras e também uma verificação do Brix médio ponderado, nas duas safras. Os resultados mostraram que as fórmulas são adequadas para o cálculo do rendimento esperado pois as diferenças, com o rendimento real, obtido foram de -1,49% e +1,74% em 1982. As perdas de tomate (descartes) foram consideradas elevadas em comparação com as de outros países o que significa tomate de baixa qualidade. O Brix médio ponderado mensal que alcançou até 5,62 foi significativamente maior que o de anos anteriores.

Internal promotion versus external recruitment: evidence in industrial plants

An analysis is carried out in a sample of 738 industrial plants of the determining factors in the use of internal promotion of blue-collar workers to middle managers and skilled technicians as against their external recruitment. The use of internal promotion is positively correlated with variables indicative of the efforts made by plants to measure employees' skills, and to a lesser extent, with the level of specificity of investments in human capital made by blue-collar workers. Contrary to what was expected, variables related with the use and efficiency of other incentive systems have no significant influence on the increased or decreased use of internal promotion. These results are initial evidence that internal promotions are used to protect and favour specific investments, especially those made by firms in order to discover their workers' skills.

Collaboration strategies and technological innovation: a contractual perspective of the relationship between firms and techonological centers

In this paper, a theoretical framework for analyzing the selection of governance structures for implementing collaboration agreements between firms and Technological Centers is presented and empirically discussed. This framework includes Transaction Costs and Property Rights’ theoretical assumptions, though complemented with several proposals coming from the Transactional Value Theory. This last theory is used for adding some dynamism in the governance structure selection. As empirical evidence of this theoretical explanation, we analyse four real experiences of collaboration between firms and one Technological Center. These experiences are aimed to represent the typology of relationships which Technological Centers usually face. Among others, a key interesting result is obtained: R&D collaboration activities do not need to always be organized through hierarchical solutions. In those cases where future expected benefits and/or reputation issues could play an important role, the traditional more static theories could not fully explain the selected governance structure for managing the R&D relationship. As a consequence, these results justify further research about the adequacy of the theoretical framework presented in this paper in other contexts, for example, R&D collaborations between firms and/or between Universities or Public Research Centers and firms.

Organización industrial y crecimiento económico en la España contemporánea: tecnología y estructura productiva

El análisis del crecimiento económico moderno debe partir, en cada caso, del escenario natural en el que los procesos históricos tienen lugar. Los datos de naturaleza geográfica son muy importantes en orden al condicionamiento de las actividades de los hombres y de las sociedades. En el caso español, las constricciones del ecosistema han jugado seguramente, un rol muy destacado. La presencia desmesuradamente grande del Estado en la actividad económica y la persistencia de un déficit crónico en la balanza comercial son hechos que han caracterizado a la economía española desde fechas muy antiguas. Las páginas que siguen, no obstante, se orientan en otra dirección y presentan algunos datos especialmente relevantes relativos al secular atraso tecnológico, a la muy baja acción en Investigación y Desarrollo (I+D) tradicionalmente efectuada por los agentes económicos en España y a la preocupante debilidad de las empresas en este terreno.

Firm Size and Geographical Aggregation: An Empirical Appraisal in Industrial Location

This paper assesses empirically the importance of size discrimination and disaggregate data for deciding where to locate a start-up concern. We compare three econometric specifications using Catalan data: a multinomial logit with 4 and 41 alternatives (provinces and comarques, respectively) in which firm size is the main covariate; a conditional logit with 4 and 41 alternatives including attributes of the sites as well as size-site interactions; and a Poisson model on the comarques and the full spatial choice set (942 municipalities) with site-specific variables. Our results suggest that if these two issues are ignored, conclusions may be misleading. We provide evidence that large and small firms behave differently and conclude that Catalan firms tend to choose between comarques rather than between municipalities. Moreover, labour-intensive firms seem more likely to be located in the city of Barcelona. Keywords: Catalonia, industrial location, multinomial response model. JEL: C250, E30, R00, R12

The optimal behaviour of firms facing stochastic costs

This paper aims at assessing the optimal behavior of a firm facing stochastic costs of production. In an imperfectly competitive setting, we evaluate to what extent a firm may decide to locate part of its production in other markets different from which it is actually settled. This decision is taken in a stochastic environment. Portfolio theory is used to derive the optimal solution for the intertemporal profit maximization problem. In such a framework, splitting production between different locations may be optimal when a firm is able to charge different prices in the different local markets.

Forward induction and the excess capacity puzzle: An experimental investigation.

While the theoretical industrial organization literature has long argued that excess capacity can be used to deter entry into markets, there is little empirical evidence that incumbent firms effectively behave in this way. Bagwell and Ramey (1996) propose a game with a specific sequence of moves and partially-recoverable capacity costs in which forward induction provides a theoretical rationalization for firm behavior in the field. We conduct an experiment with a game inspired by their work. In our data the incumbent tends to keep the market, in contrast to what the forward induction argument of Bagwell and Ramey would suggest. The results indicate that players perceive that the first mover has an advantage without having to pre-commit capacity. In our game, evolution and learning do not drive out this perception. We back these claims with data analysis, a theoretical framework for dynamics, and simulation results.

Una aproximación sectorial a la localización industrial en Cataluña

El objetivo de este estudio es analizar las decisiones de localización de las actividades industriales desde una óptica sectorial. En concreto, se explica la distribución municipal en Catalunya del número de nuevas inversiones procedentes del Registro de Establecimientos Industriales, durante el período 1986-2000. Los determinantes de la localización industrial se han agrupado en tres categorías: condiciones de oferta de factores, economías de aglomeración y accesibilidad. El análisis se lleva a cabo utilizando un modelo de eventos discretos con datos de panel. Los resultados obtenidos muestran que los tres conjuntos de variables introducidas son relevantes en la explicación de la localización de las empresas manufactureras y que actúan en diferente grado para los diferentes sectores.

Infraestructures de Transport i Localització Industrial. Evidència Empírica per a Catalunya

El propòsit d'aquest treball és analitzar fins a quin punt la millora en l'accessibilitat dels municipis a la xarxa viària d'alta capacitat ha tingut efectes positius en la creació d'establiments industrials. En concret, estudiem les decisions de localització d'establiments industrials a escala local per a 19 sectors manufacturers amb una desagregació de 2 dígits. Aquest treball incorpora variables de gran rellevància (com ara una mesura d'accessibilitat mesurada en temps de desplaçament i els efectes de les inversions viàries) i utilitza tècniques d'anàlisi espacial. Pel que fa a les entrades d'establiments industrials, les dades han estat obtingudes del Registre d'Establiments Industrials de Catalunya (REIC). Els resultats mostren una incidència positiva de les millores en la xarxa viària sobre les decisions de localització de les empreses.

Public enterprise reforms and efficiency in regulated environments: the case of the postal sector

Purpose - This paper focuses on analyzing the effect that public reforms have on the efficiency of state-owned enterprises in regulated environments. Design/methodology/approach - The research is focused in the postal sector where public and private companies must obey a legal framework related to provide a universal service. The analysis is carried out using a panel of 7 European postal operators for the period 1997-2003. The activity analyzed was the letter mail division; we take as key variable the unit cost of a letter and use a translog cost function where as independent variables we include traffic levels, labor cost per employee, quality and availability of the service as well as the type of ownership (public or private). Additionally, in a second stage the geographical differences among countries are considered. Findings - Results indicate that postal operators that experienced organizational changes without being privatized, such as the Spanish and Greek operators, do not have higher unit costs than privatized postal operators like the one of Germany and the Netherlands. Moreover, we find that in all cases the operator of Ireland appear to be the most efficient. In this case restructuring process has been carried out giving an important leadership role to workers. This suggests us that labor culture could be a key variable to study when analyzing reform processes in public enterprises. Originality/value - Our findings show that in a regulated environment like in the postal sector, public and private companies can obtain similar efficiency levels in term of unit costs.

Leadership and overcoming coordination failure with asymmetric costs

We study how the heterogeneity of agents affects the extent to which changes in financial incentives can pull a group out of a situation of coordination failure. We focus on the connections between cost asymmetries and leadership. Experimental subjects interact in groups of four in a series of weak-link games. The treatment variable is the distribution of high and low effort cost across subjects. We present data for one, two and three low-cost subjects as well as control sessions with symmetric costs. The overall pattern of coordination improvement is common across treatments. Early coordination improvements depend on the distribution of high and low effort costs across subjects, but these differences disappear with time. We find that initial leadership in overcoming coordination failure is not driven by low-cost subjects but by subjects with the most frequent cost. This conformity effect can be due to a kind of group identity or to the cognitive simplicity of acting with identical others.

Industrial location at a local level: some comments about the territorial level of the analysis

This paper contributes to the existing literature on industrial location by discussing some issues regarding the territorial levels that have been used in location analysis. We analyse which could be the advantages and disadvantages of performing locational analysis at a different local levels. We use data for new manufacturing firms located at municipality, county and travel to work areas level. We show that location determinants vary according to the territorial level used in the analysis, so we conclude that the level at which we perform the investigation should be carefully selected. Keywords: industrial location, cities, agglomeration economies, count data models.