Late-stage, primary open-angle glaucoma in Europe:Social and health care maintenance costs and quality of life of patients from 4 countries

Objective: The purpose of this study was to estimate costs and quality of life (QoL) of late-stage glaucoma patients in 4 European countries. Methods: Retrospective review of medical charts of patients with POAG who were followed in a low-vision or vision rehabilitation center in one of 4 countries for at least 1 year was used to determine patient characteristics, health status, and health care resource use. Visual impairment was measured by best-corrected visual acuity (Snellen score). Patients were also interviewed over the telephone in order to assess their health-related QoL (using EuroQol EQ-5D) and use of resources including: the number of visits to rehabilitation centers, visits to hospital and non-hospital specialists, the use of low-vision devices, medication, tests, and the use of hired home help. The costs associated with resource use were calculated from the perspective of a third-party payer of health and social care based on resource usage and unit costs in each country. Results: Patients undergoing visual rehabilitation in France (n=21), Denmark (n=59), Germany (n=60), and the United Kingdom (n=22) were identified, interviewed and had their medical charts reviewed. Annual maintenance costs of late-stage glaucoma amounted to €830 (±445) on average. Average home help costs were more than 3 times higher. QoL, on average, was 0.65 (±0.28). QoL was positively correlated with the level of visual acuity in the patients' best eye. On the other hand, visual acuity was also positively correlated to health care costs, but negatively correlated to costs of home help. Conclusions: The study was limited by its observational, uncontrolled design. The finding that late-stage glaucoma is associated with higher home help costs than health care maintenance costs suggests that potential savings from a better preventive treatment are to be found for social care payers rather than health care payers. © 2008 Informa UK Ltd All rights reserved.

Direct costs of glaucoma and severity of the disease:A multinational long term study of resource utilisation in Europe

Background: Resource utilisation and direct costs associated with glaucoma progression in Europe are unknown. As population progressively ages, the economic impact of the disease will increase. Methods: From a total of 1655 consecutive cases, the records of 194 patients were selected and stratified by disease severity. Record selection was based on diagnoses of primary open angle glaucoma, glaucoma suspect, ocular hypertension, or normal tension glaucoma; 5 years minimum follow up were required. Glaucoma severity was assessed using a six stage glaucoma staging system based on static threshold visual field parameters. Resource utilisation data were abstracted from the charts and unit costs were applied to estimate direct costs to the payer. Resource utilisation and estimated direct cost of treatment, per person year, were calculated. Results: A statistically significant increasing linear trend (p = 0.018) in direct cost as disease severity worsened was demonstrated. The direct cost of treatment increased by an estimated €86 for each incremental step ranging from €455 per person year for stage 0 to €969 per person year for stage 4 disease. Medication costs ranged from 42% to 56% of total direct cost for all stages of disease. Conclusions: These results demonstrate for the first time in Europe that resource utilisation and direct medical costs of glaucoma management increase with worsening disease severity. Based on these findings, managing glaucoma and effectively delaying disease progression would be expected to significantly reduce the economic burden of this disease. These data are relevant to general practitioners and healthcare administrators who have a direct influence on the distribution of resources.

Why Do Firms Pay Dividends?: Evidence from an Early and Unregulated Capital Market

Why do firms pay dividends? To answer this question, we use a hand-collected data set of companies traded on the London stock market between 1825 and 1870. As tax rates were effectively zero, the capital market was unregulated, and there were no institutional stockholders, we can rule out these potential determinants ex ante. We find that, even though they were legal, share repurchases were not used by firms to return cash to shareholders. Instead, our evidence provides support for the information–communication explanation for dividends, while providing little support for agency, illiquidity, catering, or behavioral explanations. © The Authors 2013. Published by Oxford University Press [on behalf of the European Finance Association]. All rights reserved.

Workplace determinants of social capital:cross-sectional and longitudinal evidence from a finnish cohort study

To examine which contextual features of the workplace are associated with social capital.

Outward foreign direct investment and human capital development:A small country perspective

Purpose - The purpose of this paper is to examine the pattern of outward foreign direct investment (FDI) by Irish MNCs, and more specifically, to investigate their approach to human capital development and how these correspond to foreign MNCs in Ireland. In particular, it seeks to investigate training and development expenditure, adoption of succession planning, use of formal development programmes for senior management "potential", and also the presence of a specific "key group" development programme. Design/methodology/approach - Data were obtained through the largest, most representative study ever conducted on multinational companies (MNCs) in Ireland. The most senior human resources practitioner in these firms completed a questionnaire, through the personal interview medium, on various facets of their human resource management (HRM) practices. In total 260 usable interviews were completed equating to an overall response rate of 63 per cent. This represents a 78 per cent response rate for Irish MNCs, the primary focus of this paper, and 60 per cent for foreign MNCs. Findings - Overall, Irish MNCs tend to compare favourably with their foreign counterparts in terms of the human capital development mechanisms examined. Only one statistically significant association was found regarding differences between Irish and foreign owned MNCs, Irish MNCs were found to be significantly less likely to have formal management development programmes. Originality/value - The study is the first large scale, representative survey to be conducted on MNCs in Ireland helping to address the research lacuna on Irish owned MNCs. © Emerald Group Publishing Limited.

Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland

The cost-effectiveness of novel interventions in the treatment of cancer is well researched; however, relatively little attention is paid to the cost of many aspects of routine care. Oesophageal cancer is the ninth most common cancer in the UK and sixth most common cause of cancer death. It usually presents late and has a poor prognosis. The hospital costs incurred by oesophageal cancer patients diagnosed in Northern Ireland in 2005 (n = 198) were determined by review of medical records. The average cost of hospital care per patient in the 12 months from presentation was £7847. Variations in total hospital costs by age at diagnosis, gender, cancer stage, histological type, mortality at 1 year, co-morbidity count and socio-economic status were analysed using multiple regression analyses. Higher costs were associated with earlier stages of cancer and cancer stage remained a significant predictor of costs after controlling for cancer type, patient age and mortality at 1 year. Thus, although early detection of cancer usually improves survival, this would mean increased costs in the first year. Deprivation achieved borderline significance with those from more deprived areas having lower resource consumption relative to the more affluent. © 2013 John Wiley & Sons Ltd.

Structural Capital of University Spin-Out Firms: The Moderating Role of University Incubators

University incubators (UI) are generally believed to be important in the successful commercialisation of university spin-outs (USO) with over half of all UK Universities having established an on-campus UI. In this chapter we examine the value of UIs in the spin-out process, focusing on the structural networks of USOs located in a UI as compared to USOs in a University with no access to a UI. Our primary research question is therefore: to what extent does the structural network of USOs with access to an on-campus UI differ from USOs without? The research therefore con-tributes to a growing critique of the effectiveness of UIs in commercialis-ing academic research and the recognition of positive direct and indirect externalities from participation in networks. Through network mapping of all USOs from two research intensive universities, we profile and ana-lyse the formal and informal network ties of USOs to various partners in-ternal and external to the host university. Through interviews we also consider how these networks enhance the resources and capabilities of USOs. Our findings highlight significant differences, with USOs located in a UI having more informal but fewer formal ties, both to other USOs as well as within the host University. In contrast, location in an incuba-tor was not found to affect the extent and nature of ties with external or-ganisations. Reasons for these differences are examined through inter-views with the USOs and point to various factors including the proactive brokering role of incubator and university staff, university bureaucracy, the hidden networks of executive board members across USOs, university equity investment policy and complementary technologies.

Income ineqaulity from 1960-2012: a brief time-series history of capital and labour

This commentary examines two principal forms of inequality and their evolution since the 1960s: the division of national income between capital and labour, and the share of total income held by the top 1 per cent of earners. Trends are linked to current discussions of inequality drivers such as financialisation, and a brief time-series analysis of the effects of trade and financial sector growth on top incomes is presented.