The theory of precautionary saving is shown in this paper to be isomorphic to the Arrow-Pratt theory of risk aversion, making possible the application of a large body of knowledge about risk aversion to precautionary saving, and more generally, to the theory of optimal choice under risk In particular, a measure of the strength of precautionary saving motive analogous to the Arrow-Pratt measure of risk aversion is used to establish a number of new propositions about precautionary saving, and to give a new interpretation of the Oreze-Modigliani substitution effect

Precautionary Saving in the Small and in the Large

Background: An Institute of Medicine (IOM) report defines six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity. The effect of emergency department (ED) crowding on these domains of quality has not been comprehensively evaluated.

Objectives:  The objective was to review the medical literature addressing the effects of ED crowding on clinically oriented outcomes (COOs).

Methods:  We reviewed the English-language literature for the years 1989–2007 for case series, cohort studies, and clinical trials addressing crowding’s effects on COOs. Keywords searched included “ED crowding,”“ED overcrowding,”“mortality,”“time to treatment,”“patient satisfaction,”“quality of care,” and others.

Results:  A total of 369 articles were identified, of which 41 were kept for inclusion. Study quality was modest; most articles reflected observational work performed at a single institution. There were no randomized controlled trials. ED crowding is associated with an increased risk of in-hospital mortality, longer times to treatment for patients with pneumonia or acute pain, and a higher probability of leaving the ED against medical advice or without being seen. Crowding is not associated with delays in reperfusion for patients with ST-elevation myocardial infarction. Insufficient data were available to draw conclusions on crowding’s effects on patient satisfaction and other quality endpoints.

Conclusions:  A growing body of data suggests that ED crowding is associated both with objective clinical endpoints, such as mortality, as well as clinically important processes of care, such as time to treatment for patients with time-sensitive conditions such as pneumonia. At least two domains of quality of care, safety and timeliness, are compromised by ED crowding.

https://www.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1553-2712.2008.00295.x

The effect of emergency department crowding on clinically oriented outcomes

Aims We conducted a systematic review of studies examining relationships between measures of beverage alcohol tax or price levels and alcohol sales or self-reported drinking. A total of 112 studies of alcohol tax or price effects were found, containing1003 estimates of the tax/price–consumption relationship. Design Studies included analyses of alternative outcome measures, varying subgroups of the population, several statistical models, and using different units of analysis. Multiple estimates were coded from each study, along with numerous study characteristics. Using reported estimates, standard errors, t-ratios, sample sizes and other statistics, we calculated the partial correlation for the relationship between alcohol price or tax and sales or drinking measures for each major model or subgroup reported within each study. Random-effects models were used to combine studies for inverse variance weighted overall estimates of the magnitude and significance of the relationship between alcohol tax/price and drinking. Findings Simple means of reported elasticities are -0.46 for beer, -0.69 for wine and -0.80 for spirits. Meta-analytical results document the highly significant relationships (P < 0.001) between alcohol tax or price measures and indices of sales or consumption of alcohol (aggregate-levelr =- 0.17 for beer, -0.30 for wine, -0.29 for spirits and -0.44 for total alcohol). Price/tax also affects heavy drinking significantly (mean reported elasticity =- 0.28, individual-level r =- 0.01, P < 0.01), but the magnitude of effect is smaller than effects on overall drinking. Conclusions A large literature establishes that beverage alcohol prices and taxes are related inversely to drinking. Effects are large compared to other prevention policies and programs. Public policies that raise prices of alcohol are an effective means to reduce

/pdf/effects-of-beverage-alcohol-price-and-tax-levels-on-drinking-4h7bkntsqs.pdf

Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies

Objectives:To analyze the evolving role, patterns of use, and costs of critical care medicine in the United States from 2000 to 2005.Design:Retrospective study of data from the Hospital Cost Report Information System (Centers for Medicare and Medicaid Services, Baltimore, Maryland).Setting:Nonfedera

Critical care medicine in the United States 2000-2005: an analysis of bed numbers, occupancy rates, payer mix, and costs.

This section offers suggestions related to helping a student deal with bullying in schools, as well as creating an environment where that individual can easily return to the school community. It also mentions the significance of the method 'Shared Responsibility' in dealing with the situation.

Assessing the Impact

https://moodle.adaptland.it/pluginfile.php/18386/mod_data/content/19558/2011_%20Moran.pdf

Long-Term Employment Effects of Surviving Cancer

This paper estimates the impact of income on the body weight and clinical weight classification of elderly Americans using a natural experiment that led otherwise identical retirees to receive significantly different Social Security payments based on their year of birth. We estimate models of instrumental variables using data from the National Health Interview Surveys and find no significant effect of income on weight. The confidence intervals rule out even moderate effects of income on weight and on the probability of being underweight or obese, especially for men. For example, they indicate that the income elasticity of body mass index is not greater in absolute value than 0.06 for men or 0.14 for women.

/pdf/the-impact-of-income-on-the-weight-of-elderly-americans-44l22sm9jp.pdf

The impact of income on the weight of elderly Americans.

The effects of advertising on consumption of alcoholic beverages in the US are analysed. The goal is to obtain evidence on the importance of advertising at the level of beverage demand(beer, wine, spirits) and for total consumption of alcohol (per capita gallons of ethanol). A three-equation conditional demand system is estimated that includes own- and cros-beverage advertising as explanatory variables. Four models of the differential demand system are estimated, including the Rotterdam, AID, CBS, and NBR models, using annual US data for the period 1964-90 on beverage consumption, prices, expednitures, and real advertising. Estimates are obtained of the complete matrix of own- and cross-elascities for each beverage’ price and advertising. At the beverage level, the results indicate a positive butr very small effect of advertising on beverage consumption, with most of the impact due to wine advertising and non due to beer advertising. There is no efect of advertising in the composite demand function for al...

Advertising and US alcoholic beverage demand: system-wide estimates

BACKGROUND:

To the authors' knowledge, this is the first study to provide national estimates of medical expenditures for all adult cancer survivors aged <65 years. Most studies of expenditures for cancer survivors in this age group have been based on the Medical Expenditure Panel Survey (MEPS) and were limited to “affected survivors.”



METHODS:

MEPS expenditure data for 2001 to 2007 were linked to data identifying all survivors from the National Health Interview Survey (NHIS), which is the MEPS sampling frame. The sample was comprised of adults ages 25 to 64 years. Propensity-score matching was used to estimate the effects of cancer on average total and out-of-pocket expenditures for all services and separately for prescriptions. Probit models were used to estimate effects on the probability of exceeding different expenditure thresholds.



RESULTS:

Mean annual expenditures on all services in 2007 were $16,910 ± $3911 for survivors who were newly diagnosed with cancer, $7992 ± $972 for survivors who had been diagnosed in previous years, and $3303 ± $103 for other adults. Fifty-three percent of survivors were not identified in MEPS but only by linking to NHIS. Expenditures for all survivors averaged approximately $9300 compared with $13,600 for “affected survivors.” For previously diagnosed survivors, the increase in mean expenditures attributable to cancer was approximately $4000 to $5000 annually. On average, relatively little of the increase was paid out of pocket, but cancer nearly doubled the risk of high out-of-pocket expenditures.



CONCLUSIONS:

Previous MEPS analyses overstated average expenditures for all survivors. Nevertheless, the current results indicated that the increase in expenditures attributable to cancer is substantial, even for longer term survivors, and that cancer increases the relative risk of high out-of-pocket expenditures. Cancer 2011;. © 2010 American Cancer Society.

Medical expenditures of adult cancer survivors aged <65 years in the United States.

There is little doubt that cancer treatment takes a toll on the employment and productivity of patients in the short term. About 40 percent stop working during treatment (Short, Vasey, and Tunceli 2005). In a recent prospective study by Bradley et al. (2005a, b), employment rates 6 months after diagnosis were 10 and 17 percentage points lower for patients with prostate and breast cancer, respectively, compared with control groups without cancer. A study of absenteeism found that patients being treated for cancer missed more work than patients with a number of other chronic conditions (Kessler et al. 2001).

Most of the published evidence suggests that cancer also has long-term effects on employment, that is, effects extending beyond the initial period of treatment and recovery. Not only are survivors at risk for recurrence of the original cancer, but treatment puts them at increased risk for second primary cancers (National Cancer Institute 2006) and a range of health problems including functional and cosmetic changes after surgery, organ damage, hormonal changes, cognitive deficits, and psychological distress (Hewitt, Greenfield, and Stovall 2005). Several surveys have found evidence of impairments that could affect employment over the long run (Bradley and Bednarek 2002; Chirikos, Russell-Jacobs, and Cantor 2002; Short, Vasey, and BeLue in press; Short, Vasey, and Tunceli 2005; Bradley et al. 2005a, b). Studies of breast cancer survivors at 3 years (Maunsell et al. 2004), 5 years (Chirikos, Russell-Jacobs, and Jacobsen 2002), and an average of 7 years after diagnosis (Bradley, Bednarek, and Neumark 2002) found lower employment rates for the survivors than for similar women with no cancer history. A study of the predominantly long-term survivors in the National Health Interview Survey found that significantly fewer survivors were employed compared with matched controls (Yabroff et al. 2004). However, findings from the Bradley study have recently raised doubts about the significance of long-term employment effects, because the significant differences between controls without cancer and prostate or breast cancer survivors 6 months after diagnosis did not persist at 12 or 18 months (Bradley et al. 2007).

Whether and how much the employment of survivors is affected over the long run is a question that has taken on greater importance as the average 5-year survival rate has reached 64 percent (Jemal et al. 2004), and the number of cancer survivors in the United States has increased to more than 10 million (Hewitt, Greenfield, and Stovall 2005). Experts now emphasize the importance of viewing cancer as a chronic condition that requires ongoing, systematic, and coordinated services (Centers for Disease Control and Prevention, Lance Armstrong Foundation 2004; President's Cancer Panel 2004; Hewitt, Greenfield, and Stovall 2005).

We undertook this study to learn more about long-term employment outcomes associated with cancer survivorship. As in most well-designed studies of this topic in the literature, we compared changes in employment from diagnosis to follow-up for a sample of survivors with a comparison group without cancer (Steiner et al. 2004). Economists commonly refer to this quasi-experimental design as a “difference-in-differences” analysis. The comparison group is critical in distinguishing the effects of cancer from general influences on the employment of survivors over time, such as changes in macroeconomic conditions or the normal propensity of older workers to retire. Comparing changes in individual behavior over time nets out unobservable, individual-specific differences in propensity to work. We compared primary data from the Penn State Cancer Survivor Study (PSCSS) with secondary data from the Health and Retirement Study (HRS), an ongoing national cohort study of Americans born from 1931 to 1947.

Most earlier studies of long-term survivors have focused on female breast cancer, but our study included both males and females and virtually all cancer types. It distinguished between survivors with and without new cancers that are likely to reduce employment later in survivorship. In making comparisons with the HRS, we specifically focused on older survivors (55–65 years of age in 2002) as they approached retirement. Cancer is likely to have different effects on workers at different stages of their lives and careers, and older workers are far more likely to be affected by cancer than younger workers. Three-quarters of adult cancer survivors in the age group from 30 to 64 are 50 or older (Hewitt, Greenfield, and Stovall 2005), and nearly half of new cancers diagnosed in the age group from 20 to 64 are diagnosed after age 54 (Ries et al. 2006).

John R. Moran

Papers

Long-Term Employment Effects of Surviving Cancer

The impact of income on the weight of elderly Americans.

Advertising and US alcoholic beverage demand: system-wide estimates

Medical expenditures of adult cancer survivors aged <65 years in the United States.

Long-Term Effects of Cancer Survivorship on the Employment of Older Workers