1
|
Salik I. A call to arms: private equity and the US healthcare system. Br J Anaesth 2024:S0007-0912(24)00140-5. [PMID: 38599915 DOI: 10.1016/j.bja.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/09/2024] [Accepted: 02/27/2024] [Indexed: 04/12/2024] Open
Affiliation(s)
- Irim Salik
- Department of Anaesthesiology, New York Medical College, Westchester Medical Center, Valhalla, NY, USA.
| |
Collapse
|
2
|
Özden-Schilling T. Trust in numbers: Serious numbers and speculative fictions in rare earth elements exploration. Soc Stud Sci 2024; 54:281-304. [PMID: 37846898 DOI: 10.1177/03063127231205044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
In the early 2010s, a spectacular fall in prices for a class of mineral commodities called the rare earth elements (REEs) and the collapse of hundreds of new exploration companies made clear the fragility of the high-risk markets around these companies and the strategies of legitimation that supported them. New regulatory processes built around technical disclosures generated vast stores of geotechnical data. Rather than generating trust among market actors, however, these processes dramatically altered the temporalities of global extraction and energized unruly narrative spaces. In their efforts to keep mineral claims active and companies afloat, REE-focused exploration experts have struggled to navigate different arenas of discussion while holding their respective logics in tension. Drawing on ethnographic fieldwork with exploration geologists and promoters, this article examines how experts federate flows of 'serious' and 'speculative' information in both carefully regulated reports and rumor-filled online forums. Such spaces are organized by aesthetic conventions and social criteria for establishing persuasiveness-forms that STS scholars have long analyzed as literary technologies. Rather than helping to secure experts' authority, however, I argue that the diverse literary technologies that now dominate exploration promotion and finance work have radically redistributed interpretive roles. In their struggles to mediate senses of 'crisis' endemic within venture markets, exploration experts must enact the ideals undergirding new regulatory requirements even as they learn to defer to the speculative musings of others.
Collapse
|
3
|
Neill CL, Roberts J, Colon J, Zhang P. What are the risks of clinic-backed payment plans? J Am Vet Med Assoc 2024; 262:426-431. [PMID: 37922712 DOI: 10.2460/javma.23.07.0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023]
Abstract
The purpose of this viewpoint is to discuss the risks associated with offering clinic-backed payment plans, with a particular focus on financial risks. We provide a financial calculator tool that clinics can use with their financial information to make more informed decisions about whether implementing clinic-backed payment plans are viable for them. Realistic but hypothetical financial information for a clinic is used to simulate financial evaluations, including cash flow budget analysis, multivariate sensitivity analysis, and risk assessment to help clinics better understand these evaluations. Our simulations show that even under high default rates, the revenue benefits outweigh the labor costs and could bring higher profitability to clinics while increasing access to care for clients and patients.
Collapse
Affiliation(s)
- Clinton L Neill
- 1Center of Veterinary Business and Entrepreneurship, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Jayden Roberts
- 2College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Jorge Colon
- 1Center of Veterinary Business and Entrepreneurship, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Peilu Zhang
- 3School of Medicine, University of Utah, Salt Lake City, UT
| |
Collapse
|
4
|
Swift J, O'Kelly N, Barker C, Woodward A, Ghosh S. A Digital Respiratory Ward in Leicester, Leicestershire, and Rutland, England, for Patients With COVID-19: Economic Evaluation of the Impact on Acute Capacity and Wider National Health Service Resource Use. JMIR Form Res 2024; 8:e47441. [PMID: 38349716 PMCID: PMC10866202 DOI: 10.2196/47441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/04/2023] [Accepted: 12/22/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic stressed global health care systems' acute capacity and caused a diversion of resources from elective care to the treatment of acute respiratory disease. In preparing for a second wave of COVID-19 infections, England's National Health Service (NHS) in Leicester, Leicestershire, and Rutland sought to protect acute capacity in the winter of 2020-2021. Their plans included the introduction of a digital ward where patients were discharged home early and supported remotely by community-based respiratory specialists, who were informed about patient health status by a digital patient monitoring system. OBJECTIVE The objective of the digital ward was to maintain acute capacity through safe, early discharge of patients with COVID-19 respiratory disease. The study objective was to establish what impact this digital ward had on overall NHS resource use. METHODS There were no expected differences in patient outcomes. A cost minimization was performed to demonstrate the impact on the NHS resource use from discharging patients into a digital COVID-19 respiratory ward, compared to acute care length of stay (LOS). This evaluation included all 310 patients enrolled in the service from November 2020 (service commencement) to November 2021. Two primary methods, along with sensitivity analyses, were used to help overcome the uncertainty associated with the estimated comparators for the observational data on COVID-19 respiratory acute LOS, compared with the actual LOS of the 279 (90%) patients who were not discharged on oxygen nor were in critical care. Historic comparative LOS and an ordinary least squares model based on local monthly COVID-19 respiratory median LOS were used as comparators. Actual comparator data were sourced for the 31 (10%) patients who were discharged home and into the digital ward for oxygen weaning. Resource use associated with delivering care in the digital ward was sourced from the digital system and respiratory specialists. RESULTS In the base case, the digital ward delivered estimated health care system savings of 846.5 bed-days and US $504,197 in net financial savings across the 2 key groups of patients-those on oxygen and those not on oxygen at acute discharge (both P<.001). The mean gross and net savings per patient were US $1850 and US $1626 in the base case, respectively, without including any savings associated with a potential reduction in readmissions. The 30-day readmission rate was 2.9%, which was below comparative data. The mean cost of the intervention was US $223.53 per patient, 12.1% of the estimated gross savings. It was not until the costs were increased and the effect reduced simultaneously by 78.4% in the sensitivity analysis that the intervention was no longer cost saving. CONCLUSIONS The digital ward delivered increased capacity and substantial financial savings and did so with a high degree of confidence, at a very low absolute and relative cost.
Collapse
Affiliation(s)
- Jim Swift
- Spirit Health, Leicester, United Kingdom
| | | | | | - Alex Woodward
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Sudip Ghosh
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
- Department of Allied Health Sciences, De Montford University, Leicester, United Kingdom
| |
Collapse
|
5
|
Eyre HA, Hynes W, Ayadi R, Swieboda P, Berk M, Ibanez A, Castelló ME, Jeste DV, Tempest M, Abdullah JM, O’Brien K, Carnevale S, Njamnshi AK, Martino M, Mannix D, Maestri K, YU R, CHEN S, NG CH, Volmink HC, Ahuja R, Destrebecq F, Vradenburg G, Schmied A, Manes F, Platt ML. The Brain Economy: Advancing Brain Science to Better Understand the Modern Economy. Malays J Med Sci 2024; 31:1-13. [PMID: 38456111 PMCID: PMC10917588 DOI: 10.21315/mjms2024.31.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/09/2024] [Indexed: 03/09/2024] Open
Abstract
The coming years are likely to be turbulent due to a myriad of factors or polycrisis, including an escalation in climate extremes, emerging public health threats, weak productivity, increases in global economic instability and further weakening in the integrity of global democracy. These formidable challenges are not exogenous to the economy but are in some cases generated by the system itself. They can be overcome, but only with far-reaching changes to global economics. Our current socio-economic paradigm is insufficient for addressing these complex challenges, let alone sustaining human development, well-being and happiness. To support the flourishing of the global population in the age of polycrisis, we need a novel, person-centred and collective paradigm. The brain economy leverages insights from neuroscience to provide a novel way of centralising the human contribution to the economy, how the economy in turn shapes our lives and positive feedbacks between the two. The brain economy is primarily based on Brain Capital, an economic asset integrating brain health and brain skills, the social, emotional, and the diversity of cognitive brain resources of individuals and communities. People with healthy brains are essential to navigate increasingly complex systems. Policies and investments that improve brain health and hence citizens' cognitive functions and boost brain performance can increase productivity, stimulate greater creativity and economic dynamism, utilise often underdeveloped intellectual resources, afford social cohesion, and create a more resilient, adaptable and sustainability-engaged population.
Collapse
Affiliation(s)
- Harris A. Eyre
- Brain Capital Alliance, San Francisco, California, USA
- Center for Health and Biosciences, The Baker Institute for Public Policy, Rice University, Houston, Texas
- Meadows Mental Health Policy Institute, Dallas, Texas, USA
- Euro-Mediterranean Economists Association, Barcelona, Spain
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University and Barwon Health, Geelong, Victoria, Australia
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center, Houston, Texas, USA
- Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, California and Trinity College Dublin, Dublin, Ireland
- FondaMental Fondation, Paris, France
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
- Houston Methodist Behavioral Health, Houston Methodist Academic Institute, Houston, Texas, USA
- Department of Psychiatry and Behavioral Sciences, University of California, California, USA
- Frontier Technology Lab, School of Engineering and Doerr School of Sustainability, Stanford University, California, USA
| | - William Hynes
- Brain Capital Alliance, San Francisco, California, USA
- Euro-Mediterranean Economists Association, Barcelona, Spain
- Rebuilding Macroeconomics, University College London, London, United Kingdom
- Santa Fe Institute, Santa Fe, New Mexico, USA
- School of Advanced International Studies Europe, Johns Hopkins University, Bologna, Italy
| | - Rym Ayadi
- Brain Capital Alliance, San Francisco, California, USA
- Euro-Mediterranean Economists Association, Barcelona, Spain
- Bayes Business School, City College London, London, United Kingdom
- Center for European Policy Studies, Brussels, Belgium
| | - Pawel Swieboda
- Brain Capital Alliance, San Francisco, California, USA
- Euro-Mediterranean Economists Association, Barcelona, Spain
- NeuroCentury, Brussels, Belgium
- European Policy Centre, Brussels, Belgium
- International Center for Future Generations, Brussels, Belgium
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University and Barwon Health, Geelong, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Agustin Ibanez
- Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, California and Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
- Laboratorio Interdisciplinario del Tiempo, Universidad de San Andrés-CONICET, Buenos Aires, Argentina
| | - María E. Castelló
- Desarrollo y Evolución Neural, Departamento Neurociencias Integrativas y Computacionales, Instituto de Investigaciones Biológicas Clemente Estable (MEC), Montevideo, Uruguay
- Programa de Desarrollo de las Ciencias Básicas (MEC-UdelaR), Montevideo, Uruguay
- Fibras, Montevideo, Uruguay
| | - Dilip V. Jeste
- Global Research Network on Social Determinants of Health and Exposomics, La Jolla, California, USA
| | | | - Jafri Malin Abdullah
- Fellow, Academy of Sciences Malaysia, Menara Matrade, Kuala Lumpur, Malaysia
- Chairman of Medical and Health Sciences Cluster, The National Council of Professors, Malaysia (MPN), Selangor, Malaysia
- Professor of Neurosciences & Senior Consultant Neurosurgeon, Department of Neurosciences & Brain and Behaviour Cluster, School of Medical Sciences/Hospital USM, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | | | | | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN), Geneva, Switzerland & Yaoundé, Cameroon, Africa
| | - Michael Martino
- Department of Neuroscience, Medical University of South Carolina (MUSC), South Carolina, USA
| | - Dan Mannix
- Brain Capital Alliance, San Francisco, California, USA
| | | | - Ruojuan YU
- School of Management, Yale University, Connecticut, USA
| | - Shuo CHEN
- Sutardja Center for Entrepreneurship and Technology, College of Engineering, University of California, California, USA
| | - Chee H. NG
- Department of Psychiatry, The Melbourne Clinic and St. Vincent’s Hospital, University of Melbourne, Australia
| | - Heinrich C. Volmink
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa, Africa
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, South Africa, Africa
| | - Rajiv Ahuja
- Milken Institute, Center for the Future of Aging, California, USA
| | | | - George Vradenburg
- UsAgainstAlzhiemer’s, Washington DC, USA
- Davos Alzheimer’s Collaborative, Washington DC, USA
| | - Astrid Schmied
- Science of Learning in Education Center, Office of Education Research, National Institute of Education, Nanyang Technological University, Singapore
| | - Facundo Manes
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Michael L. Platt
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
- Marketing Department, University of Pennsylvania, Philadelphia, PA, USA
- Wharton Neuroscience Initiative, Wharton Business School, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
6
|
Modi S, Feldman SS, Berner ES, Schooley B, Johnston A. Value of Electronic Health Records Measured Using Financial and Clinical Outcomes: Quantitative Study. JMIR Med Inform 2024; 12:e52524. [PMID: 38265848 PMCID: PMC10851116 DOI: 10.2196/52524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/29/2023] [Accepted: 11/29/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The Health Information Technology for Economic and Clinical Health Act of 2009 was legislated to reduce health care costs, improve quality, and increase patient safety. Providers and organizations were incentivized to exhibit meaningful use of certified electronic health record (EHR) systems in order to achieve this objective. EHR adoption is an expensive investment, given the resources and capital that are invested. Due to the cost of the investment, a return on the EHR adoption investment is expected. OBJECTIVE This study performed a value analysis of EHRs. The objective of this study was to investigate the relationship between EHR adoption levels and financial and clinical outcomes by combining both financial and clinical outcomes into one conceptual model. METHODS We examined the multivariate relationships between different levels of EHR adoption and financial and clinical outcomes, along with the time variant control variables, using moderation analysis with a longitudinal fixed effects model. Since it is unknown as to when hospitals begin experiencing improvements in financial outcomes, additional analysis was conducted using a 1- or 2-year lag for profit margin ratios. RESULTS A total of 5768 hospital-year observations were analyzed over the course of 4 years. According to the results of the moderation analysis, as the readmission rate increases by 1 unit, the effect of a 1-unit increase in EHR adoption level on the operating margin decreases by 5.38%. Hospitals with higher readmission payment adjustment factors have lower penalties. CONCLUSIONS This study fills the gap in the literature by evaluating individual relationships between EHR adoption levels and financial and clinical outcomes, in addition to evaluating the relationship between EHR adoption level and financial outcomes, with clinical outcomes as moderators. This study provided statistically significant evidence (P<.05), indicating that there is a relationship between EHR adoption level and operating margins when this relationship is moderated by readmission rates, meaning hospitals that have adopted EHRs could see a reduction in their readmission rates and an increase in operating margins. This finding could further be supported by evaluating more recent data to analyze whether hospitals increasing their level of EHR adoption would decrease readmission rates, resulting in an increase in operating margins. Hospitals would incur lower penalties as a result of improved readmission rates, which would contribute toward improved operating margins.
Collapse
Affiliation(s)
- Shikha Modi
- The University of Alabama in Huntsville, Huntsville, AL, United States
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sue S Feldman
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Eta S Berner
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Allen Johnston
- Department of Information Systems, Statistics, and Management Science, The University of Alabama, Tuscaloosa, AL, United States
| |
Collapse
|
7
|
O'Toole PJ, Marrison JL. A perspective into full cost recovery within a core facility/shared resource lab. J Microsc 2023. [PMID: 37973413 DOI: 10.1111/jmi.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
Here we outline a vignette of the Bioscience Technology Facility (BTF) at the University of York as a singular exemplar of the Full Cost Recovery model. It is fully appreciated that every facility operates slightly differently, and each are subject to various rules at the institutional, regional and national level. Understanding the regulations that need to be followed for your cost recovery model may require discussion with your administrators to ensure compliance regulations for your Institution and governing bodies are followed. The below is almost a pick and mix of ways of working. It is, however, one of the few examples that is able to fully recover its operating costs within an academic environment and has sought and obtained full institutional and funders support. This model is now being much more widely adopted across the United Kingdom although again always with slightly different interpretations.
Collapse
Affiliation(s)
- Peter J O'Toole
- Imaging & Cytometry Laboratory, Bioscience Technology Facility, University of York, York, UK
| | - Joanne L Marrison
- Imaging & Cytometry Laboratory, Bioscience Technology Facility, University of York, York, UK
| |
Collapse
|
8
|
Ridde V, Coulibaly A, Touré L, Ba MF, Zinszer K, Bonnet E, Honda A. Financial issues in times of a COVID-19 pandemic in a tertiary hospital in Mali. Int J Health Plann Manage 2023; 38:1676-1693. [PMID: 37507357 DOI: 10.1002/hpm.3690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/28/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND This study examines how the functioning of healthcare providers during the COVID-19 pandemic was affected by the government financing response, which was shaped by existing healthcare financing systems. METHODS The study applied a single case study design at a tertiary hospital in Bamako during the 1st and 2nd waves of the COVID-19 pandemic. Data were gathered through 51 in-depth interviews with hospital staff, participatory observation, and reviewing media articles and hospital financial records. RESULTS The study revealed the disruptions experienced by hospital managers, human resources for health and patients in Mali during the early stages of the pandemic. While the government aimed to support universal access to COVID-19-related services, efforts were undermined by issues associated with complex public financing management procedures. The hospital experienced long delays in transferring government funds. The hospital suffered a decrease in revenue during the early stages of the pandemic. Government budgets were not effectively used because of complex, non-agile procedures that could not adapt to the emergency. The challenges faced by the hospitals led to the delays in the staff payments of salaries and promised bonuses, which created potential for unfair treatment of patients. Excluding some COVID-19 related items from the government funded benefit package created a financial burden on people receiving services. The managerial challenges experienced in the study hospital during the first wave continued in the second wave. CONCLUSIONS Pre-existent issues in healthcare financing and governance constrained the effective management of COVID-19-related services and created confusion at the front line of healthcare service delivery.
Collapse
Affiliation(s)
- Valéry Ridde
- UMR 196, CEPED, The French National Research Institute for Sustainable (IRD), Université Paris Cité, Paris, France
- Institut de Santé et Développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal
| | - Abdourahmane Coulibaly
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies, Bamako, Mali
| | | | - Mouhamadou Faly Ba
- Institut de Santé et Développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal
| | - Kate Zinszer
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche en santé publique (CRePS), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Emmanuel Bonnet
- UMR 215 Prodig, French National Research Institute for Sustainable (IRD), Aubervilliers, France
| | - Ayako Honda
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study (HIAS), Hitotsubashi University, Tokyo, Japan
| |
Collapse
|
9
|
Waters AR, Turner C, Easterly CW, Tovar I, Mulvaney M, Poquadeck M, Johnston H, Ghazal LV, Rains SA, Cloyes KG, Kirchhoff AC, Warner EL. Exploring Online Crowdfunding for Cancer-Related Costs Among LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer, Plus) Cancer Survivors: Integration of Community-Engaged and Technology-Based Methodologies. JMIR Cancer 2023; 9:e51605. [PMID: 37902829 PMCID: PMC10644187 DOI: 10.2196/51605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Cancer survivors frequently experience cancer-related financial burdens. The extent to which Lesbian, Gay, Bisexual, Transgender, Queer, Plus (LGBTQ+) populations experience cancer-related cost-coping behaviors such as crowdfunding is largely unknown, owing to a lack of sexual orientation and gender identity data collection and social stigma. Web-scraping has previously been used to evaluate inequities in online crowdfunding, but these methods alone do not adequately engage populations facing inequities. OBJECTIVE We describe the methodological process of integrating technology-based and community-engaged methods to explore the financial burden of cancer among LGBTQ+ individuals via online crowdfunding. METHODS To center the LGBTQ+ community, we followed community engagement guidelines by forming a study advisory board (SAB) of LGBTQ+ cancer survivors, caregivers, and professionals who were involved in every step of the research. SAB member engagement was tracked through quarterly SAB meeting attendance and an engagement survey. We then used web-scraping methods to extract a data set of online crowdfunding campaigns. The study team followed an integrated technology-based and community-engaged process to develop and refine term dictionaries for analyses. Term dictionaries were developed and refined in order to identify crowdfunding campaigns that were cancer- and LGBTQ+-related. RESULTS Advisory board engagement was high according to metrics of meeting attendance, meeting participation, and anonymous board feedback. In collaboration with the SAB, the term dictionaries were iteratively edited and refined. The LGBTQ+ term dictionary was developed by the study team, while the cancer term dictionary was refined from an existing dictionary. The advisory board and analytic team members manually coded against the term dictionary and performed quality checks until high confidence in correct classification was achieved using pairwise agreement. Through each phase of manual coding and quality checks, the advisory board identified more misclassified campaigns than the analytic team alone. When refining the LGBTQ+ term dictionary, the analytic team identified 11.8% misclassification while the SAB identified 20.7% misclassification. Once each term dictionary was finalized, the LGBTQ+ term dictionary resulted in a 95% pairwise agreement, while the cancer term dictionary resulted in an 89.2% pairwise agreement. CONCLUSIONS The classification tools developed by integrating community-engaged and technology-based methods were more accurate because of the equity-based approach of centering LGBTQ+ voices and their lived experiences. This exemplar suggests integrating community-engaged and technology-based methods to study inequities is highly feasible and has applications beyond LGBTQ+ financial burden research.
Collapse
Affiliation(s)
- Austin R Waters
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
| | - Cindy Turner
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Caleb W Easterly
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Ida Tovar
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Megan Mulvaney
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Matt Poquadeck
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Hailey Johnston
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
| | - Lauren V Ghazal
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- School of Nursing, University of Rochester, Rochester, NY, United States
| | - Stephen A Rains
- Department of Communication, University of Arizona, Tucson, AZ, United States
| | - Kristin G Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR, United States
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| |
Collapse
|
10
|
Horváth K, Túri G, Kaposvári C, Cseh B, Dózsa CL. Challenges and opportunities for improvement in the management and financing system of Health Promotion Offices in Hungary. Front Public Health 2023; 11:1219186. [PMID: 37965520 PMCID: PMC10641462 DOI: 10.3389/fpubh.2023.1219186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background One hundred ten Health Promotion Offices (HPOs) have started operating in Hungary in response to public health challenges. Many of them have been active for almost 10 years, yet their operational experience has not been evaluated. The specific objectives of our study were: (1) to describe the current operational and funding system of HPOs, (2) to identify challenges related to the current management and funding practices, and (3) to formulate recommendations for improvement based on gathered experience and international experience. Design In order to gain a deeper insight into the operational experience of HPOs, an online survey was conducted with the professional or economic managers of HPOs. A scoping review was carried out to gather international experiences about best practices to formulate recommendations for improvement in developing the operational and financing scheme for HPOs. Results We found that current HPO network in Hungary faces three main challenges: a deficient management system, inflexible financing scheme, and unequal ability to purchase or provide services for the population. Conclusions Based on the survey complemented by international experiences, we propose the overhaul of the professional management system and switching toa combination of fixed and performance-based financing scheme for the HPOs in Hungary.
Collapse
Affiliation(s)
- Krisztián Horváth
- Department of Public Health, Semmelweis University, Budapest, Hungary
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
| | - Gergo Túri
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
| | - Csilla Kaposvári
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
- Faculty of Health Sciences, Doctoral School, University of Pécs, Pécs, Hungary
| | - Borbála Cseh
- Med-Econ Human Services Ltd., Budapest, Hungary
- Doctoral School of Medical Sciences, Semmelweis University, Budapest, Hungary
| | - Csaba László Dózsa
- Med-Econ Human Services Ltd., Budapest, Hungary
- Department of Theoretical Health Sciences, Faculty of Health Sciences, University of Miskolc, Miskolc, Hungary
| |
Collapse
|
11
|
Jolowsky CM. 2023 Report of the ASHP Treasurer. Am J Health Syst Pharm 2023; 80:1590-1592. [PMID: 37665641 DOI: 10.1093/ajhp/zxad174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
|
12
|
Porter-O'Grady T. Commentary from the left to the right side of the ledger: Fully expressing the real value of nursing. Nurs Inq 2023; 30:e12567. [PMID: 37246490 DOI: 10.1111/nin.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Tim Porter-O'Grady
- Health Systems, TPOG Associates, LLC., Atlanta, Georgia, USA
- School of Nursing, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
13
|
Vineis P. Editorial: Emerging issues in public health. Front Public Health 2023; 11:1260924. [PMID: 37736083 PMCID: PMC10509468 DOI: 10.3389/fpubh.2023.1260924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023] Open
Affiliation(s)
- Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College, London, United Kingdom
| |
Collapse
|
14
|
Yim NH, McCarter J, Haykal T, Aral AM, Yu JZ, Reece E, Winocour S. Robotic Surgery and Hospital Reimbursement. Semin Plast Surg 2023; 37:223-228. [PMID: 38444958 PMCID: PMC10911894 DOI: 10.1055/s-0043-1771234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
The field of plastic surgery remains at the forefront of technological and surgical innovation. However, the promising applications of robotics in plastic surgery must be thoughtfully balanced with hospital finances and reimbursements. Robotic systems have been studied extensively across multiple surgical disciplines and across diverse health care systems. The results show that there may be equal or better patient outcomes than alternatives. In an era where fiscal responsibility in health care is a top priority, thoughtful budgeting and spending must be considered and revisited frequently to attain sustainable organizational models that ensure appropriate use of robotic technology.
Collapse
Affiliation(s)
- Nicholas H. Yim
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Jacob McCarter
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Tareck Haykal
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Ali M. Aral
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Jessie Z. Yu
- Department of Plastic Surgery at The University of Texas, MD Anderson, Houston, Texas
| | - Edward Reece
- Division of Plastic and Reconstructive Surgery at Mayo Clinic in Arizona, Phoenix, Arizona
| | - Sebastian Winocour
- Department of Plastic Surgery at The University of Texas, MD Anderson, Houston, Texas
| |
Collapse
|
15
|
Hayes KT, Heiman HJ, Honoré PA. Developing a management and finance training for future public health leaders. Front Public Health 2023; 11:1125155. [PMID: 37250075 PMCID: PMC10213770 DOI: 10.3389/fpubh.2023.1125155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, it is critical that academic content builds capacity in management and finance focused on public health practice. This paper describes the development of a Doctor of Public Health program management and finance course designed to prepare future public health leaders. The course aims to build the knowledge and skills of doctoral-level students to recognize the inherent challenges of public health finance and the importance of cultivating and managing resources to improve public health practice and achieve strategic public health goals.
Collapse
Affiliation(s)
- Kristy T. Hayes
- School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Harry J. Heiman
- School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Peggy A. Honoré
- School of Public Health and School of Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States
| |
Collapse
|
16
|
Samuels E, Vereen D, Piechowski P, McKay A, De Loney EH, Bailey S, Evans L, Campbell B, Lewis Y, Greene-Moton E, Key K, Robinson D, Sparks A, Champagne E, Woolford S. Developing relevant assessments of community-engaged research partnerships: A community-based participatory approach to evaluating clinical and health research study teams. J Clin Transl Sci 2023; 7:e123. [PMID: 37313376 PMCID: PMC10260334 DOI: 10.1017/cts.2023.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 04/20/2023] [Accepted: 05/03/2023] [Indexed: 06/15/2023] Open
Abstract
Background/Objective In 2017, the Michigan Institute for Clinical and Health Research (MICHR) and community partners in Flint, Michigan collaborated to launch a research funding program and evaluate the dynamics of those research partnerships receiving funding. While validated assessments for community-engaged research (CEnR) partnerships were available, the study team found none sufficiently relevant to conducting CEnR in the context of the work. MICHR faculty and staff along with community partners living and working in Flint used a community-based participatory research (CBPR) approach to develop and administer a locally relevant assessment of CEnR partnerships that were active in Flint in 2019 and 2021. Methods Surveys were administered each year to over a dozen partnerships funded by MICHR to evaluate how community and academic partners assessed the dynamics and impact of their study teams over time. Results The results suggest that partners believed that their partnerships were engaging and highly impactful. Although many substantive differences between community and academic partners' perceptions over time were identified, the most notable regarded the financial management of the partnerships. Conclusion This work contributes to the field of translational science by evaluating how the financial management of community-engaged health research partnerships in a locally relevant context of Flint can be associated with these teams' scientific productivity and impact with national implications for CEnR. This work presents evaluation methods which can be used by clinical and translational research centers that strive to implement and measure their use of CBPR approaches.
Collapse
Affiliation(s)
- Elias Samuels
- University of Michigan, Michigan Institute for Clinical & Health Research, Ann Arbor, MI, USA
| | - Donald Vereen
- University of Michigan, Michigan Institute for Clinical & Health Research, Ann Arbor, MI, USA
| | - Patricia Piechowski
- University of Michigan, Michigan Institute for Clinical & Health Research, Ann Arbor, MI, USA
| | - Athena McKay
- University of Michigan, Michigan Institute for Clinical & Health Research, Ann Arbor, MI, USA
| | - E. Hill De Loney
- Health Awareness Center, Flint, MI, USA
- Community Based Organization Partners, Flint, MI, USA
| | - Sarah Bailey
- Community Based Organization Partners, Flint, MI, USA
- Bridges into the Future, Flint, MI, USA
- All Faiths Health Alliance, USA
| | - Luther Evans
- Community Based Organization Partners, Flint, MI, USA
- Anders Associates Flint, MI, USA
| | | | - Yvonne Lewis
- Community Based Organization Partners, Flint, MI, USA
- Healthy Flint Research Coordinating Center Flint, MI, USA
- National Center for African American Health Consciousness, Flint, MI, USA
| | | | - Kent Key
- Community Based Organization Partners, Flint, MI, USA
- Michigan State University. College of Human Medicine, East Lansing, MI, USA
| | - DeWaun Robinson
- Community Based Organization Partners, Flint, MI, USA
- Artistic Visions Flint, MI, USA
| | - Arlene Sparks
- Community Based Organization Partners, Flint, MI, USA
| | - Ellen Champagne
- University of Michigan, Michigan Institute for Clinical & Health Research, Ann Arbor, MI, USA
| | - Susan Woolford
- University of Michigan, Michigan Institute for Clinical & Health Research, Ann Arbor, MI, USA
| |
Collapse
|
17
|
Madden S, Martin N, Clements JM, Kirk SJ. 'Factors influencing future career choices of Queen's University Belfast Medical students.'. Ulster Med J 2023; 92:71-76. [PMID: 37649912 PMCID: PMC10464625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Decisions made by medical students on future career choice have demonstrated concordance with subsequent postgraduate career path. This study aimed to understand the factors that impact undergraduate career decision making. METHODS An anonymous voluntary survey consisting of binominal, Likert and free text responses was distributed to all medical students registered at Queen's University Belfast (QUB). Data was collected over 6 weeks in April-May 2021. The primary outcome was future career aspirations. The secondary outcomes were the impact of mentorship on career choice, the likelihood of students completing their medical degree and practicing medicine upon graduation. Local ethical approval was obtained. RESULTS 202 responses were received (response rate 15%). 67% (n = 135) were female. One third of respondents remained undecided about their future career choice. Surgery was both the most popular definite career choice (16.3%) of respondents, butalsothespecialtymarkedmostoftenas'Least preferred Specialty' (33%). Factors positively influencing career choice were academic interest and flexibility in working hours. Negative predictors of career choice were lack of interest in the area, perceived workload, and duration of training schemes. 71% (n=144) of respondents reported that a subspecialty mentor would positively influence their career choice and two-thirds of respondents reported that financial factors would influence their career decision. 11% (n= 22) of respondents were unsure or undecided if they would continue medicine as a career upon graduation. CONCLUSION Uncertainty over future career intention remains common with surgery the least popular speciality. Mentorship, integrating flexibility in training and enhancing academic interest should be considered by educational stakeholders as mechanisms to generating undergraduate interest in a subspecialty. Furthermore, the reported rate of students intention to leave their medical degree prior to graduation by this cohort is concerning, warranting further investigation.
Collapse
Affiliation(s)
- S Madden
- School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast
| | - N Martin
- School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast
| | - JM Clements
- School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast
- Ulster Hospital, Dundonald, Belfast
| | - SJ Kirk
- School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast
- Ulster Hospital, Dundonald, Belfast
| |
Collapse
|
18
|
Narayan I. Letter to the Editor. J Health Econ Outcomes Res 2023; 10:89. [PMID: 37064294 PMCID: PMC10103749 DOI: 10.36469/001c.74185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
Highlighting other risk factors for cardiovascular disease could enhance Adeniji and Obembe's study.
Collapse
|
19
|
Calderon-Monge E, Ribeiro-Soriano D. The role of digitalization in business and management: a systematic literature review. Rev Manag Sci 2023. [PMCID: PMC10043855 DOI: 10.1007/s11846-023-00647-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Digitalization is a powerful engine for economic growth in the world. In 2018, digitally transformed firms represented 13.5 billion US dollars of global GDP and, towards the end of 2023, they are expected to represent 53.3 billion US dollars, over half of the general nominal GDP (Statista, Nominal GDP driven by digitally transformed and other enterprises worldwide 2018–2023. https://www.statista.com/statistics/1134766/nominal-gdp-driven-by-digitally-transformed-enterprises/, 2022). The main objective of this study is to provide information (highlighting principal research topics and research agendas) from the literature on state-of-the-art digitalization within firms through a Systematic Literature Review (SLR). In all, 119 review articles on the most mature functional areas of the firm are analyzed: management, marketing, and finance and accounting, published in the WOS over the period 2018-April 2022. In this study, key relevant tendencies are identified in the most mature areas of the firm, which are the impact of digital technologies on the analysis of consumer behavior; digitalization and green innovation within organizations; and blockchain technology applied to financial services. The main contributions of this work are as follows: (1) to provide the most complete and up-to-date review of digitalization from a global perspective, summarizing the current state of knowledge within an integrated framework; (2) to reduce the complexity of digitalization by offering structure and clarity; and (3) to offer links between digitalization and established points of view in the literature on management, marketing, finance, and accounting. The novelty of this paper is centered on a joint analysis of digitalization, digital transformation, and digital technologies, taking into account the most mature functional areas of the firm.
Collapse
Affiliation(s)
- Esther Calderon-Monge
- grid.23520.360000 0000 8569 1592Department of Economics and Business Administration, Faculty of Economy and Business Studies, University of Burgos, Burgos, Spain
| | | |
Collapse
|
20
|
Rao SA, Deshpande NG, Richardson DW, Brickman J, Posner MC, Matthews JB, Turaga KK. Alignment of RVU Targets With Operating Room Block Time. Ann Surg Open 2023; 4:e260. [PMID: 37600898 PMCID: PMC10431441 DOI: 10.1097/as9.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023] Open
Abstract
Background Surgeon productivity is measured in relative value units (RVUs). The feasibility of attaining RVU productivity targets requires surgeons to have enough allocated block time to generate RVUs. However, it is unknown how much block time is required for surgeons to attain specific RVU targets. We aimed to estimate the effect of surgeon and practice environment characteristics (SPECs) on block time needed to attain fixed RVU targets. Methods We computationally simulated individual surgeons' annual caseloads under a variety of SPECs in the following way. First, empirical case data were sampled from ACS NSQIP in accordance with surgeon specialty, case-mix complexity, and RVU target. Surgeons' operating schedules were then constructed according to the block length, turnover time, and scheduling flexibility of the practice environment. These 6 SPECs were concurrently varied over their ranges for a 6-way sensitivity analysis. Results Annual operating schedules for 60,000,000 surgeons were simulated. The number of blocks required to attain RVU targets varied significantly with surgeon specialty and increased with increased case-mix complexity, increased turnover time, and decreased scheduling flexibility. Intraspecialty variation in block requirement with variation in environmental characteristics exceeded interspecialty variation with fixed environmental characteristics. Multivariate linear models predicted block utilization across surgical specialties with consideration for the stated factors. An online tool is shared with which to apply these results to one's particular practice. Conclusions Block time required to attain RVU targets varies widely with SPECs; intraspecialty variation exceeds interspecialty variation. The feasibility of attaining RVU targets requires alignment between targets and allocated operating time with consideration for surgical specialty and other practice conditions.
Collapse
Affiliation(s)
- Saieesh A. Rao
- From the Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Nikita G. Deshpande
- Division of Biological Sciences, Department of Medicine, University of Chicago, Chicago, IL
| | - Douglas W. Richardson
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Jon Brickman
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Mitchell C. Posner
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Jeffrey B. Matthews
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Kiran K. Turaga
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| |
Collapse
|
21
|
Mavragani A, Schwab SD, Wilkes M, Yourk D, Zahradka N, Pugmire J, Wolfberg A, Merritt A, Boster J, Loudermilk K, Hipp SJ, Morris MJ. Financial and Clinical Impact of Virtual Care During the COVID-19 Pandemic: Difference-in-Differences Analysis. J Med Internet Res 2023; 25:e44121. [PMID: 36630301 PMCID: PMC9879318 DOI: 10.2196/44121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Virtual care (VC) and remote patient monitoring programs were deployed widely during the COVID-19 pandemic. Deployments were heterogeneous and evolved as the pandemic progressed, complicating subsequent attempts to quantify their impact. The unique arrangement of the US Military Health System (MHS) enabled direct comparison between facilities that did and did not implement a standardized VC program. The VC program enrolled patients symptomatic for COVID-19 or at risk for severe disease. Patients' vital signs were continuously monitored at home with a wearable device (Current Health). A central team monitored vital signs and conducted daily or twice-daily reviews (the nurse-to-patient ratio was 1:30). OBJECTIVE Our goal was to describe the operational model of a VC program for COVID-19, evaluate its financial impact, and detail its clinical outcomes. METHODS This was a retrospective difference-in-differences (DiD) evaluation that compared 8 military treatment facilities (MTFs) with and 39 MTFs without a VC program. Tricare Prime beneficiaries diagnosed with COVID-19 (Medicare Severity Diagnosis Related Group 177 or International Classification of Diseases-10 codes U07.1/07.2) who were eligible for care within the MHS and aged 21 years and or older between December 2020 and December 2021 were included. Primary outcomes were length of stay and associated cost savings; secondary outcomes were escalation to physical care from home, 30-day readmissions after VC discharge, adherence to the wearable, and alarms per patient-day. RESULTS A total of 1838 patients with COVID-19 were admitted to an MTF with a VC program of 3988 admitted to the MHS. Of these patients, 237 (13%) were enrolled in the VC program. The DiD analysis indicated that centers with the program had a 12% lower length of stay averaged across all COVID-19 patients, saving US $2047 per patient. The total cost of equipping, establishing, and staffing the VC program was estimated at US $3816 per day. Total net savings were estimated at US $2.3 million in the first year of the program across the MHS. The wearables were activated by 231 patients (97.5%) and were monitored through the Current Health platform for a total of 3474 (median 7.9, range 3.2-16.5) days. Wearable adherence was 85% (IQR 63%-94%). Patients triggered a median of 1.6 (IQR 0.7-5.2) vital sign alarms per patient per day; 203 (85.7%) were monitored at home and then directly discharged from VC; 27 (11.4%) were escalated to a physical hospital bed as part of their initial admission. There were no increases in 30-day readmissions or emergency department visits. CONCLUSIONS Monitored patients were adherent to the wearable device and triggered a manageable number of alarms/day for the monitoring-team-to-patient ratio. Despite only enrolling 13% of COVID-19 patients at centers where it was available, the program offered substantial savings averaged across all patients in those centers without adversely affecting clinical outcomes.
Collapse
Affiliation(s)
| | - Stephen D Schwab
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX, United States.,Department of Economics, Baylor University, Waco, TX, United States
| | - Matt Wilkes
- Current Health Ltd, Edinburgh, United Kingdom
| | | | | | | | | | - Amanda Merritt
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX, United States
| | - Joshua Boster
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX, United States
| | - Kevin Loudermilk
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX, United States
| | - Sean J Hipp
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX, United States
| | - Michael J Morris
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX, United States
| |
Collapse
|
22
|
Greene D. Landlords of the internet: Big data and big real estate. Soc Stud Sci 2022; 52:904-927. [PMID: 36190152 DOI: 10.1177/03063127221124943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Who owns the internet? It depends where you look. The physical assets at the core of the internet, the warehouses that store the cloud's data and interlink global networks, are owned not by technology firms like Google and Facebook but by commercial real estate barons who compete with malls and property storage empires. Granted an empire by the US at the moment of the internet's commercialization, these internet landlords shaped how the network of networks that we call the internet physically connects, and how personal and business data is stored and transmitted. Under their governance, internet exchanges, colocation facilities, and data centers take on a double life as financialized real estate assets that circle the globe even as their servers and cables are firmly rooted in place. The history of internet landlords forces a fundamental reconsideration of the business model at the base of the internet. This history makes clear that the internet was never an exogenous shock to capitalist social relations, but rather a touchstone example of an economic system increasingly ruled by asset owners like landlords.
Collapse
Affiliation(s)
- Daniel Greene
- University of Maryland at College Park, College Park, MD, USA
| |
Collapse
|
23
|
Abstract
This article discusses similarities between the finance industry and the gambling industry. It considers empirical studies from both fields and compares both industries with regard to possible substitution effects. Afterwards, the current regulatory approach to gambling and financial markets is discussed. Based on this literature review, the author points out that regulators need to acknowledge the fact that both markets possess addictive properties and attract certain risk-seeking individuals. Moreover, the regulators need to find a way to align their fundamentally different objectives to find common solutions to cross-industry problems. Finally, an increased cooperation between (state) authorities is necessary. This cooperation could help to protect traders from developing gambling-related problems, provide significant insights for industry-wide and product-specific regulation and lead to a more informed use of technology for harm prevention purposes. The most important similarities and differences of both markets and the resulting regulatory implications are briefly summarized.
Collapse
|
24
|
Liu Z, Dai P, Huynh TLD, Zhang T, Zhang G. Industries' heterogeneous reactions during the COVID‐19 outbreak: Evidence from Chinese stock markets. Journal of International Financial Management & Accounting 2022:10.1111/jifm.12166. [PMCID: PMC9878080 DOI: 10.1111/jifm.12166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examines the heterogeneous effects of the COVID‐19 outbreak on stock prices in China. We confirm what is already known, that the pandemic has had a significant negative impact on stock market returns. Additionally, we find, this effect is heterogeneous across industries. Second, fear sentiment can directly cause stock prices to fall and panic exacerbates the negative impact of the pandemic on stock returns. Third, and most importantly, we demonstrate the underlying mechanisms of four firm characteristics and find that those with high asset intensity, low labor intensity, high inventory‐to‐revenue ratio, and small market value are more negatively affected than others. For labor‐intensive state‐owned firms, in particular, stock performance worsened because of higher idle labor costs. Finally, we created an index to measure the relative position of an industry in the supply chain, which shows that downstream companies were more vulnerable to the effects of the pandemic.
Collapse
Affiliation(s)
- Zhifeng Liu
- Management SchoolHainan UniversityHaikouChina
- Department of Mechanical, Automotive & Materials Engineering, Supply Chain and Logistics Optimization Research CenterUniversity of WindsorWindsorCanada
| | - Peng‐Fei Dai
- School of BusinessEast China University of Science and TechnologyShanghaiChina
| | - Toan L. D. Huynh
- College of Technology and DesignUniversity of Economics Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Tingting Zhang
- School of EconomicsHainan UniversityHaikouChina
- Department of Mechanical, Automotive & Materials Engineering, Supply Chain and Logistics Optimization Research CenterUniversity of WindsorWindsorCanada
| | - Guoqing Zhang
- Department of Mechanical, Automotive & Materials Engineering, Supply Chain and Logistics Optimization Research CenterUniversity of WindsorWindsorCanada
| |
Collapse
|
25
|
Brice J, Cusworth G, Lorimer J, Garnett T. Immaterial animals and financialized forests: Asset manager capitalism, ESG integration and the politics of livestock. Environ Plan A 2022; 54:1551-1568. [PMID: 36176593 PMCID: PMC9511232 DOI: 10.1177/0308518x221121132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This article uses interviews with responsible investment professionals to examine the extent to which institutional equity investors, and specifically 'universal owners' with highly diversified shareholdings, engage with public issues associated with livestock agriculture. As share ownership becomes increasingly concentrated, and the market for Environmental, Social and Governance investment products grows, these investors are increasingly involved in governing the activities of publicly traded corporations (including leading agribusinesses). This paper brings together political economy and marketization studies research to explore how universal owners become concerned about particular environmental and ethical problems, why they overlook other public concerns, and in what ways their selective engagement with ethico-political issues might be altering the content of food politics. Comparing universal owners' engagements with farm animal welfare issues and with tropical deforestation within animal feed supply chains, we argue that these institutions engage with tropical deforestation because it presents a financially material risk to firms across multiple industries. By contrast, the specificity of farm animal welfare issues to agribusinesses means that they do not pose a material risk to the overall performance of universal owners' highly diversified asset portfolios. Efforts to concern universal owners about livestock agriculture's social, environmental and health impacts thus generate a food politics which focuses primarily on risks to global economic systems and renders animals themselves distinctly immaterial.
Collapse
Affiliation(s)
- Jeremy Brice
- Jeremy Brice, Sustainable Consumption Institute and Manchester Institute of Innovation Research, Alliance Manchester Business School, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| | | | | | | |
Collapse
|
26
|
Hu X, Jin W, Yang A, Hu Z. Management of capital liquidity in public hospitals under the epidemic situation of COVID-19. Front Public Health 2022; 10:977221. [PMID: 36339180 PMCID: PMC9631788 DOI: 10.3389/fpubh.2022.977221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/07/2022] [Indexed: 01/25/2023] Open
Abstract
The epidemic of COVID-19 has a great impact on the life and safety of people around the world. As the main force in the fight against COVID-19, the financial management of public hospitals will provide a strong guarantee for the diagnosis and treatment behavior of medical staff. The financial department needs to recognize the extent of the impact of COVID-19 on hospital finance, quantify and predict the potential risk factors, and develop reasonable financial management strategies. As an important part of assessing the financial health of public hospitals, the capital liquidity can be used as the focus direction of the hospital managers. In this study, we determine the effects of COVID-19 on the finance of public hospitals. Subsequently, we invested the conception, components, risk factors of capital liquidity in public hospitals. In addition, we provided some management strategies of capital liquidity in public hospitals under the epidemic of COVID-19. We deemed that good capital liquidity can ensure that medical staff have enough confidence and mentality to face the risk of death from COVID-19.
Collapse
Affiliation(s)
- Xiaoqiao Hu
- Department of Finance, The First College of Clinical Medicine Science, Yichang Central People's Hospital, China Three Gorges University, Yichang, China,*Correspondence: Xiaoqiao Hu
| | - Wei Jin
- Department of Finance, The First College of Clinical Medicine Science, Yichang Central People's Hospital, China Three Gorges University, Yichang, China,Wei Jin
| | - Ailan Yang
- Yichang Central People's Hospital at Zhijiang, Zhijiang, China,Ailan Yang
| | - Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| |
Collapse
|
27
|
Ostrowski T, Mouzakes J. Financial Distress Experienced By Privately Insured Pediatric Hearing Aid Patients: A Pilot Study. Clin Pediatr (Phila) 2022; 61:596-604. [PMID: 35677991 DOI: 10.1177/00099228221090362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The high cost associated with pediatric hearing aids is a major barrier to the acquisition of these medically essential tools. This pilot study describes the experiences of pediatric hearing aid users with their private insurers' hearing aid reimbursement at one academic institution in upstate New York. The families interviewed had purchased an average of 3.6 units for an average price of $2353.40 per unit, resulting in an average cost of $877.62 after insurer reimbursement. These families had an average household income of $150 419.40 per annum and an average monthly family-rated insurance premium of $481.60. Of 36 families, 20 (55.6%) reported previous feelings of financial distress or concerns about future financial distress associated with high costs incurred from purchasing their child's hearing aids. This study reveals the financial distress associated with pediatric hearing aids and the need for expanded research into individual families' experiences and this problem on a broader scale.
Collapse
Affiliation(s)
- Tyler Ostrowski
- Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, NY, USA
| | - Jason Mouzakes
- Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, NY, USA
| |
Collapse
|
28
|
Seguí-Urbaneja J, Cabello-Manrique D, Guevara-Pérez JC, Puga-González E. Understanding the Predictors of Economic Politics on Elite Sport: A Case Study from Spain. Int J Environ Res Public Health 2022; 19:12401. [PMID: 36231701 PMCID: PMC9566335 DOI: 10.3390/ijerph191912401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Sport federations (NSFs) are the main promoters of sport at a national level. Their complex management involves coordinating relations with private entities, public administrations, and international organisations. Therefore, the economic situation of a country and its sport support policies have significant influences on the achievement of the NSFs' objectives and, therefore, on their sustainability and influence on an active population. This study analyses the determinants of the financial performance of 59 Spanish sport federations (SSFs), 28 Olympic and 31 non-Olympic, based on the relationship between the funding received and their international results during the period from 2007 to 2019 (both years included). The preliminary data analysis included an examination of the missing data, and a t-test was used to compare Olympic and non-Olympic sport federations regarding different variables related to their resources and results. In addition, multiple linear regressions identified the possible predictors of the financing of sport federations and were separately performed for Olympic and non-Olympic federations. The results showed that SSFs were able to maintain their results in the face of decreasing resources. In addition, Olympic SSFs were found to be less dependent on public funding than non-Olympic SSFs for competitive results. This is evidence of a paradigm shift in the management of Spanish federated sports, evolving towards a model that is less dependent on the state, more efficient, and therefore more sustainable.
Collapse
Affiliation(s)
- Jordi Seguí-Urbaneja
- National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
- Grup d’Investigació Social i Educativa de l’Activitat Física i de l’Esport (GISEAFE), INEFC, University of Barcelona (UB), 08038 Barcelona, Spain
| | - David Cabello-Manrique
- Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
| | - Juan Carlos Guevara-Pérez
- Faculty of Economics and Business, University of Zaragoza, 50005 Zaragoza, Spain
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Esther Puga-González
- Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
| |
Collapse
|
29
|
Bühlmann F, Schoenberger F, Ajdacic L, Foureault F. Elite recruitment in US finance: How university prestige is used to secure top executive positions. Br J Sociol 2022; 73:667-684. [PMID: 35932258 PMCID: PMC9542345 DOI: 10.1111/1468-4446.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/25/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Status attainment theories assert that individuals are recruited based on the length and functional background of their training. Elite theories assume that top managers often deviate from these socially acceptable mechanisms of status attainment to entrench their advantage. In this study, focusing on the US financial sector, we investigate whether educational institution prestige-rather than the subject or length of education-increasingly influences appointments to top executive positions. We analyze 1987 US top executive managers affiliated with 147 firms from both financial and non-financial sectors in 2005 and 2018. Our study demonstrates that alumni of prestigious universities have a strikingly higher likelihood of attaining a top executive role in finance than in non-finance. Within finance it is no longer investment banking, but private equity, that contains the highest proportion of elite university graduates. Our findings suggest that notwithstanding the major power shifts between finance and non-finance-and also within the finance sector-elite groups still dominate the most symbolically valued education, and as a result, top managerial positions.
Collapse
|
30
|
Jolowsky CM. 2022 Report of the ASHP Treasurer. Am J Health Syst Pharm 2022. [PMID: 36005941 DOI: 10.1093/ajhp/zxac206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
31
|
Yver CM, Chao TN, Thaler ER, Ruckenstein MJ, Chalian AA, Weinstein GS, O'Malley BW, Cannady SB. Financial impact of the COVID-19 pandemic on an academic otolaryngology department. World J Otorhinolaryngol Head Neck Surg 2022:WJO251. [PMID: 35942327 PMCID: PMC9349602 DOI: 10.1002/wjo2.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/30/2022] [Indexed: 11/07/2022] Open
Abstract
Objective To quantify the financial impact of the coronavirus disease (COVID-19) pandemic on an academic otolaryngology department. Methods A year-over-year comparison was used to compare department revenue from April 2020 and April 2021 as a percentage of baseline April 2019 activity. Results At the onset of the COVID-19 pandemic in April 2020, total department charges decreased by 83.4%, of which outpatient clinic charges were affected to the greatest extent. One year into pandemic recovery, department charges remained down 6.7% from baseline, and outpatient clinic charges remained down 9.9%. The reduction in outpatient clinic charges was mostly driven by a decrease in in-office procedure charges. Conclusion Given that precautions to mitigate the risk of viral transmission in the health care setting are likely to be long-lived, it is important to consider the vulnerabilities of our specialty to mitigate financial losses going forward.
Collapse
Affiliation(s)
- Christina M. Yver
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Tiffany N. Chao
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Erica R. Thaler
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Michael J. Ruckenstein
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Ara A. Chalian
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Gregory S. Weinstein
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Bert W. O'Malley
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Steven B. Cannady
- Department of Otorhinolaryngology–Head and Neck Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
32
|
Krichen M, Ammi M, Mihoub A, Almutiq M. Blockchain for Modern Applications: A Survey. Sensors (Basel) 2022; 22:s22145274. [PMID: 35890953 PMCID: PMC9317832 DOI: 10.3390/s22145274] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 06/01/2023]
Abstract
Blockchain is a modern technology that has revolutionized the way society interacts and trades. It could be defined as a chain of blocks that stores information with digital signatures in a distributed and decentralized network. This technique was first adopted for the creation of digital cryptocurrencies, such as Bitcoin and Ethereum. However, research and industrial studies have recently focused on the opportunities that blockchain provides in various other application domains to take advantage of the main features of this technology, such as: decentralization, persistency, anonymity, and auditability. This paper reviews the use of blockchain in several interesting fields, namely: finance, healthcare, information systems, wireless networks, Internet of Things, smart grids, governmental services, and military/defense. In addition, our paper identifies the challenges to overcome, to guarantee better use of this technology.
Collapse
Affiliation(s)
- Moez Krichen
- Faculty of Computer Science and Information Technology, Albaha University, Alaqiq 65779, Saudi Arabia; or
- ReDCAD Laboratory, National School of Engineers of Sfax, University of Sfax, Sfax 3038, Tunisia
| | - Meryem Ammi
- Digital Forensics Department, Criminal Justice College, Naif Arab University for Security Sciences, Riyadh 14812, Saudi Arabia;
| | - Alaeddine Mihoub
- Department of Management Information Systems and Production Management, College of Business and Economics, Qassim University, P.O. Box 6640, Buraidah 51452, Saudi Arabia;
| | - Mutiq Almutiq
- Department of Management Information Systems and Production Management, College of Business and Economics, Qassim University, P.O. Box 6640, Buraidah 51452, Saudi Arabia;
| |
Collapse
|
33
|
Pandrangi VC, Mace JC, Detwiller KY, Smith TL, Geltzeiler M. Financial Hardship Impacts Depression and Anxiety Among U.S. Patients with Sinusitis. Am J Rhinol Allergy 2022; 36:491-502. [PMID: 35234076 DOI: 10.1177/19458924221083383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mental health conditions are common in the United States, and recent efforts have examined the development of mental health conditions among patients with sinusitis. OBJECTIVES The purpose of this study was to investigate the association between depression, anxiety, and financial hardship among patients with sinusitis. METHODS Cross-sectional study using the 2018 National Health Interview Survey (NHIS). Data regarding demographics, perceived financial hardship, self-reported depression and anxiety, mental healthcare utilization, and treatment compliance were obtained. RESULTS Among patients with sinusitis (N = 28 million adults), 9% reported depression and 24% reported anxiety. Sinusitis patients with depression and anxiety reported an increased severity of financial insecurity (p < 0.001). On multivariable logistic regression, worsening financial insecurity increased the odds of depression and anxiety. Patients reporting the highest financial insecurity severity had the highest odds of depression (OR = 3.88, 95% CI = 3.84-3.93, p < 0.001) and anxiety (OR = 2.09, 95% CI = 2.08-2.10, p < 0.001) among measures of financial stress. Specific financial stressors were independently associated with patient-reported depression and anxiety. Sinusitis patients with increased financial insecurity were more likely to require mental health services and treatment (p < 0.001), but were also more likely to report cost-related treatment noncompliance (p < 0.001) and reduced access to mental healthcare due to costs (p < 0.001). CONCLUSION Perceived financial hardship is associated with self-reported depression and anxiety among patients with sinusitis. Sinusitis patients with financial hardship also face challenges in accessing and maintaining mental health services and treatment due to costs. Understanding the burden of financial insecurity on mental health and access to treatment may improve quality of care through the development of screening tools and individualized treatment strategies.
Collapse
Affiliation(s)
- Vivek C Pandrangi
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Jess C Mace
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Kara Y Detwiller
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Mathew Geltzeiler
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
34
|
Wu Y, Zhu Y, Zhao J. The Propulsion Path of Synergy and Linkage Based on Artificial Intelligence and Digital Economy. Front Psychol 2022; 13:854542. [PMID: 35664178 PMCID: PMC9157247 DOI: 10.3389/fpsyg.2022.854542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
From conception to birth, artificial intelligence inherited the power of human reproduction, such as creativity, self-improvement and language use, etc. These abilities cannot be exercised in other places. The purpose of this paper is to explore the path of collaborative promotion based on artificial intelligence and digital economy. First, it outlines the scattered use of data by individuals at the two application levels of the digital economy and the systematic use of data by enterprises on large organizations. In this study, artificial intelligence and digital economy are introduced into the ability of project information sharing in the field of the enterprise project, and then their important role in improving the performance of enterprise project management is analyzed. Secondly, try to use interviews, scale analysis and logical subtraction to formulate the measurement standards of the digital environment and project information publishing ability, and provide basic data for follow-up research. The experimental results show that 54% of middle-level personnel said that the synergy between enterprise artificial intelligence and digital economy is very good, and they have a positive attitude toward exploring new ways to promote digital economy integration in the field of artificial intelligence.
Collapse
Affiliation(s)
- Yan Wu
- School of Economics and Management, Northwest University, Xi'an, China
| | - Yuqin Zhu
- School of Economics and Management, Hezhou University, Hezhou, China
| | - Jingfeng Zhao
- School of Economics and Management, Northwest University, Xi'an, China
| |
Collapse
|
35
|
Sapuppo D, Bernhardt J, Carvalho LB, Churilov L, Thijs V. Self-evaluation of personal needs by community-living young stroke survivors using an online English language questionnaire. Disabil Rehabil 2022; 45:1830-1835. [PMID: 35617487 DOI: 10.1080/09638288.2022.2076935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Identifying personal needs of young stroke survivors is crucial for their recovery. PURPOSE Identify factors, burden, and significance of unmet needs of young community-living stroke survivors. MATERIALS AND METHODS We used online advertising and word-of-mouth snowballing to recruit participants for an English language online questionnaire constructed for this purpose. Eligible participants aged 18-55 at time of stroke. Needs were classified into seven domains: Healthcare Experience, Impairments from Stroke, Everyday Activities, Work/Study, Finances, Relationships, and Social Participation. Random-effects logistic regression was used to determine the probability of unmet needs and X2 test to determine significance of distribution across domains. RESULTS Out of 137 responses recorded: 32 did not meet inclusion criteria, 29 duplicates identified were discarded, and 76 eligible participants were analysed. Respondents were median 37 (IQR 32-47) years at time of stroke, and median 3 (1-5) years since stroke. Fifty-eight (76%) females. Modified Rankin Scale median score of 1 (1-3). Of 48 identified potential needs, 25 (IQR 19-30) were rated unmet. Twenty (IQR 15-25) considered of high significance. Unmet needs most frequently occurred in the domains: Impairments from Stroke, Finances, and Social Participation. CONCLUSIONS There is high burden of unmet needs in community-living young stroke survivors which are spread disproportionately across the identified domains.IMPLICATIONS FOR REHABILITATIONIdentifying personal needs of young stroke survivors is crucial for their recovery.Impairments after Stroke, Finances, and Social Participation were often selected as being high burden unmet needs for community-living young people after stroke.Employing a post-stroke checklist to guide exploration of needs in young stroke may better capture which needs are unmet.
Collapse
Affiliation(s)
- David Sapuppo
- Neurology Department, Austin Health, Melbourne, Australia
| | - Julie Bernhardt
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Lilian B Carvalho
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonid Churilov
- Department of Medicine (Austin Health) and Melbourne Brain Centre at Royal Melbourne Hospital, Melbourne Medical School, University of Melbourne, Australia
| | - Vincent Thijs
- Neurology Department, Austin Health, Melbourne, Australia.,Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| |
Collapse
|
36
|
Lange M, von Scheve C. Risk Entanglement in the Finance-State Nexus: The Case of Systemic and Political Risk. Front Sociol 2022; 7:877217. [PMID: 35548584 PMCID: PMC9082990 DOI: 10.3389/fsoc.2022.877217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/24/2022] [Indexed: 05/09/2023]
Abstract
Crises such as European debt crisis, Brexit, and COVID-19 have challenged established relations between finance and the state in attempts at mitigating a broad range of crises-related risks. We ask whether and how these altered relations in themselves constitute novel uncertainties and risks between the two fields. To better understand these dynamics, we introduce the concept of "risk entanglement" to complement financialization as a key concept presently capturing these relations. Based on qualitative research in the German finance-state nexus, we show how financial and state actors mutually construe each other as risks that need to be managed and mitigated to safeguard their particular, field-specific logics and ends. We focus on systemic risk and political risk as two cases of risk entanglement: whereas systemic risk reflects the threat of a potential financial meltdown to the state, political risk reflects how the state endangers established risk practices in finance.
Collapse
Affiliation(s)
- Markus Lange
- Institute of Sociology, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Christian von Scheve
- Institute of Sociology, Free University of Berlin, Berlin, Germany
- German Institute for Economic Research (DIW) Berlin, Berlin, Germany
| |
Collapse
|
37
|
Park C, Coles E. The Impact of Student Debt on Career Choices among Doctor of Public Health Graduates in the United States: A Descriptive Analysis. Int J Environ Res Public Health 2022; 19:4836. [PMID: 35457701 DOI: 10.3390/ijerph19084836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: As gaps in the public health workforce grow in the wake of the COVID-19 pandemic, graduates of the schools of public health, especially Doctors of Public Health (DrPH), are poised to offer relief. While there are some known recruitment issues, student debt and debt impact on career choices are understudied. (2) Methods: In the present study, we perform a descriptive analysis of the potential impact of student debt on career choices among DrPH students and alumni in the United States using a cross-sectional national online survey. A total of 203 participants (66: alumni and 137: current students) completed the survey. Descriptive statistics, a chi-squared test of independence, and content analysis were used to analyze the funding situation and its impact on career choices. (3) Results: We found that (1) 72% of current DrPH students have zero funding support for their degree, (2) scholarship opportunities for a DrPH degree are limited, especially when compared to PhD programs, and (3) student debt impacts 59% of DrPH students’ and 29% of DrPH graduates’ career choices (about 49% of all respondents). (4) Conclusions: Student debt and a misunderstanding of DrPH are likely impediments to DrPH graduates participating in the public health workforce.
Collapse
|
38
|
Rohrer F, Farokhnia A, Nötzli H, Haubitz F, Hermann T, Gahl B, Limacher A, Brügger J. Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements. Int J Environ Res Public Health 2022; 19:ijerph19074325. [PMID: 35410007 PMCID: PMC8998626 DOI: 10.3390/ijerph19074325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
The aging population and the associated demand for orthopedic surgeries are increasing health costs. Although the Diagnostic Related Groups (DRG) system was introduced to offer incentives for hospitals, concerns remain that reimbursements for older and frail patients do not cover all hospital expenses. We investigated further: (1) Does age influence net financial results in orthopedic surgery? (2) Are there patient or surgical factors that influence results? This retrospective, monocentric study compares costs and reimbursements for orthopedic patients in a tertiary care hospital in Switzerland between 2015 and 2017. The data of 1230 patients were analyzed. Overall, the net results for the hospital were positive, despite 19.5% of patients being treated at a loss. We did not find any correlation between age and profitability (p = 0.61). Patient-related factors associated with financial losses were female sex (p < 0.001) and diabetes (p = 0.013). Patients free of serious comorbidities (p = 0.012) or with a higher cost weight (p < 0.001) were more often profitable. A longer length of stay was associated with higher losses (p < 0.001). This is the first study to address the Swiss DRG reimbursement system in a broad orthopedic population, while also analyzing specific patient and surgical factors. Overall, the reimbursement system is fair, but could better account for certain interventions.
Collapse
Affiliation(s)
- Felix Rohrer
- Centre Hospitalier Universitaire Vaudois, CHUV, 1011 Lausanne, Switzerland
- Department of Internal Medicine, Sonnenhofspital, 3006 Bern, Switzerland;
- Correspondence: ; Tel.: +41-78-890-13-32
| | - Aresh Farokhnia
- Clinic for Immunology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Hubert Nötzli
- Orthopädie Sonnenhof, 3006 Bern, Switzerland;
- Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
| | | | - Tanja Hermann
- Stiftung Lindenhof, Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, 3010 Bern, Switzerland;
| | - Brigitta Gahl
- Clinical Trial Unit, University of Bern, 3012 Bern, Switzerland; (B.G.); (A.L.)
| | - Andreas Limacher
- Clinical Trial Unit, University of Bern, 3012 Bern, Switzerland; (B.G.); (A.L.)
| | - Jan Brügger
- Department of Internal Medicine, Sonnenhofspital, 3006 Bern, Switzerland;
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
| |
Collapse
|
39
|
Jessup B, Hoang H, Podubinski T, Obamiro K, Bourke L, Hellwege B, Jatrana S, Heaney S, Farthing A, Sheepway L, Rasiah R. 'I can't go, I can't afford it': Financial concern amongst health students undertaking rural and remote placements during COVID-19. Aust J Rural Health 2022; 30:238-251. [PMID: 35229400 PMCID: PMC9111257 DOI: 10.1111/ajr.12855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/06/2022] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION As the coronavirus pandemic unfolded during 2020, widespread financial uncertainty emerged amongst university students across the globe. What is not yet clear is how Australian health students were financially impacted during the initial stages of the pandemic and whether this influenced their ability to undertake planned rural or remote placements. OBJECTIVE To examine (a) financial concern amongst health students during COVID-19, (b) the financial implications of changes to planned rural or remote placements and (c) the impact of these factors on students' ability to undertake placements during the pandemic. DESIGN Mixed-methods design involving an online survey (n = 1210) and semi-structured interviews (n = 29). Nursing, medical and allied health students with a planned University Department of Rural Health-facilitated rural or remote placement between February and October 2020 were invited to participate. FINDINGS 54.6% of surveyed students reported financial concern during COVID-19. Financial concern correlated with both changes in financial position and employment, with 36.6% of students reporting a reduction in income and 43.1% of students reporting a reduction in, or cessation of regular employment. Placement changes yielded a range of financial implications. Cancelled placements saved some students travel and accommodation costs, but left others out of pocket if these expenses were prepaid. Placements that went ahead often incurred increased accommodation costs due to limited availability. Financial concern and/or financial implications of placement changes ultimately prevented some students from undertaking their rural or remote placement as planned. DISCUSSION Many nursing, allied health and medical students expressed financial concern during COVID-19, associated with a loss of regular employment and income. Placement changes also presented unforeseen financial burden for students. These factors ultimately prevented some students from undertaking their planned rural or remote placement. CONCLUSION Universities need to consider how best to align financially burdensome placements with the personal circumstances of students during periods of economic uncertainty.
Collapse
Affiliation(s)
- Belinda Jessup
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Ha Hoang
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Tegan Podubinski
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| | - Kehinde Obamiro
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Lisa Bourke
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| | - Barbara Hellwege
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| | - Santosh Jatrana
- JCU Murtupini Centre for Rural and Remote HealthJames Cook UniversityMount IsaQueenslandAustralia
| | - Susan Heaney
- The University of Newcastle Department of Rural HealthThe University of NewcastlePort MacquarieNew South WalesAustralia
| | - Annie Farthing
- Centre for Remote HealthFlinders UniversityAlice SpringsNorthern TerritoryAustralia
| | - Lyndal Sheepway
- La Trobe Rural Health SchoolLa Trobe UniversityWodongaVictoriaAustralia
| | - Rohan Rasiah
- Western Australian Centre for Rural HealthThe University of Western AustraliaKarrathaWestern AustraliaAustralia
| |
Collapse
|
40
|
Tummala S, Zhong W, Marcil LE. Embedding 529 College Savings Accounts in Pediatric Care: A Pilot Innovation. Acad Pediatr 2022; 22:501-502. [PMID: 34492376 DOI: 10.1016/j.acap.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/20/2021] [Accepted: 08/28/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Swetha Tummala
- Boston University School of Medicine (S Tummala, W Zhong, and LE Marcil), Boston, Mass.
| | - Wayne Zhong
- Boston University School of Medicine (S Tummala, W Zhong, and LE Marcil), Boston, Mass
| | - Lucy E Marcil
- Boston University School of Medicine (S Tummala, W Zhong, and LE Marcil), Boston, Mass; Boston Medical Center (LE Marcil), Boston, Mass
| |
Collapse
|
41
|
Patil SA, Luu A, Vail DG, Watane A, Levine R, Hafler B, Parikh R. Utilization of Crowdfunding for Cataract and LASIK Procedures. Semin Ophthalmol 2022; 37:657-660. [PMID: 35353643 DOI: 10.1080/08820538.2022.2054664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To study the nature of crowdfunding campaigns for common ophthalmologic procedures. METHODS Cross sectional, retrospective study of campaigns on GoFundMe.com from January 1st, 2021 to July 31st, 2021. All domestic and international campaigns referring to cataract and intraocular lens placement or LASIK procedures, excluding those with non-ophthalmologic conditions or campaigns for multiple conditions. Descriptive analysis of campaigns including condition, country of origin of patient, total and median value raised, total and median value sought, age of the patient, funding goal met, insurance status when possible. Total and median funds raised and sought, international versus domestic campaigns, success rate for campaigns, percent of campaigns involving children, percent of campaigns mentioning insurance. RESULTS 137 campaigns were identified, 67.9% (93/137) were for cataract and 32.1% (44/137) were for LASIK. 13.1% (18/137) of campaigns were international. 7.3% (10/137) campaigns were successful at reaching funding goals. Of successful campaigns, 70.0% (7/10) were for cataract and 30.0% (3/10) were for LASIK. Total value raised (in USD) was $131,763, where $106,593 was for cataract and $25,170 was for LASIK. The median value sought overall was $5,000, where the median sought for cataract procedures was $5,000 and the median for LASIK was $4,000. The median value raised was $395. 5.8% (8/137) of campaigns mentioned minors. 12.5% (1/8) of campaigns for children or minors successfully met funding goals compared to 7.0% (9/129) adult campaigns. The total funds raised for children or minors was $9,224 with a goal of $41,050. The total funds raised for adults was $122,539 out of a goal of $775,617. 14.6% (20/137) campaigns mentioned insurance coverage, of which 85% (17/20) were for cataract and 15.0% (3/20) were for LASIK. Premium lenses (toric, multifocal, etc.) were mentioned in 1.1% of cataract campaigns (1/93) as being cost prohibitive. CONCLUSIONS Crowdfunding is ineffective as a means for patients to raise funds for ophthalmic procedures. The broad range of financial requests within campaigns indicates a large patient knowledge gap in cost for procedures.
Collapse
Affiliation(s)
- Sachi A Patil
- Department of Ophthalmology New York University Grossman School of Medicine New York, New York, NY, USA
| | - Amanda Luu
- Touro College of Osteopathic Medicine New York, New York, NY, USA
| | - Daniel G Vail
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, NY, NY, USA
| | - Arjun Watane
- Department of Ophthalmology, Yale School of Medicine, New Haven, CT, USA
| | - Russell Levine
- Department of Ophthalmology New York University Grossman School of Medicine New York, New York, NY, USA
| | - Brian Hafler
- Department of Ophthalmology, Yale School of Medicine, New Haven, CT, USA
| | - Ravi Parikh
- Department of Ophthalmology New York University Grossman School of Medicine New York, New York, NY, USA.,Manhattan Retina and Eye Consultants, NY, NY, USA
| |
Collapse
|
42
|
Abstract
The assertion that 'ecosystems are infrastructure' is now common in conservation science and ecosystem management. This article interrogates that claim, which we argue underpins diverse practices of environmental investment focused on the strategic management of ecosystem functions to sustain and secure human life. We trace the genealogies and geographies of infrastructural nature as a paradigm of investment that coexists (sometimes in tension) with extractivist commodity regimes. We draw links between literatures on the political economy of ecosystem services and infrastructure and highlight three themes that hold promise for future research: labor, territory, and finance.
Collapse
Affiliation(s)
- Sara H Nelson
- Sara H Nelson, The University of British Columbia, Liu Institute for Global Issues, 6476 NW Marine Dr, Vancouver, BC V6T 1Z2, Canada.
| | | |
Collapse
|
43
|
Hadji Misheva B, Jaggi D, Posth JA, Gramespacher T, Osterrieder J. Audience-Dependent Explanations for AI-Based Risk Management Tools: A Survey. Front Artif Intell 2022; 4:794996. [PMID: 35028559 PMCID: PMC8751385 DOI: 10.3389/frai.2021.794996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Artificial Intelligence (AI) is one of the most sought-after innovations in the financial industry. However, with its growing popularity, there also is the call for AI-based models to be understandable and transparent. However, understandably explaining the inner mechanism of the algorithms and their interpretation is entirely audience-dependent. The established literature fails to match the increasing number of explainable AI (XAI) methods with the different stakeholders' explainability needs. This study addresses this gap by exploring how various stakeholders within the Swiss financial industry view explainability in their respective contexts. Based on a series of interviews with practitioners within the financial industry, we provide an in-depth review and discussion of their view on the potential and limitation of current XAI techniques needed to address the different requirements for explanations.
Collapse
Affiliation(s)
- Branka Hadji Misheva
- ZHAW, School of Engineering, Institute of Data Analysis and Process Design, Winterthur, Switzerland
| | - David Jaggi
- ZHAW, School of Management and Law, Department Banking and Finance, Winterthur, Switzerland
| | - Jan-Alexander Posth
- ZHAW, School of Management and Law, Department Banking and Finance, Winterthur, Switzerland
| | - Thomas Gramespacher
- ZHAW, School of Management and Law, Department Banking and Finance, Winterthur, Switzerland
| | - Joerg Osterrieder
- ZHAW, School of Engineering, Institute of Data Analysis and Process Design, Winterthur, Switzerland
| |
Collapse
|
44
|
Berthet V. The Impact of Cognitive Biases on Professionals' Decision-Making: A Review of Four Occupational Areas. Front Psychol 2022; 12:802439. [PMID: 35058862 PMCID: PMC8763848 DOI: 10.3389/fpsyg.2021.802439] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
The author reviewed the research on the impact of cognitive biases on professionals' decision-making in four occupational areas (management, finance, medicine, and law). Two main findings emerged. First, the literature reviewed shows that a dozen of cognitive biases has an impact on professionals' decisions in these four areas, overconfidence being the most recurrent bias. Second, the level of evidence supporting the claim that cognitive biases impact professional decision-making differs across the areas covered. Research in finance relied primarily upon secondary data while research in medicine and law relied mainly upon primary data from vignette studies (both levels of evidence are found in management). Two research gaps are highlighted. The first one is a potential lack of ecological validity of the findings from vignette studies, which are numerous. The second is the neglect of individual differences in cognitive biases, which might lead to the false idea that all professionals are susceptible to biases, to the same extent. To address that issue, we suggest that reliable, specific measures of cognitive biases need to be improved or developed.
Collapse
Affiliation(s)
- Vincent Berthet
- Université de Lorraine, 2LPN, Nancy, France
- Psychology and Neuroscience Lab, Centre d’Économie de la Sorbonne, Université de Lorraine, CNRS UMR 8174, Paris, France
| |
Collapse
|
45
|
Richardson T, Collard S, Harper A. Editorial: Financial difficulties and mental health problems. Front Psychiatry 2022; 13:1100200. [PMID: 36532170 PMCID: PMC9752090 DOI: 10.3389/fpsyt.2022.1100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Thomas Richardson
- School of Psychology, School of Geographical Sciences, University of Southampton, Southampton, United Kingdom
| | - Sharon Collard
- Personal Finance Research Centre, University of Bristol, Bristol, United Kingdom
| | - Annie Harper
- School of Medicine, Yale University, New Haven, CT, United States
| |
Collapse
|
46
|
Hinvest NS, Alsharman M, Roell M, Fairchild R. Do Emotions Benefit Investment Decisions? Anticipatory Emotion and Investment Decisions in Non-professional Investors. Front Psychol 2021; 12:705476. [PMID: 34955944 PMCID: PMC8696076 DOI: 10.3389/fpsyg.2021.705476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/16/2021] [Indexed: 12/04/2022] Open
Abstract
Increasing financial trading performance is big business. A lingering question within academia and industry concerns whether emotions improve or degrade trading performance. In this study, 30 participants distributed hypothetical wealth between a share (a risk) and the bank (paying a small, sure, gain) within four trading games. Skin Conductance Response was measured while playing the games to measure anticipatory emotion, a covert emotion signal that impacts decision-making. Anticipatory emotion was significantly associated with trading performance but the direction of the correlation was dependent upon the share’s movement. Thus, anticipatory emotion is neither wholly “good” nor “bad” for trading; instead, the relationship is context-dependent. This is one of the first studies exploring the association between anticipatory emotion and trading behaviour using trading games within an experimentally rigorous environment. Our findings elucidate the relationship between anticipatory emotion and financial decision-making and have applications for improving trading performance in novice and expert traders.
Collapse
Affiliation(s)
- Neal S Hinvest
- Department of Psychology, University of Bath, Bath, United Kingdom
| | | | - Margot Roell
- Department of Psychology, University of Bath, Bath, United Kingdom
| | | |
Collapse
|
47
|
Gunn KM, Hughes-Barton D. Understanding and addressing psychological distress experienced by farmers, from the perspective of rural financial counsellors. Aust J Rural Health 2021; 30:34-43. [PMID: 34797594 DOI: 10.1111/ajr.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To explore rural financial counsellors' experiences interacting with psychologically distressed farmers and identify contextually appropriate methods to maintain their own well-being and link farmers to psychological supports, within their existing roles. SETTING Rural, regional and remote Australia. PARTICIPANTS Fifty rural financial counsellors participated. They worked across 6 Australian states/territories. DESIGN Individual semi-structured telephone interviews were audio-recorded with consent. Qualitative data were analysed using thematic analysis. Themes were identified using an essentialist, bottom-up approach. RESULTS Forty-six themes emerged relating to the 5 topics explored: (a) how to recognise distress in farmers (eg inability to focus/make decisions, deterioration in presentation/organisation, anger, blaming); (b) impact of farmers' psychological distress on the financial case management process (eg slows, disrupts or stops it, negatively impacts counsellor well-being); (c) strategies for working effectively with distressed farmers (eg flexibility, open-ended questions, listening to story, simplicity, instilling hope); (d) referral of distressed farmers to psychological support (eg willing if tried themselves/positive reports, lack of local rural face-to-face services, stigma and lack of understanding of importance challenging, a farming focus and support from family/ community assists); and (e) strategies to maintain their own well-being (eg compartmentalising, exercise, supervision). CONCLUSION Rural financial counsellors play an important role by recognising signs of distress in farmers and referring them to appropriate psychological supports. However, this is a demanding role and ensuring counsellors have appropriate services to refer farmers to, and support with their own well-being, is imperative.
Collapse
Affiliation(s)
- Kate M Gunn
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Donna Hughes-Barton
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| |
Collapse
|
48
|
Escontrías OA, Istrate EC, Flores S, Stewart DCL. Operational and financial impact of the COVID-19 pandemic on U.S. dental school clinics. J Dent Educ 2021; 85:1863-1869. [PMID: 34729773 PMCID: PMC8657527 DOI: 10.1002/jdd.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE This study assessed the impact of the COVID-19 pandemic on U.S. dental schools and their school-based clinic operations and finances during the first eight months (April to December 2020) of the outbreak. School-based clinics are critical to training and educating future dentists and delivering oral health care services to underserved communities. METHODS The American Dental Education Association (ADEA) conducted a structured survey with the 67 accredited U.S. dental schools between November 2020 and January 2021 to assess the impact of the COVID-19 pandemic on their operations, especially on their school-based clinics. The response rate was 67%. The authors employed descriptive statistics and text analysis to examine the survey results. RESULTS This study revealed that from April to December 2020, dental schools experienced a 50% reduction in patient visits at dental school clinics, a 7% median decrease in budget, a 42% decline in revenue, changes in clinical and nonclinical faculty and staff, and investments related to infection control measures to remain operational. Ninety-two percent of dental school clinics suspended community-based patient care experiences outside the dental school in the first eight months of the pandemic compared to the same time period the year prior. CONCLUSIONS This research shows the extent of the operational and financial challenges dental school clinics faced in the pandemic's first eight months, April to December 2020. In these unique times, dental school clinics continued to train and educate the dentists of tomorrow and deliver oral health care services to vulnerable communities while implementing safeguards and infection control measures to combat the propagation of the COVID-19 virus in their institutions.
Collapse
Affiliation(s)
- Omar A. Escontrías
- Office of Policy and Education ResearchAmerican Dental Education Association655 K St. NW, Ste 800.WashingtonDistrict of Columbia20001USA
| | - Emilia C. Istrate
- Office of Policy and Education ResearchAmerican Dental Education Association655 K St. NW, Ste 800.WashingtonDistrict of Columbia20001USA
| | - Sariah Flores
- College of Graduate Health StudiesA.T. Still University5850 E. Still CircleMesaArizona85206USA
| | - Denice C. L. Stewart
- Office of Policy and Education ResearchAmerican Dental Education Association655 K St. NW, Ste 800.WashingtonDistrict of Columbia20001USA
| |
Collapse
|
49
|
Halina B, Magdalena W. The use of IT systems in financial and accounting services for enterprises in the conditions of the COVID-19 pandemic. Procedia Comput Sci 2021; 192:4112-4119. [PMID: 34630759 PMCID: PMC8486232 DOI: 10.1016/j.procs.2021.09.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In Poland, remote teams and work outside of the company were rare by this time. Almost all organizations had to virtualize at a faster rate by delegating their employees to work remotely, facing many challenges that they had to overcome in a short time. This article aims to check the directions and effects of changes in the digitalization of financial-accounting processes concerning the COVID-19 pandemic. The rate of use financial-accounting programs in remote work and upgrade of work organization, availability to internet platforms, identification security level of data, defining barriers that influence the limit of digitalization processes and financial-accounting programs were made.
Collapse
Affiliation(s)
- Buk Halina
- The WSB University in Poznań, Powstańców Wlkp. 5, 61-895 Poznań, Poland
| | | |
Collapse
|
50
|
McCann BT, Davis JM, Osborne D, Durham C, O'Brien M, Raymond NA. Quantifying climate change-relevant humanitarian programming and spending across five countries with high vulnerability to disaster. Disasters 2021; 45:819-843. [PMID: 32643198 PMCID: PMC8518874 DOI: 10.1111/disa.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Climate change is increasing the severity and the frequency of natural hazards and associated disasters worldwide, yet there is little data tracking how and whether it is being addressed by humanitarian assistance initiatives. Drawing on publicly available United Nations programme data and vulnerability indexes, this study pilots a novel approach to identifying and quantifying the prevalence of climate change-related humanitarian programmes from 2016-18 in five disaster-affected countries. The funding levels of proposed and undertaken interventions were analysed within specific programmatic sub-areas and across clusters. The study found that 1.8 per cent (99 of 5,558) of projects included in humanitarian proposals reviewed during the research have a climate change-related component. Of 1,361 funded projects, 40 of these were climate change-related and received funding. The methodologies tested here to assess and classify climate change-related humanitarian programmes could be expanded to support further tracking of humanitarian responses to climate change across operational contexts.
Collapse
Affiliation(s)
| | - Jenna M. Davis
- Research Assistant at the School of the EnvironmentYale UniversityUnited States
| | - Devin Osborne
- Graduate student at the School of the EnvironmentYale UniversityUnited States
| | - Courtney Durham
- Officer with the International Conservation Unit at Pew Charitable TrustsUnited States
| | - Madeleine O'Brien
- Graduate student at the School of the EnvironmentYale UniversityUnited States
| | - Nathaniel A. Raymond
- Lecturer at the Jackson Institute for Global AffairsYale UniversityUnited States
| |
Collapse
|