There are few papers in the literature focusing on the issue of the optimal depletion of exhaustible resources in the framework of variable time preference. This paper attempts to analyze the pure consumption of exhau...There are few papers in the literature focusing on the issue of the optimal depletion of exhaustible resources in the framework of variable time preference. This paper attempts to analyze the pure consumption of exhaustible resource under hy- perbolic time preference, and to discuss the optimal depletion rate and the effect of the protection of the exhaustible resource under different commitment abilities. The results of model show that the case of the hyperbolic discount with the full commitment of the govemment is equivalent to the case of constant discount of the social planner problem. In that case, the optimal depletion rate and the initial consumption of exhaustible resource are the slowest. On the contrary, they are the highest and the myopic behaviors lead to excessive consumption of exhaustible resources inevitably without commitment. Otherwise, in the case of partial commit- ment, the results are between the cases of full commitment and of no commitment. Therefore, with the hyperbolic time preference, the optimal depletion rate of resource depends on the commitment ability. Higher commitment ability leads to lower effective rate of time preference, and consequently, lower depletion rate and lower initial depletion value. The improvement of commitment ability can decrease the impatience and myopia behaviors, and contribute to the protection of the exhaustible resources.展开更多
AIM:To assess the impact of guidelines for albumin prescription in an academic hospital,which is a referral center for liver diseases.METHODS:Although randomized trials and guidelines support albumin administration fo...AIM:To assess the impact of guidelines for albumin prescription in an academic hospital,which is a referral center for liver diseases.METHODS:Although randomized trials and guidelines support albumin administration for some complications of cirrhosis,the high cost of albumin greatly limits its use in clinical practice.In 2003,a multidisciplinary panel at Sant'Orsola-Malpighi University Hospital(Bologna,Italy)used a literature-based consensus method to list all the acute and chronic conditions for which albumin is indicated as first-or second-line treatment.Indications in hepatology included prevention of post-paracentesis circulatory dysfunction and renal failure induced by spontaneous bacterial peritonitis,and treatment of hepatorenal syndrome and refractory ascites.Although still debated,albumin administration in refractory ascites is accepted by the Italian health care system.We analyzedalbumin prescription and related costs before and after implementation of the new guidelines.RESULTS:While albumin consumption and costs doubled from 1998 to 2002,they dropped 20%after 2003,and remained stable for the following 6 years.Complications of cirrhosis,namely refractory ascites and paracentesis,represented the predominant indications,followed by major surgery,shock,enteric diseases,and plasmapheresis.Albumin consumption increased significantly after guideline implementation in the liver units,whereas it declined elsewhere in the hospital.Lastly,extra-protocol albumin prescription was estimated as<10%.CONCLUSION:Albumin administration in cirrhosis according to international guidelines does not increase total hospital albumin consumption if its use in settings without evidence of efficacy is avoided.展开更多
基金Funding of Humanities and Social Science Fundation of Education Ministry (Grant No.11YJC790308)
文摘There are few papers in the literature focusing on the issue of the optimal depletion of exhaustible resources in the framework of variable time preference. This paper attempts to analyze the pure consumption of exhaustible resource under hy- perbolic time preference, and to discuss the optimal depletion rate and the effect of the protection of the exhaustible resource under different commitment abilities. The results of model show that the case of the hyperbolic discount with the full commitment of the govemment is equivalent to the case of constant discount of the social planner problem. In that case, the optimal depletion rate and the initial consumption of exhaustible resource are the slowest. On the contrary, they are the highest and the myopic behaviors lead to excessive consumption of exhaustible resources inevitably without commitment. Otherwise, in the case of partial commit- ment, the results are between the cases of full commitment and of no commitment. Therefore, with the hyperbolic time preference, the optimal depletion rate of resource depends on the commitment ability. Higher commitment ability leads to lower effective rate of time preference, and consequently, lower depletion rate and lower initial depletion value. The improvement of commitment ability can decrease the impatience and myopia behaviors, and contribute to the protection of the exhaustible resources.
文摘AIM:To assess the impact of guidelines for albumin prescription in an academic hospital,which is a referral center for liver diseases.METHODS:Although randomized trials and guidelines support albumin administration for some complications of cirrhosis,the high cost of albumin greatly limits its use in clinical practice.In 2003,a multidisciplinary panel at Sant'Orsola-Malpighi University Hospital(Bologna,Italy)used a literature-based consensus method to list all the acute and chronic conditions for which albumin is indicated as first-or second-line treatment.Indications in hepatology included prevention of post-paracentesis circulatory dysfunction and renal failure induced by spontaneous bacterial peritonitis,and treatment of hepatorenal syndrome and refractory ascites.Although still debated,albumin administration in refractory ascites is accepted by the Italian health care system.We analyzedalbumin prescription and related costs before and after implementation of the new guidelines.RESULTS:While albumin consumption and costs doubled from 1998 to 2002,they dropped 20%after 2003,and remained stable for the following 6 years.Complications of cirrhosis,namely refractory ascites and paracentesis,represented the predominant indications,followed by major surgery,shock,enteric diseases,and plasmapheresis.Albumin consumption increased significantly after guideline implementation in the liver units,whereas it declined elsewhere in the hospital.Lastly,extra-protocol albumin prescription was estimated as<10%.CONCLUSION:Albumin administration in cirrhosis according to international guidelines does not increase total hospital albumin consumption if its use in settings without evidence of efficacy is avoided.
