Evaluation of Medical Costs of Kidney Diseases and Risk Factors in Japan

Background: Kidney (renal) diseases and dialysis are among the most costly disorders and represent a worldwide burden. In this study, we evaluate the medical costs for individuals with kidney diseases and risk factors for the diseases in Japan. Data and Methods: The dataset used contained 113,979 medical checkups and 3,172,066 medical cost records obtained from 48,022 individuals in one health insurance society. The sample period was April 2013 to March 2016. We evaluated the distribution of all medical costs, and those of kidney diseases specifically. Then the power transformation Tobit model was used to remove the effects of other variables. Finally, a probit analysis was used to analyze the risk factors. Results: In 0.25% of all cases, individuals were diagnosed with kidney diseases. An individual with kidney disease cost 14.5 times more than those without kidney disease. If the diseases progressed into chronic kidney disease (CKD), the medical costs increased substantially. Even disregarding various characteristics of individuals, this conclusion did not vary. We found important risk factors included diabetes and blood pressure problems. In particular, an individual with both factors had a high probability of developing kidney disease. Conclusion: Kidney diseases are much costlier than other diseases. Screening high-risk individuals, educating patients, and ensuring that treatment begins at an early stage are critically important to controlling medical costs. Limitations: The dataset was observatory, and the sample period was only 3 years.

Risk Acceptability and Cost-Effectiveness of Protective Measures Against Terrorist Threats to Built Infrastructure Considering Multiple Threat Scenarios

Decisions are often needed about the need and/or extent of protective measures against explosive blast loads on built infrastructure. A decision support analysis considers fatality risks and cost-effectiveness of protective measures expressed in terms of expected cost spent on risk reduction per life saved for terrorist threats to infrastructure. The analysis is applicable to any item of infrastructure, but in this paper is applied to casualties arising from building facade glazing damage. Risks may be compared with risk acceptance criteria in the form of quantitative safety goals. The risk acceptability and cost-effectiveness of protective measures includes cost of the protective measures, attack probability,reduction in risk due to protective measures,probability of fatality conditional on successful terrorist attack and number of exposed individuals.

Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.

Risk factors for cost-related medication non-adherence among older patients with diabetes

AIM: To assess the risk factors for cost-related medication non-adherence(CRN) among older patients with diabetes in the United States. METHODS: We used data from the 2010 Health and Retirement Study to assess risk factors for CRN including age, drug insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization. CRN was self-reported. We conducted multivariate regression analysis to assess the effect of each risk factor. RESULTS: Eight hundred and seventy-five(18%) of 4880 diabetes patients reported CRN. Age less than 65 years, lack of drug insurance coverage, and frequent hospitalization significantly increased risk for CRN. Limitation in both activities of daily living and instrumental activities of daily living were also generally associated with increased risk of CRN. Residence in a nursing home and Medicaid coverage significantly reduced risk.CONCLUSION: These results suggest that expandingprescription coverage to uninsured, sicker, and community-dwelling individuals is likely to produce the largest decreases in CRN.

Research on Cost Overrun Risk of Construction Phase of Vietnam Highway International Contracting Project

Recently, the highway construction projects increase rapidly in Vietnam and most of them are international contracting projects. It results serious negative influence on the local government and enterprises that the common cost overrun of projects, and the risk factors of it is different in the different countries, different stages and projects types. So in this paper, we generate an evaluation index system of highway construction projects cost overrun risk in Vietnam in the perspective of different project participants, and also evaluate the effects of these factors in method of regression analysis. The empirical results confirmed 7 main factors that have aggravated cost overrun risk in construction stages, e.g. survey and design scheme risk. In final, the corresponding suggestions are proposed to reduce the project cost overrun risk.

Investment risk of rural family education: From the persepective of educational cost and income

With the implementation of the policy of popularization of education, rural families make the choice of interests and behavior decisions through the calculation of their own benefits and costs, and gradually become the main body of rural education investment decisions. The relationship between educational cost and income plays a major role in the rural family education investment. Based on the current situation of rural education in our country, this paper focuses on the risk of rural education investment and rural education costs and benefits, and then puts forward scientific, operational measures and suggestions.

考虑成本风险的装备科研激励约束定价设计

带有激励约束机制的装备科研合同定价模式能够较好地适应因科研项目不确定性所带来的成本风险,而激励系数的确定是其中的关键设计。在总结和比较典型的激励约束定价设计的基础上,针对激励系数设计与科研成本风险分析未能有效结合的问题,基于项目工作分解结构(WBS),采用模拟仿真方法得到项目成本概率分布,考虑成本风险大小给出装备科研价格激励约束原则,结合成本概率分布的分位数选择成本上下限,进而确定激励系数和约束系数。同时,还进行了实例分析,结果验证了研究方法的有效性。

NPV risk simulation of an open pit gold mine project under the O'Hara cost model by using Gas

This paper analyzes an open pit gold mine project based on the O'Hara cost model. Hypothetical data is proposed based on different authors that have studied open pit gold projects, and variations are proposed according to the probability distributions associated to key variables affecting the NPV, like production level, ore grade, price of ore, and others, so as to see what if, in a gold open pit mine project of 3000 metric tons per day of ore. Two case scenarios were analyzed to simulate the NPV, one where there is low certainty data available, and the other where the information available is of high certainty. Results based on genetic algorithm metaheuristic simulations, which combine basically Montecarlo simulations provided by the Palisade Risk software, the O'Hara cost model, net smelter return and financial analysis tools offered by Excel are reported, in order to determine to which variables of the project is more sensitive the NPV.

Seismic Risk Assessment of Buildings in the Extended Urban Region of Athens and Comparison with the Repair Cost

A complete research of seismic risk assessment is presented herein focused on the existing build- ings of the extended urban region of Athens in Greece. The seismic risk assessment is fulfilled by discriminating the current study in two approaches, probable and actual, conducting afterwards between them a comparison analysis. In the first part, a pilot methodology is developed for the seismic loss assessment in monetary terms regarding the buildings damages, consistent with the National Programme for Earthquake Management of Existing Buildings (NPEMEB). The building stock consists of typical building types of Southern Europe and refers to 750,085 buildings (18.80% of buildings in Greece) situated in the entire region of Athens according to the results of the 2000-1 statistical census. A wider research of seismic risk assessment could include direct losses of infrastructures and indirect economic losses. The evaluation of loss due to building damage in a certain region requires an assessment of both seismic hazard and vulnerability of the building stock in the study area. Four different existing damage scenarios are applied for the vulnerability assessment. The results of the seismic risk assessment for the four different aspects of the es- timated damage and the different soil conditions are presented in a map of the study region. The existing vulnerability curves corresponding to defined types of buildings have been derived from the National Technical Chamber of Greece and also from recently developed DPMs. The last DPMs were obtained in a previous research (Eleftheriadou, 2009) from the process of a created damage database after the 7th of September 1999 Parnitha’s earthquake and comprised 180,945 buildings which developed damage of varying degree, type and extent. In the second part of the research, the seismic risk is evaluated from the available data regarding the mean statistical repair/ strengthening or replacement cost for the total number of damaged structures (180,427 buildings) after the same (1999 Parnitha’s) seismic event. Data regarding the compatible (budget approved according to the ministry’s provisions) repair cost has been collected. The structural losses in monetary terms for the 180,427 buildings damaged structures are evaluated equal to 2450.0 Μ€, 1887.8 Μ€ and 2118.9 Μ€ based on the previously mentioned statistical seismic risk data. The statistically derived repair cost for Attica is compared with the results of the economic loss esti- mation for buildings using the aforementioned risk assessment methodology. From the analysis results, the seismic scenario based on the recently developed DPMs (Eleftheriadou, 2009) pre- sented the better correlation (2627.77 M€) with the total statistically evaluated repair cost (2450.02 M€). It is important to stress that the inclusion of the coefficient parameter S overes- timates significantly the seismic losses. The last result should be taken into consideration in future risk researches. The comparison of the estimated economic loss with the statistical repair cost calibrates the reliability of the commonly used risk assessment method and serves in the im- provement of seismic security prioritizing the criteria for seismic rehabilitation programmes of existing buildings.

企业数字化如何影响创新风险?——来自中国制造业的经验证据

数字化赋予传统企业新的发展契机,同时重塑研发流程和重构研发组织带来的双重成本不确定性引发了企业创新风险的变动。基于2011—2020年中国沪深A股制造业上市企业数据,结合面板固定效应模型,实证检验企业数字化对创新风险的影响及作用机制。研究发现:(1)企业数字化对创新风险存在显著的U型影响,即随着企业数字化水平的提高,其对创新风险会产生先抑制后促进的影响;(2)企业数字化对创新风险的影响具有明显的异质性,在国有企业、大型企业、东部和市场化程度较高地区的企业样本中抑制作用更为明显;(3)成本不确定性是企业数字化作用于创新风险的主要机制。企业在数字化前应进行风险评估与规划,在数字化后要根据所处数字化阶段实施差异化的研发支持措施;政府部门应当实施针对性的数字化政策,以有效应对企业数字化引致的创新风险困境。

交易所问询监管与股权融资成本--基于投资者风险感知视角

本文以2013—2021年中国沪深A股上市公司为样本,从投资者风险感知视角实证检验交易所问询监管对股权融资成本的影响。结果显示:公司收到定期报告问询函后股权融资成本显著上升,并且同年收到定期报告问询函数量越多、同一份定期报告被问询次数越多、定期报告问询函中的问题总数量越多,股权融资成本上升幅度越大,说明交易所问询监管会增加投资者的风险感知,进而导致股权融资成本升高。异质性检验结果显示,当投资者专业能力较强、交易风险较大、市场化程度较低和审计质量较低时,投资者对定期报告问询函所披露风险的感知能力更强,交易所问询监管对股权融资成本的正向影响更大。进一步研究发现,作为一种非处罚性监管,交易所问询监管是处罚性监管的有力补充,二者都具有良好的市场监管效果。本文的研究结论为证券监管部门依法保护投资者合法权益和防范市场风险提供了政策参考。

Risk stratification for coronary artery disease in multi-ethnic populations:Are there broader considerations for cost efficiency?

Coronary artery disease(CAD) screening and diagnosis are core cardiac specialty services.From symptoms,autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies.While angina remains a clinical diagnosis,most cases require correlation with a diagnostic modality.At the onset of the evidence building process much research,now factored into guidelines were conducted among population and demographics that were homogenous and often prior to newer technologies being available.Today we see a more diverse multi-ethnic population whose characteristics and risks may not consistently match the populations from which guideline evidence is derived.While it would seem veryunlikely that for the majority,scientific arguments against guidelines would differ,however from a translational perspective,there will be populations who differ and importantly there are cost-efficacy questions,e.g.,the most suitable first-line tests or what parameters equate to an adequate test.This article reviews non-invasive diagnosis of CAD within the context of multi-ethnic patient populations.

超额商誉与商业信用成本:基于风险和内控视角

为厘清超额商誉与商业信用成本间的关系,从供应商与企业间融资成本视角出发,以2014—2021年沪深A股公司为样本,基于信号传递理论,分析超额商誉对商业信用成本的影响机制。研究发现:超额商誉正向影响企业商业信用成本;超额商誉通过加剧企业经营风险,进而增加商业信用成本;较高的内部控制质量对超额商誉与商业信用成本间关系起负向调节作用,且随着内部控制质量的提升,超额商誉加剧经营风险的作用会有所减少,相应其对商业信用成本的正向影响也会减弱;在独立董事比例高、高管股权激励水平高和高管薪酬激励水平低的情形下,超额商誉对商业信用成本的正向影响降低,较高的独董比例和高管股权激励能一定程度缓解超额商誉的负面影响。

自愿披露客户信息影响了债券违约风险吗?

以2010—2021年沪深A股上市公司发行的公司债为样本,实证检验了自愿披露客户信息对债券违约风险的影响。研究发现,自愿披露客户信息产生的额外风险加剧了债券违约风险,这种影响在高专有成本和高融资约束的企业中表现更为显著,但企业发行的绿色债券并未受到影响。机制检验表明,经营风险增加和机构投资者持股降低是自愿披露客户信息影响债券违约风险的重要途径。研究表明,企业需要慎重考虑披露客户信息带来的风险,审慎制定信息披露策略。

基于ECSDNN的航空安全事件风险等级预测

航空安全事件风险等级预测是主动风险管理的重要手段。考虑海量航空安全事件数据呈现的高维复杂、类不平衡等特性,提出一种基于集成代价敏感深度神经网络(ECSDNN)的航空安全事件风险等级预测方法。采用分类型属性嵌入特征编码和数值型属性拼接的方法实现航空安全事件数据的特征表示;综合考虑错分比例和固定代价设计代价敏感矩阵和代价敏感损失函数,构建基于代价敏感深度神经网络(CSDNN)的基分类器模型;采用硬投票方法,集成多个参数不同、性能各异的基分类器,构建航空安全事件风险等级预测模型。在航空安全事件报告系统(ASRS)数据集上的实验结果表明:相比基准算法,所提ECSDNN模型的预测准确率提升了4.51%;相比单个CSDNN基分类器,所提ECSDNN模型的预测准确率提升了3.17%。验证了基于ECSDNN的航空安全事件风险等级预测方法的有效性。

家长决策下的研学旅游消费——基于消费者与购买者不一致的二元视角

中小学生研学旅游既存在消费者与购买者的主体不一致性,又存在家长为未成年子女做决策的必要性,意味着从作为购买者的家长视角探讨研学旅游购买决策的影响因素尤为重要。文章以中小学生家长为研究对象,基于推拉理论构建家长视角下研学旅游动机与购买决策的基本关系,并利用价值感知、风险感知与成本感知揭示内在机制和理论边界。结果显示:研学旅游动机不仅直接促进购买决策,还会通过价值感知的部分中介作用来实现;风险感知激发了研学旅游动机与价值感知间的正向关系;成本感知、风险感知与研学旅游动机的交互作用对价值感知产生负向影响。该研究拓展了旅游动机的主体视角,深化了包含利他和利己的价值内涵,为风险感知的调节作用分歧提供实证答案,细分了不同利失类型的家长决策特征,为教育部门、学校、研学企业和教师的实践提供启示。

ESG信息披露、外部关注与企业风险

以中国A股2011~2020年上市公司为研究对象,实证检验了ESG信息披露对企业风险的影响效应与影响机制。研究发现:积极进行ESG信息披露能够降低企业风险,外部的媒体关注和分析师关注均强化了ESG信息披露的风险降低效应。机制检验表明:ESG信息披露通过增强利益相关者认同、减少信息不对称和管理ESG风险来降低企业风险水平。异质性检验还发现,ESG信息披露对企业风险的降低效应在非国有企业、成长期和成熟期企业样本中更显著。本研究有助于理解企业通过ESG战略进行风险管理的内在逻辑,为监管机构强化ESG信息披露指引以提升上市公司质量提供了经验证据。

基于价值流程图的公立医院高值耗材成本与风险管控策略——基于A公立医院的案例研究

医用高值耗材作为公立医院成本高企和内控的薄弱点已日益成为国家整治的焦点。研究目的是旨在把价值流图这一先进的现代企业管理工具应用至公立医院高值耗材管控上,以匹配近年来国家对公立医院建立现代医院管理制度和增强内部控制的要求。围绕高值耗材事前、事中、事后全流程,通过对A医院应用价值流图前后进行对比分析,提出高值耗材源头管理、过程管理的有效闭环管控策略。