Fee Expenses Research Articles

322 A Cost Analysis of Medical Students Applying to Neurological Surgery Residency: An Analysis of the Texas STAR Database

INTRODUCTION: Medical Students applying to competitive residencies such as neurosurgery incur substantial costs associated with interviews, away rotations, and application fees. Researchers in the past have examined the sources of expenses during the residency application cycle, but few studies have compared the expenses prior to and during the COVID-19 pandemic. METHODS: The TEXAS STAR database was surveyed for applicants of neurosurgical residency programs during the COVID-19 pandemic (2021) and post-pandemic (2022). In total, 66 applicants for the 2021 application cycle and 50 applicants for the 2022 application cycle completed the survey. We compared the application fees, away rotations cost, interview cost, and total expenses as reported by the neurosurgery applicants of the 2021 and 2022 application cycle. A Shapiro-Wilk test was used to test for data normality, and a Mann-Whitney U-Test was used to compare costs during the 2021 and 2022 neurosurgery application cycle. RESULTS: There was a statistically significant reduction in total expenses in 2021 vs 2022 ($3,934 vs $9,860). Interview expenses and away rotation expenses were also decreased in 2021 vs 2022 (interview expenses $786 vs $4511, away rotation $1,083 vs $3,000, p < 0.001). Application fee expenses were not different between the 2021 and 2022 application cycle. Regional stratification revealed the greatest reduction in cost, an $11,908 savings, in the South region for the year of 2021. CONCLUSIONS: Our study revealed that the COVID-19 pandemic caused a significant reduction in the total fees associated with the neurosurgical residency application. The use of virtual platforms in place of in-person interviews could lessen the financial burden on applicants and alleviate socioeconomic barriers in the neurosurgical application process even after COVID-19.

A cost analysis of medical students applying to neurological surgery residency: An analysis of the Texas STAR database

IntroductionMedical Students applying to neurosurgery residency programs incur substantial costs associated with interviews, away rotations, and application fees. However, few studies have compared expenses prior to and during the COVID-19 pandemic. This study evaluates the financial impact of COVID-19 on the neurosurgery residency application and identifies strategies that may alleviate the financial burden of prospective neurosurgery residents. MethodsThe TEXAS STAR database was surveyed for applicants of neurosurgical residency programs during the COVID-19 pandemic (2021) and post-pandemic (2022). 66 applicants for the 2021 application cycle and 50 applicants for the 2022 application cycle completed the survey. We compared application fees, away rotations cost, interview cost, and total expenses as reported by the neurosurgery applicants of the 2021 and 2022 application cycle. A Shapiro-Wilk test was used to test for data normality, and a Mann-Whitney U-Test was used to compare costs during the 2021 and 2022 neurosurgery application cycle. ResultsThere was a statistically significant reduction in total expenses in 2021 vs 2022 ($3,934 vs $9,860). Interview and away rotation expenses decreased in 2021 vs 2022 (interview expenses $786 vs $4511, away rotation $1,083 vs $3,000, p < 0.001). Application fee expenses were not different between 2021 and 2022. The greatest reduction in application cost ($11,908) was seen in the South for 2021. ConclusionsThe COVID-19 pandemic significantly reduced total fees associated with the neurosurgical residency application. Virtual platforms in place of in-person interviews could lessen the financial burden on applicants and alleviate socioeconomic barriers in the neurosurgical application process after COVID-19.

On Optimizing Transaction Fees in Bitcoin using AI: Investigation on Miners Inclusion Pattern

The transaction-rate bottleneck built into popular proof-of-work (PoW)-based cryptocurrencies, like Bitcoin and Ethereum, leads to fee markets where transactions are included according to a first-price auction for block space. Many attempts have been made to adjust and predict the fee volatility, but even well-formed transactions sometimes experience unexpected delays and evictions unless a substantial fee is offered. In this article, we propose a novel transaction inclusion model that describes the mechanisms and patterns governing miners decisions to include individual transactions in the Bitcoin system. Using this model we devise a Machine Learning (ML) approach to predict transaction inclusion. We evaluate our predictions method using historical observations of the Bitcoin network from a five month period that includes more than 30 million transactions and 120 million entries. We find that our Machine Learning (ML) model can predict fee volatility with an accuracy of up to 91%. Our findings enable Bitcoin users to improve their fee expenses and the approval time for their transactions.

The Only Fund in Town? Geographic Segmentation in the US Mutual Fund Industry

AbstractWe find that mutual funds located in regions with more competing funds charge lower management fees, but higher fees related to sales and distribution (12b‐1 fees), sales loads, and other nonmanagement fee expenses. There is some evidence that funds in more competitive regions have higher total expense ratios than similar funds in less competitive regions. Our results indicate that while increased competition drives down fund profits, it creates a negative externality by way of increased sales expenses. Overall, our results suggest the mutual fund industry is characterized by monopolistic competition determined at the local level.

Medical expenditure for liver cancer in urban China: A 10-year multicenter retrospective survey (2002-2011).

This study aims to understand the medical expenditure for liver cancer during 2002-2011 in urban areas of China. This is a retrospective study. Based on a stratified cluster sampling method, a medical expenditure survey collected basic personal information from related medical records. Two-tailed independent sample t-test, variance analysis, and Student-Newman-Keuls Tests were used in cost analysis for the corresponding data types. A total of 12,342 liver cancer patients were included in the analysis. Overall average medical expenditure per case for liver cancer diagnosis and treatment in China has increased from ¥21, 950 to ¥40, 386 over the study period. For each liver cancer patient diagnosed between 2009 and 2011, the average expenditures were 29,332 CNY for stage I, 35,754 CNY for stage II, 34,288 CNY for stage III, and 30,275 CNY for stage IV diseases (P < 0.001). Pharmaceuticals accounted for the biggest part of the medical expenditure and it rose from 48.01% to 52.96% during these ten years, and the share of nursing fee expenses was the lowest (around 1%). Over the entire 10-year data period, the per capita expenditure of the east region (32,983 CNY) was higher than that of the west region (26,219 CNY) and slightly higher than the central region (31,018 CNY, P < 0.001). As a major cancer in China, liver cancer accounts for a large portion of health economic burden and its medical expenditure is heavy for families. Early diagnosis and treatment for liver cancer will save medical expenditure. The economic burden of liver cancer is high in China and related medical expenditure has increased.

Cost-benefit analysis of special nursing of stoma care

Objective To investigate the actual cost and benefit of stoma nursing at present as a reference for the improvement of stoma care cost management program. Methods A cross sectional study was carried out in gastrointestinal surgery of a tertiary-level hospital in southwestern China from April 2014 to December 2014. The consumption of intestinal stoma care work, the average monthly income/average monthly working hours ratio and other indicators of stoma care nurse specialist were measured by the step cost allocation method, to investigate the actually cost of a single stoma care service which colostomy patients had received and analyze the gap between actually costs and charge standard of Sichuan Province. Results The directly human cost of stoma care expenses were (22.33 ± 3.66) yuan; working fee expenses were (4.18 ± 0.68) yuan; administrative expenses were (1.87 ± 1.32) yuan; research and education expenses were (1.87 ± 1.32) yuan; the total cost of investment was (29.14 ± 4.76) yuan, which was much higher than the current charge standard of Chengdu Bureau of Commodity Prices (t=119.50, P <0.05). Conclusions There is a difference between the actual cost and charge standard of stoma care. The situation of low pay to labor is not in line with economic laws, and not conducive to the future development of stoma care speciality. Key words: Stoma nursing; Cost-benefit analysis; Health economics

Study on the factors associated with postpartum visits in rural China.

BackgroundPostpartum visits (PPVs) have been advocated as a way to improve health outcomes for mothers and their infants, but the rate of PPVs is still low in rural China. This study aims to investigate the utilization of PPVs and to explore the factors associated with PPVs in rural China. Parity is the most concerned factor in this study.MethodsA cross-sectional household survey was performed in two counties of Zhejiang province. Questions include socio-economic, health services and women's delivery data. Chi-square tests and multivariate logistic regression analyses were performed to identify factors associated with PPVs.Results223 women who had a delivery history in the recent five years were enrolled in analyses. 173 (78%) of them were primiparous. Among the primiparous women, 43 (25%) had not received any PPVs. The majority, 27 (55%) of the 49 multiparous women, had not received any PPVs. Multiparous women were less likely to receive PPVs than primiparous women. Among 223 puerperal women, 47 (21%) had been compensated for delivery fee expenses. Women who received compensation were found to be more likely to receive standard (at least 3) PPVs.ConclusionsIt was found that women with “second babies” were less likely to use PPVs. This could be an unintended consequence of the “one-child policy”, due to fear that contact with public health facilities could result in sanctions. This phenomenon should be taken seriously by government in order to improve the health of babies and their mothers. Financial compensation for delivery fee charges can improve the use of PPVs, thus free-of-charge delivery should be promoted.

Financial Advice and Individual Investors' Portfolios

This paper is an early response to Campbell's (2006) call to analyze the role of financial intermediaries in household finance. We first sketch a basic theory of financial advice that proceeds from cognitive errors and costly information acquisition. We then derive hypotheses about honest and deceptive financial advice and test them on a unique administrative dataset from a large German retail bank. We find that the clients advised are older, wealthier, more risk averse and more likely to be female. Financial advice enhances portfolio diversification, makes investor portfolios more congruent with predefined model portfolios, and increases investors' fee expenses. Our empirical evidence is broadly in line with honest financial advice. A general implication of the paper is that financial advisory service has a significant impact on household investment behavior and that it deserves more attention in future research on household finance.