Lower Spending Research Articles

The effect of crude oil price changes on civil conflict intensity in rentier states

While existing literature has considered the relationship between oil and conflict, most of the studies have failed to consider mechanisms that might mediate the effect of the fluctuating market price of oil on conflict. We theorize that the military capacity of the state is a key mediating mechanism for understanding the relationship between shifting oil market prices and conflict intensity. We argue that states which rely upon oil sales to fund a large portion of government spending will have a more difficult time maintaining conflict-reducing state capacity during times in which oil prices are below previously prevailing averages for extended lengths of time. Using country-year data in 67 conflict states from 1989–2019, we find that low average oil prices are associated with lower military spending which in turn is associated with higher rates of battle fatalities in existing civil conflicts.

Behavioural determinants of health-care utilisation among elderly population: a cross-sectional analysis from Punjab

PurposePopulation ageing is a demographic transition and burdens every country’s health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab.Design/methodology/approachThis study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above.FindingsThis study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population.Originality/valueThis study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences.

Less is more? Why do we find less severe mental and material impact of COVID-19 among the most marginalised and homeless in countries with lower welfare spending?

The study examines how various policy approaches in countries may have influenced the material and mental well-being outcomes of the COVID-19 pandemic among marginalised groups and people experiencing homelessness in Europe. In a structured country comparison case study approach, we combine country-based indicators, e.g., the level of infection, unemployment, and restrictions, with individual data from a cross-sectional survey with 226 participants from 6 European countries. Contrary to expectations, our results suggest that vulnerable people living in countries with low welfare expenditure report lower negative mental and material impact of the COVID-19 pandemic than people living in countries with high welfare expenditure countries. This unexpected result could be explained by higher expectations of the level of support they should have received during extraordinary times such as the pandemic among respondents in the studied high welfare expenditure countries. Due to our cross-sectional design across only six countries, we cannot generalise the trend to Europe and only speculate on the causal mechanisms behind the observed association. We also discuss factors like the accessibility of care organisations' support and pre-existing welfare policies. We suggest possible additional factors that may shed light on our results, noting that these issues need to be examined further in future studies with a more extensive study sample.

Improving public school productivity: Evidence from model schools in India

This paper studies the impact of India’s “model” school program which aimed to provide high quality education to economically disadvantaged students. Model schools combine better infrastructure with more accountability, contract teachers, and lower per-pupil spending than regular public schools. Using a fuzzy Regression Discontinuity Design based on entrance exam cutoffs, I find attending a model school for five years increases test scores in math by 0.38 standard deviations, in science by 0.26 sd, and in social science by 0.26 sd on average. Furthermore, model schools increase the probability of joining pre-university by 11.5 percentage points. The results suggest it is possible to deliver substantial improvement of outcomes in public schools at a slightly lower level of school spending through a package of reforms.

Predicting health related deprivation using loyalty card digital footprints

Predicting health related deprivation using loyalty card digital footprints

Challenges and HRM Practices within Jordanian Business Organizations

This paper highlights and provides a more grounded foundation for Jordan's human resource management (HRM) concept. It examines four HRM practices: enrollment and choice, preparation and advancement, execution examination and rewards and advantage; what is more, associations these practices with social components, the universe of legislative issues, judicious issues, and social characteristics, the revelations recommend that HRM in Jordan has not yet gotten due thought. The delegate selection and decision cycle could be more robust and need feasible ideas. The adequacy of even talented and qualified employees will be limited if they are not urged and roused to work. However, through HRM practices, they can be encouraged to work more diligently and more brilliantly. Use and time spent preparing and advancing are considered pointless capacities in many Arab businesses, particularly Jordanian ones. Dynamically, representatives' show and abilities can, in like manner, be impacted by HRM rehearses, which control the preparation and improvement of the affiliation's HR; Jordanian organisations and firms are managing complex issues enveloping the progression of HR, including high turnover rates and a shortfall of gifted laborers. Low spending on investigation, planning, and headway has fueled these issues. The HRM writing shows that many Arab businesses, including public and private Jordanian companies, need to pay more attention to their HRM practices.

ANALISIS LAPORAN KEUANGAN TERHADAP PENILAIAN KINERJA KEUANGAN PT TRANS MULTI CARGO KOTA BATAM

This study aims to determine the company's financial performance as assessed by financial ratio analysis at PT. Trans Multi Cargo from 2018 to 2021. The data analysis method used is a quantitative descriptive method using measurements of liquidity ratios, solvency, activity and profitability. based on the results of research on the liquidity ratio in the 2018-2021 period it can be said that it is not good because the company has difficulty paying off current liabilities using current assets owned by the company. Based on solvency in the 2018-2021 period, it is quite good where it has increased every year, this is due to low corporate spending originating from loans. Based on activities in the 2018-2021 period, it is quite good where every year there is an increase in this situation. This situation must be maintained so that the use of company assets is more effective and efficient. Meanwhile, based on profitability in the 2018-2021 period, this shows an increase in profits or profits generated in the company.

MFSE-based two-scale concurrent topology optimization with connectable multiple micro materials

The concurrent design of different lattice material microstructures and their corresponding macro-scale distributions has great potential in achieving both lightweight and desired multiphysical performances. In such design problems, the lattice microstructures are usually separately optimized on the basis of the homogenization method, and the possibly poor connectivity between them is a key factor that severely hinders the fabrication and application of optimized two-scale structures. To handle the microstructure connectivity issue, this paper proposes a novel microstructure connectable strategy to bridge the gap between the two-scale and the full-scale model using the material-field series expansion (MFSE) method. Assuming different lattice material types in several pre-defined macro-scale regions, describe all types of microstructural topology with different portions of one material field function and update them simultaneously during the optimization process. Benefits from the material field definition with spatial correlation, the microstructures are well-connected without requiring additional constraints in the topology optimization model. The energy-based homogenization method is utilized for bridging the two-scale with different microstructures, while a decoupled sensitivities analysis for the microscale is employed to enhance the computation efficiency. Additionally, the proposed method significantly reduces the dimension of design variables, resulting in lower optimizer spending. The effectiveness and efficiency of the proposed method are demonstrated by several benchmark two-scale problems. Compared to density-based connectable methods, the proposed framework is easy to implement and reduces computational time by an order of magnitude in the 2D case.

Incidence and Outcomes of School Finance Litigation: 1968–2021

State courts regularly enter in school finance decision making. School finance court cases have proceeded one or more times in all but two states. Plaintiffs ask the courts to rule that the existing funding formula is unconstitutional under state constitutions, and the defendants call for continuation of the existing finance formula. By compiling and analyzing the universe of such cases, we can accurately describe the nature of the cases, the decisions made, and the long run impact on overall financing of schools. Defendants win a slight majority of decisions with, surprisingly, their victories coming most frequently in low spending states and in low achieving states. And, while plaintiff victories on average yield an immediate increase in funding, they have no influence on long run growth in school spending.

Demographic change, government debt and fiscal sustainability in Japan: The impact of bond purchases by the Bank of Japan

We reconsider the fiscal consequences of an aging population in Japan that were reported in Hansen and İmrohoroğlu (2016). That paper predicted that the net debt to GNP ratio would reach 250 percent in 2021, while the actual net debt to GNP ratio was roughly constant at about 120% from 2011 to 2019. Here we study the role played by higher tax revenues, lower spending, and lower interest rates than were assumed in the previous paper. Most importantly, we consider the role played by Japanese government bonds held by the Bank of Japan in enabling this period of debt stability. We conclude that the stable net debt to output ratio is predicted to be temporary and reach 250 percent before 2040.

Future health expenditure in the BRICS countries: a forecasting analysis for 2035

BackgroundAccelerated globalization especially in the late 1980s has provided opportunities for economic progress in the world of emerging economies. The BRICS nations’ economies are distinguishable from other emerging economies due to their rate of expansion and sheer size. As a result of their economic prosperity, health spending in the BRICS countries has been increasing. However, health security is still a distant dream in these countries due to low public health spending, lack of pre-paid health coverage, and heavy out-of-pocket spending. There is a need for changing the health expenditure composition to address the challenge of regressive health spending and ensure equitable access to comprehensive healthcare services.ObjectivePresent study examined the health expenditure trend among the BRICS from 2000 to 2019 and made predictions with an emphasis on public, pre-paid, and out-of-pocket expenditures for 2035.MethodsHealth expenditure data for 2000–2019 were taken from the OECD iLibrary database. The exponential smoothing model in R software (ets ()) was used for forecasting.ResultsExcept for India and Brazil, all of the BRICS countries show a long-term increase in per capita PPP health expenditure. Only India’s health expenditure is expected to decrease as a share of GDP after the completion of the SDG years. China accounts for the steepest rise in per capita expenditure until 2035, while Russia is expected to achieve the highest absolute values.ConclusionThe BRICS countries have the potential to be important leaders in a variety of social policies such as health. Each BRICS country has set a national pledge to the right to health and is working on health system reforms to achieve universal health coverage (UHC). The estimations of future health expenditures by these emerging market powers should help policymakers decide how to allocate resources to achieve this goal.

Ethnic politics and sovereign credit risk

How does domestic politics affect sovereign credit risk? To date, scholars have largely focused on how economic interests along class-cleavages influence sovereign default risk and borrowing costs. Ethnic dynamics are another important political factor that explains governments’ creditworthiness, yet are understudied. We investigate how ethnic politics shape governments’ credit access and argue that the fiscal incentives generated by ethnic coalitions influence credit risk differently than those created by class cleavages. Because ethnic coalitions are usually smaller than class coalitions, left governments with ethnic support can commit to lower spending and receive more favorable risk assessments. Right governments that rely on ethnic support, however, will have greater spending demands because of their need to satisfy ethnic groups. We test our argument using a new indicator of government ethnic support and four indicators of sovereign credit risk. We find that, in emerging markets, the borrowing costs of right governments increase as they become more dependent on ethnic groups for political support. Our findings suggest that financial markets are attuned to multiple dimensions of domestic politics and demonstrate that ethnic divisions can have strong implications for governments’ access to credit.

AI Driven Customer Segmentation and Recommendation of Product for Super Mall

The prime objective of the paper is to propose customer segmentation for the retail customer for a large retail chain super mall. Along with customer segmentation, product recommendation is integrated with the system. Segmentation is required to identify the customer with specific behaviour. The real-world data comes from the customer support department of a retail chain super mall. For customer segmentation, the k- means algorithm is applied by using RFM data and the Association Rule Mining algorithm is applied to create the mapping rules between customer segments and favourite products. The customers are segmented into “Traditional”, “High Spending”, “Occasional”, “Low Spending”, “Disloyal” and “Frequent Buyer”. Customer segmentation is necessary for efficient marketing strategy providing discounts, promotions, campaigns, etc. Moreover, the ARM algorithm is used to map the preferred combo for all customer segment. This combined approach is used to create an effective marketing strategy for retail chain management.

Enrollment of Households in Community-Based Health Insurance (CBHI) in Ethiopia: The Case of the Aleltu District

In developing countries, people’s attitude about their health is very poor. People visit health institutions only when they are sick. This trend is especially common in rural areas. For the majority of people, health care is accessed and covered by money sourced from their existing funds or assets, which frequently results in citizens not using health care services. Poor health care financing remains a major challenge for the health system in Ethiopia. It leaves households vulnerable to impoverishment from high health expenditures and slows progress towards health improvements such as the Sustainable Development Goals, limiting access to essential health services among citizens with lower socio-economic status. Important barriers to improved health care financing include low government spending on the health sector, strong reliance on out-of-pocket expenditure, inefficient and inequitable utilization of resources, and poorly harmonized and unpredictable donor funding. Different studies illustrated that in developing countries the majority of people from poor families cover health care costs with out-of-pocket funding. As a result, many fall into debt, which aggravates the severe poverty conditions. This study revealed that all households (n=150) are aware. This awareness has positive contribution on enrollment and sustainability of the scheme by minimizing the drop out of the member. The major benefit the households experienced by enrolling in Community-Based Health Insurance (CBHI) is that it saves people from having unplanned health costs. Eighty percent of the respondents stated that their health status improved and that their families were insured. Currently, both premiums were paid and Poor members of the scheme are enrolling in the Aleltu district because they understand the advantages of being members of CBHI.

Digital transformation technologies to analyze product returns in the e-commerce industry

PurposeAs e-commerce has expanded rapidly, online shopping platforms have become widespread in India and throughout the world. Product return, which has a negative effect on the E-Commerce Industry's economic and ecological sustainability, is one of the E-Commerce Industry's greatest challenges in light of the substantial increase in online transactions. The authors have analyzed the purchasing patterns of the customers to better comprehend their product purchase and return patterns.Design/methodology/approachThe authors utilized digital transformation techniques-based recency, frequency and monetary models to better understand and segment potential customers in order to address personalized strategies to increase sales, and the authors performed seller clustering using k-means and hierarchical clustering to determine why some sellers have the most sales and what products they offer that entice customers to purchase.FindingsThe authors discovered, through the application of digital transformation models to customer segmentation, that over 61.15% of consumers are likely to purchase, loyal customers and utilize firm service, whereas approximately 35% of customers have either stopped purchasing or have relatively low spending. To retain these consumer segments, special consideration and an enticing offer are required. As the authors dug deeper into the seller clustering, we discovered that the maximum number of clusters is six, while certain clusters indicate that prompt delivery of the goods plays a crucial role in customer feedback and high sales volume.Originality/valueThis is one of the rare study that develops a seller segmentation strategy by utilizing digital transformation-based methods in order to achieve seller group division.

Compensation mechanism for port time extension in cruise line designs

Low onboard spending and insufficient onshore time are the two main problems affecting the earnings of both cruise lines and port cities in the Chinese cruise market. However, increasing port berthing time can benefit port cities at the cost of cruise lines. To balance the two parties, we propose a compensation mechanism based on the cooperative game-theory, where the city subsidizes the cruise ship to stay longer to maximise overall incremental benefits. A questionnaire survey is conducted to collect data on tourists' spending and onshore time in different port cities and their budgets. The feasibility of the mechanism depends on the sailing distance of the cruise ship, the number of connected ports, and the tourists’ average budget. This compensation mechanism can enhance the total benefits of the cruise chain, improve customer satisfaction, and provide a new model for developing the cruise industry in China.

End-of-life spending analysis of randomized trial of machine learning nudges to prompt serious illness communication among patients with cancer.

6515 Background: Early serious illness conversations (SICs) between oncology clinicians and patients in the outpatient setting may improve mood and quality-of-life among patients with cancer. However, the impact of early SIC “nudges” on end-of-life spending is unknown. Methods: This was a secondary analysis of a stepped-wedge randomized trial (NCT03984773) that randomized 9 medical oncology practices and their high-risk patients at a large academic institution to a behavioral intervention to increase SICs (performance reports and peer comparisons; precommitments for high-risk patients; weekly opt-out text prompts before high-risk encounters) vs. standard of care, between June 2019 and April 2020. We identified high-risk patients using a machine learning (ML) algorithm predicting 180-day mortality. This secondary analysis included 1187 (957 intervention, 230 control) patients with complete data who died by December 2020. We abstracted spending (defined as inflation-adjusted reimbursements for acute care [inpatient + ED], office/outpatient care, intravenous chemotherapy, other therapy [e.g. radiation], long-term care, and hospice) from the institution’s accounting system; we captured spending at University of Pennsylvania inpatient, outpatient, and pharmacy settings. To evaluate intervention impacts on spending, we used a two-part model: first, logistic regression to model zero versus nonzero spending, and second, generalized linear models with gamma distribution and log-link function to model daily mean spending in the last 180 days of life. Models were adjusted for clinic and wedge fixed effects and clustered at the oncologist level. Results: Median age at death was 68 years (IQR 15.5), 317 (27%) patients were non-White, and 448 (38%) patients had a SIC prior to death. The intervention was associated with lower mean spending in the last 180 days of life (mean daily spending $377.96 [intervention] vs. $449.92 [control]; adjusted mean difference -$75.33, 95% CI -$136.42, -$14.23 , p = 0.016) (Table), translating to $13,559 total adjusted savings. Intervention patients incurred lower mean daily spending for chemotherapy (adjusted difference -$51.35, p < 0.001), office/outpatient care (-$14.59, p < 0.001), and other therapy (-$10.35, p = 0.043). The intervention was not associated with differences in end-of-life spending for acute care utilization, long-term care, and hospice. Results were consistent for spending in the last 30 and 90 days of life and after adjusting for age, race, and ethnicity. Conclusions: A ML intervention to prompt SICs led to end-of-life savings, driven by decreased chemotherapy and outpatient spending. Clinical trial information: NCT03984773 . [Table: see text]

The Impact of Increased Access to Telemedicine

Abstract We estimate the impact of increased access to telemedicine following widespread adoption during the March–April 2020 COVID-19 lockdown period. We focus on the post-lockdown period, which was characterized by near-complete reopening. Using a difference-in-differences framework, we compare primary care episodes before and after the lockdown between patients with high and low access to telemedicine, as defined by their primary care physician adoption. Our results show that access to telemedicine leads to slightly more primary care visits but lower spending. Visits involve fewer prescriptions and more follow-ups, but we find no evidence of missed diagnoses or adverse outcomes. Results suggest that telemedicine does not compromise care quality or raise costs.

HEADLINE INFLATION AND CONSUMERS’ CONFIDENCE IN NIGERIA

Introduction: The Nigerian economy experienced a significant growth turning point in early 2000 after returning to democratic rule in 1999. Nonetheless, the country's strong economic growth has done little to address the issues such as poverty, inequality, unemployment, the exchange rate, inflation, and interest rate spread. As a result, consumer confidence falls, resulting in lower spending. Methods: The ARDL model was used to highlight the importance of consumer confidence (household spending) and inflation in Nigeria using data from the cbn survey of consumer expectations from 1996 to 2022. Results: The findings show that a unit increase in headline inflation corresponds to a 0.01 increase in consumer confidence, implying that consumers lose 99.99 percent of their confidence at every point of increase in headline inflation, indicating that headline inflation is a core determinant of consumption in Nigeria. Conclusion and suggestion: In light of the study's findings, the federal government should consider raising the nation's minimum wage, among other policy options, in order to increase household consumption expenditures. Furthermore, Nigerian government policies should address disparities in consumption among the citizenries.

Effect of Free Medicine Distribution on Health Care Costs in Canada Over 3 Years

Few interventions are proven to reduce total health care costs, and addressing cost-related nonadherence has the potential to do so. To determine the effect of eliminating out-of-pocket medication fees on total health care costs. This secondary analysis of a multicenter randomized clinical trial using a prespecified outcome took place across 9 primary care sites in Ontario, Canada (6 in Toronto and 3 in rural areas), where health care services are generally publicly funded. Adult patients (≥18 years old) reporting cost-related nonadherence to medicines in the past 12 months were recruited between June 1, 2016, and April 28, 2017, and followed up until April 28, 2020. Data analysis was completed in 2021. Access to a comprehensive list of 128 medicines commonly prescribed in ambulatory care with no out-of-pocket costs for 3 years vs usual medicine access. Total publicly funded health care costs over 3 years, including costs of hospitalizations. Health care costs were determined using administrative data from Ontario's single-payer health care system, and all costs are reported in Canadian dollars with adjustments for inflation. A total of 747 participants from 9 primary care sites were included in the analysis (mean [SD] age, 51 [14] years; 421 [56.4%] female). Free medicine distribution was associated with a lower median total health care spending over 3 years of $1641 (95% CI, $454-$2792; P = .006). Mean total spending was $4465 (95% CI, -$944 to $9874) lower over the 3-year period. In this secondary analysis of a randomized clinical trial, eliminating out-of-pocket medication expenses for patients with cost-related nonadherence in primary care was associated with lower health care spending over 3 years. These findings suggest that eliminating out-of-pocket medication costs for patients could reduce overall costs of health care. ClinicalTrials.gov Identifier: NCT02744963.