Monetary Value Research Articles

Discounted monetary value of human lives lost during the mass demonstrations in Khartoum State, Sudan, 2022

BACKGROUND: Sudan is rich in natural resources and diverse climate but faces significant food insecurity. The country’s challenges stem from prolonged civil wars and economic decline after South Sudan’s secession, leading to political instability and uprisings. The human cost has been devastating, with millions killed or affected by violence, displacement, and infrastructure destruction. OBJECTIVE: This paper aimed to estimate the total discounted value of 112 human lives lost during peaceful demonstrations in Khartoum State in 2022. METHODS: Data collected by the Doctors’ Committee from Oct 2021 to Oct 2023 was used. The Human Capital approach (HCA) estimated the total discounted value of human lives lost using a 3% discount rate and the national life expectancy in 2022 as 65.86. Sensitivity analysis tested the robustness of the results. The model was re-estimated using 5% and 10% discount rates and global and Sub-Saharan life expectancies. RESULTS: Human lives lost had a total discounted value of $1,871,745 and an average value of $136,816 per life. Recalculating the total discounted value of human lives lost (TDVHL) using higher rates, 5% and 10%, reduced the values by $499,516 (26.7%) and $1,094,609 (58.5%), respectively. Using Sub-Saharan life expectancy reduced the TDVHL by $105,821 (5.7%), while the global life expectancy increased it by $130,992 (7.0%). About 82% of the TDVHL was shared by dead persons aged 15-29. The average value per dead person decreased with age. The average for the 14-19 age group was almost four times that of the 55-59 group. CONCLUSION: The study reveals the high economic cost of premature deaths from mass demonstrations in Khartoum State, stressing the need for policies protecting young people and promoting stability to drive economic growth and sustainable development KEYWORDS: Human Capital Approach, Life expectancy, Dead persons, Mass demonstrations, Sensitivity analysis, Total discounted value of human lives lost

Estimating the societal cost of heroin dependence in an Australian population engaged in treatment or harm reduction services

IntroductionHeroin dependence is a public health concern in Australia. High mortality rates, increased risk of physical/mental health comorbidities and increased risk of social issues contribute to a high personal and societal cost. The aim of this paper is to understand the societal cost of heroin dependence in an Australian population. MethodsA longitudinal cohort study of 600 people with heroin dependence were interviewed at five timepoints. Resource use was determined from interviews and was multiplied by unit costs to estimate the annual healthcare, productivity, crime and other costs (homelessness, heroin drug and prison costs). The monetary value of premature mortality was calculated using the value of a statistical life year method. ResultsThe annual mean societal cost of heroin dependence in Australia was A$120,599/person. This included healthcare costs (A$10,055), lost productivity costs (A$63,158), crime costs (A$7204) and other costs (A$40,182). Healthcare costs, lost productivity costs, crime costs and other costs trended downwards over the five waves. Lost productivity was the highest cost contributor (52 %), followed by heroin drug (25 %). The estimated number of life years lost due to heroin over the 11-year study period was 2703 years, which approximates to a monetary value of premature death of $213 million. Discussion and conclusionsThe significant societal cost emphasises the importance of providing resources to heroin dependence. The cost of lost productivity, crime and heroin contributed to over 80 % of the total costs, which highlights the illicit nature and reduced capacity to work contributes to the high costs to society.

Economic burden of suicide deaths in India (2019): a retrospective, cross-sectional study

India has the highest number of suicide deaths in the world. Suicide prevention requires policy attention and resource allocation. Evidence of economic losses due to disease burden can influence such allocations. We assessed the economic burden and its distribution across states and demographic groups in India. We used the human capital approach in this retrospective cross-sectional analysis to assess the economic burden of suicide in India for the year 2019 for 28 Indian states and 3 union territories (UTs). We calculated the monetary value for the years of life lost disaggregated by states, age groups, and sexes. For sensitivity, we present a library of estimates using different discount rates, life expectancy thresholds, and estimates specific to the populations that can participate in the workforce. The national economic burden of suicide was US$ 16,749,079,455 (95% Uncertainty Interval: 11,913,034,910-22,404,233,468). The top three states, Karnataka, Tamil Nadu, and Maharashtra, contributed to 44.82% of the total burden in India. The age group 20-34 years had the largest suicide burden and contributed to 53.05% of the overall national economic burden (US$ 8,885,436,385 [6,493,912,818-11,694,138,884]). Twenty states and UTs had a greater economic burden for females than males. The current analysis ascertains a high economic burden of suicide among the Indian youth and females, necessitating concerted multisectoral efforts and immediate investments. None.

Capital is not a factor of production but organizes the allocation and distribution of resources in capitalism

AbstractEconomists usually define capital as a factor of production—roughly speaking, as physical equipment. This paper demonstrates the limits of this common approach and develops a meaningful alternative. In actual business life, capital refers to the monetary value of business assets, regardless of what the assets consist of, and as such, it is an important aspect of economic calculations that helps to guide entrepreneurial activities. In this sense, capital is pervasive in capitalist societies. Virtually all goods and services are produced by profit-oriented enterprises. Natural resources, intermediate goods, and finished products all appear on the balance sheets of enterprises and are consequently part of business capital. Likewise, the majority of people are employees of enterprises. They receive their pay because the employing firms consider this to be a profitable investment of their capital. Despite its extreme practical importance, this business notion of capital is ignored by nearly the entire economics profession. The paper shows how economists could profit from adopting the business notion of capital, irrespective of their ideological backgrounds.

The hidden costs of informal caregiving: a concept analysis

Background“The hidden costs of informal caregiving” is an interdisciplinary concept. While caregivers make a significant contribution to the process of caregiving, they sacrifice their leisure time, and incur risks of dropping out of the job, impaired mental and physical health, and decreased well-being within the context of caregiving. Those invisible sacrifices are often overlooked and described as hidden costs of informal caregiving. However, the conceptualisation of hidden costs of informal caregiving has not yet been clarified and scientifically assessed. The research aimed to clarify the concept of hidden costs of informal caregiving and develop an operational definition.MethodsWalker and Avant’s concept analysis was conducted. Databases of CBM, CNKI, WanFang, VIP, PubMed, Embase, CINAHL, Web of Science, MEDLINE, Cochrane Library, Econlit, CINAHL and ProQuest were searched with the term “hidden costs of informal caregiving”. Information about the uses of the concept, defining attributes, model cases, antecedents, consequences and empirical referents of hidden costs of informal caregiving was extracted and synthesized.ResultsA total of 25 articles were included. The six defining attributes of hidden costs of informal caregiving were identified as including “undertaken by informal caregivers”, “the time costs of caregiving”, “costs of career development” “physical well-being costs”, “mental well-being costs” and “social relationship costs”. Personal characteristics of the caregivers and care recipients, along with caregiving attributes, were among the antecedents. The consequences of hidden costs of informal caregiving resulted in negative influences which included poor quality of life, life-altering decisions, options for the type of care, some degree of economic hardship, decreased compliance with treatment plans and monetary value informal caregivers are willing to pay to be replaced.ConclusionThis concept analysis decisively illuminated the hitherto nebulous concept and expanded the contents of hidden costs of informal caregiving, which will foster a deeper appreciation of the invisible cost of caregivers. Moreover, it will provide a reference for the study of the hidden costs of informal caregiving in future, contribute to the development of assessment tools and theoretical models of hidden costs of informal caregiving, and create a basis for designing an evidence-based care program.

The Knowledge and Application of Economics in Healthcare in a High-Income Country Today: The Case of Belgium.

Healthcare is a huge business sector in many countries, focusing on the social function of delivering quality health when people develop illness. The system is essentially financed by public funds based on the solidarity principle. With a large financial outlay, the sector must use economic evaluation methods to achieve better efficiency. The objective of our study was to evaluate and to understand how health economics is used today, taking Belgium as an example of a high-income country. The evaluation started with a historical view of healthcare development and ended with potential projections for its future. A literature review focused on country-specific evaluation reports to identify the health economic methods used, with a search for potential gaps. The first results indicated that Belgium in 2021 devoted 11% of its GDP, 17% of its total tax revenue, and 30% of the national Social Security Fund to health-related activities, totalizing EUR 55.5 billion spending. The main health economic method used was a cost-effectiveness analysis linked to budget impact, assigning reimbursable monetary values to new products becoming available. However, these evaluation methods only impacted at most 20% of the money circulating in healthcare. The remaining 80% was subject to financial regulations (70%) and budgeting (10%), which could use many other techniques of an economic analysis. The evaluation indicated two potentially important changes in health economic use in Belgium. One was an increased focus on budgeting with plans, time frames, and quantified treatment objectives on specific disease problems. Economic models with simulations are very supportive in those settings. The other was the application of constrained optimization methods, which may become the new standard of practice when switching from fee-for-service to pay-per-performance as promoted by value-based healthcare and value-based health management. This economic refocusing to a more constrained approach may help to keep the healthcare system sustainable and affordable in the face of the many future challenges including ageing, climate change, migration, pandemics, logistical limitations, and financial instability.

Recent Medicare Billing Trends of Hospitals and Surgeons for Revision Hip and Knee Total Joint Arthroplasty: Is the Value of a Surgeon’s Work Decreasing?

BackgroundRevision hip and knee total joint arthroplasty (TJA) is associated with higher health care costs and work burden than primary TJAs. However, previous studies demonstrated a decrease in the value of reimbursements for revision TJA, causing concerns for hospitals and surgeons regarding the financial sustainability of these resource-expensive procedures. This study aimed to investigate the Medicare billing trends of hospitals and surgeons for revision TJA between 2017 and 2022. MethodsMedicare claims and payments for revision TJA were identified from the Centers for Medicare and Medicaid Services Part A and B databases. Hospital claims for revision TJA were identified through Diagnostic-Related Groups (467, 468). Surgeon claims were identified using Current Procedural Terminology codes for revision hip (27134, 27137, 27138) and knee (27486, 27487) TJA. Yearly charges, reimbursements, and markup ratios (MR = charge/reimbursement) were analyzed. All monetary values were adjusted to the 2022 U.S. dollars. ResultsA total of 43,125 surgeons and 152,974 hospital claims were included in this study. From 2017 to 2022, the total volume of revision TJA decreased by 19.4%. Hospital reimbursements remained relatively unchanged, with a decrease of 1.4%, while hospital charges increased by 11.8%, resulting in a 13.3% increase in the MR. For surgeons, reimbursements decreased by 13.8%, and charges decreased by 11.0%, leading to a 3.3% increase in the MR. The proportion of surgeon reimbursement to hospital reimbursement decreased from 8.5 to 7.5%. ConclusionsThe comparison of the billing trends of hospitals and surgeons showed the relatively stable value of hospital reimbursement while the value of surgeon reimbursement continued to decline, implying the decreasing fiscal value of physicians’ work. The study suggests the need for sustainable financial incentives for surgeons performing revision TJA and strategies to control hospital charges to alleviate financial burdens and improve patient access to revision TJA.

Value of lost leisure among sandwich generation women performing caregiving duties for older parents

This study evaluates the extent of leisure time loss experienced by middle-aged women in South Korea who care for their aging parents and quantifies the monetary value of this lost leisure time. By employing an open-ended direct question, we derived respondents' willingness to pay and willingness to accept compensation for leisure time lost due to caregiving duties. Our findings reveal that middle-aged women engaged in regular caregiving are willing to pay an average of 9313 KRW (US$7.74) per hour for leisure time and would require 13,539 KRW (US$11.40) per hour as compensation for their lost leisure. The annual total monetary value of leisure time loss for consistent caregivers was estimated to range between 7403.4 billion KRW (US$6232 million) and 10,127.5 billion KRW (US$8525 million). The study highlights the significant challenges faced by caregivers, particularly middle-aged women, emphasizing the need for social awareness and discussions on gender role distribution to promote gender equality. It underscores the importance of developing effective support policies, including financial compensation and mental health resources, to alleviate caregivers' dual burden of work and home responsibilities. Understanding the economic impact of leisure time loss can help address long-term socioeconomic issues associated with an aging society, crucial for improving the efficiency and sustainability of care services for the older generation. The economic value estimated in this study will provide essential information for evaluating the cost-effectiveness of public services, supporting the economic feasibility of policies and programs, especially because respite services involve significant government expenditure.

Mega project impact on urban growth and ecosystem service

In an effort to forecast and estimate the value of ecosystem services (ESVs) and land use and land cover changes (LULC), recent global events and research have centered on the evaluation of LULC. This study evaluates the effectiveness of an integrated approach using multi-layer perceptron-Markov chain analysis (MLP-MCA) and remote sensing data for monitoring land use and land cover (LULC) changes. The study area comprises the three Bangladeshi upazilas that the Padma Bridge connects: Shariatpur, Louhajang, and Janjira. The Ecosystem Services Valuation Database (ESVD) was used to evaluate the impacts of changes in land use and land cover (LULC) on Ecosystem Service Values (ESVs). The LULC of the study area was estimated for the years 2000, 2010, and 2020, and the forecast period for urban development was 2030 and 2040. Additionally, the monetary value of ecosystem services was evaluated across the time. As per the LULC change analysis, there is a projected 4.35% growth in the built-up area from 2000 to 2020. After the bridge is constructed, the built-up area is projected to increase by 7% in 2030 and 14% in 2040, according to the forecast. The exponential expansion of developed land has a paradoxical effect on the value of ecosystem services. From 2020 to 2040, it is expected that the ESVs for provision, regulation, culture, and support will experience a reduction of approximately 213.24 million USD/ha. Even if the establishment of a bridge results in economic stability and investment attraction for the nation, unforeseen ecosystem service losses cannot contribute to long-term, sustainable development. This study, by establishing a correlation between urban area expansion and the deterioration of ecosystem services, can serve as a standard and basis for guiding management decisions.

Work after lawful status: formerly undocumented immigrants’ gendered relational legal consciousness and workplace claims-making

AbstractUndocumented status impedes immigrants’ workplace claims to legal rights and better treatment. But what happens when they obtain lawful permanent residency – does the reluctance to make claims in the workplace change? If so, how? Drawing on timeline interviews, I examine changes in the relational legal consciousness and reported workplace claims-making of 98 formerly undocumented Latino immigrants. Most respondents reported increased willingness to engage in, and follow through with, workplace claims. However, gendered differences emerged. Men’s claims largely revolved around wage negotiations, moving to a better paying position, and enforcement of legal rights with an attached monetary value. They were also more likely to frame claims as legal rights. In contrast, women’s claims largely revolved around better work treatment, access to job benefits, and workplace accommodations. They were also more likely to frame claims as moral rights. I explain these outcomes as a function of three relational mechanisms: lawful status being understood relative to experiences being undocumented; gendering in the legalization process; and social ties promoting gendered expectations of lawful permanent residency. My findings highlight the importance of gendered differences in relational legal consciousness and how lived reference points (e.g., prior undocumented experience) inform how legal consciousness changes over time.

Co-Benefits of Antimicrobial Resistance Mitigation from China’s PM2.5 Air Pollution Reduction Between 2014–2020

The One Health concept acknowledges the importance of multiple dimensions in controlling antimicrobial resistance (AMR). However, our understanding of how anthropological, socioeconomic, and environmental factors drive AMR at a national level remains limited. To explore associations between potential contributing factors and AMR, this study analyzed an extensive database comprising 13 major antibiotic-resistant bacteria and over 30 predictors (e.g., air pollution, antibiotic usage, economy, husbandry, public services, health services, education, diet, climate, and population) from 2014 to 2020 across China. The multivariate analysis results indicate that fine particulate matter with a diameter of 2.5 μm or less (PM2.5) is associated with AMR, accounting for 12% of the variation, followed by residents’ income (10.3%) and antibiotic usage density (5.1%). A reduction in PM2.5 of 1 µg·m−3 is linked to a 0.17% decrease in aggregate antibiotic resistance (p < 0.001, R2 = 0.74). Under different scenarios of China’s PM2.5 air-quality projections, we further estimated the premature death toll and economic burden derived from PM2.5-related antibiotic resistance in China until 2060. PM2.5-derived AMR is estimated to cause approximately 27 000 (95% confidence interval (CI): 6468–48 830) premature deaths and about 0.51 (0.12–0.92) million years of life lost annually in China, equivalent to an annual welfare loss of 8.4 (2.0–15.0) billion USD. Implementing the “Ambitious Pollution 1.5 ℃ Goals” scenario to reduce PM2.5 concentrations could prevent roughly 14 000 (3324–26 320) premature deaths—with a potential monetary value of 9.8 (2.2–17.6) billion USD—from AMR by 2060. These results suggest that reducing air pollution may offer co-benefits in the health and economic sectors by mitigating AMR.

Interpretation of Fairness Concept and Economic Impact Analysis of Carbon Quota Allocation between Industries in Indonesia

Abstract Quota allocation is critical in implementing supporting policies for carbon reduction efforts, such as the carbon cap and trade mechanism. Depending on the allocation rules, certain company types may benefit more economically. Inequality conditions can happen and reduce the willingness to participate in sustainability efforts. This study aims to propose fairness interpretations in the context of company-level carbon quota allocation. Four industries in Indonesia with inherently different emission and financial profiles were selected as case studies: energy, oil palm, basic materials, and finance. Fairness principles were analyzed to represent the interests of companies based on their financial and environmental performance. Indicators were selected to quantify the equality principles and aggregated into a Comprehensive Index (CI) for quota allocation, where the companies’ quota surplus/deficit is quantified into monetary value to estimate the economic impact with varying reduction targets. According to our analysis, the sectoral advantages/disadvantages would depend on the viewpoint of fairness principles, and the oil palm and financial sectors be less impacted than the basic materials and energy sectors with increased emission reduction targets. The sensitivity analysis suggests that the vertical, horizontal, polluter pays, and historical responsibility principles are more sensitive to weighting than the merit and basic needs principles.

Diversity Scholarships for Plastic Surgery Subinternships: A National Review of US Residency Programs.

Residency programs have developed monetary initiatives for students underrepresented in medicine (URiM). Our team sought to provide a centralized resource for URiM students seeking plastic surgery subinternships with funded opportunities. A cross sectional analysis of URiM scholarships offered by US integrated plastic surgery programs (n = 91) between July and September 2023. The study used residency program web domains. Investigators collected information on the monetary value of scholarship, eligibility criteria, and required application documents. Inferential analyses were conducted to investigate whether programs' geographic region or Doximity ranking played a role in likelihood of scholarship existence. The study found that approximately 52.7% (n = 48) of programs have in place monetary support for underrepresented visiting medical students (eg, stipend or reimbursement). The average monetary support was $1670. A univariate test demonstrated that programs with lower rankings in both reputation and research were less likely to have a scholarship available than higher ranking programs (P = 0.002; P = 0.02, respectively). Programs located in the Midwest regions were 3.5 times more likely to have a diversity scholarship available (P = 0.034). In our multivariate analysis, reputation ranking and geographic region remained significant. A Pearson chi square test showed the greatest proportions of scholarships among geographically similar programs to be in the Midwest (70%), however, not statistically significant. This study provides a centralized resource for URiM students interested in completing away rotations. Further investigation into development of these scholarship opportunities would be of much benefit and could guide other programs in the funding their own diversity scholarships.

Increasing cost of Trauma Hospitalizations in the Pediatric Population. Cost Analysis of Treatment of Musculoskeletal Injuries in Children and Adolescents

Background. Musculoskeletal injuries in children and adolescents have rarely been investigated in the recent literature. This study aimed to perform a comparative medical and economic analysis of the cost of treatment of musculoskeletal injuries and that of selected pediatric surgical procedures in children and adolescents.Material and methods, We performed a retrospective analysis of data of children treated in a pediatric surgery department for musculoskeletal injuries and selected general surgical conditions in 2021-2023. The number of hospitalizations, procedures, the number of NHF credits awarded, and the monetary value (PLN) of procedures performed were assessedResults. There were a total of 3,809 children hospitalized in 2021-2023, of whom 1,933 received surgical treatment (51%). In this group, 529 children (28%) were treated due to musculoskeletal injuries (Group I), and 402 (20%), due to general surgical conditions (Group II). The average monetary value of the procedures performed was 949,238.2 PLN / year for Group I and 740,583.6 PLN / year for Group II.Conclusions. 1. In the pediatric population, musculoskeletal injuries account for the highest percentage of injuries associated with serious sequelae. 2. The monetary value of procedures for treating musculoskeletal injuries is higher compared to selected general surgical procedures according to DRGs. 3. The cost of performing trauma procedures constitutes 56% of the NHF contract value and has been gradually increasing. 4. The significant and increasing incidence of traumatic injuries and the high cost of their treatment require an increase in the overall contract value for centers treating injuries in children and adolescents.

Assessment of air pollution removal by urban trees based on the i-Tree Eco Model: The case of Tehran, Iran.

Air quality concerns have become increasingly serious in metropolises such as Tehran (Iran) in recent years. This study aims to assess the contribution of urban trees in Tehran toward mitigating air pollution and to evaluate the economic value of this ecosystem service using the i-Tree Eco model. To accomplish this objective, we utilized Tehran's original land use map, identifying five distinct land use categories: commercial and industrial, parks and urban forests, residential areas, roads and transportation, and urban services. Field data necessary for this analysis were collected from 316 designated plots, each with a radius of 11.3 m, and subsequently analyzed using the i-Tree Eco model. The locations of these plots were determined using the stratified sampling method. The results illustrate that Tehran's urban trees removed 1286.4 tons of pollutants in 2020. Specifically, the annual rates of air pollution removal were found to be 134.8 tons for CO; 299.7 tons for NO2; 270.3 tons for O3; 0.7 tons for PM2.5; 489.4 tons for PM10 (particulate matter with a diameter size between 2.5 and 10 µm); and 91.5 tons for SO2, with an associated monetary value of US$1 536 619. However, despite this significant removal capacity, the impact remains relatively small compared with the total amount of pollution emitted in 2020, accounting for only 0.17%. This is attributed to the high emissions rate and low per capita green space in the city. These findings could serve as a foundation for future research and urban planning initiatives aimed at enhancing green spaces in urban areas, thereby promoting sustainable urban development. Integr Environ Assess Manag 2024;00:1-11. © 2024 SETAC.

Evaluating Named Entity Recognition: A comparative analysis of mono- and multilingual transformer models on a novel Brazilian corporate earnings call transcripts dataset

Since 2018, when the Transformer architecture was introduced, Natural Language Processing has gained significant momentum with pre-trained Transformer-based models that can be fine-tuned for various tasks. Most models are pre-trained on large English corpora, making them less applicable to other languages, such as Brazilian Portuguese. In our research, we identified two models pre-trained in Brazilian Portuguese (BERTimbau and PTT5) and two multilingual models (mBERT and mT5). BERTimbau and mBERT use only the Encoder module, while PTT5 and mT5 use both the Encoder and Decoder. Our study aimed to evaluate their performance on a financial Named Entity Recognition (NER) task and determine the computational requirements for fine-tuning and inference. To this end, we developed the Brazilian Financial NER (BraFiNER) dataset, comprising sentences from Brazilian banks’ earnings calls transcripts annotated using a weakly supervised approach. Additionally, we introduced a novel approach that reframes the token classification task as a text generation problem. After fine-tuning the models, we evaluated them using performance and error metrics. Our findings reveal that BERT-based models consistently outperform T5-based models. While the multilingual models exhibit comparable macro F1-scores, BERTimbau demonstrates superior performance over PTT5. In terms of error metrics, BERTimbau outperforms the other models. We also observed that PTT5 and mT5 generated sentences with changes in monetary and percentage values, highlighting the importance of accuracy and consistency in the financial domain. Our findings provide insights into the differing performance of BERT- and T5-based models for the NER task.

Measuring the harm of sugar sweetened beverages and internalities associated with it.

Obesity, which is partly driven by the consumption of sugar-sweetened beverages (SSBs), significantly increases the risk of type-2 diabetes and cardiovascular diseases, leading to substantial health and economic burdens. This study aims to quantify the monetary value of health harms caused by SSB consumption, along with the associated internalities, through a contingent valuation survey. The results are crucial for determining the socially optimal tax rate. We surveyed 293 residents of Wellington, New Zealand, to assess their willingness to pay (WTP) for reductions in the risks of diabetes, stroke, and heart disease associated with SSB intake. Logistic regression analysis revealed the marginal WTP for a 1% risk reduction in diabetes, stroke, and heart disease to be NZ$404.86, NZ$809.04, and NZ$1,236.84, respectively. Based on these values, we estimate the marginal harm from SSB consumption to be approximately NZ$17.37 per liter in New Zealand, with internalities amounting to NZ$6.43 per liter, suggesting an optimal tax rate of NZ$6.49 per liter. Implementing such a tax is feasible and would likely double or triple the price of SSBs in New Zealand.

Assessing the Value of a Human Life in Heat-Related Mortality: Lessons from COVID-19 in Belgium

This study evaluates the cost of heat-related mortality using economic impacts and mortality data from the COVID-19 pandemic in Belgium as a proxy. By examining the economic loss measured by gross domestic product (GDP) decline and excess mortality during the first COVID-19 wave (March–June 2020), a new estimate for avoided heat-related mortality is derived. The results show that the cost per avoided death is EUR 377,000 ± EUR 222,000, significantly lower than numerical values of the commonly used Value of a Statistical Life (VSL). However, when this cost is divided by the expected remaining (eight) life years at the age of death, the resulting monetary value for a saved life year, in a EUR 47,000 ± EUR 28,000 range, aligns well with commonly used values for the Value of a Life Year (VOLY). Thus, the present study contributes to the ongoing debate on the most appropriate methods for valuing human life in the context of heat-related mortality. By comparing our results with both VSL and VOLY, we underscore the limitations of VSL in the context of heat-related mortality and advocate for VOLY as a more accurate and contextually relevant metric. These findings may offer useful insights for policymakers in evaluating and prioritizing investments in heat-related mortality-prevention strategies.

Trends in Medicare Charges, Reimbursements, and Utilization for Ophthalmic Versus Non-Ophthalmic Procedures: Medicare Charges in Ophthalmic Procedures

ObjectiveTo investigate trends in Medicare charges, reimbursements, and utilization for ophthalmic and non-ophthalmic procedures. MethodsWe examined all ophthalmic, non-ophthalmic, and the 15 most performed ophthalmic medical/surgical procedures in Medicare Provider Utilization and Payment Data from 2013 to 2019. Monetary values were adjusted for inflation based on the 2019 United States (US) dollar using the Bureau of Labor Statistics Consumer Price Index. We calculated annual procedural utilization by adjusting service counts per million Medicare beneficiaries and examined trends for ophthalmic and non-ophthalmic procedures from 2013-2019 using descriptive statistics. ResultsFrom 2013-2019, Medicare inflation-adjusted charges and reimbursements changed by -14% and -23%, respectively, for ophthalmic procedures compared to +14% and +5%, for non-ophthalmic procedures, and -24% and -31% for the 15 most common ophthalmic procedures. Utilization of ophthalmic, non-ophthalmic, and common ophthalmic procedures changed by +2%, -15%, and +17%, respectively. ConclusionsLower reimbursements likely compensate for higher utilization in ophthalmology, especially since the magnitude of change in charges and reimbursements was larger for the 15 most performed ophthalmic procedures. In future reimbursement deliberations, policymakers should consider the declining reimbursements for procedures in ophthalmology relative to other medical specialties. Public Interest SummaryMedicare reimbursement rates for common ophthalmic procedures decreased by 31% from 2011-2020. These reductions may lead to lower hospital revenue and, subsequently, higher prices. This shifts the financial burden onto uninsured and underinsured patients and is a potential barrier to care. Additionally, as there are not enough ophthalmologists in the US to adequately meet demand, further reimbursement reductions may influence student interest and contribute to earlier retirements in the existing ophthalmic workforce. This study identifies a decline in charges and reimbursements as utilization concurrently increased for ophthalmic procedures. In contrast, there has been an increase in charges and reimbursements with a decrease in utilization for non-ophthalmic procedures. Policymakers should take these findings into consideration in future decisions on reimbursement changes for ophthalmology.

Impacts of COVID-19 on the premiums of proximity to railway stations: An in-depth analysis using passenger flows

As a result of the coronavirus (COVID-19) pandemic, work and leisure patterns have changed significantly, as have commuting and travel behavior. This has led to changes in the degree of dependence and demand for mass transportation. This paper proposes that these changes decrease people's demand to live near public transportation services and cause the decline of the positive externality created by public transit as measured by house prices. This paper explores the train stations of Taiwan's two largest cities (Taipei and Kaohsiung) by adopting various hedonic price models to estimate the COVID-19 effect on the premiums of proximity to rail stops. We then analyze whether the changes in premiums are affected by the passenger flow at the station. This paper uses four variables to measure passenger flows: the number of total passengers on services, the net number of passengers (the number leaving the local area minus the number of arriving at the local area), and the expected numbers of commuters and non-commuters. The empirical results of this paper show that after the COVID-19 outbreak, the monetary value of the proximity of railway stations decreased significantly. However, the COVID-19 effect on different stations is heterogeneous. The post-COVID-19 decrease in the positive externality associated with proximity to a rail station is significantly affected by passenger flows. The changes in the positive externality of stations found in this study suggest the public has reduced their dependence on stations due to changes in commuting behavior. We urge the government to pay attention to whether the commuting flows and the public's demand for public transportation have shifted and the use of vehicles and road transportation has risen.