Size Of Payments Research Articles

Medical Malpractice Litigation Following Arthroscopic Surgery

Our study aims to analyze a variety of factors involving malpractice lawsuits following arthroscopy, focusing on reasons for lawsuit and establishing predictors for the outcome of the lawsuit. Two legal databases, VerdictSearch and Westlaw, were queried for arthroscopic cases in adult patients. For all included cases, clinical and demographic data were recorded. The effects of plaintiff demographics, joint involved, lawsuit allegation, case ruling, and size of indemnity payments were assessed. Of the 240 included cases, 62 (26%) resulted in plaintiff verdict, 160 (67%) resulted in defense verdict, and 18 (8%) were settled without trial. Plaintiff demographics (age and sex) had no effect on the case ruling. There was no statistical difference between indemnity awards for plaintiff verdicts ($1,013,494) and settled cases ($848,331; P= .13). Patient death was noted in 20 cases (8.3%); a significantly higher proportion of these cases were settled versus went to trial (P= .0022), including 19 patients (95%) who had knee arthroscopy and 16 deaths (80%) resulting from a pulmonary embolus. Plaintiff verdict or settlement were seen significantly more frequently for vascular complications and wrong-sided surgery. Alternatively, defense verdicts followed lawsuits alleging surgeon technical error. Wrong-sided surgery, retained instruments, deep venous thrombosis, and postoperative infections were seen at a significantly higher proportion after knee arthroscopy than after arthroscopy of other joints. Similarly, neurological injury was significantly associated with elbow and hip arthroscopy, while allegations of technical error by the surgeon and block-related complications were associated with shoulder arthroscopy. Plaintiff verdict or settlement were seen for vascular complications and wrong-sided surgery, while defense verdicts followed lawsuits alleging surgeon technical error and block-related complications. We also identified types of allegations that were associated with arthroscopy of different joints. All but one case of patient death (20 cases) were noted to involve knee arthroscopy, and an overwhelming majority resulted due to a pulmonary embolism. This information helps the arthroscopic surgeon better counsel patients and employ strategies to mitigate preventable complications. Level IV, case series.

Medicare Secondary Payer and Settlement Delay

The Medicare Secondary Payer Act of 1980 and its subsequent amendments require that insurers and self‐insured companies report settlements, awards, and judgments that involve a Medicare beneficiary to the Centers for Medicare and Medicaid Services. The parties then may be required to compensate CMS for its conditional payments. In a simple settlement model, this makes settlement less likely. Also, the reporting delays and uncertainty regarding the size of these conditional payments are likely to further frustrate the settlement process. We provide results, using data from a large insurer, showing that, on average, implementation of the MSP reporting amendments led to a delay in the resolution of disputes involving auto accidents of about six months.

Pirates of the Mediterranean: An empirical investigation of bargaining with asymmetric information

We investigate the effect of delay on prices in bargaining situations using a data set containing thousands of captives ransomed from Barbary pirates between 1575 and 1692. Plausibly exogenous variation in the delay in ransoming provides evidence that negotiating delays decreased the size of ransom payments, and that much of the effect stems from the signalling value of strategic delay, in accordance with theoretical predictions. We also structurally estimate a version of the screening type bargaining model, adjusted to our context, and find that the model fits both the observed prices and acceptance probabilities well. Bargaining piracy ransom D23 K42 N45

Down Payment and Mortgage Rates: Evidence from Equity Loans

We present new evidence that lenders use down payment size to price unobservable borrower risk. We exploit the contractual features of a UK scheme that helps home buyers top up their down payments with equity loans. We find that a 20 percentage point smaller down payment is associated with a 22 basis point higher interest rate at origination, and a higher ex-post default rate. Lenders see down payment as a signal for unobservable risk, but the relative importance of this signal is limited, as it accounts for only 10% of the difference in mortgage rates between loans with 75% and 95% loan to value ratio.

An IBNR–RBNS insurance risk model with marked Poisson arrivals

Inspired by the claim reserving problem in non-life insurance, this paper proposes to study the insurer’s surplus process under a micro-level framework, with particular focus on modeling the Incurred But Not Reported (IBNR) and the Reported But Not Settled (RBNS) claims. It is assumed that accidents occur according to a Poisson point process, and each accident is accompanied by a claim developmental mark that contains the reporting time, the settlement time, and the size of (possibly multiple) payments between these two times. Under exponential reporting and settlement delays, we show that our model can be represented as a Markovian risk process with countably infinite number of states. This can in turn be transformed to an equivalent fluid flow model when the payments are phase-type distributed. As a result, classical measures such as ruin probability or more generally the Gerber–Shiu expected discounted penalty function follow directly. The joint Laplace transform and the pairwise joint moments involving the ruin time and the aggregate payments of different types (with and without claim settlement) are further derived. Numerical illustrations are given at the end, including the use of a real insurance dataset.

Application of the methodology for determining the “growth poles” of the region’s industrial economy in the system of public administration

The article deals with the topical issue of applying the theory of “growth poles” to the economic development of Ukraine. A variety of theoretical definitions of the “growth pole” concept existing in the world economic and scientific thought has been studied. The ways and issues of practical application of the theory of “growth poles” for the Ukrainian economy have been identified. It has been proved that the formation of “growth poles” in industry is the determination of priority locomotive branches of the region’s industrial economy. The possible mechanisms of their localization in the form of growth areas have been substantiated. The methodology for determining “growth areas” of the industrial region has been developed and applied to the industry of the Carpathian economic region. In order to identify regional economic growth areas, Ivano-Frankivsk, Lviv, Chernivtsi, and Zakarpattia regions have been analyzed, evaluated, and classified for the period 2011–2016: by the relative share of the industry in the total output produced in the region of interest; by the relative share of unprofitable businesses in the industry; by the level of profitability of industries (goods) and by the monetary value of the profit earned by industries. The procedure for classifying the branches has been put forward for the purpose of identifying economic growth areas by totality of leading businesses and by fiscal performance (size of tax payments) of industries. It has been proved that the advanced development of the region’s industrial economy is possible as a result of intensifying the areas of the growth poles, with the priority innovative and investment projects for the development of the locomotive regional branches serving as the principal growth areas of the regional economy.

Minimizing the payments and borrower risk in a mortgage

We consider a mathematical model of borrower behavior in an annuity mortgage. The price of the apartment, amount of the borrower’s own capital, the probability distribution of his income at each time moment, and the interest rate are known. The problem is to find the loan size and schedule of payments that minimize both the total payment and the borrower’s risk. We pay the most attention to the problem of optimal reserves of capital. We study a variation of this problem where it is allowed to open an additional credit line.

Demand-side financing for maternal and newborn health: what do we know about factors that affect implementation of cash transfers and voucher programmes?

BackgroundDemand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising ‘healthy behaviours’. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health.MethodsA secondary analysis (using an adapted Supporting the Use of Research Evidence framework – SURE) was performed on studies that had previously been identified in a systematic review of evidence on DSF interventions in maternal and newborn health.ResultsThe article draws on findings from 49 quantitative and 49 qualitative studies. The studies give insights on difficulties with exclusion of migrants, young and multiparous women, with demands for informal fees at facilities, and with challenges maintaining quality of care under increasing demand. Schemes experienced difficulties if communities faced long distances to reach participating facilities and poor access to transport, and where there was inadequate health infrastructure and human resources, shortages of medicines and problems with corruption. Studies that documented improved care-seeking indicated the importance of adequate programme scope (in terms of programme eligibility, size and timing of payments and voucher entitlements) to address the issue of concern, concurrent investments in supply-side capacity to sustain and/or improve quality of care, and awareness generation using community-based workers, leaders and women’s groups.ConclusionsEvaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social, geographical and health systems factors as barriers to accessing care. Careful design of DSF programmes as part of broader maternal and newborn health initiatives would need to take into account these barriers, the behaviours of staff and the quality of care in health facilities. Research is still needed on the policy context for DSF schemes in order to understand how they become sustainable and where they fit, or do not fit, with plans to achieve equitable universal health coverage.

Frequency and Type of Situational Awareness Errors Contributing to Death and Brain Damage

Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. Surgical and procedural anesthesia death and brain damage claims in the Anesthesia Closed Claims Project database were analyzed. Situational awareness error was defined as failure to perceive relevant clinical information, failure to comprehend the meaning of available information, or failure to project, anticipate, or plan. Patient and case characteristics, primary damaging events, and anesthesia payments in claims with situational awareness errors were compared to other death and brain damage claims from 2002 to 2013. Anesthesiologist situational awareness errors contributed to death or brain damage in 198 of 266 claims (74%). Respiratory system damaging events were more common in claims with situational awareness errors (56%) than other claims (21%, P < 0.001). The most common specific respiratory events in error claims were inadequate oxygenation or ventilation (24%), difficult intubation (11%), and aspiration (10%). Payments were made in 85% of situational awareness error claims compared to 46% in other claims (P = 0.001), with no significant difference in payment size. Among 198 claims with anesthesia situational awareness error, perception errors were most common (42%), whereas comprehension errors (29%) and projection errors (29%) were relatively less common. Situational awareness error definitions were operationalized for reliable application to real-world anesthesia cases. Situational awareness errors may have contributed to catastrophic outcomes in three quarters of recent anesthesia malpractice claims.Situational awareness errors resulting in death or brain damage remain prevalent causes of malpractice claims in the 21st century.

Accommodation of ecological and economic interests in placer gold mining

An attempt is made to find the answer to the question as to why the measures of the environmental institutions of Russia are ineffective for the avoidance and prevention of the degradation of aquatic ecosystems in placer gold mining. It is established that the size of payments to be made by companies engaged in placer gold mining are such that they almost cannot stimulate any nature conservation initiatives. Moreover, they even cannot be the argument for observance of environmental legislation. It is shown that the high transaction costs borne by the State, with minor expenditures of nature resource users connected with the protection of environmental natural systems fail to achieve the objectives imposed upon the supervising institutions. It is established that local authorities are directly interested in increasing placer gold mining as well as in gaining the loyalty of artels implying registration of the enterprise in this region, because these tax proceeds are exceptionally important for municipal formations facing a chronic financial deficit, a budgetary uncertainty and a dependence on regional and federal subsidies and transfers. Finance flows were calculated and analyzed to show that a very important problem for Russia’s eastern regions that involves reconciling the economic and ecological interests in placer gold mining is not resolved through “cosmetic changes” in organs of state supervision. It is concluded that there is a need for new institutional solutions in order to create and increase incentives for users of mineral resources and local authorities for observance of environmental regulations, the preservation and restoration of disturbed ecosystems, and for the ecologization of production processes.

Assessment of malpractice claims due to spinal epidural abscess.

OBJECTIVE Spinal epidural abscesses (SEAs) can be difficult to diagnose and may result in neurological compromise or even death. Delays in diagnosis or treatment may worsen the prognosis. While SEA presents a high risk for litigation, little is known about the medicolegal ramifications of this condition. An enhanced understanding of potential legal implications is important for practicing spine surgeons, emergency medicine physicians, and internists. METHODS The VerdictSearch database, a large legal-claims database, was queried for "epidural abscess"-related legal cases. Demographic and clinical data were examined for all claims; any irrelevant cases or cases with incomplete information were excluded. The effects of age of the plaintiff, sex of the plaintiff, presence of a known infection, resulting paraplegia or quadriplegia, delay in diagnosis, and delay in treatment on the proportion of plaintiff rulings and size of payments were assessed. RESULTS In total, 56 cases met the inclusion criteria. Of the 56 cases, 17 (30.4%) were settled, 22 (39.3%) resulted in a defendant ruling, and 17 (30.4%) resulted in a plaintiff ruling. The mean award for plaintiff rulings was $5,277,468 ± $6,348,462 (range $185,000-$19,792,000), which was significantly larger than the mean award for cases that were settled out of court, $1,914,265 ± $1,313,322 (range $100,000-$4,500,000) (p < 0.05). The mean age of the plaintiffs was 47.0 ± 14.4 years; 23 (41.1%) of the plaintiffs were female and 33 (58.9%) were male. The proportion of plaintiff verdicts and size of monetary awards were not affected by age or sex (p > 0.49). The presence of a previously known infection was also not associated with the proportion of plaintiff verdicts or indemnity payments (p > 0.29). In contrast, juries were more likely to rule in favor of plaintiffs who became paraplegic or quadriplegic (p = 0.03) compared with plaintiffs who suffered pain or isolated weakness. Monetary awards for paraplegic or quadriplegic patients were also significantly higher (p = 0.003). Plaintiffs were more likely to win if there was a delay in diagnosis (p = 0.04) or delay in treatment (p = 0.006), although there was no difference in monetary awards (p > 0.57). Internists were the most commonly sued physician (named in 13 suits [23.2%]), followed by emergency medicine physicians (named in 8 [14.3%]), and orthopedic surgeons (named in 3 [5.4%]). CONCLUSIONS This investigation is the largest examination of legal claims due to spinal epidural abscess to date. The proportion of plaintiff verdicts was significantly higher in cases in which the patient became paraplegic or quadriplegic and in cases in which there was delay in diagnosis or treatment. Additionally, paralysis is linked to large sums awarded to the plaintiff. Nonsurgeon physicians, who are often responsible for initial diagnosis, were more likely to be sued than were surgeons.

Overcoming the Impact of Corruption through Diligence: The Experience of Russian Female Managers

ABSTRACTThis article proposes that managerial time spent dealing with regulations, in addition to being a reflection of regulatory burden, can also be partially accounted by managerial strategy and propensity to “play by the rules” rather than rely on informal corrupt means to solve business problems in Russia. Using top-manager gender as a proxy for such behaviors, the study finds that firms headed by female managers are more likely to devote more time to dealing with regulations, and to protect their interests in courts. Such firms are less likely to be in a situation where corrupt requests are made, and also minimize corruption impact such as relative size of payments, when actually exposed to corruption pressures. It appears that there are non-spurious gender effect persisting after controlling for multiple firm- and region- level variables. With regards to managerial time spent on dealing with regulations in particular, it appears that the gender effects are reflected in differential responses to corrupt pressures (e.g. spending more time dealing with regulations), but increase in time tax by itself does not appear to limit impact of corruption, except waiting times for operating license, which are shortened. Implications for theory and practice are discussed.

Physician Response to Target-Based Performance Payment

In many health care systems payers reward physicians for reaching predetermined performance targets. These targets may be based on measures for which own performance is difficult to predict. This paper uses a principal-agent model to analyse physicians’ response to a target-based performance payment and the role uncertainty about own performance plays. It is shown that physicians’ response depends on their type (determined by abilities and preferences), the size of the performance payment, and their uncertainty about own performance. Only in the presence of uncertainty do all physician types respond to the target payment, and they respond by increasing effort. Meanwhile, increased uncertainty leads some physician types to reduce the magnitude of their response and other types to increase their response. Therefore, when designing target-based payment schemes it is important to perform baseline measurements to assess the distribution of physician types and to predict physicians’ ability to assess own performance.

Sliding-scale environmental service payments and non-financial incentives: Results of a survey of landowner interest in Costa Rica

This study presents the results from a survey of landowner interest in a propositional payment modality for Costa Rica's Pagos por Servicios Ambientales (PSA) program that is based on a sliding-scale payment scheme. This payment scheme would transition from higher monetary payments per hectare per year for the first units of land invested, to lower payments per hectare per year for additional units of land invested; however, as payments per hectare decrease, monetary payments would be supplemented with non-financial rewards. This program structure is designed to 1) offer higher per-hectare financial incentives to smaller-scale landowners, who would otherwise face steep trade-off costs by transitioning to conservation-based land-use, and 2) offer greater non-financial incentives to larger-scale landowners, who face less sharp trade-off costs, and who might be more interested in prestige- and status-based non-financial incentives than the currently meager PSA payments. I found support for the proposed program modality across all classes of landowners. Interest in PSA participation by small- and medium-scale landowners showed sensitivity to proposed payments, with landowners indicating a strong desire to participate in conservation land-use as soon as the proposed financial incentives were sufficient to cover their opportunity costs. Large-scale landowners showed little sensitivity to payment size, and in general—with mode=10 and median=7 responses on a 10 point Likert-scale—indicated strong willingness to participate in the PSA program under the proposed structure, even if financial incentives per hectare were decreased significantly for large investments of land, but prestige- and status-based awards were introduced. These results are discussed in the context of an emerging literature on signaling theory, conspicuous conservation, and the interaction of financial incentives and social norms.

Are firms paying more for performance?

Purpose – The purpose of this paper is to investigate changes in the economic importance of performance-related-pay (PRP) in Britain through the 2000s using firm-level data. Design/methodology/approach – The authors utilise nationally representative, monthly data on the total wage bill and employment of around 8,500 firms. Using these data, the authors decompose the share of the total economy-wide wage bill accounted for by bonuses into the shares of employment in the PRP and non-PRP sectors, the ratio of base pay between the two sectors, and the gearing of bonus payments to base pay within the PRP sector. Findings – The growth in the economic importance of bonuses in Britain in the mid-2000s – and subsequent fluctuations since the onset of recession in 2008 – can be almost entirely explained by changes in the gearing of bonus to base pay within the PRP sector. There has been no substantial change in the percentage of employment accounted for by PRP firms; if anything it has fallen over time. Furthermore, movements in the gearing of bonuses to base pay in the economy are heavily influenced by changes in Finance: a sector which accounts for a large proportion of all bonus payments in Britain. Research limitations/implications – The paper demonstrates the importance of understanding further how firms decide the size of bonus payments in a given period. Originality/value – This is the first paper to present monthly firm-level data for Britain on the incidence and size of bonus payments in the 2000s.

Организационно-экономические аспeкты процесса стимулирования трудовой деятельности персонала предприятий промышленности

In this work, the authors conducted a statistical analysis of fi xed assets in the Russian Federation: dynamics of availability of fi xed assets in the Russian Federation by types of economic activity, the coeffi cient of renewal and disposal of fi xed assets in the Russian Federation by types of economic activity. For formation of eff ective system of stimulation it was given a classifi cation of industry factors in the system of stimulation of labor activity of the personnel of industrial enterprises. In order to improve this system the authors give the developed model of system of stimulation of labor activity of personnel, propose a scheme of interconnection of effi ciency and productivity and incentives, the technique of determining the size of incentive payments.

Poverty and Child Development: A Longitudinal Study of the Impact of the Earned Income Tax Credit.

Although adverse socioeconomic conditions are correlated with worse child health and development, the effects of poverty-alleviation policies are less understood. We examined the associations of the Earned Income Tax Credit (EITC) on child development and used an instrumental variable approach to estimate the potential impacts of income. We used data from the US National Longitudinal Survey of Youth (n = 8,186) during 1986-2000 to examine effects on the Behavioral Problems Index (BPI) and Home Observation Measurement of the Environment inventory (HOME) scores. We conducted 2 analyses. In the first, we used multivariate linear regressions with child-level fixed effects to examine the association of EITC payment size with BPI and HOME scores; in the second, we used EITC payment size as an instrument to estimate the associations of income with BPI and HOME scores. In linear regression models, higher EITC payments were associated with improved short-term BPI scores (per $1,000, β = -0.57; P = 0.04). In instrumental variable analyses, higher income was associated with improved short-term BPI scores (per $1,000, β = -0.47; P = 0.01) and medium-term HOME scores (per $1,000, β = 0.64; P = 0.02). Our results suggest that both EITC benefits and higher income are associated with modest but meaningful improvements in child development. These findings provide valuable information for health researchers and policymakers for improving child health and development.

Dividend Payment Behaviour and its Determinants: The Nigerian Evidence

This paper offers new evidence on the existence of disappearing dividend phenomenon in the Nigerian stock market and as to how clientele, catering and life-cycle theories of dividend affect firms' dividend paying behaviour. We did not find conclusive evidence to suggest that dividend payments had become second order of importance in firms' payout policies during 2003–2012 because we only observed a downward trend in dividend payments during 2010–2012. Logistic regression of a probability to pay or not to pay dividend and a panel regression of the size of dividend payment show that clientele theory stands out as compared to catering and life-cycle theories. Firms in our sample shape their dividend policies in line with the preference of foreign investors who have less preference for dividend over capital gain due to dividend taxes imposed on these shareholders. This underlines the importance of foreign investors on firms' corporate decisions given the fact they owned more than half of the total shares traded on the Nigerian Stock Exchange. Other determinants that affect the propensity to pay are profitability, investment opportunities, leverage, cash flow, crisis, stock market performance, past dividend and interest rate with signs that are consistent with the prediction of traditional dividend theories.

ЛИЗИНГ: ОСОБЕННОСТИ УЧЕТА ИМУЩЕСТВА НА БАЛАНСЕ ЛИЗИНГОПОЛУЧАТЕЛЯ

The paper considers the issues of accounting the operations under the lease agreement. The relevance of the research is caused by the fact that leasing as a kind of financial service is widely used in modern business and provides an opportunity to update the production assets of an organization without significant financial costs. The main focus is on the accounting of the lessee, who takes the leased property onto the books, due to the fact that these operations cause a lot of questions and disputes. The paper identifies the basic terms of the lease agreement that are defined by article 432 of the Civil Code of the Russian Federation; however from the experience of business and judicial practice or any other cases different conditions may arise that are recognized by the authors as essential: description of the leased object, the size of the lease payments, the methods and frequency of payments of the lessor, etc. The paper offers examples of the correspondence of accounts for the lessee which illustrate the variation of accounting depending on the conditions of the lease agreement. As a result of the study, the author finds that the terms of the agreement and the structure of the lease payment determine the order of reflection of lease transactions in the accounting and tax implications for the parties of the transaction. The author proves the necessity of inclusion of the following conditions into the lease agreement: definition of the holder of the leased property, definition of advance payment and order of its offset, determination of the redemption price of the leased object and the order of ownership transfer at the end of the lease agreement. The examples represent the variation of accounting operations in different wordings of the agreement.

Do Large-Scale Refinancing Programs Reduce Mortgage Defaults? Evidence from a Regression Discontinuity Design

In 2012, the Federal Housing Administration (FHA) reduced fees to refinance FHA-insured mortgages obtained before -- but not after -- a retroactive deadline. We use a natural experiment to study how reduced mortgage payments affect default rates. Using a regression discontinuity design, we find that reducing payment size by 1 percent lowers conditional default rates by 2.75 percent. Evidence suggests that those effects are larger for borrowers with negative equity and lower credit scores. We estimate that the policy will prevent more than 35,000 defaults of FHA-insured mortgages, saving FHA nearly $1 billion in present-value terms.