Real Expenditure Research Articles

Economic burden of healthcare-associated infections (HAI) in a pediatric hospital in Honduras

Abstract Background In numerous reports, the World Health Organization has published that in LMICs approximately 15% of hospitalized patients acquire an HAI. In the Region of the Americas, many countries have made considerable progress in implementing IPC Programs. At Hospital María Especialidades Pediátricas (HMEP), the IPC Program aims to generate a patient safety culture mainly, but also reduce costs for the hospital and the patient. However, in LMICs, non-quality costs, including those associated with HAI, are rarely measured. This abstract aims to demonstrate the economic burden of HAI in hospitalized patients at HMEP between January 2020 and October 2023 and estimate the number of HAIs and associated costs prevented by the IPC Program. Methods At HMEP the IPC Program started in 2017, and the Accounting Department has measured the costs associated with treating and managing every HAI reported since January 2020. Provider costs for every HAI are estimated using a bottom-up (microcosting) approach in which three variables are considered: days of stay, all laboratory tests used for diagnosis and follow-up, and antimicrobials administered to treat the infection. The costs for each variable derive from the hospital’s purchasing system. This process allows us to estimate the annual HAI expenditure. For the estimation of costs avoided, we first calculated the average cost of each HAI using the yearly amount spent and dividing this amount by the number of HAIs registered in the same period. Considering the proportion of patients who suffered an HAI at HMEP compared to the 15% incidence reported by the WHO, we calculated a difference in proportions and were able to estimate the number of HAIs prevented and subsequent costs avoided. We use the NHSN HAI definitions since Honduras does not have a National IPC Program with standardized epidemiological criteria. The results are presented using descriptive statistics. Results During this time, 260 HAIs were identified at HMEP, average 5.6 per month, 57-70 yearly. The proportion of patients who developed an HAI was found to have decreased from 8.6% in 2020 to 5.2% in 2023. The total expenditure attributed to HAIs during the period was USD 913,774.21 (USD 19,865.0 pm). The costliest HAIs were CVC-associated bloodstream infections. HMEP is a public hospital and operates with funds provided by the government, which are deemed insufficient considering the complexity of the patients receiving care at the hospital. The estimated costs represent 2-3% of the hospital’s annual budget. Without the IPC Program, the predicted number of HAIs, according to the WHO, would have been 570 (15% of inpatients). We estimate 310 prevented HAIs, with an associated total cost of USD 1,103,577.99. Conclusion Regardless of the hospital’s methodology, measuring the economic burden related to HAIs is important for decision-making. The main objective of an IPC Program is to guarantee patient safety; however, especially in low-resource settings, it is also important to aim for a cost reduction. Limitations: our methodology does not include other variables (e.g. human resources); therefore, the data underestimates the real expenditure. We aim to improve the costing methodology for more accurate data.

IMPORTANCE OF PUBLIC FUNDS AND DEBT CAPITAL IN FINANCING INVESTMENTS IN POLISH AGRICULTURE IN 2004-2022

The article assesses the importance of public funds and debt capital in financing investment outlays in agriculture in Poland in 2004-2022. The analysis used statistical data on inputs of production factors in agriculture, in particular investment outlays, as well as budget expenditure on agriculture, farmers’ credit indebtedness and leasing of agricultural machinery. The analysis included both nominal values and values adjusted for the CPI index. It has been shown that capital expenditure in agriculture increased in the years 2004-2022, including nominal and real investment expenditure. During the period under study, the importance of public funds, from the national budget and European funds, in financing agriculture increased. This also applied to investments in agricultural farms. In 2004-2019, a dynamic increase in investment outlays financed in the form of bank loans and leasing could also be observed. A positive correlation was demonstrated between investment expenditure in agriculture and the level of budget expenditure on agriculture and farmers’ credit indebtedness. In the last years of the period under review, i.e. 2020-2022, a decrease in the share of external capitals in the form of long-term bank loans and leasing in financing fixed assets in agriculture was observed.

Crop Diversification, Household Welfare and Conflict: Afghanistan 2011–2017

We use three waves (2011–2012 to 2016–2017) of nationally representative repeated cross section surveys to study the impact of crop diversification (number of crops grown) on household welfare, measured by real adult equivalent consumption and food expenditure and dietary diversity, in Afghanistan. Diversification is very low (almost half grow only one crop and fewer than a fifth grow three or more crops) but increased during the period. A multinomial endogenous switching regression (MESR) addressing selection bias and endogeneity is used to estimate average treatment effects of moving from one crop to two crops and then to three or more crops. The analysis shows that crop diversification increases household consumption and food spending, and, to a modest extent, dietary diversity compared to undiversified households. This holds irrespective of conflict although the effect varies; households experiencing violence tend to divert spending to food from other consumption spending and only the most diversified are able to increase spending compared to undiversified households. The evidence implies that supporting crop diversification can improve food security (through combined effects on spending and food diversity) and mitigate the negative impacts of conflict.

THE ROLE OF IMPORTS AS THE FACTOR OF ENSURING ECONOMIC GROWTH IN ARMENIA։ CHALLENGES AND PROSPECTS

Trade is an essential factor in ensuring the economic growth of every country. Therefore, we identified the role of real imports in explaining statistically significant changes in the real GDP, and the role of changes in the real household final consumption expenditures and real exports of goods and services in explaining statistically significant changes in the real imports in the short-run, based on the least square estimation technique and using quarterly data covering from the first quarter of 2012 to the second quarter of 2023 to indicate the respective priorities to face external shocks and challenges, based on the scenarios designed by us. The respective estimates allowed us to conclude that the real imports have started to have a statistically significant impact in explaining the changes in the real GDP of Armenia due to the increased role of imports in ensuring export growth in Armenia. The increased role of imports is substantiated by the increased role of exports of services and goods and household final consumption expenditure due to the small size of the domestic market of Armenia and the appreciated Armenian dram against the US dollar and the Russian ruble. We stress the role of export diversification of those goods that Armenia has a comparative advantage in producing thereof by export markets and increase in the share of value-added created in Armenia with respect to the exported goods.

Wearable Sensors and the Evaluation of Physiological Performance in Elite Field Hockey Players.

Sports performance tracking has gained a lot of interest and widespread use in recent years, especially in elite and sub-elite sports. This makes it possible to improve the effectiveness of training, to calibrate and balance workloads according to real energy expenditure, and to reduce the likelihood of injuries due to excessive physical stress. In this context, the aim of this review was to map the scientific literature on wearable devices used in field hockey, evaluating their characteristics and the available evidence on their validity in measuring physiological and movement parameters. A systematic investigation was carried out by employing five electronic databases and search terms that incorporated field hockey, wearables, and performance analysis. Two independent reviewers conducted assessments of the 3401 titles and abstracts for inclusion, and at the end of the screening process, 102 full texts were analyzed. Lastly, a total of 23 research articles that specifically concentrated on field hockey were incorporated. The selected papers dealt with performance monitoring (6 papers), technical analysis and strategy game (6), injury prevention (1), and physiological measurements (10). To appraise the quality of the evaluations, the Oxford quality scoring system scale was employed. The extraction of information was carried out through the utilization of the participants, intervention, comparison, and outcomes (PICOS) format. The analysis encompassed research studies that implemented wearable devices during training and competitive events. Among elite field hockey competitions, GPS units were identified as the predominant wearable, followed by heart rate monitors. The intraclass correlation coefficient (ICC) related to wearable devices showed reasonably high between-trial ICCs ranging from 0.77 to 0.99. The utilization of wearable devices in field hockey primarily centers around the measurement of player activity profiles and physiological demands. The presence of discrepancies in sampling rates and performance bands makes it arduous to draw comparisons between studies. Nevertheless, this analysis attested to the fact that wearable devices are being employed for diverse applications in the realm of field hockey.

The Asymmetric Effects of Consumer Confidence on Credit Card Spending in Turkey

This paper analyzes the asymmetric effects of consumer confidence on personal credit card expenditures in Turkey. To this end, the impact of the consumer confidence index on real credit card spending is investigated from January 2013 to June 2023 using the threshold generalized method of moments (GMM). The linear GMM model findings indicate that consumer confidence increases real credit card expenditures. Furthermore, when the threshold GMM model is estimated using the annual percentage change of the consumer confidence index as a threshold variable, the coefficients differ across low- and high-confidence regimes. More specifically, the consumer confidence index has a statistically significant positive impact on credit card expenditure in the low-confidence regime but not in the high-confidence regime. This indicates that the optimistic expectations of economic units in a low-confidence environment may stimulate credit card spending.

A rising tide lifts all homes? Housing consumption trends for low-income households since the 1980s

This study analyzes patterns of housing consumption and expenditures among low-income households since 1985. For households in the bottom income quintile, real monthly housing expenditures have risen from $605 to $1,045. However, these increased expenditures partially reflect housing quantity improvements, including more square footage, more rooms, and larger lot sizes. The data also show a marked improvement in housing quality, such as fewer sagging roofs, broken appliances, rodents, and peeling paint. The housing quality for low-income households improved across all 35 indicators we can measure. These quality improvements equate to between a 34 to 43 percent increase in housing consumption and suggest that a typical low-income household in 2021 experiences housing quality equivalent to the average national household in 1985. Though relative housing consumption has remained similar, this “rising tide” of housing may have additional benefits for the well-being of families and children living in better housing.

Gambling in Victoria: Changes in Participation, Problem Gambling and Gambling Environment Between 2008 and 2018

Gambling and its impacts are an important public health issue. The relationship between gambling, problem gambling and gambling harm is complex and dynamic. Replicate prevalence studies are useful for surveillance and monitoring gambling impacts within jurisdictions. The purpose of this study was to compare changes in gambling and problem gambling in the Victorian adult population between 2008 and 2018 by investigating individual gambling activities and exploring their relationship with the Victorian gambling ecosystem. Gambling participation has decreased; problem gambling prevalence has not. Investigation beyond these summary measures reveals important details: (a) Electronic Gaming Machines (EGMs), casino table games, race and sports betting (‘high-risk activities’), informal private betting, and Keno, and their associations with problem gambling endure. Further, the strength of this association is unaffected by changes in product technology, delivery, or the Victorian environment in which they reside, (b) participation in high-risk activities, excluding EGMs, increased while for other activities they decreased, (c) EGMs continue to pose the greatest risk for Victorians, (d) males and young adults continue having a higher problem gambling prevalence rate and preferring both online gambling and high-risk activities (excluding racing favoured by an ageing, older cohort, and Keno, by all ages), and (e) gambling access and exposure proliferated enabling single site multiple gambling opportunities on high-risk activities. Young adults represented a new vulnerable group as they reach the legal gambling age. The most effective interventions (based on major falls in real expenditure (losses) on EGMs, the highest risk activity) were the smoking bans, removal of ATMs from venues and decreases in bet size. There is great potential for prevention, intervention, and minimising harm in the gambling environment.

Correction: Getting Real in the Real Consumption Expenditure: A Case of Rural India

Correction: Getting Real in the Real Consumption Expenditure: A Case of Rural India

Research on the Impact of American Consumer Behavior after COVID-19

The spread of COVID-19 has significantly influenced people’s lives and brought worldwide recession. In order to society to recover faster from the epidemic, the first step is to understand the impact of the epidemic on people and changes in people's consumption habits. This paper uses the Real Personal Consumption Expenditure provided by Fred to categorize consumption into service, durable goods, and non-durable goods and to analyze the change of consumption focus of citizens. After the epidemic, overall consumption dropped, and it took almost a year to recover to the previous stage. After COVID-19, consumers are less willing to spend on service and this is the part that the government needs to put most effort on. After analyzing consumers’ consumption behavior, the government can make suitable policies to encourage consumption activities.

Pengelolaan Pembiayaan Pendidikan pada Jenjang Pendidikan Dasar (Studi Deskriptif Penggunaan Dana BOS Sekolah)

Bantuan Oprasional Sekolah (BOS) are one of the school's financial sources for carrying out educational activities at school. Schools are obliged to plan the allocation of funds carefully and calculatingly, as well as monitor the use of funds for operational and capital costs, as well as provide administrative and physical (material) evidence of how funds are used. However, unfortunately there are still many schools that are still indifferent to managing school finances, especially BOS funds. For this reason, this research aims to determine the management of education financing, in this case BOS funds, as a guide for other institutions in managing BOS funding in accordance with established regulations. The method used in this research uses a qualitative descriptive method with data collection using observation, interview and documentation techniques. The results of this research are: a) planning a budget by identifying goals, determining priorities, describing goals into measurable operational performance, analyzing alternatives for achieving goals with cost-effectiveness analysis, making recommendations for alternative approaches to achieving targets. b) budget realization by making real expenditures according to needs and physical evidence. c) carry out budget supervision and control, supervision carried out by certain parties within the school whose official function is to carry out supervision such as the principal and treasurer of the BOS, as well as the education office and the BPK as external supervisors of BOS finances in the school.

Poverty Changes Among Regions of Uttar Pradesh: A Decomposition Exercise During the 2000s

This article examines the disparities in poverty among the regions of Uttar Pradesh during the 2000s through a poverty decomposition exercise. While the poverty reduction from 2004–2005 to 2011–2012 is faster in the northern and southern upper Ganga plain, the reduction is slower in the eastern and southern regions. The poverty headcount ratio increases for the central region. While eastern and southern regions have higher real Monthly Per Capita Expenditure (MPCE) growth than the state average, the lower poverty elasticity in these regions caused slower poverty reduction. The southern and northern upper Ganga plain have high poverty elasticity causing a faster poverty reduction. This study finds that Uttar Pradesh’s central region faces a critical problem with increased Head-Count Ratio and declining MPCE. The differential change in poverty among the regions has also been analysed using the occupational pattern and landholding distribution among regions, both rural and urban areas. JEL Codes: R32, R11, R12

The effect of inflation on the budget deficit in Turkiye: Evidence from cointegration test with multiple structural breaks

In determining the relationship between the budget deficit and inflation in literature, the effect of the budget deficit on inflation has been widely focused on. Although the impact of inflation on the budget deficit is highly significant, there has been a lack of sufficient research on this matter. There are two different views put forward on this issue. The first of these is the Tanzi effect; argues that an increase in inflation will cause a real decrease in tax revenues and therefore the budget deficit will increase. The opposing view is known as the Patinkin effect and suggests that the budget deficit will decrease because inflation will reduce real public expenditures. In this study, the effect of inflation on the budget deficit was investigated for the period 1960 2022 in Turkiye. Considering that the data period may contain many structural breaks, Carrion-i-Silvestre unit root test and Maki cointegration test were used. The years 1995, 2002, 2007, 2011 and 2018 were determined as the break dates. According to the results, the inflation rate has an increasing effect on the budget deficit in the period when there is no break. The overall result did not change when the effect of breaks was included. With these findings, it can be said that the Tanzi effect is more dominant in Turkiye.

SUBSISTENCE MINIMUM AND SOCIAL MINIMUM LEVELS BY AREA IN POLAND IN 2022

The article presents the results of estimates of the subsistence minimum (ME) as well as social minimum baskets (MS) in 2022. Both indicators are important for assessing the well-being of households.The subsistence minimum (ME) sets the model for meeting needs at the minimum level below which there is a biological threat to life. The social minimum (MS), in turn, represents the model cost of living for households that are beginning to be threatened by the sphere of deprivation. Between these two extremes, the sphere of deprivation spreads, in different facets.At the regional level, the value of the subsistence minimum in 2022 for a family with two children was highest in the Dolnośląskie Voivodeship (+5.3 p.p. in relation to the national average) and lowest in the Podkarpackie Voivodeship (-5.5 p.p.). With high inflation (14.4% for Poland), the values of the subsistence minimum in 2022 increased from 13.3 p.p. (Zachodniopomorskie Voivodeship) to 18.5 p.p. (Pomeranian Voivodeship). The spreads between the extreme values in the voivodeships oscillate similarly to the previous one (10.8 p.p.). For one-person households, however, the spreads were higher (16.2 p.p. at working age and 17.2 p.p. at retirement age).Across city categories of towns, there was little variation in ME values. In the largest agglomerations with more than 500,000 inhabitants, the ME value for a family with two children was 3.9 p.p. higher, and in cities with 50,000 to 100,000 people, ME values were only 1.3 p.p. lower.In the period under study, the lowest values of the social minimum were observed in the Lubelskie voivodeship (-3.8 p.p.) and the highest - in the Dolnośląskie voivodeship (+4.3 p.p.). The spread between regions with extreme values was 8 p.p. (compared to 7 p.p. in 2021 and 8.2 p.p. in 2020). The scale of the spread could be considered small, especially when the level of variation in real household expenditure (the results of the latest CSO survey concern 2021) was more than five times higher. In the cross-section of city classes, the differences in the value of the social minimum were not large. Its amount in the largest agglomerations was higher than the average by only 2.8 p.p. (in 2021, it was 3.4 p.p.). The lowest value of the social minimum occurred in cities with 50,000 to 100,000 inhabitants: it was lower than the average by only 1.6 p.p.

Relevance of Fiscal Illusion Proposition and Wagner Theory to Nigerian Budget Performance (Nexus among Fiscal Illusion Index, Recurrent and Capital Budget)

This paper presents an empirical analysis of the consequences of fiscal illusion for public spending outcomes in a developing country context, specifically Nigeria, over the period 1993- 2022. The presence of fiscal illusion and its main indicators are identified (measured here through deficit illusion, and degree of tax visibility, where the real burden of taxation is underrepresented to the citizen-voter). We find that the Nigerian economy reveals significant fiscal illusion as measured in above terms. Also, fiscal illusion is found to have major and positive impact on the demand for government capital expenditure and government recurrent expenditure and consequently, on real government expenditure in the economy over the chosen time period. This work demonstrated that the controversial question involving the role of fiscal illusion practices on public finances is not recent, but can be thought of as deriving from the discussion invoked by Puviani (1903) and substantially enriched by Buchanan (1960). In spite of the fact that the ‘Fiscal Illusion’ School of Buchanan and Wagner (1977) identifies higher levels of fiscal illusion promoting increasing increments in the size of the public sector, this work developed a model that predicts higher levels of fiscal illusion also decrease national economic growth rates. The government additionally creates the false illusion that public expenditures are lower than they are in reality and for this reason it is easier to maintain the illusive fiscal discipline. On the one hand, the government may cut expenditures in an ostensible way and step towards reducing the budget deficit. On the other hand, without additional procedures the government may introduce new public expenditures outside the budget and, consequently, without any special control of the law-making arm of government.

DIRECTIONS OF CHANGES IN THE EXPENDITURE OF POLAND’S AGRICULTURAL BUDGET DURING THE PERIOD OF GOVERNMENTS OF SUBSEQUENT COALITIONS IN 2010-2023

The purpose of the article was to indicate the directions of changes that occurred in the expenditures of the Polish agricultural budget in 2010-2023 in quantitative terms. The period adopted for analysis is interesting in that it covers successive coalition governments in Poland. The subject of the study was budget expenditures on agriculture in Poland, broken down into expenditures from the national budget (excluding the Agricultural Social Insurance Fund – ASIF, and with it) and the Budget of European Measures (BEE), taking into account Poland’s total budget expenditures, as well as GDP. The source of empirical materials was data from the Ministry of Agriculture and Rural Development. An analysis of the structure and dynamics of nominal volumes, as well as those adjusted for inflation (CPI, constant prices of 2023), was applied. The research shows that during the period under analysis, there was a relatively persistent trend of real decrease in the level of total agricultural budget expenditures. The reduction in these expenditures concerned both the volume of domestic and EU funds. The relationship of the agricultural budget to the total budget and GDP also deteriorated significantly. This proves the declining importance of agriculture in the hierarchy of state budget expenditures in the long term and that the agricultural sector in Poland does not benefit proportionally from the effects of GDP growth. These unfavorable trends for agriculture have been somewhat halted in the last two years. If it were not for the financial support from the WBE (which, unfortunately, is also declining), sectoral disparities in the distribution of funds from national income would have grown even more pronounced. The rank of real expenditures on ASIF in the state budget expenditures is also successively decreasing.

Getting Real in the Real Consumption Expenditure: A Case of Rural India

Getting Real in the Real Consumption Expenditure: A Case of Rural India

Effecs of Bolsa Família on rural welfare: a computable equilibrium analysis

This paper analyzes the effects of the Bolsa Família Program on the economic well-being of rural families in the Brazilian macrorregions, contributing to the debate on income transfer programs. The objectives of the study are to analyze the impact of the Bolsa Program on the economic well-being of families living in rural areas in each Brazilian macrorregion and on the impact of government transfers on the prices of primary factors. The results indicate that, although the program is initially efficient in promoting the fight against inequality, gains in terms of economic well-being are minimal, as well as reducing the price of the labor factor, suggesting that in the long run, besides the effects of the Bolsa Família Program becoming more lenient, and there is a need for transfers from the Bolsa Família Program to be linked to labor market policies in rural areas. The effects of a real public expenditure on the Bolsa Família Program in rural families in the brazilian regions, considering the rural families, are low but positive and higher than the unit, which confirms the guiding hypothesis of the research.

The impact of warming on food consumption

ABSTRACT We provide new evidence on the effects of temperature on farm income, non-farm income, and real food expenditure. We first apply a Heckman model to a large household dataset (10,200 observations) from Ghana in order to fit farm and non-farm income and then subsequently estimate a 3-stage least squares model. Consistent with our expectations, we find that income determines real food consumption. The elasticity of consumption of farm income (0.44) and non-farm income (0.33) are both positive and less than one. The difference in elasticities is statistically insignificant. We find an inverse relationship between the two types of income. Compared to non-farm income, we find that temperature has a larger negative effect on farm income. Warming also impacts negatively on real food consumption. For a typical adult, a 1°C increase in temperature results in a 4% decline in real food consumption. The decline in food consumption can be attributed to the negative effect of temperature on land and labour productivity. In the absence of microlevel adaptation, our results show that general welfare levels in Ghana will likely decline with warming.

What determines private and household savings in India?

Using data from 1960 to 2016, this paper examines the determinants of private and household saving behavior in India. The results indicate that per capita real income and access to banks are significant determinants with favorable impacts on private as well as household saving rates in short as well as long run. Further, as inflation accelerates, the uncertainty about the future value of their accumulated savings and expected real rate of return discourage households and other private agents from saving. A desire to maintain a certain level of real expenditures also contributes to this decrease in saving rate. An increase in dependent population reduces private and household saving rates in the short run while it increases the private saving rate in the long run. The results further indicate that a rise in the real interest rate increases household saving rate in the short run but reduces both private and household saving in the long run. It does not seem to have any significant impact on total private saving in the short run. Additionally, increased corporate saving tends to reduce household saving in both time horizons. Further, both private and household saving rates have declined significantly after the global financial crisis. Finally, any deviation from the long run equilibrium for saving rates dissipates rather quickly. Overall, these results seem to suggest that policies intended to increase per capita income, lower inflation, and increase accessibility to banking will go a long way in increasing private and household saving in India.