Statistical Information System Research Articles

Association of Primary Care Physicians’ Individual- and Community-Level Characteristics With Contraceptive Service Provision to Medicaid Beneficiaries

Little is known about primary care physicians who provide contraceptive services to Medicaid beneficiaries. Evaluating this workforce may help explain barriers to accessing these services since contraceptive care access is critical for Medicaid beneficiaries' health. To describe the primary care physician workforce that provides contraceptive services to Medicaid beneficiaries and explore the factors associated with their Medicaid contraceptive service provision. This cross-sectional study, conducted from August 1 to October 10, 2022, used data from the Transformed Medicaid Statistical Information System from 2016 for primary care physicians from 4 specialties (family medicine, internal medicine, obstetrics and gynecology [OBGYN], and pediatrics). The main outcomes were providing intrauterine devices (IUDs) or contraceptive implants to at least 1 Medicaid beneficiary, prescribing hormonal birth control methods (including a pill, patch, or ring) to at least 1 Medicaid beneficiary, the total number of Medicaid beneficiaries provided IUDs or implants, and the total number Medicaid beneficiaries prescribed hormonal birth control methods in 2016. Physician- and community-level factors associated with contraceptive care provision were assessed using multivariate regression methods. In the sample of 251 017 physicians (54% male; mean [SD] age, 49.17 [12.58] years), 28% were international medical graduates (IMGs) and 70% practiced in a state that had expanded Medicaid in 2016. Of the total physicians, 48% prescribed hormonal birth control methods while 10% provided IUDs or implants. For OBGYN physicians, compared with physicians younger than 35 years, being aged 35 to 44 years (odds ratio [OR], 3.51; 95% CI, 2.93-4.21), 45 to 54 years (OR, 3.01; 95% CI, 2.43-3.72), or 55 to 64 years (OR, 2.27; 95% CI, 1.82-2.83) was associated with higher odds of providing IUDs and implants. However, among family medicine physicians, age groups associated with lower odds of providing IUDs or implants were 45 to 54 years (OR, 0.66; 95% CI, 0.55-0.80), 55 to 64 years (OR, 0.51; 95% CI, 0.39-0.65), and 65 years or older (OR, 0.29; 95% CI, 0.19-0.44). Except for those specializing in OBGYN, being an IMG was associated with lower odds of providing hormonal contraceptive service (family medicine IMGs: OR, 0.80 [95% CI, 0.73-0.88]; internal medicine IMGs: OR, 0.85 [95% CI, 0.77-0.93]; and pediatric IMGs: OR, 0.85 [95% CI, 0.78-0.93]). Practicing in a state that expanded Medicaid by 2016 was associated with higher odds of prescribing hormonal contraception for family medicine (OR 1.50; 95% CI, 1.06-2.12) and internal medicine (OR, 1.71; 95% CI, 1.18-2.48) physicians but not for physicians from other specialties. In this cross-sectional study of primary care physicians, physician- and community-level factors, such as specialty, age, and the Medicaid expansion status of their state, were significantly associated with how they provided contraceptive services to Medicaid beneficiaries. However, the existence of associations varied across clinical specialties. Ensuring access to contraception among Medicaid beneficiaries may therefore require policy and program approaches tailored for different physician types.

Environment statistics and material flow accounts development in Lao PDR: A case study on multiple data sources integration for a new statistical domain in a lower middle-income country national statistical system

The Lao Statistics Bureau has launched the development of Statistical Information System on the Environment. With its integrated systems approach, incorporating multiple data sources within a unified analytical framework enabling an understanding of tradeoffs and synergies to monitor sustainable development and formulate integrated, evidence-based policies, the System of Environmental-Economic Accounting (SEEA) plays a central role in Lao PDR strategy for the development of environment statistics, as well as for the mainstreaming of their use in policy processes. However routinely producing environmental-economic accounts at the national level by the national statistical office requires addressing the technical and institutional barriers to the integration of these different data sources. In the context of the national statistical systems of a lower middle income country, the case of the development of Material Flow Accounts by the Lao Statistics Bureau with support from the Lao Luxembourg Cooperation Project in Statistics is illustrative of the challenges faced to integrate data from multiple sources into one single database (the number and diversity of stakeholders and domains and the consequent dispersion of data, the difficulty of access, the often poor quality of the data (linked notably to the relative novelty of the statistics involved) etc.) and provides feedback on the solutions applied to overcome the challenges.

Особенности и эколого-экономическая целесообразность внешней торговли отходами в Российской Федерации

Despite the low proportion of recycled waste against the total one generated in the Russian Federation, it is imported into the country specifically for recycling. At the same time some of the generated waste is exported. The purpose of this study is to assess the current waste export and import indicators in Russia and any dialectical and institutional constraints on increasing the rate of waste recycling, which determine the ecological and economic rationale of international waste trade operations. The main sources of data featured reports of the Federal Customs Service and the Federal Service for Supervision of Natural Resources, and the Unified Interdepartmental Statistical Information System and UN Comtrade databases. Econometric methods, cluster analysis of Russian regions, analysis of any regulatory impact and content analysis of laws and regulations were applied and carried out within the study. It is demonstrated that the external waste-related economic operations in the Russian Federation have certain peculiarities against other countries. Their being in place is driven by both dialectical and institutional factors. However, the actors’ opportunistic economic interests rather than the environmental ones and the extent of the country take the lead. Some tools to reduce the transaction costs of transboundary waste movement and to increase the waste management efficiency are proposed. The study is novel in that it analyzes the foreign waste trade transactions of Russia that have not been comprehensively studied before. The theoretical relevance of the research consists in its finding new factors that drive the transboundary waste movement. Recommendations on improving the export and import regulation, reducing the rate of waste generation and increasing the recycling one in Russia, which would both enhance the economic efficiency of companies and provide equitable solution to environmental problems faced by the country, are of practical value.

Racialized economic segregation and potentially preventable hospitalizations among Medicaid/CHIP-enrolled children.

To examine geographic variation in preventable hospitalizations among Medicaid/CHIP-enrolled children and to test the association between preventable hospitalizations and a novel measure of racialized economic segregation, which captures residential segregation within ZIP codes based on race and income simultaneously. We supplement claims and enrollment data from the Transformed Medicaid Statistical Information System (T-MSIS) representing over 12 million Medicaid/CHIP enrollees in 24 states with data from the Public Health Disparities Geocoding Project measuring racialized economic segregation. We measure preventable hospitalizations by ZIP code among children. We use logistic regression to estimate the association between ZIP code-level measures of racialized economic segregation and preventable hospitalizations, controlling for sex, age, rurality, eligibility group, managed care plan type, and state. We include children ages 0-17 continuously enrolled in Medicaid/CHIP throughout 2018. We use validated algorithms to identify preventable hospitalizations, which account for characteristics of the pediatric population and exclude children with certain underlying conditions. Preventable hospitalizations vary substantially across ZIP codes, and a quarter of ZIP codes have rates exceeding 150 hospitalizations per 100,000 Medicaid-enrolled children per year. Preventable hospitalization rates vary significantly by level of racialized economic segregation: children living in the ZIP codes that have the highest concentration of low-income, non-Hispanic Black residents have adjusted rates of 181 per 100,000 children, compared to 110 per 100,000 for children in ZIP codes that have the highest concentration of high-income, non-Hispanic white residents (p < 0.01). This pattern is driven by asthma-related preventable hospitalizations. Medicaid-enrolled children's risk of preventable hospitalizations depends on where they live, and children in economically and racially segregated neighborhoods-specifically those with higher concentrations of low-income, non-Hispanic Black residents-are at particularly high risk. It will be important to identify and implement Medicaid/CHIP and other policies that increase access to high-quality preventive care and that address structural drivers of children's health inequities.

Prospects for the Formation of the Information Space of the Regional Level in the Digital Economy

The directions of development of socio-economic information systems used for regional management are considered. Systems that need to be upgraded in accordance with modern capabilities and requirements of the digital economy. As a result of the consistent implementation of many private software solutions to achieve individual tasks, the so-called “patchwork” (“niche”) automation has been formed, aimed at creating socio-economic information, which should fundamentally be systematic and consistent. Currently, the sources of statistical data differ in structure, format, composition of indicators and periodicity of the generated data, their state is characterized by the fragmentation of the software systems used, data storage forms and the data itself. Collecting and processing this data requires a lot of money, but the result does not meet the increased requirements of users. The existing initiatives to create a single space of socio-economic information in the regional context are described: the Volgograd Regional Statistical Information and Analytical System (RSIAS), the interdepartmental Information and Analytical System (EMISS), the central analytical platform (CAP), the national data management system (NMS), the federal cloud platform of the state market “Gostech”. The article assesses the efforts being made to integrate information about the regions into a single information space. The proposed ways of integrating economic information into a single information space are considered. A conceptual approach to such integration based on ontologies of the subject area of socio-economic relations is proposed.

Telepsychiatry Use Before and During the COVID-19 Pandemic Among Children Enrolled in Medicaid.

This study examined telepsychiatry use among children enrolled in Medicaid before and during the COVID-19 pandemic. A retrospective analysis was conducted of claims data from the Transformed Medicaid Statistical Information System for children (ages 3-17) with any mental health service use in 2019 (N=5,606,555) and 2020 (N=5,094,446). The number of children using mental health services declined by 9.1% from 2019 to 2020. Mental health services in all care settings (inpatient, outpatient, residential, emergency department, intensive outpatient/partial hospitalization) declined except for telehealth, which increased by 829.6%. In 2020, 44.5% of children using telehealth were non-Hispanic White, 16.1% were non-Hispanic Black, and 19.7% were Hispanic. Attention-deficit hyperactivity disorder, trauma, anxiety, depression, and behavior/conduct disorder were the most prevalent psychiatric diagnoses among children using telehealth services. Although telehealth use increased substantially in 2020, overall mental health service use declined among Medicaid-enrolled children. Telehealth may not fully address unmet mental health service needs.

Conceptual plants for obliko-informational security of management of the economic potential of agricultural enterprises

The article examines the main conceptual principles of accounting and information management of the economic potential of agricultural enterprises. The main approaches to understanding the concept of enterprise potential, considering its elements, are systematized. Three main approaches are highlighted: resource, effective and strategic (target). The main elements of accounting and information support for managing the potential of agricultural enterprises are highlighted: external marketing information, regulatory and legal support, statistical information system, accounting and reporting system, operational accounting, and reporting system. The depth and completeness of the accounting of all factors affecting the management of the economic potential of agricultural enterprises is largely determined by the state of its accounting and information support. The construction of a system of accounting and information support for the management of the economic potential of enterprises involves the formation of an information base. Based on the tasks of analyzing the potential, recommended analytical indicators for its assessment, a structure of accounting and information support for managing the economic potential of agricultural enterprises is proposed. A step-by-step analysis and assessment of the economic potential, formed taking into account accounting and information support, is proposed for the implementation of the goals and tasks of managing the economic potential of agrarian enterprises. It has been established that the formation of specialized reporting forms in agricultural enterprises allows interested users to obtain more extensive and versatile information about economic business processes, the efficiency of production and sale of agricultural products by individual types, the use of labor resources and their contribution to the final financial results. Particular attention in these reports is paid to the issues of state support and subsidization of agricultural production, tax aspects of activity, state and movement of biological assets, display of information about the costs incurred by an agro-industrial enterprise. Keywords: potential, economic potential, potential management, accounting and information support, agricultural enterprises.

Medicaid can and should play an active role in advancing health equity.

Medicaid can and should play an active role in advancing health equity.

Estimating the Prevalence of Substance Use Disorders in the US Using the Benchmark Multiplier Method

Prevalence estimates of substance use disorders in the US rely on general population surveys. However, major population groups, such as homeless individuals and institutionalized individuals, are not captured by these surveys, and participants may underreport substance use. To estimate the prevalence of substance use disorders in the US. The benchmark multiplier method was used to estimate the prevalence of alcohol, cannabis, opioid, and stimulant use disorders based on data from the Transformed Medicaid Statistical Information System (T-MSIS) (the benchmark) and the National Survey on Drug Use and Health (NSDUH) (the multiplier) for 2018 and 2019. T-MSIS collects administrative data on Medicaid beneficiaries 12 years and older with full or comprehensive benefits. NSDUH is a nationally representative annual cross-sectional survey of people 12 years and older. Data were analyzed from February to June 2022. Prevalence of substance use disorders was estimated using the benchmark multiplier method based on T-MSIS and NSDUH data. Confidence intervals for the multiplier method estimates were computed using Monte Carlo simulations. Sensitivity of prevalence estimates to variations in multiplier values was assessed. This study included Medicaid beneficiaries 12 years and older accessing treatment services in the past year with diagnoses of alcohol (n = 1 017 308 in 2018; n = 1 041 357 in 2019), cannabis (n = 643 737; n = 644 780), opioid (n = 1 406 455; n = 1 575 219), and stimulant (n = 610 858; n = 657 305) use disorders and NSDUH participants with 12-month DSM-IV alcohol (n = 3390 in 2018; n = 3363 in 2019), cannabis (n = 1426; n = 1604), opioid (n = 448; n = 369), and stimulant (n = 545; n = 559) use disorders. The benchmark multiplier prevalence estimates were higher than NSDUH estimates for every type of substance use disorder in both years and in the combined 2018 to 2019 sample: 20.27% (95% CI, 17.04-24.71) vs 5.34% (95% CI, 5.10-5.58), respectively, for alcohol; 7.57% (95% CI, 5.96-9.93) vs 1.68% (95% CI, 1.59-1.79) for cannabis; 3.46% (95% CI, 2.97-4.12) vs 0.68% (0.60-0.78) for opioid; and 1.91% (95% CI, 1.63-2.30) vs 0.85% (95% CI, 0.75-0.96) for stimulant use disorders. In sensitivity analyses, the differences between the benchmark multiplier method and NSDUH estimates persisted over a wide range of potential multiplier values. The findings in this study reflect a higher national prevalence of substance use disorders than that represented by NSDUH estimates, suggesting a greater burden of these conditions in the US.

Retraction Note: Designing statistical assessment healthcare information system for diabetics analysis using big data

Retraction Note: Designing statistical assessment healthcare information system for diabetics analysis using big data

Monitoring the Level of Digital Transformation in Education: Indexes and Technologies

Purpose of the study. Digital transformation is the foundation of global and national economic growth. Currently, a strategic direction has been adopted in the field of digital transformation of education until 2030, which belongs to the field of activity of the Ministry of Education of the Russian Federation. In the process of implementing educational programs, the introduction of digital technologies for learning is of paramount importance, so the problem of assessing the degree of their integration in education is relevant. As part of the study, the existing approaches to monitoring the use of modern technologies in schools, lyceums and gymnasiums were analyzed. The purpose of this work is to develop criteria indexes and groupings of educational organizations for use in the methodology for assessing the level of digital transformation of education, improving the information base and increasing the accuracy of the results of a comparative analysis. To create a model for the process of assessing the level of digital transformation of education, it is necessary to identify the key stages in the monitoring system.Materials and methods. The study of approaches to monitoring digital transformation in the field of education was performed as a result of a review of the methods used to assess the degree of implementation of digital technologies in education. The methods of statistical, systemic and comparative analysis were used in the paper. The basis of the study is indexes of the development of specific technologies defined in regulations, official statistical reporting, and materials of the Unified Interdepartmental Statistical Information System. The methodology for assessing the level of digital transformation of education in the region is applicable in the framework of achieving the indexes of the national project “Education”. Modeling the process of monitoring the state of digitalization of education was performed considering the use of a methodology that includes indexes of the introduction of digital technologies and the grouping of educational institutions.Results.The main issues of monitoring the digital transformation of school education are viewed, considering the assessment of the degree of integration of end-to-end digital technologies. The main results of the study are improving the information base, supplementing the methodology for assessing the digital transformation of school education and building a model for the process of assessing the level of digital transformation of education in the region. Within the framework of the monitoring of the education system, criteria indexes for the introduction of end-to-end digital technologies are proposed. The developed model characterizes the stages of monitoring from data collection to decision-making, and shows the interrelation between the system functions. The modeling was performed to develop a system that determines the level of implementation of digital solutions in the field of education in the regional context.Conclusion.The digitalization of school education involves the integration of new technologies in education, primarily to achieve higher educational results for students. It is important to assess the current state of the digital transformation of educational organizations at different levels in the framework of the application of modern technologies in the educational process. The proposed indexes for the introduction of end-to-end digital technologies and the groupings of educational institutions can be used by data analysts, as well as in research and practical activities of executive authorities when monitoring the education sector.

Long-term trends in differentiation between regions: Sverdlovsk oblast vs Chelyabinsk oblast

Threats of increased differentiation across regions, which have caused inefficient spatial development, are progressively coming into the scientists’ focus. By and large, a peripheral region is unlikely to take the place of the center. In the Urals1 , the Sverdlovsk oblast has long been the center and stayed ahead of its neighbours in terms of socioeconomic performance. Our previous research revealed a phenomenon called ‘synchronisation of economies’. Accordingly, the Chelyabinsk oblast in many instances repeats the trends of the Sverdlovsk oblast, but remains at the periphery. In this regard, studying the differentiation between the two economies becomes a relevant issue. The research aims to construct long-term trends of differentiation between regions using the case of the Sverdlovsk and Chelyabinsk oblasts. The theories of spatial development, including the theory of cumulative growth, constitute the methodological basis of the research. Applying the methods of statistical comparison and times series analysis, the study interprets the data published by Russia’s Federal State Statistics Service (Rosstat), the Unified Interdepartmental Statistical Information System (UISIS), and generated by FIRA PRO information analytics system (OOO “First Independent Rating Agency”). The author proposes a method for assessing differentiation across regions based on 12 indicators. The findings demonstrate that for 2001–2020, the variation between the regions in terms of GRP per capita (in 2001 prices) has increased, whereas in terms of wages in prices of the same year it decreased. In relation to the outsider region, the Sverdlovsk oblast has kept its position in terms of the real GRP per capita compared to the Chelyabinsk oblast, which is approaching the outsider. At the same time, for 2001–2020, both regions have become closer to the leader. With regard to the real wages, the positions of the regions have nearly equalized, the ‘superiority’ over the outsider has decreased.

Racial‒Ethnic Disparities of Buprenorphine and Vivitrol Receipt in Medicaid

Expanding access to medications for opioid use disorder is a cornerstone to addressing the opioid overdose epidemic. However, recent research suggests that the distribution of medications for opioid use disorder has been inequitable. This study analyzes the racial‒ethnic disparities in the receipt of medications for opioid use disorder among Medicaid patients diagnosed with opioid use disorder. Medicaid claims data from the Transformed Medicaid Statistical Information System for the years 2017-2019 were used for the analysis. Logistic regression models estimated the odds of receiving buprenorphine and Vivitrol within 180 days after initial opioid use disorder diagnosis on the basis of race‒ethnicity. Analysis was conducted in 2022. Non-Hispanic Black people, non-Hispanic American Indian or Alaskan Native/Asian/Hawaiian/Pacific Islander people, and Hispanic people had 42%, 12%, and 22% lower odds of buprenorphine receipt and 47%, 12%, and 20% lower odds of Vivitrol receipt, respectively, than non-Hispanic White people, controlling for clinical and demographic patient variables. This study suggests that there are racial‒ethnic disparities in the receipt of buprenorphine and Vivitrol among Medicaid patients diagnosed with opioid use disorder after adjusting for demographic, geographic, and clinical characteristics. The potential strategies to address these disparities include expanding the workforce of providers who can prescribe medications for opioid use disorder in low-income communities and communities of color and allocating resources to address the stigma in medications for opioid use disorder treatment.

M-SIS to T-MSIS Migration-Challenges and Solutions

An advancement in Medicaid data management in the US is needed for migration from the Medical Statistical Information System (M-SIS) to the Transformed Medical Statistical Information System (T-MSIS). The focus of this study is to check the prime principles of this transition, which includes source data handling, combined working with external vendors, and mapping that is source to target. The adoption of T-MSIS’s goal is to restrict the limitations of M-SIS by giving perfect, up-to-date and reliable information. The process is filled with the issues that are related to techniques, operations, amd aorganization. By taking an example that the data should be protected and secured. To solve such issues in the information exchange process, it is very important to be punctual in putting the efforts and investments for the betterment of technology and its infrastructure. Many advantages will be achieved from this transmission like the policies will be improved and the delivery of healthcare will be efficemt. The success of this transmission will lead to better transparency, accountability, and efficiency of the program.

National and regional description of healthcare measures among adult Medicaid beneficiaries with schizophrenia within the United States

Aims Provide the first national description across the US of variations in healthcare measures in 2018 among Medicaid beneficiaries with schizophrenia. Materials and methods Adult beneficiaries with ≥2 diagnoses for schizophrenia, and continuous enrollment with consistent geographical data in all of 2018 were identified from Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) data for 45 of 50 states. Antipsychotic (AP) utilization rates, including long-acting injectable APs (LAIs), quality metrics, and all-cause healthcare resource utilization and costs for claims submitted to Medicaid were reported nationally and by state. Pearson correlation evaluated associations between LAI utilization and total healthcare costs at state and county levels. Results Across the US 688,437 patients with schizophrenia were identified. The AP utilization rate was 51% (state range: 24–77%), while the LAI utilization rate was 13% (range: 4–26%). The proportion of patients adherent to any AP was 56% (range: 19–73%). Within 30 days post-discharge from an inpatient admission, 22% (range: 8–58%) of patients had an outpatient visit, and 12% (range: 4–48%) had a readmission. The proportion of patients with ≥1 inpatient admission and ≥1 emergency room visit was 34% (range: 19–82%) and 45% (range: 20–70%). Per-patient-per-year total healthcare costs averaged $32,920 (range: $717–$93,972). At the county level, a weak negative correlation was observed between LAI utilization and total healthcare costs. Limitations This study included Medicaid beneficiaries enrolled with pharmacy and medical benefits, including beneficiaries dually eligible for Medicare; results cannot be generalized to the overall schizophrenia population or those with other payer coverage. Conclusions In 2018, half of beneficiaries with schizophrenia did not submit any claims for APs to Medicaid, nearly half had an emergency room visit, and one-third had an inpatient admission. Moreover, healthcare measures varied considerably across states. These findings may indicate unmet treatment needs for Medicaid beneficiaries with schizophrenia.

Economic Efficiency of the Korean Container Terminals: A Stochastic Cost Frontier Approach

Purpose - Recent issues such as vessel enlargement, strengthening of environmental regulations, and port smartization are expected to increase costs and intensify competition in the port industry. In the new normal era, when external growth has reached its limit, the efficient operation of ports is becoming indispensable for achieving sustainable growth. This study aims to identify the determinants of inefficiency by examining the cost structure and efficiency of container terminals in Korea and furthermore propose the political implications to derive the maximization of efficiency.&#x0D; Design/methodology - This study estimates the cost function of container terminal operators and identifies the efficiency of container terminals using stochastic cost frontier (SCF) in the first stage. In the second step, the SCF results are compared with the data envelopment analysis (DEA). Last, this paper proposes efficiency determinants on container terminal operation to establish appropriate strategies. Out of the 29 container terminal operators in South Korea, 13 operators participated in the survey. The translog cost function was estimated utilizing a total of 116 observations collected over the 2007-2017 period.&#x0D; Findings - Empirical analysis shows that economies of scale exist in Korea’s container ports, which provides a rationale for the government’s policy to establish the global terminal operator by integrating small terminal operators to enhance competitiveness. In addition, as a result of the determinants analysis, container throughput, weight of direct employment costs, and labour cost share have positive effects on improving cost efficiency, while inefficiency increases as the length of quay increases. More specifically, cost efficiency improves as the proportion of direct employment costs to outsourcing service costs increases.&#x0D; Originality/value - This study contributes to analyzing the inefficiency factors of container terminals through efficiency analysis with respect to a cost function. In addition, this study proposes the practical and political implications, such as establishing a long-term manpower pool, the application of the hybrid liner terminal system, and the construction of a statistical data system, to improve the cost inefficiency of terminal operators.

Influence of Climate Change and Land-Use Alteration on Water Resources in Multan, Pakistan

This study presents an evaluation of climate and land-use changes induced impacts on water resources of Multan City, Pakistan. Statistical Down Scaling Model (SDSM) and Geographical Information System (GIS) are used for climate change scenario and spatial analyses. Hydrologic Engineering Center’s Hydraulic Modeling System (HEC-HMS) model is used for rainfall-runoff simulation. The investigated results show significant changes in climatological parameters, i.e., an increase in temperature and decrease in precipitation over the last 40 years, and a significant urban expansion is also observed from 2000 to 2020. The increase in temperature and urbanization has reduced the infiltration rate into the soil and increased the runoff flows. The HEC-HMS results indicate that surface runoff gradually increased over the last two decades. Consequently, the depth of the water table in the shallow aquifer has declined by about 0.3 m/year. Projected climate indices stipulate that groundwater depletion will occur in the future. Arsenic levels have exceeded the permissible limit owing to unplanned urban expansion and open dumping of industrial effluents. The results can help an efficient water resources management in Multan.

ANALYSIS OF THE INFLUENCE OF REGULATION AND MANAGEMENT INFORMATION SYSTEM ON ASSET MANAGEMENT (EMPIRICAL STUDY ON UPT RADIO SPECTRUM MONITORING, DIRECTORATE-GENERAL OF POSTS AND INFORMATICS RESOURCES)

This research aimed to determine the effect of Regulation and Information Systems on Asset Management. This research applied multiple regression analysis method where sampling technique used systematic sampling with purposive sampling. Based on the results of statistical tests, regulations and information systems have an influence on asset management at the UPT Radio Frequency Spectrum Monitoring, Directorate-General of Posts and Informatics Resources. The regulation partially has an influence on asset management at the UPT Radio Frequency Spectrum Monitoring, Directorate-General of Posts and Informatics Resources. The information system partially has an influence on asset management at the UPT Radio Frequency Spectrum Monitoring, Directorate-General of Posts and Informatics Resources.&#x0D; Keywords: Regulation, Information Systems, Asset Management.&#x0D;

The national economic burden of rare disease in the United States in 2019

BackgroundTo provide a comprehensive assessment of the total economic burden of rare diseases (RD) in the United States (U.S.) in 2019. We followed a prevalence-based approach that combined the prevalence of 379 RDs with the per-person direct medical and indirect costs, to derive the national economic burden by patient age and type of RD. To estimate the prevalence and the direct medical cost of RD, we used claims data from three sources: Medicare 5% Standard Analytical File, Transformed Medicaid Statistical Information System, and Optum claims data for the privately insured. To estimate indirect and non-medical cost components, we worked with the rare disease community to design and implement a primary survey.ResultsThere were an estimated 15.5 million U.S. children (N = 1,322,886) and adults (N = 14,222,299) with any of the 379 RDs in 2019 with a total economic burden of $997 billion, including a direct medical cost of $449 billion (45%), $437 billion (44%) in indirect costs, $73 billion in non-medical costs (7%), and $38 billion (4%) in healthcare costs not covered by insurance. The top drivers for excess medical costs associated with RD are hospital inpatient care and prescription medication; the top indirect cost categories are labor market productivity losses due to absenteeism, presenteeism, and early retirement.ConclusionsOur findings highlight the scale of the RD economic burden and call for immediate attention from the scientific communities, policy leaders, and other key stakeholders such as health care providers and employers, to think innovatively and collectively, to identify new ways to help improve the care, management, and treatment of these often-devastating diseases.

Geochemical stream sediment signatures from Precambrian terrains of Uruguay

Geochemical data of Uruguayan crystalline terrains collected in the 80’s were recovered by the National Mining and Geology Directorate of Uruguay (DINAMIGE) in 2020 involving 32,000 soil and stream sediment samples analyzed for 22 elements (Ag, As, B, Ba, Be, Cd, Co, Cr, Cu, Fe, Mn, Mo, Nb, Ni, P, Pb, Sb, Sn, V, W, Y and Zn) by direct current plasma spectrometry. A set of 6755 samples of these data, more or less 21% of the total, were processed by multivariate statistical methods and geographic information system (GIS) procedures aiming characterization of geochemical signatures derived from environmental and geological processes. Samples were classified as background or anomalies/outliers at the beginning. The general data and the different sets were processed by statistical methods and GIS individually. The results considered the original units or sometimes, the transformed data for uniformity of variability. Nine geochemical signatures related to the geological domains were defined; three of them involved low contrast units with moderate enrichment in Ba, Co, Cu or Mn. The remaining six geochemical signatures were related to specific geological units and presented multivariate signatures. Seven signatures related to anomalies were defined, three of them of lithological origin, two superficial and the others mixed, including the possibility of sulphide deposits.