Time-invariant Characteristics Research Articles

The impact of variable renewables on the distribution of hourly electricity prices and their variability: A panel approach

This paper investigates the impact of intermittent renewable generation on the distribution of electricity prices and their variability in Denmark and Germany. We exploit hourly data from 2015 to 2020 and employ a novel panel quantile approach - the Quantiles via moments (MMQR) method. Previous research has mainly used aggregated-daily data and have applied a time-series setting. We argue that since the electricity price formation and renewable energy generation can show great variations during a day, a panel setting with 24 individuals-hours could offer higher accuracy. Therefore, we apply a panel approach that accounts for both the time and cross-sectional dimension of electricity prices. The panel allows us to control for time-invariant (hourly-specific) characteristics and can reveal hidden market dynamics that exist during a day. The combination of hourly-specific effects and the quantile approach enable us to estimate the renewable sources effect on various price quantiles while controlling for market dynamics. In this way, we investigate extreme market cases accounting for the range and distribution of the electricity prices data. The results suggest that the merit-order effect occurs in both countries, with wind and solar generation having diverse effects on the electricity price distribution. Thus, policy makers should consider this diversifying effect to develop efficient renewable support schemes. We also explore non-linearities by including different demand levels in our model and investigate price variability. The outcomes indicate that wind generation increases (decreases) the occurrence of price fluctuations for low demand (high demand) in both countries. Meanwhile, in Germany, solar power stabilizes price fluctuations for high demand levels, stronger than wind. Market risk information could be useful for organizations in recognizing beneficial investment opportunities or hedging strategies. We finally aggregate the hourly observations into daily and compare the estimation outcomes. The results prompt us to believe that aggregated time-series tend to underestimate the RES impact on prices. In addition, we estimate the same models using hourly data in a time-series approach in order to verify that the diverse effect between aggregated time-series and hourly panel data is driven by the time-invariant characteristics, and not the data resolution. We find that the hourly time-series underestimate the merit-order effect, like in the aggregated time-series case, which supports our claims that the results are steered by the cross-sectional dimension. Thus, a panel approach could provide higher accuracy estimates of the RES influence on electricity prices. In conclusion, hourly-related features seem to affect the merit-order effect and its robustness, and a panel approach should be considered when investigating electricity markets.

Primary care physicians' participation in the Medicare shared savings program and preventive services delivery: Evidence from the first 7 years.

To evaluate whether primary care physicians' participation in the Medicare Shared Savings Program (MSSP) is associated with changes in their preventive services delivery. Medicare Provider Utilization and Payment Physician and Other Supplier Public Use File and MSSP Accountable Care Organizations (ACO) Provider-Level Research Identifiable File from 2012 to 2018. The design was a two-way fixed effects model estimating within-provider changes in preventive services delivery over time controlling for provider time-invariant characteristics, national time trends, and characteristics of served patients. The following preventive services were evaluated: influenza vaccination, pneumococcal vaccination, clinical depression screening, colorectal cancer screening, breast cancer screening, Body Mass Index (BMI) screening and follow-up, tobacco use assessment, and annual wellness visits. Both the likelihood of providing services and the volume of services delivered were evaluated. Secondary data linked at the provider level. MSSP participation was associated with an increase in the likelihood of providing influenza vaccination (0.7 percentage-points), pneumococcal vaccination (2.0 percentage-points), clinical depression screening (2.1 percentage-points), tobacco use assessment (0.3 percentage-points), and annual wellness visits (4.1 percentage-points). A similar increase was found for the volume of services delivered per 100 patients for several preventive services: influenza vaccination (0.18), pneumococcal vaccination (0.56), clinical depression screening (0.46), and annual wellness visits (1.52). MSSP participation was associated with a decrease in the likelihood (-0.4 percentage-points) and the volume of colorectal cancer screening (-0.03). Primary care physicians' participation in MSSP was associated with an increase in the likelihood and the volume of several preventive services.

Current Unemployment, Unemployment History, and Mental Health: A Fixed-Effects Model Approach.

Poor mental health among the unemployed—the long-term unemployed in particular—is established, but these associations may be driven by confounding from unobserved, time-invariant characteristics such as past experiences and personality. Using longitudinal register data on 2,720,431 residents aged 30–60 years, we assessed how current unemployment and unemployment history predict visits to specialized care due to psychiatric conditions and self-harm in Finland in 2008–2018. We used linear ordinary-least-squares and fixed-effects models. Prior to adjusting for time-invariant characteristics, current unemployment was associated with poor mental health, and the risk increased with longer unemployment histories. Accounting for all time-invariant characteristics with the fixed-effects models, these associations attenuated by approximately 70%, yet current unemployment was still associated with a 0.51 (95% confidence interval: 0.48, 0.53) percentage-point increase in the probability of poor mental health among men and women. Longer unemployment histories increased the probability among men in their 30s but not among older men or among women. The results indicate that selection by stable characteristics may explain a major part of the worse mental health among the unemployed and especially the long-term unemployed. However, even when controlling for this selection, current unemployment remains associated with mental health.

Politicians’ willingness to agree: evidence from the interactions in twitter of Chilean deputies

ABSTRACT We contrast the number of “likes” that a given politician gives to another one on Twitter and the number of bills voted in favor by the same pair of politicians to empirically study how signals of agreement in Twitter translate into cross-cutting voting during a highly polarized period of time. As our main contribution, we document empirical evidence that ”likes” between opponents are positively related to the number of bills voted by the same pair of politicians in Congress, even when we control by politicians’ time-invariant characteristics, coalition affiliation, directed and undirected dyads and following links in Twitter.

Value of Reducing Wait Times for Chimeric Antigen Receptor T-Cell Treatment: Evidence From Randomized Controlled Trial Data on Tisagenlecleucel for Diffuse Large B-Cell Lymphoma

ObjectivesThis study aimed to quantify the value of reducing chimeric antigen receptor T-cell (CAR-T) treatment wait times on patients with refractory and relapsed aggressive blood cancer who can newly gain access to treatment or access treatment earlier in their disease course. MethodsUsing data from the JULIET clinical trial, we first identified the number of additional patients with diffuse large B-cell lymphoma that would have been treated with tisagenlecleucel CAR-T therapy if wait times were shortened. For these patients, we estimated mortality benefits using literature estimates of CAR-T effectiveness. Next, among patients who already received CAR-T, we estimated tumor burden progression over time using a linear probability regression model. The primary outcome variable was an indicator for having above-normal lactate dehydrogenase, and we controlled for time, use of bridging therapy, and time-invariant patient characteristics. The regression results, along with literature estimates relating lactate dehydrogenase to CAR-T effectiveness, were used to compute the survival benefits of earlier CAR-T treatment. ResultsReducing wait times by 2 months increased the number of eligible patients receiving CAR-T by at least 10.7%. For patients already receiving tisagenlecleucel CAR-T, a 2-month reduction in wait times generated a 3.3% increase in survival gains per treated patient. Thus, among patients seeking treatment, the combined treatment efficacy increased by 14%, with approximately one-quarter of survival benefits accruing to existing patients receiving faster treatment. ConclusionsDelays affected not only access to CAR-T treatments but also treatment effectiveness. Our results highlight the survival benefits of expediting treatment access and may help explain some observed differences in CAR-T effectiveness across countries.

Personality, gender, and age resilience to the mental health effects of COVID-19

RationaleUnderstanding the impact of COVID-19 on different population cohorts and which personality traits affected individual's coping responses can help identify strategies to promote self-directed behaviours, thereby enhancing and maintaining individual's mental well-being. ObjectiveUsing longitudinal data for the UK, we examine the impact of the COVID-19 pandemic on individuals’ mental well-being, focusing on age, gender, and personality traits as possible modifiers. MethodsWe explore the longitudinal nature of the data using individual fixed effects models, which implicitly control for unobserved time-invariant individual-level characteristics. Our sample is an unbalanced panel consisting of 373,555 person-years observations, observed from 2009 until June 2020. ResultsThe negative impacts of the first months of the pandemic period are found to be larger for young adults (aged 16–25 years) and vary by personality traits. The increase in psychological distress symptoms is more pronounced for individuals who score higher in neuroticism, extroversion, and openness to experience. Indeed, for introverted young people, recent events may have actually brought a sense of calm. Other findings indicate that worsening in the psychological distress level occurs alongside with increased feelings of loneliness. ConclusionsOur findings support the theoretical knowledge that different people have different psychological and behaviour responses and personality concepts can be used when studying individual's adaptive behaviour in critical situations such as COVID-19. Our results indicate the necessity of public health programmes to assist distressed young individuals.

Can regional integration narrow city-level energy efficiency gap in China?

Improving energy efficiency is essential for energy conservation, emissions reduction, and sustainable development. Prevalent huge efficiency gaps are not advantageous for the improvement of the region's overall energy efficiency. Although studies have analyzed the influencing factors of the regional energy efficiency gap, the impact of regional integration on the regional energy efficiency gap remains untested. This paper applies the extended stochastic frontier analysis (SFA) method that incorporates time-varying, time-invariant and city heterogeneous characteristics to estimate the city-level energy efficiency in China from 2005 to 2017. Building on the “center-periphery” framework, we further calculate the regional energy efficiency gap and investigate the impact of regional integration on the regional energy efficiency gap through the generalized moment method (GMM). The results show that 1) average city-level energy efficiency is 44.2%, ranging from 2.9% to 75.5%, indicating that China has a huge regional energy efficiency gap; 2) there is a U-shaped relationship between regional integration and the regional energy efficiency gap within city agglomeration. Improvement in regional integration can narrow the regional energy efficiency gap when the degree of regional integration is low, and expand the efficiency gap when regional integration level is high; 3) government intervention will smooth the impact of regional integration on the regional energy efficiency gap within city agglomeration. Practicable policies to mitigate the regional energy efficiency gap in China are suggested and applicable to other emerging economies, especially for those with a huge imbalance in regional energy efficiency.

Physical punishment, physical abuse, and child behavior problems in South Korea

BackgroundPrior literature has demonstrated the associations of parental physical punishment with child behavior problems and increased risk of physical abuse. In South Korea, physical punishment is a common parenting practice. In 2021, legislative reforms eliminated legal grounds for parental physical punishment in South Korea. However, research on physical punishment, physical abuse, and child behavior problems in the Korean context is scarce. ObjectiveThis study examined whether physical punishment and physical abuse have unique associations with child behavior problems and whether physical punishment is associated with increased exposure to physical abuse. Participants and settingData came from the 2010 Korean Child and Youth Panel Survey (KCYPS), a nationally representative sample of South Korean children who attended 1st grade in 2010. Our analyses were based on three waves of the KCYPS (N = 2,180). MethodsWe employed fixed-effects regression to examine the associations of physical punishment and physical abuse with child behavior problems and the association of physical punishment with physical abuse after controlling for time-invariant characteristics. ResultsExposure to physical punishment and physical abuse was associated with higher levels of aggression, depression, and lower levels of academic behavior regulation. Physical punishment was associated with increased risk of physical abuse. ConclusionsOur findings suggest that physical punishment is a risk for child behavior problems and physical abuse in South Korea. Child maltreatment prevention efforts should focus on shifting favorable social norms around physical punishment and promoting non-physical disciplinary practices.

Do Resource-Rich Provinces Perform Lower Democratization Progress? Estimating Oil Impact on Democracy Indicators in Indonesia

This study examined whether oil dependence affected democracy quality by referring to provincial-level data in Indonesia. While physical quantity production was used to measure oil dependence, democracy was measured based on the Indonesian Democracy Index (IDI). Static panel data analysis was employed to control unobserved time-invariant characteristics of each province, including a robust Driscoll and Kraay (D-K) standard error model for the general forms of cross-sectional dependence when dealing with panel observation. The results showed that oil-dependent provinces tended not to have weak democratic qualities. The effects were also robust when democracy was separated into three main elements of the IDI: political rights, civil liberties, and democratic institutions, or when an alternative measure of dependency was used. Interestingly, this study found that oil dependence had a stronger effect on democracy in provinces with a lack of oil than in Sumatra and Kalimantan, globally known as dominant resource locations.

The role of project’s initiatives focused on the reduction of environmental footprints during COVID-19: evidence from the United States firms

In this paper, we examine whether the projects of the United States (U.S.) corporations have implemented initiatives to reduce the environmental footprint of their supply chains during coronavirus (COVID-19). Environmental footprint reductions could be achieved by reducing waste, reducing resource use, and reducing ecological emissions by introducing environmental management systems in the supply chains. For this aim, the project’s initiatives play a crucial role. This study has the primary purpose of examining the impact of ecological footprints on financial performance achieved by US corporations’ initiatives implemented through projects during the COVID-19 period. The final sample comprises 9997 company-year observations over the investigation period between 2010 and 2020. The results suggest that firms implementing the initiatives to reduce environmental footprint have shown a significant positive financial performance during the COVID-19 period. The results are robust to alternative specifications of informativeness and sensitivity tests controlling for time-invariant firm characteristics and alternative firms' performance measures. Our results corroborate with stakeholder theory, which implies implementing green policies will alleviate the agency issue and safeguard the shareholders' interest. Moreover, it clearly demonstrates the positive impact of environmental projects-focused organizations on the financial and environmental performance even while challenging and disrupting situations such as this unprecedented pandemic.

Every Book You Take: Evaluating Compliance Behavior in an Information Commons

Abstract There has been a heated debate related to the effects of business background on ethical behavior. According to some authors, students majoring in business courses - such as accounting, economics, and management - would be more likely to free ride or defect from coalitions in collective action situations, given the emphasis of such courses on individualistic values. Other authors have challenged that view, presenting empirical evidence that questions the link between business education and opportunistic behavior. The present paper revisits this debate, by studying the impact of business education on rule compliance in a specific type of information commons (libraries). Employing a novel dataset related to more than 700,000 library transactions during a 10-year period (2006-2015), I correlate business background with users’ compliance behavior, while controlling for their time-invariant characteristics. I find no evidence of a significant effect of business education on rule compliance in this specific setting. In fact, some of the estimates here reported suggest a negative correlation between business background and compliance behavior. These results have important implications for ethical theories in economics, suggesting that compliance behavior is context-dependent.

S230 More Colonoscopies, but at What Cost? Determinants of Healthcare Utilization for Patients Requiring Inpatient Colonoscopy

Introduction: Colonoscopy has become one of the most widely utilized diagnostic and therapeutic procedures in America, with approximately 19 million performed annually. As the number of inpatient colonoscopies is on the rise, there is poor understanding of the effects on healthcare utilization. The aim of this study was to determine individual and hospital-related factors which play a role in total length of stay (LOS) and overall cost of inpatient colonoscopy. Methods: Data from the nationwide inpatient sample from 2016 to 2017 were used, which included 108,245 cases. The tenth version of the International Classification of Disease coding system (ICD10) was used for patient selection. We included demographic characteristics with a primary focus on independent variables affecting LOS and overall cost for patients requiring inpatient colonoscopy. The panel data was analyzed using hospital fixed-effects regression models to account for unobserved, time-invariant hospital characteristics. Results: The majority of the hospitals conducting inpatient colonoscopies in our sample period were large, urban, not-for-profit teaching hospitals. The average age of patients was 65 years with a largely female (52%), White (66%), low median household income (31%) and Medicare insured (60%) predominance. Female patients were found to have a shorter LOS compared to males (β = -0.3618, P < 0.05) as well as lower total cost (β = -4339.00, P < 0.05). Total hospital charges decreased with increasing patient age (β = -202.38, P < 0.05). Patients of Black (β = 0.2540, P < 0.05) and Native American races (β = 1.0265, P < 0.05) had longer LOS compared to those who are White. Among the included indications for colonoscopy, patients with inflammatory bowel disease, radiologic evidence of colitis, hematochezia and melena, and irritable bowel syndrome had both shorter LOS and lower overall cost. Patients with documented history of cerebrovascular accident had longer LOS after inpatient colonoscopy. Finally, comorbid conditions associated with higher total charges included chronic anticoagulation use, type 2 diabetes mellitus, obesity, and hypertension. Conclusion: The burden to healthcare utilization for patients undergoing inpatient colonoscopy remains largely variable amongst multiple patient etiologies. With the expanding need for inpatient colonoscopies, further studies are needed to evaluate the timing of colonoscopy with regards to patient characteristics and its impact on length of stay and overall hospitalization cost.Table 1.: Demographic characteristics and inpatient outcomes in oncologic patients with and without CDI in 2015-2017 in the US

Patient Self-Reported Health, Clinical Quality, and Patient Satisfaction in English Primary Care: Practice-Level Longitudinal Observational Study

ObjectivesTo examine the association of self-reported health of patients in general practices, as measured by the EQ-5D-5L, with practice clinical quality and patient-reported satisfaction with accessibility and consultations. MethodsWe used data from the General Practitioner (GP) Patient Survey to construct a practice-level EQ-5D-5L index as the health outcome. Key explanatories were patient-reported measures of satisfaction with access and consultations (also derived from the GP Patient Survey) and clinical quality measured by the achievement of clinical quality indicators reported in the Quality and Outcomes Framework. We estimated practice-level linear panel data models with random and fixed practice effects and practice and patient covariates using 2012/13 to 2016/17 data on more than 7500 English general practices. ResultsBivariate correlations of the EQ-5D-5L index with quality measures were 0.048 for clinical quality, 0.071 for satisfaction with access, and 0.107 for satisfaction with GP consultations (all with P<.001). In both fixed effects regressions, which allow for unobserved time invariant practice characteristics, and random effects regressions which do not, the EQ-5D-5L index was positively associated with 1-year lags of patient satisfaction with access and GP consultations. Patient-reported health was positively associated with clinical quality in the fixed effects regressions. The implied effects were small in all cases. ConclusionPractice-level EQ-5D-5L is positively associated with clinical quality and with 1-year lags of patient-reported satisfaction with access and GP consultations.

Estimation of long-term exposure to PM2.5 based on short-term personal measurements in mother-child pairs in rural Ghana

BACKGROUND AND AIM: Air pollution epidemiological studies usually rely on estimates of long-term exposure to air pollutants, which are difficult to ascertain. This problem is accentuated in low- and middle-income countries where sources of personal exposure often differ from those of ambient concentrations. METHODS: We used a well-characterized cohort of mother and child pairs in 29 communities in rural Ghana and evaluated modeled long-term predictions of PM2.5 exposure. The models relied on three types of short-term measurements: personal exposure to PM2.5 in mother-child pairs, ambient PM2.5 concentration at the community level, and ambient PM2.5 concentration at a central site. Intra-class correlation coefficients (ICC) were computed to assess sources of variability in community ambient and personal exposure. Empty models were linear mixed models with a random intercept for the community or for the participant. Additional predictors included time-varying factors for the community and time-invariant characteristics for the household and participant. Personal exposure in mother and children were modeled separately. Models were evaluated using leave-one-out cross validation and the lowest root-mean-square-error (RMSE) was used to select the best performing model. RESULTS:We analyzed 240 community-days and 251 participant-days of PM2.5. Means (sd) of daily PM2.5 were 30.2 (24.9) μg/m³ for the central site, 43.5 (36.2) μg/m³ for the communities, 83.0 (53.2) μg/m³ for mothers, and 82.3 (43.6) μg/m³ for children. The ICCs (95% CI) for community ambient and personal exposure were 0.30 (0.17, 0.47) and 0.74 (0.65, 0.81) respectively. The sources of variability differed during the Harmattan season. Children’s daily exposure was best predicted by models that used community ambient compared to mother’s exposure as a predictor (log-scale RMSE: 0.165 vs 0.325). CONCLUSIONS:Our results support the feasibility of predicting long-term personal exposure to PM2.5 using short-term measurements in settings similar to rural Ghana and suggest that mother’s exposure may not be the best proxy for child’s exposure. KEYWORDS: Particulate matter, long-term exposure, children's environmental health

Is growing your own food necessary for dietary diversity? Evidence from Nigeria

In developing countries, a large share of the population is involved in agriculture, and policies encouraging households to grow their own food have a long history. Given the rapid expansion of food markets in developing countries, this paper revisits the value of such policies. With due recognition of Africa’s rapidly expanding urban population and concerns about urban food security, we consider both rural and urban households. We apply panel data methods to a nationally representative data set from Nigeria to account for time-invariant unobserved characteristics that could jointly determine food production and dietary diversity. We find that households producing a greater share of their own food have lower dietary diversity scores, compared to households that buy all their food, especially for rural dwellers. This finding reflects the reality that households are usually limited in the set of food items that they can produce. With improved access to markets and non-farm income, households do not need to produce all of their own food to improve dietary diversity. Thus, our results indicate the need to revisit policies encouraging undue focus on own production of food.

Impact of re-election on development in India: a comparative analysis of leading and lagging states

Purpose The purpose of this paper is to examine political accountability to the voter in India by studying re-election patterns in 14 major states categorized as leading and lagging during the period 1952–2015. Design/methodology/approach This study has computed a state-wise re-election index by taking the ratio of the number of constituencies exhibiting re-election in four consecutive terms during 1952–1999 to the total number of constituencies in the state. The time-invariant re-election index as of the year 1999 is used to estimate the impact of the re-election on per capita state income during 2001–2015. This paper has used the correlated random effects estimation procedure that considers the state-specific unobserved factors while using a time-invariant regressor to ascertain the impact of re-election. Findings This study finds that persistent re-election does not seem to lead to better development outcomes. When this study computes the re-election index by excluding constituencies that are underdeveloped both in the economic and social spheres, this paper finds the asymmetric impact of re-election for the leading and the lagging states. The findings suggest that historical institutions in the laggings states could be driving the empirical results. The empirical findings are corroborated by the relatively poor availability of basic amenities in constituencies exhibiting persistent re-election when compared to the state average. Practical implications The findings suggest that the provision of re-election without term limits may need to be revisited in the lagging states for better political accountability. Originality/value First, the authors study the pattern of constituency-wise re-election to compute state-wise re-election index to capture persistent re-election. Second, the authors assess the development status of a constituency by mapping it to the development indicators of the district in which the constituency is located. This paper considers both economic as well social indicators of development. Third, the time-invariant nature of the re-election index helps to address reverse causality while studying the impact of re-election on development. Fourth, the authors use a novel econometric methodology to study the impact of the re-election on development given the time-invariant characteristic of the re-election index.

Impact of Oral Voriconazole As Prophylaxis during Intensive Chemotherapy for Adult Patients with Acute Myeloid Leukemia: A Retrospective Cohort Study Using Japanese Administrative Database

BackgroundPrevention of invasive fungal infections (IFIs) during chemotherapy is an important issue for patients with hematologic malignancies. Although preventive effects of antifungal drugs on hematological stem cell transplantation (HSCT) has been reported, the appropriate approach for prophylaxis of IFIs during intensive chemotherapy for patients with acute myeloid leukemia (AML) has been still unclear. To solve this issue, we analyzed the Diagnosis Procedure Combination/Per-Diem Payment System (DPC/PDPS) database instituted by the Ministry of Health, Labour and Welfare of Japan as a payment system for medical services, which contains a large nationwide inpatient administrative data. The objective of this study is to investigate the effectiveness of oral voriconazole (VRCZ) as prophylaxis of IFIs in adult AML patients undergoing intensive chemotherapy.MethodsThis is a retrospective cohort study analyzing data of which were extracted from the DPC database collected from July 2010 to June 2015. The prophylactic usage of oral antifungal drugs is defined as administration of these drugs for more than 3 consecutive days prescribed within 3 days after the onset of chemotherapy. The selection criteria were as follows: patients diagnosed as AML, aged 18 years or older, conducted intensive chemotherapy under aseptic management, and administrated either of oral fluconazole (FLCZ), itraconazole (ITCZ) or VRCZ for the prophylactic usage defined as above. The data for HSCT were excluded. The main analyses were conducted in these 2 groups: the group of patients administrated oral VRCZ, and the other oral azoles (FLCZ or ITCZ). Primary outcome was the intravenous antifungal drug usage within 30 days after the onset of chemotherapy. Subgroup analyses were performed in the following categories: 1) VRCZ group vs FLCZ group/VRCZ group vs ITCZ group; 2) Age < 65/ Age ≥ 65. Secondary outcomes were 1) length of hospital stay, and 2) in-hospital mortality. The log-transformed values were used for analyses of length of hospital stay because its distribution was right-skewed. Panel instrumental variable (IV) method was carried out to address unobserved time-invariant characteristics of individuals, time-variant factors, and the endogeneity due to the unmeasured bias.ResultsA total of 63,197 inpatient data of 923 hospitals for AML patients aged 18 years or older were screened. Finally, 10,083 data of 413 hospitals, including 655 in VRCZ group, 4,445 in FLCZ group, and 4,983 in ITCZ group, were met to the selection criteria. The result of panel IV approach showed that prophylactic administration of oral VRCZ was significantly associated with the reduction of intravenous antifungal drug usage within 30 days after the onset of chemotherapy compared to the other azoles (RD −0.13, 95%CI −0.22 to −0.03, p = 0.012). It was also associated with the shortening the log-transformed value of length of hospital stay compared to the other oral azoles (RD −0.11, 95%CI −0.23 to −0.00, p = 0.043), but not with in-hospital mortality (RD 0.02, 95%CI −0.04 to 0.08, p = 0.513). In the subgroup analyses, prophylactic administration of oral VRCZ was significantly associated with the reduction of intravenous antifungal drug usage compared with FLCZ (RD −0.18, 95%CI −0.28 to −0.08, p < 0.001), but not with ITCZ (RD −0.07, 95%CI −0.16 to 0.34, p = 0.150). When the data was analyzed by age groups, it was significantly associated with the reduction of intravenous antifungal drug usage in patients under the age of 65 (RD −0.18, 95%CI −0.35 to −0.02, p = 0.033), but not in patients aged 65 years or older (RD −0.09, 95%CI −0.22 to 0.04, p = 0.196) compared to the other azoles.ConclusionsBy analyzing the large nationwide database, the present results revealed that the prophylactic administration of oral VRCZ would be effective for reducing the intravenous antifungal drug usage and shortening of hospital stay, which might contribute to reduction of IFIs and improvement of quality of life especially for young AML patients receiving the intensive chemotherapy. DisclosuresYoshida:Bristol-Myers Squibb: Honoraria, Speakers Bureau; Novartis: Honoraria, Speakers Bureau; ONO PHARMACEUTICAL CO., LTD.: Honoraria; Nippon Kayaku Co.,Ltd.: Honoraria.

Dental Care Use, Edentulism, and Systemic Health among Older Adults

Past research suggests there are systematic associations between oral health and chronic illness among older adults. Although causality has not yet been credibly established, periodontitis has been found to be associated with higher risk of both heart disease and stroke. We advance this literature by estimating the direct association between dental care use and systemic health using multiple waves of the 1992 to 2016 Health and Retirement Study. Through the inclusion of individual fixed effects in our regression models, we account for unobservable time-invariant characteristics of individuals that might otherwise bias estimates of the association between dental care use and health. We find statistically significant negative associations between dental care use and the number of health conditions, self-reported overall health, the incidence of heart disease, and the incidence of stroke. In particular, the use of dental care within the past 2 y is associated with a 2.7% reduction in the likelihood of being diagnosed with a heart condition and a reduction in the likelihood of a stroke diagnosis of between 5.3% and 11.6%. We also find large positive correlations between edentulism and the measures of chronic illness. Associations from models estimated separately for men and women are qualitatively similar to one another. These findings provide additional motivation for the consideration of a Medicare dental benefit.

The Incidence, Valuation, and Management of Tax-Related Reputational Costs: Evidence from a Period of Protest

ABSTRACTWe examine the incidence, valuation, and management of tax-related reputational costs during 2011, a year of extensive social protest that temporarily increased scrutiny of corporate tax avoidance. We report three main results. First, tax avoidance is positively associated with negative media sentiment during the protest period (i.e., 2011). Second, a hedge portfolio long (short) in low (high) tax avoidance firms generates positive abnormal returns during the protest period. Third, firms experiencing the largest reputational costs during the protest period report higher tax rates in subsequent years. Supplemental analyses indicate tax-related media coverage increased during the protest period, and that the results are unlikely driven by political costs or other time-invariant firm characteristics. Our findings suggest that tax-related reputational costs are not pervasive. Instead, these costs only occur during periods of unusually high scrutiny, which helps explain prior studies' difficulties in providing large-sample evidence of tax-related reputational costs.

End-of-Life Planning Depends on Socio-Economic and Racial Background: Evidence from the US Health and Retirement Study (HRS)

ContextAmericans express a strong preference for participating in decisions regarding their medical care, yet they are often unable to participate in decision-making regarding their end-of-life care. ObjectiveTo examine determinants of end-of-life planning; including, the effect of an individual's ageing and dying process, health status and socio-economic and racial/ethnic background. MethodsUS observational cohort study, using data from the Health and Retirement Study (1992 – 2014) including 37,494 individuals. Random-effects logistic regression analysis was used to examine the relationship between the presence of a living will and a range of individual time-varying characteristics, including time to death, and several time-invariant characteristics. ResultsEnd-of-life planning depends on several patient characteristics and circumstances, with socio-economic and racial/ethnic background having the largest effects. The probability of having a living will rises sharply late in life, as we would expect, and is further modified by the patient's proximity to death. The dying process, exerts a stronger influence on end-of-life planning than does the aging. ConclusionsUnderstanding differences that increase end-of-life planning is important to incentivize patients’ participation. Advance planning should be encouraged and accessible to people of all ages as it is inevitable for the provision of patient-centered and cost-effective care.