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1.
Philos Trans R Soc Lond B Biol Sci ; 379(1903): 20220328, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38643793

RESUMO

Nature loss threatens businesses, the global economy and financial stability. Understanding and addressing these risks for business will require credible measurement approaches and data. This paper explores how natural capital accounting (NCA) can support business data and information needs related to nature, including disclosures aligned with the Taskforce on Nature-related Financial Disclosures recommendations. As businesses seek to measure, manage and disclose their nature-related risks and opportunities, they will need well-organized, consistent and high-quality information regarding their dependencies and impacts on nature, which few businesses currently collect or track in-house. NCA may be useful for these purposes but has not been widely used or applied by businesses. National NCA guided by the U.N. System of Environmental-Economic Accounting may provide: (i) a useful framework for businesses in conceptualizing, organizing and managing nature-related data and statistics; and (ii) data and information that can directly support business disclosures, corporate NCA and other business applications. This paper explores these opportunities as well as synergies between national and corporate natural capital accounts. In addition, the paper discusses key barriers to advancing the wider use and benefits of NCA for business, including: awareness of NCA, data access, business capabilities related to NCA, spatial and temporal scales of data, audit and assurance considerations, potential risks, and costs and incentives. This article is part of the theme issue 'Bringing nature into decision-making'.


Assuntos
Comércio , Revelação , Contabilidade/métodos , Conservação dos Recursos Naturais/métodos , Medição de Risco/métodos
2.
J Environ Manage ; 356: 120567, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38537459

RESUMO

Criticism is mounting that market-led and state-led initiatives for environmental impact disclosure are too limited in scope and that they rest on too strong assumptions about the quality and impartiality of monitoring and enforcement, with resulting insufficient effect on environmental sustainability. It has been proposed that citizen monitoring may contribute to counteract this void. However, to our knowledge, policy analysis in general and economics in particular has not paid much attention to this role of citizen monitoring. This paper aims to bridge that gap from an economics lens, by exploring the dynamics of disclosing local environmental impact and the potential role of citizen monitoring in environmental policy. To this end, the paper addresses monopolistic versus pluralistic environmental disclosure, letting citizen monitoring represent the latter. The study uses the mining industry as an illustrative case, because of that sector's particular transparency challenges in international value chains, typically with strong negative local environmental impact. It is shown how pluralistic information provision such as citizen monitoring can contribute to incentivizing more reliable information provision, especially in countries with weak state institutions, which is particularly important in the case of high-risk environmental impact. The findings should be of use for shaping environmental policy, providing valuable insights for both policymakers and scholars.


Assuntos
Revelação , Política Ambiental , Conhecimento , Monitoramento Ambiental
3.
PLoS One ; 19(3): e0291338, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38527019

RESUMO

As an important part of the cultural industry, small and medium-sized online game enterprises undertake the functions of technological innovation, employment absorption and cultural cultivation. However, the lack of credit ability restricts the financial development of such enterprises. To solve the financing problem of online small and medium-sized game enterprises, this paper firstly uses the information of intangible assets to identify their credit ability, and considers that the information of intangible assets is a problem worthy of attention in evaluating credit risk. Secondly, the intangible assets information disclosure index, the revenue sharing contract of credit synergy and the dynamic game mechanism are constructed to study the importance of the intangible assets index and the evolution of the dynamic game. Finally, the empirical study shows that the intangible assets of delisting and special treated online game small and medium-sized enterprises still have value, this type of enterprise and credit suppliers have the behavior of seeking advantages and avoiding disadvantages. Therefore, credit synergy should be constructed and government regulation should be implemented.


Assuntos
Revelação , Emprego , Pesquisa Empírica , Regulamentação Governamental , Indústrias , China
5.
PLoS One ; 19(3): e0297055, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38547105

RESUMO

This study selects stock data of listed companies in China's A-share stock market from 2011 to 2020 as research samples. Using a fixed-effects model, it examines the impact of analyst optimism on stock price collapses and the moderating effect of information disclosure quality. Simultaneously, it conducts additional research to explore the potential transmission mechanisms involved. The main findings are as follows: Firstly, a positive correlation exists between analyst optimism and the risk of stock price collapse. Secondly, improving information disclosure quality of listed companies can enhance the positive impact of analyst optimism on the risk of stock price collapses and expedite the market's adjustment of overly optimistic valuations of listed companies. Additionally, analyst optimism can increase the risk of stock price collapses by affecting institutional ownership. These findings provide theoretical support for regulatory authorities to revise and improve the "information disclosure evaluation" system, regulate the analyst industry, guide analyst behavior, and encourage listed companies to enhance internal governance and improve information disclosure practices.


Assuntos
Revelação , Choque , Humanos , Instalações de Saúde , Indústrias , Otimismo , China
6.
BMC Public Health ; 24(1): 767, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38475807

RESUMO

BACKGROUND: The study uncovers micro and macro socioeconomic disparities in terms of health behavior, disease perception, and reception of information. Furthermore, findings shed light on the possible role of health insurance on access to information, disease perception and the adoption of preventive behaviors in the context of a public health emergency such as the COVID-19 pandemic. METHODS: This study employed a cross-sectional design using the Philippine Demographic and Health Survey (DHS). With a total of 29,809 respondents, it evaluated the individual or household and systemwide socioeconomic determinants of four different outcomes: receipt of information, disease perception, uptake of free preventive services, and treatment-seeking behavior. In addition to logistic regression models with the socioeconomic variables as the independent variables, models for the evaluation of the moderating effect of insurance ownership were fitted. Predicted probabilities were reported for the analysis of moderating effects. RESULTS: Findings show that individual and householdsocioeconomic determinants affected health-behavior and access to or receipt of information pertinent to the COVID-19 pandemic. Both education and wealth affected the receipt of information such that individuals in more advantaged socioeconomic positions were at least 30% more likely to have received information on COVID-19. Wealth was also associated to treatment-seeking behavior. Regional differences were seen across all dependent variables. Moreover, the study provides evidence that ownership of insurance can close education-based gaps in the uptake of free vaccination and COVID-19 testing. CONCLUSION: It is imperative that targeted efforts be maximized by utilizing existing strategies and mechanisms to reach the marginalized and disadvantaged segments of the population. Health insurance may give off added benefits that increase proficiency in navigating through the healthcare system. Further research may focus on examining pathways by which health insurance or social policies may be used to leverage responses to public health or environmental emergencies.


Assuntos
COVID-19 , Revelação , Humanos , Estudos Transversais , Filipinas , Teste para COVID-19 , Pandemias , Fatores Socioeconômicos , Seguro Saúde , Comportamentos Relacionados com a Saúde
7.
J Environ Manage ; 356: 120562, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38522277

RESUMO

PURPOSE: We analyse lobbying behaviour by using Machine Learning approaches. In the context of Sustainable Finance Disclosure Regulation (SFDR), we gain detailed insights, assign these to existing strategies, and measure how strongly which participant influences the regulation. STUDY DESIGN/METHODOLOGY/APPROACH: We use tri-gram analysis, sentiment analysis, and similarity analysis as methods to obtain insights into the political commentary process of European Supervisory Authorities (ESAs) drafts dealing with SFDR. FINDINGS: Our metadata helps to identify stakeholders and lobbying strategies. We found that the most negative comments came from the regulated, who argued strongly subjectively in a very objective environment of ESG disclosure. We also identified typical lobbying strategies based on arguments, persuasion, and classic cost-benefit considerations. ORIGINALITY/VALUE: We generate emotion values and synthesise detailed argument differences and show that modern algorithms can contribute to the identification of interest groups and lobbying strategies. Furthermore, we generate similarity values of arguments that can be taken into account in the analysis of the success of a lobbying strategy.


Assuntos
Revelação , Manobras Políticas , Humanos , Política , Análise Custo-Benefício
8.
Eur J Pediatr ; 183(5): 2301-2309, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38427037

RESUMO

We aimed to compare disclosure of social risks according to self-report on an iPad versus face-to-face questions from a health professional and to explore carers' experiences of screening. This two-arm, parallel group, randomized trial was conducted from January 19, 2021, to December 17, 2021, in a public hospital pediatric ward serving a disadvantaged area of an Australian capital city. Carers of children aged ≤ 5 years admitted to the Children's Ward were eligible. The primary outcome was disclosure of social risks. The screener included nine items on food security, household utilities, transport, employment, personal and neighborhood safety, social support, housing and homelessness. Disclosure of social risks was similar between the self-completion (n = 193) and assisted-completion (n = 193) groups for all 9 items, ranging 4.1% higher for worrying about money for food (95% CI - 11.4, 3.1%) among the assisted-completion group, to 5.7% (-1.6, 13.0%) higher for unemployment among the self-completion group. In qualitative interviews, participants were positive about screening for social risks in the hospital ward setting and the majority indicated a preference for self-completion.  Conclusion: Differences in the disclosure of social risks according to self- versus assisted-completion were small, suggesting that either method could be used. Most carers expressed a preference for self- completion, which is therefore recommended as the ideal mode for such data collection for Australian pediatric inpatient settings.  Trial registration: Australia New Zealand Clinical Trial Registry ( www.anzctry.org.au ; #ACTRN12620001326987; date of registration 8 December 2020). What is Known: • Most evidence on screening of social risks in pediatric inpatient settings is from the USA. • Little is known about disclosure of social risks in countries with universal health care and social welfare. What is New: • Disclosure of social risks was similar for electronic compared with face-to-face screening. • Carers preferred electronic completion over face-to-face completion.


Assuntos
Cuidadores , Humanos , Masculino , Feminino , Cuidadores/psicologia , Pré-Escolar , Adulto , Austrália , Lactente , Autorrelato , Apoio Social , Pacientes Internados/psicologia , Programas de Rastreamento/métodos , Revelação , Pessoa de Meia-Idade
10.
BMC Med Ethics ; 25(1): 22, 2024 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-38378633

RESUMO

BACKGROUND: Financial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020. METHODS: A retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends were analyzed using generalized estimating equation models. RESULTS: Of the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 - $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 - 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic. CONCLUSION: The majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic's onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan.


Assuntos
Alergistas , Pandemias , Humanos , Estudos Transversais , Japão , Estudos Retrospectivos , Indústria Farmacêutica , Preparações Farmacêuticas , Conflito de Interesses , Revelação
11.
World J Surg ; 48(3): 723-728, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38323663

RESUMO

BACKGROUND: Surgeon-industry collaboration is a key driver of advancement in surgical technology and practice. Disclosures of financial relationships between investigators and industries are important to ensure transparent and critical evaluation of literature. METHODS: All American cardiothoracic (CT) surgeons who published in three major CT surgery journals in 2019 were identified. Whether these surgeons disclosed any conflicts of interest was recorded and compared to actual payments received within 5 years of publication as reported by the Centers for Medicare and Medicaid Services data. RESULTS: In the study period, there were 1079 unique manuscripts involving 885 American CT surgeons as authors, which combined for 2719 author instances. Of these, 96.2% of authors (851 of 885) received payments from companies. The authors who received payments produced 2651 author instances (97.4%). Financial disclosure was reported in only 11.4% (301 of 2651) of these instances. In total, 851 surgeons received more than $187 million over 5 years, with the highest-paid surgeon receiving an average of over $5.9 million per year. The largest individual payments were from "Associated Research Funding," with over $115 million being paid to 277 surgeons over 5 years. The top paying company issued over $96.5 million to American CT surgeons over 5 years. CONCLUSIONS: Nearly all the reviewed publications in three top CT surgery journals were by surgeons who received payments from companies, but very few of these payments were recorded as potential conflicts of interest. A more consistent and robust policy of COI disclosure is needed to reduce perceptions of bias.


Assuntos
Especialidades Cirúrgicas , Cirurgiões , Idoso , Humanos , Estados Unidos , Revelação , Conflito de Interesses , Medicare
12.
Eur J Clin Invest ; 54(6): e14184, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38407501

RESUMO

OBJECTIVE: To assess the characteristics and financial conflicts of interest of presenters, panellists and moderators at haematology and oncology workshops held jointly with or hosted by the US FDA. SETTING: We included information on all publicly available haematology or oncology FDA workshop agendas held between 1 January 2018 and 31 December 2022. EXPOSURE: General and research payments reported on Open Payments, industry funding to patient advocacy organizations reported on their webpages or 990 tax forms and employment in both pharmaceutical and regulatory settings. RESULTS: Among physicians eligible for payments, 78% received at least one payment from the industry between 2017 and 2021. The mean general payment amount was $82,170 for all years ($16,434 per year) and the median was $14,906 for all years ($2981 per year). Sixty-nine per cent of patient advocacy speakers were representing organizations that received financial support from the pharmaceutical industry. Among those representing regulatory agencies or pharmaceutical companies, 16% had worked in both settings during their careers. CONCLUSIONS AND RELEVANCE: Our findings in this cross-sectional study show a majority of US-based physician presenters at haematology and oncology workshops held jointly with members of the US FDA have some financial conflict of interest with the pharmaceutical industry. These findings support the need for clear disclosures and suggest that a more balanced selection of presenters with fewer conflicts may help to limit bias in discussions between multiple stakeholders.


Assuntos
Conflito de Interesses , Indústria Farmacêutica , Hematologia , Oncologia , United States Food and Drug Administration , Estados Unidos , Humanos , Indústria Farmacêutica/economia , Hematologia/economia , Estudos Transversais , Defesa do Paciente , Médicos/economia , Educação/economia , Revelação
13.
Nicotine Tob Res ; 26(Supplement_1): S13-S18, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38366339

RESUMO

INTRODUCTION: We examined the impact of financial disclosures and warning labels on pro-e-cigarette Instagram posts and their association with attitudes toward the ad and product among youth and young adults. METHODS: During March to May 2021, we conducted a factorial experiment using an online convenience sample of youth and young adults (N = 1687, Mage = 21.54). Participants were randomized to one of four conditions: pro-e-cigarette Instagram posts with only a financial disclosure, only a warning label, both a financial disclosure + warning label, or no financial disclosure or warning label. After viewing the posts, participants answered questions regarding their attitude toward the ad and the product. We used one-way ANOVA to estimate the association of condition on outcomes controlling for demographics. RESULTS: Young adults who viewed Instagram posts with only a financial disclosure reported more positive attitudes toward the ad than those who viewed posts with both a financial disclosure + warning label (p < .05). Young adults who viewed posts with only a financial disclosure reported more positive attitudes toward the product than those who viewed posts with only a warning label, both a financial disclosure + warning label, and without either (ps < .05). Differences were not statistically significant for youth. E-cigarette use status was associated with increased positive attitudes toward the ad (p < .001) and product (p < .001) for all participants. CONCLUSIONS: Our results can inform policy interventions to mitigate the effects of e-cigarette social media marketing among youth and young adults. Including financial disclosures may not decrease appeal of e-cigarettes compared to posts without either. IMPLICATIONS: Findings from the study suggest that a warning label may be more effective in reducing the effects of pro-e-cigarette social media posts than a financial disclosure among young adults. Public health officials should examine additional strategies beyond financial disclosures and warning labels (eg, social media peer mentoring program) to offset the persuasive effects of pro-e-cigarette social media marketing posts on young people. Additional policy interventional efforts are needed to limit the impact of e-cigarette social media marketing.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Mídias Sociais , Produtos do Tabaco , Vaping , Humanos , Adulto Jovem , Adolescente , Revelação , Marketing/métodos
14.
Environ Res ; 247: 118170, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38215921

RESUMO

Accompanying China's accession to the World Trade Organization, the rapid development of the Chinese economy has led to increasingly serious environmental issues. However, the inherent mechanisms underlying the impact of Environmental Information Disclosure (EID) policy and trade on the environmental effects of Chinese paper enterprises remain unclear in the context of the era's requirement for a resource-conserving and environmentally-friendly society. The pollution problem in the papermaking industry has received attention worldwide, and how to balance the environmental and development issues of papermaking enterprises is an urgent issue that needs to be solved in the academic community. This study explores the impact mechanisms of EID policy and trade on the environmental effects of enterprises from the perspective of financial constraints. Utilizing the PSM-DID model, the study investigates the moderating effects of financial constraints on the EID policy and import-export trade. The findings reveal that both external and internal financial constraints have negative, detrimental effects on the environmental effects of the EID policy and trade. These constraints impede research and development investment and technological upgrades, hinder productivity improvement, and hamper the realization of "regulatory and trade innovation effects". This study enriches our understanding of the mechanisms by which trade affects the environmental effects of Chinese paper enterprises and further identifies the impacts of Chinese EID policy and trade on pollution emissions by enterprises, providing a theoretical basis and practical foundation for the government in formulating financial, environmental, and trade policies.


Assuntos
Revelação , Política Ambiental , China , Clima , Poluição Ambiental , Políticas
15.
Environ Sci Pollut Res Int ; 31(5): 7793-7805, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38168851

RESUMO

Environmental protection, which is beneficial for the present and the future, has become a global consensus, and environmental information disclosure (EID) is an effective way to realize and fulfill enterprise environmental responsibility. Although some scholars have studied the impact of EID on firms, there is less empirical evidence on the impact of EID on investors. In this study, we examine the impact of EID on enterprise investment value based on signaling theory using a time-varying difference-in-differences model and extract two channels of this effect. The study shows that the implementation of EID helps to enhance the value of enterprise investment. This enhancement will vary according to the location, the industry pollution type, and the nature of the enterprise: EID has a remarkable enhancement effect on the investment value of the eastern region, heavily polluted enterprises, and non-state-owned enterprises. To investigate the channel of EID's effect on enterprise investment value, we use the moderating effect model to analyze and find that enterprises with low tax ratios and small financing constraints can significantly enhance the effect of EID on investment value.


Assuntos
Revelação , Poluição Ambiental , Consenso , Indústrias , Investimentos em Saúde , China , Política Ambiental
16.
Environ Sci Pollut Res Int ; 31(2): 1995-2008, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38049691

RESUMO

Financial performance is a critical aspect of a company's overall health and sustainability. It directly influences investor decisions, stock market performance, credit ratings, and the company's ability to access capital. Corporate financial performance is influenced by multitude of facts, both internal and external such as disclosure of the information, and social and environmental factors. On the ground of the facts, we aimed to investigate non-financial firms that belong to Asian economies affected by climate policy uncertainty and corporate social responsibility disclosures in terms of their financial performance. To conduct quantitative study analysis, we used the two effective statistical tools such as two-stage regression method and generalized method of movement (GMM). Our results show that corporate high value of social responsibility disclosure and climate policy uncertainty has significant negative impact on return on asset (ROA) of the listed organizations of China, Pakistan, and India. Moreover, CSR disclosure attributes higher values such as social (SC) and governance score (GOV), and climate policy uncertainty (CPU) has significant negative relationship with return on equity (ROE) and earning per share (EPS) respectively, while a higher value of ESG total score and the environmental (ENV) score has a significant positive impact on ROE and EPS. Additionally, the research concludes that climate policy uncertainty is a key factor that motivates CSR disclosure practices, which ultimately improves corporate financial performance. Moreover, we concluded from our finding that the climate policy uncertainty creates ambiguity surrounding government regulations, international agreements, or market mechanisms that affect financial performance. Moreover, environmental disclosure information that has the large part in total ESG scores attract the investors around the globe which leads to rise in the financial performance, while the other attributes of the CSR disclosure decrease performance. This study advocated the great implications for researchers, investors, the government, and regulatory authorities. Policy makers can make the policy about the CSR disclosure for creating the good image of the organization to attract investors around the globe.


Assuntos
Revelação , Organizações , Incerteza , China , Paquistão , Responsabilidade Social
17.
Environ Sci Pollut Res Int ; 31(2): 1790-1810, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38057679

RESUMO

The revolutionary and transformative potential of FinTech has led to the Green Digital Finance Alliance, noting the dawn of a new era of FinTech-"the green FinTech", yet, surprisingly, the scholarly exploration surrounding climate finance in general and green FinTech and climate FinTech remains restrained. In our attempt to decode the intricate interlinkage between green finance and FinTech, the study wrestles with the theoretical complexity of the "green FinTech" concept through a systematic review of relevant studies and conceptual mapping. We develop a comprehensive grasp of the concept, how to leverage it to combat the pressing climate crisis, and its implications for the FinTech segment-the first of its kind in the scanty green FinTech literature. Based on the PRISMA analysis, we find that green FinTech promotes a green economy through its manifold impact on all aspects of the finance sphere, thereby channelling climate finance and promoting sustainability. It has the power to heighten inclusivity, disclosure, trust, and democratisation, thus reducing information asymmetry and greenwashing. Hence, FinTech integration can be game-changing in eliminating the hurdles before conventional green finance. However, the literature remains fragmented, along with a young, growing green FinTech market. Therefore, this study proposes a framework for future researchers by providing a holistic research agenda to fully integrate "green FinTech" into practical real-world applications.


Assuntos
Clima , Revelação
18.
Value Health Reg Issues ; 40: 27-34, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37972431

RESUMO

OBJECTIVES: The high cardiovascular disease burden globally and in Australia necessitates attention on statin expenditure, the primary pharmacological intervention for cardiovascular disease risk factors. The Pharmaceutical Benefits Scheme (PBS) subsidies approved statins for Australians. Managing PBS government expenditure occurs through price control strategies of statutory price decreases upon first generic entry and price disclosure. This study investigates the impact price control measures had on statin price evolution and government expenditure between 2010 and 2022. METHODS: Prescription and pricing data were obtained from Services Australia Medicare Statistics, and price reduction strategies from the PBS. Summary statistics compared and described statin price, prescription, number of brands, market share, and government expenditure to atorvastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin price control timelines. RESULTS: Statin prices exposed to price control measures decreased irrespective of dosage and correlated with reductions in government expenditure, with a comparison of 2010 and 2022 showing annual statin expenditure declined by AU$833.5 million (83.25%) whereas prescriptions reduced by 3.0 million (15.7%). Effects of price disclosure on atorvastatin and rosuvastatin market share suggest industry-prompted price reductions may arise from market share loss, whereas reasons external to pricing prompted rosuvastatin to gain market share. CONCLUSIONS: Limited publications on contemporary effects of statin price control measures exist. This investigation found these measures reduced government expenditure for statins by AU$949.1 million, with the price reduction correlating with price control measures. In addition to affirming price control mechanisms remain effective in contemporary times, this investigation provides data for key insights into the Australian statin industry.


Assuntos
População Australasiana , Doenças Cardiovasculares , Inibidores de Hidroximetilglutaril-CoA Redutases , Idoso , Humanos , Atorvastatina/uso terapêutico , Austrália , Revelação , Custos de Medicamentos , Gastos em Saúde , Inibidores de Hidroximetilglutaril-CoA Redutases/economia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Programas Nacionais de Saúde , Rosuvastatina Cálcica/uso terapêutico
19.
Breast Cancer Res Treat ; 203(2): 397-406, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37851289

RESUMO

PURPOSE: Mastectomy, breast reconstruction (BR) and breast conserving therapy (BCT) are core components of the treatment paradigm for early-stage disease but are differentially associated with significant financial burdens. Given recent price transparency regulations, we sought to characterize rates of disclosure for breast cancer-related surgery, including mastectomy, BCT, and BR (oncoplastic reconstruction, implant, pedicled flap and free flap) and identify associated factors. METHODS: For this cross-sectional analysis, cost reports were obtained from the Turquoise Health price transparency platform for all U.S. hospitals meeting national accreditation standards for breast cancer care. The Healthcare Cost Report Information System was used to collect facility-specific data. Addresses were geocoded to identify hospital referral and census regions while data from CMS was also used to identify the geographic practice cost index. We leveraged a Poisson regression model and relevant Medicare billing codes to analyze factors associated with price disclosure and the availability of an OOP price estimator. RESULTS: Of 447 identified hospitals, 221 (49.4%) disclosed prices for mastectomy and 188 42.1%) disclosed prices for both mastectomy and some form of reconstruction including oncoplastic reduction (n = 184, 97.9%), implants (n = 187, 99.5%), pedicled flaps (n = 89, 47.3%), and free flaps (n = 81, 43.1%). Non-profit status and increased market competition were associated with price nondisclosure. 121 hospitals (27.1%) had an out-of-pocket price estimator that included at least one breast surgery. CONCLUSIONS: Most eligible hospitals did not disclose prices for breast cancer surgery. Distinct hospital characteristics were associated with price disclosure. Breast cancer patients face persistent difficulty in accessing costs.


Assuntos
Neoplasias da Mama , Retalhos de Tecido Biológico , Mamoplastia , Humanos , Idoso , Estados Unidos/epidemiologia , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/cirurgia , Mastectomia , Revelação , Estudos Transversais , Medicare
20.
Intern Med J ; 54(1): 62-73, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37255333

RESUMO

BACKGROUND: Pharmaceutical industry exposure is widespread during medical training and may affect education and clinical decision-making. Medical faculties' conflict of interest (COI) policies help to limit this exposure and protect students against commercial influence. AIMS: Our aim was to investigate the prevalence, content and strength of COI policies at Australian medical schools and changes since a previous assessment conducted in 2009. METHODS: We identified policies by searching medical school and host university websites in January 2021, and contacted deans to identify any missed policies. We applied a modified version of a scorecard developed in previous studies to examine the content of COI policies. All data were coded in duplicate. COI policies were rated on a scale from 0 (no policy) to 2 (strong policy) across 11 items per medical school. Oversight mechanisms and sanctions were also assessed, and current policies were compared with the 2009 study. RESULTS: Of 155 potentially relevant policies, 153 were university-wide and two were specific to medical schools. No policies covered sales representatives, on-site sponsored education or free samples. Oversight of consultancies had improved substantially, with 76% of schools requiring preapproval. Disclosure policies, while usually present, were weak, with no public disclosure required. CONCLUSION: We found little indication that Australian medical students are protected from commercial influence on medical education, and there has been limited COI policy development within the past decade. More attention is needed to ensure the independence of medical education in Australia.


Assuntos
Conflito de Interesses , Faculdades de Medicina , Humanos , Austrália , Revelação , Políticas
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