Financial Considerations II: Loans, Debt Management, Saving, and Investing.

The financial considerations of becoming a physician are often not fully understood or appreciated until after residency and fellowship training. Once training is complete, physicians face a combination of increased financial rewards mixed with significant, and seemingly overwhelming, financial responsibilities, often with limited financial knowledge or understanding. Appropriately managing debt obligations, living expenses, saving for retirement, children's education, and establishing financial safety nets through savings, investments, and insurance are critical. This article is a starting point to provide the new physician with an introduction into some of those financial considerations, to both encourage further learning and promote successful financial decisions.

[Impact of the Nursing Personnel Strengthening Act on minimally invasive surgery exemplified by right-sided hemicolectomy from an economic perspective]. / Auswirkungen des Pflegepersonalstärkungsgesetzes auf die minimal-invasive Chirurgie am Beispiel der Hemikolektomie rechts aus ökonomischer Perspektive.

BACKGROUND: In the past, a reduced length of postoperative hospital stay was considered a sufficient trade-off to refinance the additional costs associated with minimally invasive surgery; however, with the implementation of the Nursing Personnel Strengthening Act and disincorporation of nursing costs, this argumentation needs to be fundamentally reevaluated. METHOD: Using right-sided hemicolectomy as an example, a retrospective case analysis was conducted. Cost reductions associated with the length of hospital stay were compared before and after the introduction of the revised German diagnosis-related groups (aG-DRG) and offset against the increased material and personnel costs. RESULTS: Among the analyzed cases, the utilization of minimally invasive surgical techniques led to a substantial cost reduction per case compared to conventional surgical treatment. After the introduction of the aG-DRGs the financial benefits of a shortened hospital stay are greatly diminished and cannot be used to refinance the expenses necessary to perform minimally invasive surgery. From a strictly economical perspective, there is a strong incentive to only perform open surgical procedures. CONCLUSION: Disincorporation of nursing costs has destabilized the fragile concept of indirect refinancing of advanced operative techniques by the financial incentives associated with a shorter hospital stay. In order to comply with statutory regulations to implicate a performance-based funding, there is an urgent necessity to adjust the grouping algorithms for minimally invasive surgical procedures to the corresponding flat rates.

"Mortgage renegotiation, monetary gains and financial literacy: A dataset of Chilean households".

This article provides data on the Mortgage Renegotiation behavior of a sample of Chilean households, plus estimates of the Present Value of the gains of mortgage refinancing and the number of past months in which it was optimal to make a refinancing choice. Furthermore, I impute the value of the Financial Literacy index of each household, according to the OCDE-INFE methodology. This data is useful for academics, policy makers and business analysts interested in the relationship between mortgage refinancing and financial literacy.

How Much Are Car Purchases Driven by Home Equity Withdrawal?

Previous research indicates that changes in housing wealth affect consumer spending on cars. We find that home equity extraction plays only a small role in this relationship. Consumers rarely use funds from equity extraction to purchase a car directly, even during the mid-2000s housing boom; this finding holds across three nationally representative household surveys. We find in credit bureau data that equity extraction does lead to a statistically significant increase in auto loan originations, consistent with equity extraction easing borrowing constraints in the auto loan market. This channel, though, accounts for only a tiny share of overall car purchases.