Browsing by Subject "Financial Management"
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Item Open Access Cost of capital to the hospital sector.(J Health Econ, 1988-03) Sloan, FA; Valvona, J; Hassan, M; Morrisey, MAThis paper provides estimates of the cost of equity and debt capital to for-profit and non-profit hospitals in the U.S. for the years 1972-83. The cost of equity is estimated using, alternatively, the Capital Asset Pricing Model and Arbitrage Pricing Theory. We find that the cost of equity capital, using either model, substantially exceeded anticipated inflation. The cost of debt capital was much lower. Accounting for the corporate tax shield on debt and capital paybacks by cost-based insurers lowered the net cost of capital to hospitals.Item Open Access Impact of Funding Source on Clinical Trial Results Including Cardiovascular Outcome Trials.(Am J Cardiol, 2015-12-15) Riaz, Haris; Raza, Sajjad; Khan, Muhammad Shahzeb; Riaz, Irbaz Bin; Krasuski, Richard APrevious authors have suggested a higher likelihood for industry-sponsored (IS) studies to have positive outcomes than non-IS studies, though the influence of publication bias was believed to be a likely confounder. We attempted to control for the latter using a prepublication database to compare the primary outcome of recent trials based on sponsorship. We used the "advanced search" feature in the clinicaltrials.gov website to identify recently completed phase III studies involving the implementation of a pharmaceutical agent or device for which primary data were available. Studies were categorized as either National Institutes of Health (NIH) sponsored or IS. Results were labeled "favorable" if the results favored the intervention under investigation or "unfavorable" if the intervention fared worse than standard medical treatment. We also performed an independent literature search to identify the cardiovascular trials as a case example and again categorized them into IS versus NIH sponsored. A total of 226 studies sponsored by NIH were found. When these were compared with the latest 226 IS studies, it was found that IS studies were almost 4 times more likely to report a positive outcome (odds ratio [OR] 3.90, 95% confidence interval [CI] 2.6087 to 5.9680, p <0.0001). As a case example of a specialty, we also identified 25 NIH-sponsored and 215 IS cardiovascular trials, with most focusing on hypertension therapy (31.6%) and anticoagulation (17.9%). IS studies were 7 times more likely to report favorable outcomes (OR 7.54, 95% CI 2.19 to 25.94, p = 0.0014). They were also considerably less likely to report unfavorable outcomes (OR 0.11, 95% CI 0.04 to 0.26, p <0.0001). In conclusion, the outcomes of large clinical studies especially cardiovascular differ considerably on the basis of their funding source, and publication bias appears to have limited influence on these findings.Item Open Access Non-disruptive tactics of suppression are superior in countering terrorism, insurgency, and financial panics.(PLoS One, 2011-04-13) Siegel, David ABACKGROUND: Suppressing damaging aggregate behaviors such as insurgency, terrorism, and financial panics are important tasks of the state. Each outcome of these aggregate behaviors is an emergent property of a system in which each individual's action depends on a subset of others' actions, given by each individual's network of interactions. Yet there are few explicit comparisons of strategies for suppression, and none that fully incorporate the interdependence of individual behavior. METHODS AND FINDINGS: Here I show that suppression tactics that do not require the removal of individuals from networks of interactions are nearly always more effective than those that do. I find using simulation analysis of a general model of interdependent behavior that the degree to which such less disruptive suppression tactics are superior to more disruptive ones increases in the propensity of individuals to engage in the behavior in question. CONCLUSIONS: Thus, hearts-and-minds approaches are generally more effective than force in counterterrorism and counterinsurgency, and partial insurance is usually a better tactic than gag rules in quelling financial panics. Differences between suppression tactics are greater when individual incentives to support terrorist or insurgent groups, or susceptibilities to financial panic, are higher. These conclusions have utility for policy-makers seeking to end bloody conflicts and prevent financial panics. As the model also applies to mass protest, its conclusions provide insight as well into the likely effects of different suppression strategies undertaken by authoritarian regimes seeking to hold on to power in the face of mass movements seeking to end them.Item Open Access Science incubators: synthesis centers and their role in the research ecosystem.(PLoS Biol, 2013) Rodrigo, Allen; Alberts, Susan; Cranston, Karen; Kingsolver, Joel; Lapp, Hilmar; McClain, Craig; Smith, Robin; Vision, Todd; Weintraub, Jory; Wiegmann, BrianHow should funding agencies enable researchers to explore high-risk but potentially high-reward science? One model that appears to work is the NSF-funded synthesis center, an incubator for community-led, innovative science.