How a choice between emission trading and tax schemes affects an environment-biased Environmental Protection Bureau's discretion?

In choosing environmental regulatory instrument and setting standards, a government relies on an Environmental Protection Bureau's (EPB) informational advantage, even though these two entities may have different preferences for internalizing environmental damage. A three-level hierarchical model between the government, the EPB and polluting firms is constructed to derive the government's optimal delegation policy for the EPB. Given the uncertainty in firms' costs and asymmetric information on transaction costs, this paper presents a demonstration of the communication process between the government and the EPB in formulating the standards of environmental regulation and choosing between the instruments of emission trading and tax schemes.

Impact of FDA Actions, DTCA, and Public Information on the Market for Pain Medication.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most important classes of prescription drugs used by primary care physicians to manage pain. The NSAID class of products has a somewhat controversial history, around which a complex regulatory and informational environment has developed. This history includes a boxed warning mandated by the Food and Drug Administration (FDA) for all NSAIDs in 2005.

Effects of direct-to-consumer advertising of hydroxymethylglutaryl coenzyme a reductase inhibitors on attainment of LDL-C goals.

Background: Although highly controversial, directto-consumer (DTC) television advertising for prescription drugs is an established practice in the US health care industry. While the US Food and Drug Administration is currently reexamining its regulatory stance, little evidence exists regarding the impact of DTC advertising on patient health outcomes.

Objective: The objective of this research was to study the relationship between heavy television promotion of 3 major hydroxymethylglutaryl coenzyme A reductase inhibitors ("statins") and the frequency with which patients are able to attain low-density lipoprotein cholesterol (LDL-C) blood-level goals after treatment with any statin.

How direct-to-consumer television advertising for osteoarthritis drugs affects physicians' prescribing behavior.

Concern about the potential pernicious effect of direct-to-consumer (DTC) drug advertising on physicians' prescribing patterns was heightened with the 2004 withdrawal of Vioxx, a heavily advertised treatment for osteoarthritis. We examine how DTC advertising has affected physicians' prescribing behavior for osteoarthritis patients. We analyzed monthly clinical information on fifty-seven primary care practices during 2000-2002, matched to monthly brand-specific advertising data for local and network television.

Comparing willingness to pay for telemedicine across a chronic heart failure and hypertension population.

This paper presents estimates of the willingness to pay for a new telemedicine technology in the absence of market data. The study utilizes a contingent valuation method to determine patient willingness to pay for access to telemedicine services. Willingness to pay was assessed in two populations: patients who are being treated for chronic heart failure (CHF) and patients who are being treated for hypertension.

Willingness to pay for telemedicine assessed by the double-bounded dichotomous choice method.

We investigated the willingness of patients with chronic heart failure (CHF) to pay for access to medical care via telemedicine, as an alternative to visits to a physician's office. Willingness to pay was estimated using a double-bounded dichotomous choice contingent valuation method. One hundred and twenty-six patients were surveyed after their discharge from a CHF-related hospital stay.

False positive mammograms and detection controlled estimation.

Objective: To investigate the causes of false positive in mammograms.

Data Sources: Secondary data collected from extracts from computerized medical records from 1999 from five thousand patients at a single hospital in a medium-sized Southern city.

Study Design: Retrospective analysis of electronic medical data on screening and diagnostic mammograms.

A method to report utilization for quality initiatives in medical facilities.

Objective: We undertook this project to outline a methodology for quantifying aggregate health care utilization of medical "technologies" that could be rank ordered by volume. The identification of specific high-volume technologies could guide future efforts for quality initiatives such as program planning, preventive services implementation, quality improvement activities, and innovative and cost-effective technology development.

Design: This study utilized a retrospective cross-sectional study design.

The effect of education on patients' willingness to participate in a telemedicine study.

We assessed the effect of previous education on patients' willingness to participate in a clinical study of telemedicine for hypertensive patients. The design was a cross-sectional study of adult patients arriving for appointments in a hypertension clinic. Of the 259 patients approached, 86% completed a baseline survey and were subsequently asked if they would be willing to participate in a one-year telemedicine study.

Testing efficacy with detection controlled estimation: an application to telemedicine.

Detection controlled estimation (DCE) is a powerful new econometric estimator in the family of missing data estimators. By collecting measures from a variety of inspectors or inspection technologies, DCE is able to make inferences about the entire population, even when that population is not directly observed. Using this innovative method, we were able to assess whether telemedicine technology could be substituted for in-person visits when providing maintenance care for patients with hypertension.

Patient and physician satisfaction in a clinical study of telemedicine in a hypertensive patient population.

We studied patient and physician satisfaction with telemedicine for the care of a hypertensive population. Once recruited, participants were seen both in person and via telemedicine (in random order) on the same day. After each meeting, patient and physician satisfaction surveys were completed.