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Idiopathic intracranial hypertension (IIH) can be a debilitating disorder that is difficult to identify and treat. Failure to adequately manage IIH symptoms may force patients to present at emergency departments (EDs) seeking symptom relief. The purpose of this paper is to empirically characterize ED use by previously diagnosed IIH patients.

Patients diagnosed with IIH, and who registered with the Intracranial Hypertension Registry by 2014, were solicited for study inclusion. A survey was designed to elicit ED use during the period 2010–2012. Information on demographic and socioeconomic characteristics, IIH signs and symptoms, time since diagnosis, perspectives of ED use and quality of life was collected. Quality of life was assessed using an adaptation of the Migraine-Specific Quality of Life Questionnaire. Data were analyzed using descriptive statistics and nonparametric hypothesis tests.

In total, 39 percent of IIH patients used emergency services over the study period; those that did used the services intensely. These patients were more likely to be non-white, live in households making less than $25,000 annually, have public insurance and have received a diversional shunt procedure. Patients who used the ED were less likely to live in households making $100,000, or more, annually and have private insurance. Participants who used the ED had significantly lower quality-of-life scores, were younger and had been diagnosed with IIH for less time.

ED staff and outside physicians can utilize the information contained in this study to more effectively recognize the unique circumstances of IIH patients who present at EDs.

Community asset mapping (CAM) is an evidence-based activity commonly used in local socioeconomic development initiatives. Residents and other stakeholders collaboratively identify the resources that they deem most important to the vitality of their community. Results are depicted qualitatively using maps. While maps are a useful means to convey information, alternate approaches to summarize data drawn from CAM activities may yield additional inferences that better inform community development initiatives.

This study conducted a retrospective analysis of secondary, de-identified data collected from the 2015–2016 Gonzaga University Logan Neighborhood Asset Mapping Project. Hierarchical and nonhierarchical cluster analyses were used to establish interrelationships between the perceived importance of various community assets.

The hierarchical cluster analysis revealed a very intuitive hierarchical clustering of community assets, with various health care services tightly clustered together. Similarly, farmers’ markets, community gardens and meeting spaces were clustered closely together. Third, community education and care services for all age groups were clustered together. The nonhierarchical cluster analysis revealed intuitive clustering of respondent groups who valued particular sets of assets.

By identifying these clusters and characterizing the linkages between them, it is possible to fund multiple development initiatives that are mutually reinforcing. For example, if the neighborhood obtains funds to invest, then they could be used to facilitate both community gardens and farmers’ markets, two closely related activities. Additional physical locations might also be developed to support (possibly outdoor) meeting space.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-04-2020-0206.

The purpose of this study is to empirically identify incentives that drive resource shifting by US pharmaceutical firms to comparatively low-tax jurisdictions.

Using a panel of publicly listed companies, we investigate whether resource shifting is facilitated by two underlying factors. First, we examine whether pharmaceutical manufacturers whose intangible assets are disproportionately held as intellectual property are more or less likely to shift resources to jurisdictions outside of the USA. Second, we empirically determine whether manufacturers that derive most of their revenues from producing a specific type of product are more or less likely to shift income-producing resources to their international affiliates.

The empirical results suggest that pharmaceutical factors do practice strategic resource shifting. Moreover, pharmaceutical manufacturers which produce biologic medications are significantly less likely than other manufacturers to practice resource shifting. We find no evidence to suggest that firms whose intangible assets are more composed of intellectual property are any more or less likely to practice resource shifting.

To date, a plethora of studies exist which examine resource shifting in a large, general population of multinational corporations. However, there are relatively few studies that examine international resource shifting in the pharmaceutical industry.

Medical bankruptcies occur when an individual experiences an acute or chronic health event, and the costs of care exceed the individual’s ability to pay. In such cases, the individual typically files for bankruptcy. There is an extensive literature that estimates the prevalence of medical bankruptcy, but studies either select a population whose medical care is extremely expensive or chooses ad hoc thresholds for medical bankruptcy categorizations. In both cases, the prevalence of medical bankruptcy is biased. The purpose of this paper is to estimate the actual prevalence of medical bankruptcies in a manner that avoids these limitations.

Data are randomly drawn from a single US Bankruptcy Court district. Following the literature, an ad hoc threshold of medical debts which places the bankruptcy filer “at risk” for a medical bankruptcy is postulated. Misclassification analyses are used to estimate the likelihood of a medical bankruptcy filing while adjusting for the use of ad hoc thresholds.

The naive prevalence of medical bankruptcy is 23.1 percent, but exceeds 50 percent when accounting for misclassification. Many individuals are “ostensibly” medically bankrupt. They are already seriously indebted, and any outside financial shock, including but not limited to medical bills, can push these debtors into insolvency.

Bankruptcy is an important social safety net. An improved understanding of the types and magnitudes of medical debts which precipitate a bankruptcy filing can lead to policies that improve outcomes for bankruptcy filers and reduce the social costs of bankruptcy.

The purpose of this paper is to examine whether the timing associated with the implementation of the health insurance-related provisions of the Patient Protection and Affordable Care Act (ACA) altered the presence and distribution of medical/non-medical debts accumulated by different types of bankruptcy filers.

Data were drawn from the US Bankruptcy Court’s Eastern Washington District over the years 2009, 2011 and 2014 using interval random sampling. Binary probit and Tobit analyses were used to model the existence, and distribution, of medical debts and total debts, respectively, at the time of filing. The impact of the time frame associated with the ACA was operationalized via a Chow test for structural dynamic change.

Chapter 13 filers in 2014 (post-ACA-based health exchange implementation) were more likely to report medical debts than Chapter 7 filers in the pre-intervention period, and were also more likely to report a larger proportion of outstanding debts owed to a single creditor. Filers claiming health insurance premium expenses in 2011 were (at the 10 percent significance level) more likely to report a more skewed distribution of medical debts.

The time frame associated with the implementation of the ACA impacts the distribution of medical debts among filers who have sufficient net disposable income to fund a Chapter 13 plan. The polarization of outstanding medical debts may indicate coverage gaps in existing health insurance policies, whose costs would be disproportionately borne by patients operating on thin financial margins.

This study aims to assess whether patients [who receive community pharmacy services at locations where routine medication therapy management (MTM) care is reimbursed] who were adherent to their medications generated lower inpatient hospitalization expenses.

This is a retrospective, descriptive and cross-sectional study using administrative claims data drawn from 84 community pharmacies in North Dakota. The included patients were enrolled in a Blue Cross Blue Shield of North Dakota insurance plan and were taking one or more of eight groups of medications (metformin, antidepressants, anti-asthmatics, ACEs/ARBs, beta-blockers, calcium channel blockers, diuretics and statins) commonly prescribed to treat chronic conditions filled between July 1, 2014 and June 30, 2015. Community pharmacists used software that allowed the pharmacists to provide and bill for MTM services. Data from these sources were used to calculate medication adherence and inpatient costs.

Patients prescribed a beta blocker, a calcium channel blocker, and a diuretic or an anti-diabetic medication, and those who are fully adherent to their medications were associated with significantly lower inpatient hospitalization costs (as measured by insurance payments to hospitals) as compared to non-adherent patients. Patients who were fully adherent to their medications had no statistically significant differences in patient-specific costs compared to non-adherent patients.

Patients receiving services at a community pharmacy that offers MTM services and those who were adherent to their medication regimens generate lower health care expenses. Most of the savings come from lower hospitalization expenses, rather than patient-paid expenses.

In 2004, as the economy lay in stagnation, Congress searched for ways to stimulate job growth. Many members of Congress believed that high US taxes on repatriated earnings discouraged US-based multinational enterprises (MNEs) from bringing cash (in the form of dividends) home and investing those monies in the USA. As a result, Congress passed, and President Bush signed into law, the 2004 American Jobs Creation Act (AJCA), which reduced tax rates to a maximum 5.25 percent on cash repatriations to the USA over the course of a single tax year, i.e. a “tax holiday”. The purpose of this paper is to explore key determinants of repatriated earnings by US multinational enterprises.

This paper uses data collected from IRS documents between 2004 and 2008 to explore the drivers of MNE repatriations, including the AJCA tax holiday, from various countries to the USA. The paper applies a Lintner equation within a gravity model framework to estimate international liquidity flows.

The results indicate that repatriations to the USA are more likely to originate in Latin America and other countries in the Western Hemisphere. Significant evidence is also found of agglomeration effects; countries with higher numbers of MNE subsidiaries were significantly more or less likely (depending on the year in question) to repatriate earnings to the USA.

While several studies in the literature have examined the effects of the AJCA on individual firm earnings, very few studies have examined the aggregate effects of MNE repatriations in the context of the AJCA. More specifically, past studies have identified how much money flows back to the USA, but have not examined the set of countries from which most of the money flows.

This paper examines the interrelationships among debt policy, dividend policy, and ownership structure using a simultaneous equation framework. Our approach allows us to test both the convergence of interests theory and entrenchment theory. Using a sample of publicly traded South Korean manufacturing firms, we find that debt policy and ownership structure have a positive impact on dividend policy. We also find that both debt and dividend policy are positively related to ownership structure. Our findings support both the theory of convergence of interests between management and ownership and entrenchment theory, and also explain why many studies have found conflicting results.

This paper presents a simple methodological framework to characterise the tangible and intangible benefits of a university athletics department. The methodology is applied to the athletics department at Gonzaga University (GU) in Spokane, Washington USA. The brand equity associated with this department is estimated at approximately US$5.8 million in 2006. Of this, between $617,000 and $2.71 million is ascribed to a specific type of tangible brand equity (with the most plausible estimate being $926,000); namely, the impact of GU athletics events on the economic vitality of the local community. The remainder is attributed to (unobserved) intangible brand equity benefits.

The purpose of this manuscript is to quantify exactly how much information and/or predictive content is contained in business sentiment surveys.

This paper uses techniques drawn from information theory econometrics, and more specifically the theory of information entropy, to characterize the predictive content of business sentiment surveys. The authors apply these techniques to publicly available information obtained from various editions of the Federal Reserve Bank of New York's Empire State Manufacturing Survey, one of the most popular business sentiment surveys conducted in the USA. Parametric and non‐parametric statistical analyses are used to examine differences in the quantity of predictive content across various questions in the survey.

The results suggest that business sentiment surveys contain a reasonably high degree of informative content. However, the amount of informative content varies considerably from question to question in the survey. Questions that are more general in nature and ask about current perceptions (as opposed to future expectations) contain more informative content.

Business sentiment surveys are a practical, low‐cost method to assess the current and expected future state of local and regional economies. However, the value of these surveys is questionable if they do not contain much information. This research finds that such surveys do contain a large amount of information, and are worth administering. However, specific types of survey items convey more information that others, which also suggests that business sentiments surveys can be further revised to maximize the amount of content gained from respondents.