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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.

Tests the theory that owners (hospital, physician, insurance) of vertically integrated health maintenance organizations (HMOs) might substitute towards production of their own specialty goods. Uses data from various sources in the USA. Determines the impact of ownership on factors such as average physician ambulatory services per enrollee and average hospital days per enrollee. Concludes that policymakers need to encourage the development of standard publicly available quality measures to intensify competition and eliminate excess profits accruing to provider‐owners who substitute towards production of their own goods.

Estimates a total effects cost function using a national 1994 health maintenance organization (HMO) data set to examine and update findings related to HMO efficiency. The cost function controls for ownership characteristics (profit status and ownership), size, enrollment diversity, regional location, product diversity, model type, payment characteristics, and years of operation. While not explicitly controlling for quality or acuity, measures of plan and enrollee diversity help control for acuity and quality. Results show that most of the difference in cost efficiency between HMOs is explained by factors specific to the HMO, including efficiencies of scale and scope, lower levels of Medicare patients, and efficient levels of capital. The study also shows that for‐profits are more efficient than non‐profits because they rely less on withhold pools to control costs. Limitations of the study include weak controls for quality of care, and limited data related to payment characteristics.

The purpose of this article is to analyze the effects patients' socioeconomic characteristics, along with hospital size and location, had on the initial treatment choice for individuals with hypertension with complications and secondary hypertension.

The analysis uses retrospective data and binary logistic regression to analyze treatment choice determinants. Initial diagnostic and/or therapeutic procedures were categorized as invasive or non‐invasive, which served as the dependent variable.

Uninsured people were more likely to get less expensive non‐invasive treatment. Medicare patients were approximately twice as likely to receive an invasive procedure as individuals with private insurance, even after controlling for age and other socioeconomic characteristics. Minorities and males were also more likely to receive an invasive primary procedure. Significant treatment variations across States were also found.

There were insufficient observations to look at variability within patients treated by a single physician. Future research could tie this information into a simultaneous equation system in order to determine whether patients who received one treatment type versus another were better off.

Finding that characteristics other than morbidity affect the type of treatment received indicates that public policy could improve care. Most important, the ability to pay, type of insurance, geographic location and race influence whether patients receive invasive or non‐invasive treatment upon hospitalization for hypertension, indicating that policies prescribing treatment alternatives that remove non‐medical issues from calculation may improve overall outcomes.

Comprehensive treatment‐choice analyzes have been largely overlooked in the hypertension literature. Additionally, few studies analyze choice using data from such a diverse array of geographic areas and socio‐economic strata.

To analyze SEC Staff’s announced 2018 OCIE Examination priorities to provide insight to investment advisers and other regulated entities regarding areas of focus during SEC examinations.

This article discusses the US Securities and Exchange Commission’s (SEC) Office of Compliance Inspections and Examinations (OCIE) published its examination priorities for 2018 (the “2018 Priorities Report”).

Given that OCIE’s examination priorities for 2017 were published before the beginning of the Trump administration, differences between the 2017 and the 2018 priorities provide important insights into the focus of examinations under SEC Chair Clayton. Investment advisers and other regulated entities should allocate resources towards their preparedness for the areas of focus identified in the 2018 Priorities Report.

This article contains valuable insight regarding the SEC’s 2018 OCIE examination priorities and practical guidance from industry experts.

This article provides a comprehensive look at suitability rules, first in the traditional brokerage context and then in terms of their application to online brokerages in general. It outlines the arguments made by the online brokerages to differentiate their world from traditional broker‐dealers, and offers hypothetical scenarios in which suitability concepts may apply in the online brokerage setting. The authors suggest that online brokerages should be allowed time to determine the appropriate rules in light of how the technology itself evolves over the next several years.

Data from sophisticated portable heart‐rate monitors and “work diaries” were used to relate in Mintzberg's “nature of managerial work” to physiological stress in a small sample of working principals. Subjects were categorised by years of experience, Type A and Type B personality, and were “shadowed” for three complete work days in their schools doing regular activities to learn what management functions were stressful. Principals were found to be working under extreme stress (a few at catastrophically high levels), for long hours, and that certain managerial activities were more physiologically stressful than others. Implications for training, deployment and the use of bio‐feedback techniques are discussed.

Film provides an alternative medium for assessing our interpretations of cultural icons. This selective list looks at the film and video sources for information on and interpretations of the life of Woody Guthrie.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.