News Article | December 2, 2016
Battling an epidemic of opiate addiction, U.S. drug treatment facilities have made progress with methadone. A daily dose of at least 60 milligrams of methadone is recommended to achieve therapeutic effects and has been associated with improvements that include significant decreases in heroin use, in relapse rates, and in HIV incidence. Some patients of “opiate agonist treatment” facilities, however, receive less than 60 milligrams per day. A team of researchers led by a Johns Hopkins University expert on health care organizations examined differences in methadone dose levels and the role that program directors may play in accounting for these variations. For a study recently published in Health Services Research, the team discovered that, overall, the proportion of patients getting lower than the recommended daily dose of methadone for opiate addiction has declined in recent years. However, facilities run by African-American directors were more likely to provide low methadone doses than facilities run by managers of other races and ethnicities. This relationship was even stronger at facilities run by African-American directors serving a high proportion of African-American patients. Lead author Jemima A. Frimpong, an assistant professor at the Johns Hopkins Carey Business School in Baltimore, says the finding was unexpected. She and her co-authors ― doctoral candidate Karen Shiu-Yee of Columbia University and Professor Thomas D’Aunno of New York University ― set out to determine a possible link between the characteristics of facility managers and the lower doses of methadone. While manager race and ethnicity were conceptually relevant to the analysis, the specific finding regarding African-American managers was not anticipated, Frimpong explains. But its importance became apparent as the researchers examined data compiled from 1995 through 2011 in the National Drug Abuse Treatment System Survey (NDATSS). Frimpong and her colleagues suggest possible reasons for the lower methadone doses at facilities run by African-American directors ― for example, negative perceptions of methadone in the African-American community, and a preference among those directors for psychosocial treatment, including talk therapy, as a supplement to methadone in treating opiate addiction. The authors concede that further research is needed to better understand their finding regarding the relationship between the races of program managers and dosing patterns. “We know that the problem of low dosing exists, and research has looked at how patient characteristics may play a role,” says Frimpong. “Our study extends such analyses and examines characteristics of managers and how they may influence methadone dosing patterns in opioid treatment programs.” In that way, she says, this new paper helps advance the literature because it is among the first to examine the role of managers. The ultimate goal of such research, adds Frimpong, is to encourage more effective treatment practices for the growing scourge of opiate addiction. As the Centers for Disease Control and Prevention noted in January 2016, “The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137 percent, including a 200 percent increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin).” Previously, the CDC reported that 259 million prescriptions for painkillers were written in 2012, enough to supply every American adult with a bottle of pills. “Because opiate addiction is increasing at such a disturbing rate,” Frimpong says, “it is important that treatment programs are adopting and implementing evidence-based practices. The available research suggests that too many persons with opiate addiction are not getting methadone dose levels shown to be effective.” According to the NDATSS, the percentage of patients getting less than 60 milligrams of methadone per day actually decreased over 16 years ― from 49 percent in 1995 to 23 percent in 2011. “That is definitely an improvement, but it also means that nearly a quarter of patients were not getting dose levels more likely to be effective. The magnitude of opiate addiction remains a big problem. Therefore, an 80-percent success rate is not adequate. We still have a lot of work to do in order to address the opioid epidemic,” says Frimpong, who earned her PhD at the University of Pennsylvania’s Wharton School of Business. Her research, as seen in this study, focuses on organizational factors and the extent to which they affect health care practices and outcomes. The paper, titled “The Role of Program Directors in Treatment Practices: The Case of Methadone Dose Patterns in U.S. Outpatient Opioid Agonist Treatment Programs,” appeared September 2016 on the website of Health Services Research and is forthcoming in the print version of that journal. The study was supported by research grants from the National Institute of Drug Abuse.
News Article | February 16, 2017
TAMPA, Fla., Feb. 16, 2017 /PRNewswire-USNewswire/ -- AACSB International (AACSB) announces that the Johns Hopkins Carey Business School has earned accreditation. Founded in 1916, AACSB International is the longest serving global accrediting body for business schools that offer undergradua...
News Article | February 16, 2017
TAMPA, Fla., Feb. 16, 2017 /PRNewswire-USNewswire/ -- AACSB International (AACSB) announced today that Asia University-Taiwan (Chinese Taipei), ISC Paris (France), Johns Hopkins Carey Business School (United States), Soochow University (China), Universidad Carlos III de Madrid (Spain),...
News Article | November 1, 2016
The Johns Hopkins Carey Business School has teamed with YouVisit to offer a new immersive tour experience for the school’s locations in Baltimore and Washington, D.C. Using 360 ° 3-D photography, narration, and video, the Carey virtual tour brings the campus experience to any desktop, laptop, or mobile device anywhere in the world. “Our facilities and resources exceed what many expect—even for a school like Johns Hopkins. It’s important for students to either come to visit in person or at least have an opportunity to virtually experience Carey. Many prospective students want to know what the school will be like before choosing to study here,” said Monica Moore, associate dean for Admissions and Academic Programs at the Carey Business School. “Our virtual tours give us another way to share the Carey experience with prospective students from afar. It is as close as you can get without visiting one of our campuses in person.” Highlights of the Carey virtual experience include scenes of Baltimore’s scenic waterfront and the bustling streets of Washington, D.C., as well as many of the school’s services and amenities available to students. The tour narration is provided in English, Spanish, and Chinese. The Carey Business School virtual tour is available online at youvisit.com/tour/jhu?pl=v. The experience is also accessible through the Johns Hopkins YouVisit app available at Apple’s App Store and Google’s Play Store. A regular schedule of campus events is available on the Carey Business School calendar at carey.jhu.edu. Personal visits and tours can also be arranged through Carey Admissions at carey(dot)admissions(at)jhu(dot)edu or by calling 410-234-9220. Established in 2007, the Johns Hopkins Carey Business School is the business school of Johns Hopkins University. The Carey mission supports business knowledge development and education through its own initiatives, innovations, and collaborative programs across Johns Hopkins University. Carey creates and shares knowledge that shapes business practices while educating business leaders who will grow economies and societies, and are exemplary citizens. With locations in Baltimore and Washington, D.C., the Carey Business School offers graduate degree programs for full-time, part-time, and online students. For more information, visit carey.jhu.edu.
News Article | December 20, 2016
The Johns Hopkins Carey Business School has established the Carey Business Fellows program to provide full tuition and a stipend for the most competitive and accomplished MBA students. The Carey Business Fellows initiative will be available for students admitted to the fall 2017 class of the full-time Global MBA program. As Carey Business Fellows, students will receive full tuition for one year and an $18,000 stipend during the academic year. Students in good standing can renew the scholarship and stipend for the second year of the Global MBA program. To be considered for the Carey Fellows, Global MBA candidates must have attained at least two to four years of full-time work experience; achieved an overall GMAT or GRE score at or above the 80th percentile (680 or higher); and earned a minimum cumulative grade point average of 3.3 or higher from an accredited college or university. “Nearly every industry today faces challenges in attracting the best talent. The same is true for business education,” said Bernie Ferrari, dean of the Carey Business School. “The Carey Business School Global MBA is an innovative program, and we believe the Carey Business Fellows initiative will make our program even more inviting for the best students.” Candidates for the Carey Fellows will be selected during the admissions review process. Additional interviews may be required for final acceptance to the program. A maximum of eight Carey Business Fellows will be named for the fall 2017 Global MBA class. The Johns Hopkins Global MBA is a two-year, 54-credit degree program that prepares students to be business leaders who will be a positive force for building a greater society. As part of the curriculum, students complete the Innovation for Humanity and Discovery to Market courses. Innovation for Humanity empowers students to apply their business skills and collaborative thinking toward solving real-life challenges in developing countries. The course includes an intensive three-week international, on-site practicum. Discovery to Market provides students with opportunities to work alongside inventors, scientists, and entrepreneurs to transform emerging technologies into tangible products and businesses. Established in 2007, the Johns Hopkins Carey Business School is the business school of Johns Hopkins University. The Carey mission supports business knowledge development and education through its own initiatives, innovations, and collaborative programs across Johns Hopkins University. Carey creates and shares knowledge that shapes business practices while educating business leaders who will grow economies and societies, and are exemplary citizens. With locations in Baltimore and Washington, D.C., the Carey Business School offers graduate degree programs for full-time, part-time, and online students. For more information, visit carey.jhu.edu.
News Article | March 2, 2017
When Stockholm, Sweden, introduced a “congestion tax” to discourage driving in the center of town, traffic eased and the pollution level dropped by between 5 and 10 percent. One other result was less expected but no less welcome: The rate of asthma attacks among local children decreased by nearly 50 percent, according to a Johns Hopkins Carey Business School economist’s study of the tax and its impact. The health improvement in the children appeared more gradually than the observed decline in the pollution level. This suggests that the full health benefits from reduced pollution might not occur immediately, says Emilia Simeonova, an assistant professor at the Johns Hopkins Carey Business School. Indeed, the drop in the rate of asthma attacks was more than 12 percent during the first seven months of the tax but soared to 47 percent after a few years of implementation. Simeonova says, “The key takeaways of this paper are that health gains can be realized through efforts to lower air pollution, and that we need to be patient in waiting for the complete picture to emerge.” Asthma, chronic inflammation of the breathing passages, afflicts people of all ages. Its onset in childhood can lead to poor lung development, causing ill effects ― wheezing, breathlessness, chest tightness, and coughing ― that can recur over a lifetime. It is the leading cause of hospitalization among children in the United States, especially those living in densely populated areas with frequent traffic congestion, the paper states. The study by lead author Simeonova and three colleagues examined official health and environmental data compiled in Sweden from 2004 through 2010. The research team focused on health statistics for children up to six years old, who tend to experience the most acute asthma episodes because their families haven’t yet learned how to tame the flare-ups. Stockholm’s congestion tax began as an experiment from January through July 2006. Traffic was reduced by 20 to 25 percent. Deeming the trial a success, the city government reinstituted the congestion tax in August 2007, and it has been in place ever since. The tax costs up to $2.60 (U.S.) per vehicle, depending on the time of day. No charges are made at night, on weekends and public holidays, or during July. Tolls are automatically assessed via scanners that collect the license plate information of cars crossing the “congestion pricing zone.” A positive impact on health was evident from the start. During the seven-month trial period, visits to doctors for asthma symptoms fell from a baseline of 18.7 per 10,000 children to 16.4, a drop of 12 percent. For about a year after the trial period, the congestion tax wasn’t in effect. Pollution levels rose again slightly, though not up to pre-trial levels ― and the number of asthma visits among children continued to fall, to 13.9 per 10,000, or 26 percent below the baseline. A few years after the tax was made permanent, visits had dropped even further, to 10 per 10,000 children, a reduction of 47 percent from the baseline. (The baseline figure of 18.7 asthma visits was an average of statistics from a two-year period before the trial.) Simeonova explains that during the “in between” period when the tax wasn’t being assessed, the level of pollution still wasn’t high enough to reverse the health benefits that Stockholm’s children had begun to realize. But, she adds, the rate of asthma visits probably would have started climbing if the tax had not been made permanent. “These findings show that traffic congestion fees in large cities can have significantly positive effects on health in the short term but even larger effects in the longer term,” says Simeonova. In addition, she points out that Stockholm’s average pollution levels are not nearly as bad as the levels judged acceptable by the United States Environmental Protection Agency. Pollution reductions, then, even in a city of relatively mild smog such as Stockholm, can produce benefits for respiratory health, especially among young children. Simeonova presented the study, titled “Congestion Pricing, Air Pollution and Children’s Health,” at the annual meeting of the American Economic Association in January in Chicago. She and her co-authors ― Professor Janet Currie of Princeton University, Assistant Professor Peter Nilsson of Stockholm University, and Assistant Professor Reed Walker of the University of California at Berkeley ― say their paper is the first to examine how Stockholm’s congestion fee affected both local pollution levels and asthma attacks. It is also the first study to analyze the health effects of long-term exposure to cleaner air in an experimental setting. Funding was provided by the Swedish Research Council.
News Article | September 11, 2016
Imagine getting the bill for an ordinary dinner and noticing, in tiny print, that the restaurant charged you $40 for coffee. Surely you'd be upset. It turns out that hospitals inflate specific prices all the time in ways that aren't transparent to the patient, according to a new study that appeared today (Sept. 7) in the journal Health Affairs. Researchers at Johns Hopkins University in Baltimore found that many hospitals charged more than 20 times the cost of some services, particularly for certain services like CT scans and anesthesiology. The researchers said that the pattern of charging suggests that hospitals strategically look for surreptitious ways to boost revenue. "Hospitals apparently mark up higher in the departments with more complex services, because it is more difficult for patients to compare prices in these departments," Ge Bai, who led the study and is an assistant professor at the Johns Hopkins Carey Business School, said in a statement. [7 Medical Myths Even Doctors Believe] Other high-tech services with exorbitant markups include MRI, electrocardiology (tests of the heart's electrical patterns) and electroencephalography (tests of the brain's impulse patterns), according to the findings. The services that had fees that were more in line with their actual costs to hospitals included "old-school" physical therapy and nursing, the researchers found. The markups occurred in all types of hospitals, both private and nonprofit, the researchers said. Yet hospitals with the highest markups, on average, tended to be for-profit hospitals with strong power within their markets, because of either their system affiliations or their dominance of regional markets. In other words, those hospitals that can mark up prices, do mark up prices, according to the researchers. The pricing can have serious consequences for the payer, the researchers said. For example, hospitals whose costs for a CT scan run at about $100 may charge a patient $2,850 for a CT scan, the study found. "[The markups] affect uninsured and out-of-network patients, auto insurers and casualty and workers' compensation insurers," said Gerard Anderson, a professor at the Johns Hopkins Bloomberg School of Public Health and a co-author on the study. "The high charges have led to personal bankruptcy, avoidance of needed medical services and much higher insurance premiums." In their study, based on 2013 Medicare and other data from nearly 2,500 U.S. hospitals, the researchers compared a hospital's overall charge-to-cost ratio, which is the ratio of what the hospital charged compared to the hospital's actual medical expense. The charge is recorded on a document called a chargemaster, which is an exhaustive list of the prices for all hospital procedures and supplies. In 2013, the average hospital with more than 50 beds had an overall charge-to-cost ratio of 4.32 ? that is, the hospital charged $4.32 for every $1 of its own costs. However, at most hospitals that they examined, the researchers found that the charge-to-cost ratio was far higher in departments that were technologically advanced. The highest was in the CT department, with an average ratio of 28.5. [5 Amazing Technologies That Are Revolutionizing Biotech] While understanding that hospitals need to generate revenue, the researchers recommend a cap on markups and consistency from department to department. They also suggest more transparency, by requiring hospitals to provide patients with examples in clear language of rates from area hospitals or what Medicare would pay. "There is no regulation that prohibits hospitals from increasing revenues," Bai told Live Science. "The problem is when they raise rates on people that have no ability to say no because they have an emergency and cannot compare prices." This includes uninsured and out-of-network patients, "because they don’t have bargaining power against hospitals," Bai added. "We realize that any policy proposal to limit hospital markups would face a very strong challenge from the hospital lobby," Anderson said. "But we believe the markup should be held to a point that's fair to all concerned ? hospitals, insurers and patients alike." The researchers noted that Johns Hopkins Hospital has a charge-to-cost ratio of 1.3, among the lowest 1 percent of the sample studied. Maryland, the state in which the hospital is located, in general has the lowest ratios of any other state, they said. Follow Christopher Wanjek @wanjek for daily tweets on health and science with a humorous edge. Wanjek is the author of "Food at Work" and "Bad Medicine." His column, Bad Medicine, appears regularly on Live Science. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
News Article | December 8, 2016
The road to perdition, the adage goes, is paved with good intentions. Similarly, many observers say the road to poor economic performance may be paved with well-meaning regulations. Count economist Ricard Gil of Johns Hopkins University among those offering that observation. In a new study for Economic Inquiry, Gil and co-author Fernanda Gutierrez-Navratil show that the deregulation of the once-constrained television industry in Spain set off a boom in TV viewing. This in turn led to a substantial decline in attendance and box office revenues at Spanish movie houses. “When governments take regulatory actions, they focus on the particular industry they’re trying to help. But often neighboring industries are affected in unintended negative ways. That’s a tradeoff that is rarely considered in advance by regulators,” says Gil, an associate professor at the Johns Hopkins Carey Business School. The deregulation of Spanish television began with a 1995 national law that allowed each town to have up to two local stations. In 2002, with a more conservative government in Madrid, deregulation was expanded so larger towns could have a station for every 250,000 inhabitants. The number of local stations throughout the country multiplied, many of them running TV programs about local culture, politics, and sports that attracted viewers who might otherwise have gone out to the movies. Between 1995 and 2002, movie attendance in Spain increased by 55 percent, thanks to a rise in the number of suburban multiplex cinemas. However, in the eight years following the 2002 deregulation, movie attendance fell by 30 percent. A clear correlation exists, the paper affirms, between the increase in small-screen viewing and the decrease in big-screen viewing among Spaniards during this period. Gil, who earned his doctorate in economics from the University of Chicago, says he views this study as a sort of cautionary tale for regulators at all levels of government, across all industries and policy areas. The paper warns starkly against “naïve implementation of regulation and policy that does not examine potential impact on neighboring industries.” From beyond the media world, Gil cites the example of subsidies designed to protect the price of soybean crops in Argentina. The upshot was that many meat producers became soybean farmers to cash in on the new policy. The supply of meat went down, the price went up, and fewer Argentines could afford one of their favorite foods. “Is that to say regulating the soybean industry in Argentina was a mistake? Not necessarily,” Gil explains. “It’s probably a good thing when you consider how many people are dependent on the soybean market. But the government clearly didn’t understand what the consequences of their policy would be. They didn’t give enough thought to the possibility that if you pay some people to do A, then other people will stop doing B to produce A and get paid as well.” Last April, the two co-authors presented their paper at a seminar for policy makers at the Federal Communications Commission in Washington, D.C. The findings found an appreciative audience there, says Gil: “These were people who write many of the policies and regulations of the FCC, and they told us they’re often pressured to work quickly in making recommendations. They’d like to take more time with their assessments, and the paper helped put across their point that these issues are never as simple as they look. More time is needed to consider a regulation’s potential repercussions.” He adds, “We’re not saying it’s easy to anticipate every possible impact. But regulators need to start thinking more about ‘If we take this step, what’s going to happen as a result?’” Further research could dig even more deeply into how regulations for one industry can affect another, Gil suggests. For instance, would the TV-related declines in movie attendance and box office receipts hinder the ability of studios to produce high-quality, engaging films? The study “Does Television Entry Decrease the Number of Movie Theaters?” received financial support from the Spanish Ministry of Economy and Competitiveness and the Basque Country Government. Gutierrez-Navratil served as a post-doctoral researcher in economics at the Carey Business School while working with Gil on the project. Besides having appeared online last month, the paper is forthcoming in the print edition of Economic Inquiry.
Lee S.B.,Johns Hopkins Carey Business School
Health and Human Rights | Year: 2010
The past several years have seen an evolution in the obligations of pharmaceutical companies conducting clinical trials abroad. Key players, such as international human rights organizations, multinational pharmaceutical companies, the United States government and courts, and the media, have played a significant role in defining these obligations. This article examines how such obligations have developed through the lens of past, present, and future recommendations for informed consent protections. In doing so, this article suggests that, no matter how robust obligations appear, they will continue to fall short of providing meaningful protection until they are accompanied by a substantive enforcement mechanism that holds multinational pharmaceutical companies accountable for their conduct. Issues of national sovereignty, particularly in the United States, will continue to prevent meaningful enforcement by an international tribunal or through one universally adopted code of ethics. This article argues that, rather than continuing to pursue an untenable international approach, the Alien Torts Statute (ATS) offers a viable enforcement mechanism, at least for US-based pharmaceutical companies. Recent federal appellate court precedent interpreting the ATS provides the mechanism for granting victims redress and enforcing accountability of sponsors (usually pharmaceutical companies and research and academic institutions) for informed consent misconduct. Substantive human rights protections are vital in order to ensure that every person can realize the "right to health." This article concludes that by building on the federal appellate court's ATS analysis, which grants foreign trial participants the right to pursue claims of human rights violations in US courts, a mechanism can be created for enforcing not only substantive informed consent, but also human rights protections. © 2010 Lee.
Gallego G.,Columbia University |
Wang R.,Johns Hopkins Carey Business School
Operations Research | Year: 2014
We study firms that sell multiple substitutable products and customers whose purchase behavior follows a nested logit model, of which the multinomial logit model is a special case. Customers make purchasing decisions sequentially under the nested logit model: they first select a nest of products and subsequently purchase one within the selected nest. We consider the multiproduct pricing problem under the general nested logit model with product- differentiated price sensitivities and arbitrary nest coefficients. We show that the adjusted markup, defined as price minus cost minus the reciprocal of price sensitivity, is constant for all the products within a nest at optimality. This reduces the problem's dimension to a single variable per nest. We also show that the adjusted nest-level markup is nest invariant for all the nests, which further reduces the problem to maximizing a single-variable unimodal function under mild conditions. We also use this result to simplify the oligopolistic multiproduct price competition and characterize the Nash equilibrium. We also consider more general attraction functions that include the linear utility and the multiplicative competitive interaction models as special cases, and we show that similar techniques can be used to significantly simplify the corresponding pricing problems. © 2014 INFORMS.