In Côte d’Ivoire, the electricity grid covers only 54% of the localities in 2017 while the country has a high solar potential due to a regular solar radiation. This paper analyses the welfare ...benefits of using solar home system as a source of electricity in remote areas in Côte d’Ivoire. We use household-level data gleaned from 2015 Living Standards Measurement Surveys (LSMS). The household welfare is measured using three indicators that are income, education and health. To account for the endogeneity bias due to this simultaneity between welfare and energy use, we use a regression model with an endogenous treatment. The results confirm the positive effects of SHS use on welfare outcomes. Specifically, we find that the use of solar home system increases the household consumption per capita and the household average years of schooling by 41.96% and 1.79 years respectively and reduces the number of household members that report an illness by 2.35. The highly significant magnitude of SHS impact on the welfare in remote areas makes a powerful argument for implementing a policy for spreading its use.
•More than 3500 localities are not connected to the electricity grid in Côte d’Ivoire.•Solar photovoltaic panels are an alternative energy source in remote localities.•The welfare benefits of using solar home system in remote areas are analyzed.•41.96% increase in the household consumption per capita.•1.79 years increase in the household average years of schooling.
In Côte d’Ivoire, only 31.3% of peoples living in rural areas have access to the grid electricity. With the potential of solar energy of the country, the solar home system provides a crucial ...alternative that is being exploited by households. This paper analyses the effect of the adoption of solar home system on entrepreneurship in off-grid areas using the data from the 2015’s Living Standard Measurement Survey of Côte d’Ivoire. The estimates show that access to solar home system increases by 6.5% points the probability of engaging in entrepreneurial activities. This result holds for the trade, industry, and service sectors, while there is no evidence for the agricultural sector. Hence, the expansion of solar home system – as alternative to electricity grid in off-grid areas – has benefits for alleviating poverty via the promotion of entrepreneurship.
Entrepreneurship, Solar home system, Off grid areas.
Abstract
Background
The purpose of this study was to estimate individuals’ expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life ...expectancy in a sample of elderly people (50 years and older) in Côte d’Ivoire.
Methods
Paper-based questionnaires were administered to a sample (
n
= 267) of older adults residing in the city of Dabou, Côte d’Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities was collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals’ life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants.
A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants.
Results
The mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02, and 77.79 years in the first, second, third, and fourth component of the subjects’ overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component.
Conclusions
We extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly’s perception of aging, which could be used to forecast the demand for health services and long-term care needs.
Abstract
Background
Frailty, a syndrome resulting in heightened risk of negative outcomes for older adults, is increasing across the globe. However, little is known about the health service impacts ...of frailty in low-income countries (LICs), and in particular, sub-Saharan Africa (SSA). This study explores the relationship between frailty and health service 1) utilisation and 2) expenditure within Côte d’Ivoire.
Methods
Participants aged 50 years and over participated in the Living Condition, Health and Resilience among the Elderly study. Frailty was assessed using a 30-item Frailty Index (FI). The association between frailty and self-reported health service utilisation was analysed for general practitioners (GPs), specialists, overnight hospitalisations, traditional practitioners and self-medication. Expenditure over the previous month included consulting, medications, hospitalisations and total expenditure.
Results
Among participants
n
= 860, mean age (SD) = 61.8 (9.7) years, 42.9% female, 60.0% were frail, 22.8% pre-frail and 17.2% robust. The mean (SD) FI was 0.28 (0.17). Increased health service utilisation was associated with frailty for GP attendance, traditional practitioners and self-medication but not specialists or overnight hospitalisation. Pre-frailty and frailty were associated with increased total health service expenditure, with frailty also associated with aggregate consulting costs and medications.
Conclusions
Although frailty is associated with health service utilisation and expenditure in a variety of contexts, the study results suggest that such impacts may vary across the globe. The experience of frailty in LICs is likely to differ from that experienced elsewhere due to cultural traditions, attitudes to the health system, and accessibility, with more research needed.
This study examines the asymmetric effects of both international and local oil prices on the inflation rate in Côte d’Ivoire over the period 2005–2022. A nonlinear autoregressive distributed lag ...(NARDL) model is used to account for the asymmetric effects and analyse both long run and short run effects of oil prices on inflation. The results indicate that in the long run, an increase in international and local oil prices results in an increase in inflation rate, with higher effect for local oil prices. In addition, long run effects of a negative oil price variation on inflation have a greater magnitude than that of a positive one. The effects on inflation of Brent and diesel are statistically symmetrical. It is also found that the inflationary effects of diesel prices are greater than those of other petroleum products. Policy recommendations are provided based on the empirical results of the paper.
•A nonlinear model was used to analyse the effects of oil prices on inflation.•Both international and local oil prices have asymmetric effects on inflation.•Local oil prices have greater effects on inflation than international oil prices.•Diesel price variations have the highest inflationary effects.
To examine determinants, trends, and costs associated with 30-day all-cause readmission (R) for suicidal ideation (SI) in early-aged patients.
This was a retrospective cohort study using the ...2010-2014 Nationwide Readmissions Database. Discharge records for those aged 5-24 with an SI diagnosis were analyzed. Hierarchical models (HMs) were used to assess factors of R, length of stay (LOS), and total costs of Rs.
There were 197,603 SI index admissions (IAs). Of these, 2% had a R. The annualized trend of R rates for all age groups remained constant. Those aged 13-18 had the highest rate of Rs, while IA and R mean total costs were highest for those aged 5-12 (IA, $4,546-$5,822; R, $5,361-$7,113). The strongest risk factors for increasing R included nonelective admission and private hospital ownership. The strongest risk factors for increasing LOS and cost were major/extreme severity of illness and 30-day all-cause R. The intracluster correlation coefficient for the HMs were 0.06, 0.33, and 0.55 for the R, LOS, and cost model, respectively.
The R rate was highest for those in the 13-18 age group, while the costs were highest for those aged 5-12.
To develop and validate a tool to predict patients with ischaemic heart disease (IHD) at risk of excessive healthcare resource utilisation.
A retrospective cohort study.
We identified patients ...through the State of Florida Agency for Health Care Administration (N=586 518) inpatient dataset.
Adult patients (at least 40 years of age) admitted to the hospital with a diagnosis of IHD between 1 January 2007 and 31 December 2016.
We identified patients whose healthcare utilisation is higher than presumed (analysis of residuals) and used logistic regression (binary and multinomial) in estimating the predictive models to classify individual as high-need, high-care (HNHC) patients relative to inpatient visits (frequency of hospitalisation), cost and hospital length of stay. Discrimination power, prediction accuracy and model improvement for the binary logistic model were assessed using receiver operating characteristic statistic, the Brier score and the log-likelihood (LL)-based pseudo-R
, respectively. LL-based pseudo-R
and Brier score were used for multinomial logistic models.
The binary logistic model had good discrimination power (c-statistic=0.6496), an accuracy of probabilistic predictions (Brier score) of 0.0621 and an LL-based pseudo-R
of 0.0338 in the development cohort. The model performed similarly in the validation cohort (c-statistic=0.6480), an accuracy of probabilistic predictions (Brier score) of 0.0620 and an LL-based pseudo-R
of 0.0380. A user-friendly Excel-based HNHC risk predictive tool was developed and readily available for clinicians and policy decision-makers.
The Excel-based HNHC risk predictive tool can accurately identify at-risk patients for HNHC based on three measures of healthcare expenditures.
In this study, our aim is to explore the formation of electricity consumption habits in Cote d'Ivoire, specifically focusing on new subscribers. The growth of residential electricity consumption ...globally has been influenced by these habits, which can lead to inertia and inefficient energy usage. Using the unique database of the National Electricity Company, we uncover that electricity consumption habits exhibit a high level of persistence, and this persistence tends to strengthen over time. These findings highlight the need to develop policies that encourage electricity efficiency among new subscribers, to combat energy inefficiency and foster positive consumption habits at the household level.
Suicidal ideation (SI) is a major health concern in children, adolescents, and young adults (CAYA) population. Inaccurate estimates of SI-related hospital readmission rates may contribute to ...inappropriate allocation of resources for the prevention of future readmissions. The estimation of these readmission rates using claims data may be sensitive to the diagnosis code position used to establish analytic cohorts.
To examine the prevalence and effects of SI diagnosis code position in claims on 30-day readmission rates using the Nationwide Readmissions Database (NRD).
This was a cross-sectional study using the NRD (2010–2015). We established six cohorts of hospitalized CAYA (5–24 years old) with a diagnosis of SI based on different combinations of SI diagnosis code (ICD-9 code V62.84) positions in claims. Thirty-day hospital readmission rates following an index SI discharge were estimated for each cohort. We tested the null hypothesis that hospital readmission rates following an index SI discharge are not sensitive to diagnosis code positions using a test for equality of proportions between the predefined SI cohorts.
The prevalence of SI diagnosis codes increased yearly from 2.9% in 2010 to 5.8% in 2015. SI hospital readmission rates ranged from 0 to 41.1 per 1000 index events based on cohort definitions (i.e. diagnosis code positions). We rejected the null hypothesis that SI-related readmission rates are not sensitive to diagnosis code positions.
SI-related readmission rate estimates are sensitive to SI diagnosis code positions. Determining appropriate diagnostic positions can further improve readmission analyses for SI and its applications in healthcare policies.
There is an increasing demand for supporting the adoption of rapid whole-genome sequencing (rWGS) by demonstrating its real-world value. We aimed to assess the cost-effectiveness of rWGS in ...critically ill pediatric patients with diseases of unknown cause. Data were collected prospectively of patients admitted to the Nicklaus Children's Hospital's intensive care units from March 2018 to September 2020, with rWGS (N = 65). Comparative data were collected in a matched retrospective cohort with standard diagnostic genetic testing. We determined total costs, diagnostic yield (DY), and incremental cost-effectiveness ratio (ICER) adjusted for selection bias and right censoring. Sensitivity analyses explored the robustness of ICER through bootstrapping. rWGS resulted in a diagnosis in 39.8% while standard testing in 13.5% (p = 0.026). rWGS resulted in a mean saving per person of $100,440 (SE = 26,497, p < 0.001) and a total of $6.53 M for 65 patients. rWGS in critically ill pediatric patients is cost-effective, cost-saving, shortens diagnostic odyssey, and triples the DY of traditional approaches.
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