This paper uses a unique panel dataset of consumer financial transactions to study how consumers respond to an exogenous unanticipated income shock. Consumption rose significantly after the fiscal ...policy announcement: during the ten subsequent months, for each $1 received, consumers on average spent $0.80. We find a strong announcement effect—19 percent of the response occurs during the first two-month announcement period via credit cards. Subsequently, consumers switched to debit cards after disbursement before finally increasing spending on credit cards in the later months. Consumers with low liquid assets or with low credit card limit experienced stronger consumption responses.
Distance and Private Information in Lending Agarwal, Sumit; Hauswald, Robert
Review of financial studies/The Review of financial studies,
07/2010, Volume:
23, Issue:
7
Journal Article
Peer reviewed
Open access
We study the effects of physical distance on the acquisition and use of private information in informationally opaque credit markets. Using a unique data set of all loan applications by small firms ...to a large bank, we show that borrower proximity facilitates the collection of soft information, leading to a trade-off in the availability and pricing of credit, which is more readily accessible to nearby firms albeit at higher interest rates ceteris paribus. Analyzing loan rates and firms' decision to switch lenders provides further evidence for banks' strategic use of private information. However, distance erodes our lender's ability to collect proprietary intelligence and to carve out local captive markets, suggesting that the requisite soft information is primarily local.
Burnout negatively affects physician health, productivity, and patient care. Its prevalence is high among physicians, especially those in primary care, yet few qualitative studies of burnout have ...been performed that engage frontline primary care practitioners (PCPs) for their perspectives.
To identify factors contributing to burnout and low professional fulfillment, as well as potential solutions, by eliciting the views of PCPs.
For this qualitative study, focus group discussions and interviews were conducted between February 1 and April 30, 2018, among 26 PCPs (physicians, nurse practitioners, and physician assistants) at a US academic medical center with a network of 15 primary care clinics. Participants were asked about factors contributing to burnout and barriers to professional fulfillment as well as potential solutions related to workplace culture and efficiency, work-life balance, and resilience.
Perceptions of the factors contributing to burnout and low professional fulfillment as well as potential solutions.
A total of 26 PCPs (21 physicians, 3 nurse practitioners, and 2 physician assistants; 21 81% women) from 10 primary care clinics participated. They had a mean (SD) of 19.4 (9.5) years of clinical experience. Six common themes emerged from PCPs' experiences with burnout: 3 external contributing factors and 3 internal manifestations. Participants described their workloads as excessively heavy, increasingly involving less "doctor" work and more "office" work, and reflecting unreasonable expectations. They felt demoralized by work conditions, undervalued by local institutions and the health care system, and conflicted in their daily work. Participants conveyed a sense of professional dissonance, or discomfort from working in a system that seems to hold values counter to their values as clinicians. They suggested potential solutions clustered around 8 themes: managing the workload, caring for PCPs as multidimensional human beings, disconnecting from work, recalibrating expectations and reimbursement levels, promoting PCPs' voice, supporting professionalism, fostering community, and advocating reforms beyond the institution.
In sharing their perspectives on factors contributing to burnout, frontline PCPs interviewed during this study described dissonance between their professional values and the realities of primary care practice, an authority-responsibility mismatch, and a sense of undervaluation. Practitioners also identified possible solutions institutions might consider investing in to resolve professional dissonance, reduce burnout rates, and improve professional fulfillment.
We analyze the effects of cognitive abilities on two examples of consumer financial decisions where suboptimal behavior is well defined. The first example features the optimal use of credit cards for ...convenience transactions after a balance transfer and the second involves a financial mistake on a home equity loan application. We find that consumers with higher overall test scores, and specifically those with higher math scores, are substantially less likely to make a financial mistake. These mistakes are generally not associated with nonmath test scores.
Benzodiazepines are implicated in a growing number of overdose-related deaths.
To quantify patterns in outpatient benzodiazepine prescribing and to compare them across specialties and indications.
...This serial cross-sectional study (January 1, 2003, through December 31, 2015) used nationally representative National Ambulatory Medical Care Survey data. The yearly population-based sample of outpatient visits among adults, ranging from 20 884 visits in 2003 (representing 737 million visits) to 24 273 visits in 2015 (representing 841 million visits) was analyzed. Prescribing patterns were examined by specialty and indication and used to calculate the annual coprescribing rate of benzodiazepines with other sedating medications. Data were analyzed from July 1, 2017, through November 30, 2018.
Annual benzodiazepine visit rate.
Among the 386 457 ambulatory care visits from 2003 through 2015, a total of 919 benzodiazepine visits occurred in 2003 and 1672 in 2015, nationally representing 27.6 million and 62.6 million visits, respectively. The benzodiazepine visit rate doubled from 3.8% (95% CI, 3.2%-4.4%) to 7.4% (95% CI, 6.4%-8.6%; P < .001) of visits. Visits to primary care physicians accounted for approximately half of all benzodiazepine visits (52.3% 95% CI, 50.0%-54.6%). The benzodiazepine visit rate did not change among visits to psychiatrists (29.6% 95% CI, 23.3%-36.7% in 2003 to 30.2% 95% CI, 25.6%-35.2% in 2015; P = .90), but increased among all other physicians, including primary care physicians (3.6% 95% CI, 2.9%-4.4% to 7.5% 95% CI, 6.0%-9.5%; P < .001). The benzodiazepine visit rate increased slightly for anxiety and depression (26.6% 95% CI, 22.6%-31.0% to 33.5% 95% CI, 28.8%-38.6%; P = .003) and neurologic conditions (6.8% 95% CI, 4.8%-9.5% to 8.7% 95% CI, 6.2%-12.1%; P < .001), but more so for back and/or chronic pain (3.6% 95% CI, 2.6%-4.9% to 8.5% 95% CI, 6.0%-11.9%; P < .001) and other conditions (1.8% 95% CI, 1.4%-2.2% to 4.4% 95% CI, 3.7%-5.2%; P < .001); use did not change for insomnia (26.9% 95% CI, 19.3%-36.0% to 25.6% 95% CI, 15.3%-39.6%; P = .72). The coprescribing rate of benzodiazepines with opioids quadrupled from 0.5% (95% CI, 0.3%-0.7%) in 2003 to 2.0% (95% CI, 1.4%-2.7%) in 2015 (P < .001); the coprescribing rate with other sedating medications doubled from 0.7% (95% CI, 0.5%-0.9%) to 1.5% (95% CI, 1.1%-1.9%) (P < .001).
The outpatient use of benzodiazepines has increased substantially. In light of increasing rates of overdose deaths involving benzodiazepines, understanding and addressing prescribing patterns may help curb the growing use of benzodiazepines.
FinTech, Lending and Payment Innovation: A Review Agarwal, Sumit; Zhang, Jian
Asia-Pacific journal of financial studies,
June 2020, 2020-06-00, 20200601, 2020-06, Volume:
49, Issue:
3
Journal Article
Peer reviewed
The global landscape has seen the advent of new technology in offering innovative financial services and products and reshaping the financial sector, namely FinTech. In this review, we discuss the ...literature on recent FinTech development and its interaction with both banks and consumers. We synthesize the insights it provides into two domains: credit supply and payment and clearing services. The rise of FinTech has introduced digital transformation of the “bricks‐and‐mortar” banking model and dramatically changed the way financial services are delivered. We also present several future questions and directions that are worthy of investigation for researchers and policy‐makers.
Efforts to better support primary care include the addition of primary care-focused billing codes to the Medicare Physician Fee Schedule (MPFS).
To examine potential and actual use by primary care ...physicians (PCPs) of the prevention and coordination codes that have been added to the MPFS.
Cross-sectional and modeling study.
Nationally representative claims and survey data.
Medicare patients.
Frequency of use and estimated Medicare revenue involving 34 billing codes representing prevention and coordination services for which PCPs could but do not necessarily bill.
Eligibility among Medicare patients for each service ranged from 8.8% to 100%. Among eligible patients, the median use of billing codes was 2.3%, even though PCPs provided code-appropriate services to more patients, for example, to 5.0% to 60.6% of patients eligible for prevention services. If a PCP provided and billed all prevention and coordination services to half of all eligible patients, the PCP could add to the practice's annual revenue $124 435 (interquartile range IQR, $30 654 to $226 813) for prevention services and $86 082 (IQR, $18 011 to $154 152) for coordination services.
Service provision based on survey questions may not reflect all billing requirements; revenues do not incorporate the compliance, billing, and opportunity costs that may be incurred when using these codes.
Primary care physicians forego considerable amounts of revenue because they infrequently use billing codes for prevention and coordination services despite having eligible patients and providing code-appropriate services to some of those patients. Therefore, creating additional billing codes for distinct activities in the MPFS may not be an effective strategy for supporting primary care.
National Institute on Aging.
Immediately following a minimum wage hike, household income rises on average by about $250 per quarter and spending by roughly $700 per quarter for households with minimum wage workers. Most of the ...spending response is caused by a small number of households who purchase vehicles. Furthermore, we find that the high spending levels are financed through increases in collateralized debt. Our results are consistent with a model where households can borrow against durables and face costs of adjusting their durables stock.
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