Este artigo discute resultados de pesquisa sobre formas de financiamento do negócio de energia elétrica no Brasil, por controle de capital, utilizando amostra de 31 firmas, de 1997 a 2013. A pesquisa investiga como essas firmas são preponderantemente financiadas, por capital próprio (CP) seguindo a Pecking OrderTheory (POT) ou capital de terceiros (CT), e ainda como financiamento e taxa de retorno se relacionam. O objetivo é analisar as formas de financiamento e a relação do uso preponderante de capital (UPC) com retorno preponderante de capital (RPC). A metodologia utiliza modelos analíticos e regressão linear multivariada para obtenção dos resultados. Os resultados sugerem que as firmas tem financiamento compatível com a POT; a relação entre CP e CT é menor nas firmas com controle privado; o retorno das firmas com controle privado é superior ao das firmas com controle governamental, o UPC com deslocamento dinâmico, é inverso ao RPC. A pesquisa inova e se diferencia por relacionar UPC com RPC.
Este artigo discute formas de financiamento de empresas de energia elétrica no Brasil, porcontrole de capital, listadas na BOVESPA, de 1997 a 2013. A amostra é composta de 31empresas sendo 21 com controle privado e 10 com controle governamental. A motivação dapesquisa está relacionada com a importância da energia elétrica no crescimento da indústria,geração de emprego e riqueza, e na forma que as empresas se financiam. O problema depesquisa investiga como as empresas de energia elétrica são preponderantemente financiadas,por capital próprio seguindo a Pecking Order Theory ou por capital de terceiros, e qual arelação do financiamento com a taxa de retorno, por controle de capital. Neste contexto oobjetivo da pesquisa é analisar as formas de financiamento das empresas e a relação do usopreponderante de capital (UPC) e com o retorno preponderante de capital (RPC), que é aprincipal inovação da pesquisa. A metodologia é quantitativa, utilizando modelos analíticosespecíficos e modelo de regressão linear múltipla, para subsidiar testes de hipóteses. Osresultados sinalizam que as empresas do negócio de energia elétrica, preponderantementeusam capital próprio, compatível com a Pecking Order Theory; a relação entre o capitalpróprio e o capital de terreiros é menor nas firmas com controle privado; o retorno das firmascom controle privado é superior ao das firmas com controle governamental, e o usopreponderante de capital (UPC), com deslocamento dinâmico, é inverso ao retornopreponderante de capital (RPC). Finalmente, ainda que não se possa generalizar apreponderância do uso do capital próprio como preferência ou restrição à obtenção de capitalde terceiros, as contribuições da pesquisa são relevantes para pesquisadores e usuários dainformação do negócio de energia elétrica.
OBJECTIVES: Malnutrition (MN) in cancer patients is associated with poorer clinical outcomes. Here we demonstrate benefits of timely nutritional therapy based on amalgamated real-world data that informs treatment optimization. METHODS: We analyzed data from three observational, retrospective studies that used administrative healthcare data to investigate diagnosis of malnutrition and use of nutritional therapy in cancer patients in France (N¼644,720), Italy (N¼58,468) and Germany (N¼4,642) to highlight the clinical benefits of clinical nutrition in oncology. Methods included descriptive statistic, propensity score matched analysis to compare length and frequency of hospitalizations in France in patients with early, late, and no MN diagnosis during hospitalization, and Kaplan-Meier survival analysis. RESULTS: Despite ESPEN recommendations for routine screening, MN diagnoses rates are much lower than anticipated based on literature indicating rates of 40-60% (10% at first hospitalization in France). Nutritional therapy remains under-utilized (i.e. in only 50% of patients with cachexia in Germany) even if clearly indicated. Data from Italy and Germany shows that nutritional therapy is often initiated as an end-of-life measure 3 to 4 months before death. Results from France indicate that early MN diagnosis (i.e. at first, compared to after first cancer hospitalization) is associated with a~45% lower frequency of cancer hospitalizations and a reduced length-of-stay (-25%) during follow-up. Data from Italy indicates a survival advantage of over 3 months among patients with and without metastatic disease, whose malnutrition was diagnosed and treated early. CONCLUSIONS: Our analyses indicate that MN diagnosis and use of nutritional therapy remains low and sub-optimal. Our results, notwithstanding limitations of administrative retrospective data, provide indication that early use of clinical nutrition may help to improve patients' outcomes and optimize use of health care resources. Improving malnutrition diagnosis and generating evidence to confirm benefits of clinical nutrition using detailed clinical data are immediate priorities in oncology. OBJECTIVES:Outcomes-based payment arrangements (OBA) for cancer drugs are used internationally with more limited use in the U.S. These arrangements seek to increase the realized value of pharmaceuticals and decrease value uncertainty for payers. Our objective was to identify and characterize OBAs involving oncology products. METHODS: OBAs were defined as arrangements between a payer and a pharmaceutical developer where the price or reimbursement level is related to its performance in clinical practice. We used a systematic search, leveraging the University of Washington's Performance Based Risk Sharing Database that contains information obtained by searching Google, PubMed, and government websites from 1993 to 2018. Included arrangements had a financial or health outcomes related component linked to reimbursement. We collected data on product name, year, country, tumor type, payer,...
Considering that data from the Social Security Secretariat of the Ministry of Finance show that the social security regimes themselves have been maintaining deficits all over the years, and that alternatives should be discussed in order to seek the financial and actuarial equilibrium of these regimes, the current study has as its general goal to analyze the perspectives of adopting an Asset and Liability Management (ALM) in its own social security regimes. In the process of structuring the modeling used for the RPPS, a content analysis of ALM models was made from the literature review, with the stochastic modeling of asset returns and inflation, selected assets that provided the actuarial target with their earnings and developed like an objective function, aiming to meet the regulatory constraints of RPPS. The findings of the study show that the adoption to ALM is feasible in own regimes, and that when apply the ALM model developed through multi-period stochastic programming in a real RPPS, it was verified that the adoption of the ALM provided an improvement in the marriage of flows of assets and liabilities of the RPPS, maximizing the previously obtained results without its use. Therefore, it is possible to infer that the ALM can be an important instrument for the sustainability of social security accounts, confirming the literature findings, which considers the adoption of the ALM can be presented as an enabling measure to make compatible the flow of financial availability at each moment of payment of the benefits in their office, besides assisting in the construction of investment policies that improve the risk and return relation of the investment portfolio of the RPPS.
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