Anthony A. Romeo

Social and Private Rates of Return from Industrial Innovations

I. Introduction, 221.—II. The sample of innovations, 222.—III. Estimation of social benefits: product innovations used by firms, 222.—IV. Parallel innovative efforts, time horizon, and rates of return, 226.—V. Product innovations used by households, 229.—VI. Process innovations, 231.—VII. Social and private rates of return, 233.—VIII. Factors associated with the gap between social and private rates of return, 235.—IX. Unemployment, repercussions on other markets, and future changes in technology, 238.—X. Conclusion, 239.

Technology Transfer to Overseas Subsidiaries by U. S.-Based Firms

Although economists and policy makers have devoted considerable attention to the transfer of technology by U. S.-based multinational firms to their overseas subsidiaries, very little is known about the nature of the technology that is being transferred overseas in this way, the extent to which it leaks out to non-U. S. competitors, the size of the benefits it confers on the host (and other non-U. S.) countries, and the sorts of non-U. S. firms that receive the largest benefits of this sort. This paper presents findings that shed new light on each of these topics.

Overseas Research and Development by US-Based Firms

AbstractThe following sections are included:INTRODUCTIONOVERSEAS R AND D EXPENDITURES: 1960–1980FACTORS INFLUENCING THE PERCENTAGE OF A FIRMs R AND D EXPENDITURES CARRIED OUT OVERSEASOVERSEAS R AND D: MINIMUM ECONOMIC SCALE AND RELATIVE COSTOVERSEAS R AND D: NATURE OF WORK AND RELATION TO DOMESTIC R AND DCONCLUSIONSACKNOWLEDGMENTSNOTESREFERENCES (This abstract was borrowed from another version of this item.)

Prospective reimbursement and the diffusion of new technologies in hospitals

This paper presents new evidence on the effects of prospective hospital reimbursement on the diffusion of new medical technologies in American hospitals. The probability, speed, and extent of adoption of five specific new technologies in six states, three with prospective reimbursement and three without, are examined using the results of a hospital survey conducted by the American Hospital Association for this study in 1980. The analysis demonstrates the influence of prospective reimbursement on the diffusion of new technologies. It is clear as well that these effects depend upon the specific attributes of the prospective reimbursement program and the characteristics of the technologies themselves.

R&D price indexes and real R&D expenditures in the United States☆

The rate of inflation in R&D is very difficult to measure. The official government statistics in the United States use the GNP deflator to deflate R&D expenditures. Little is known about the extent to which price indexes for R and D inputs, if they were constructed in various industries, would differ from the GNP deflator. This paper reports the findings of a study that attempts to fill this important gap. Laspeyres price indexes are presented both for R and D inputs and for inputs used in other stages of the innovation process. Also, price indexes for R and D inputs are constructed, assuming that the relevant production function is Cobb-Douglas. On the basis of the results, we estimate the extent and direction of the errors in the official R&D statistics due to the use of the GNP deflator. Our findings, based on detailed data obtained from firms accounting for about one-ninth of all company-financed R&D in the U.S., indicate that the GNP deflator underestimated the rate of price increase for R&D inputs during 1969-79 in practically every industry we studied. The bulk of the apparent increase in real R&D in these industries (which was relatively modest in any event) seems to have been due to the inadequacies of the GNP deflator. One important moral seems to be that more attention and resources should be devoted to the construction of better price indexes for R&D.

Suprascapular Nerve Neuropathy

Although not a common cause of shoulder dysfunction in patients, entrapment of the suprascapular nerve can become a debilitating problem, specifically in the overhead athlete population. As this problem is somewhat rare, it can be difficult to diagnose on initial presentation and is often missed. The suprascapular nerve can be injured secondary to repetitive traction injury, trauma, and compression, often by cystic lesions. The nerve is specifically vulnerable to injury at two points along its course: the suprascapular notch and spinoglenoid notch. Entrapment of the suprascapular nerve typically occurs in patients between the ages of 20 and 50 years, is more common in men than women, and has a reported incidence of 1%–2% in the general population in patients who present with shoulder pain. There are several athletic populations that are at risk for suprascapular nerve entrapment, including swimmers, volleyball players, tennis players, and baseball players, with baseball pitchers and volleyball players at the highest risk for injury. Unless a large cystic lesion is seen compressing the suprascapular nerve on magnetic resonance imaging (MRI), nonoperative management is typically the initial treatment of choice. In patients who fail a course of nonoperative treatment, operative decompression can provide excellent results when performed well.

Are Post-Operative Drains Beneficial in Total and Reverse Total Shoulder Arthroplasty?

Background: Total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) are effective treatments for glenohumeral arthritis and rotator cuff arthropathy. Purpose: To determine if the use of a post operative closed-suction drain following TSA and RTSA affects hemoglobin levels, clinical outcomes, and complications. Hypothesis: Patients who did not receive a drain will have less hemoglobin loss, better clinical outcome scores, and lower complication rates following TSA/RTSA. Methods: All patients who underwent TSA or RTSA by one of two surgeons between January 1, 2011 and May 15, 2013 were recorded. Patient demographic information was recorded. Patients were grouped based on use of a post-operative deep drain. Pre and post-operative hemoglobin, length of hospital stay, clinical outcome scores, and complications were recorded and analyzed. Results: Sixty-four patients (average age 58.9±9.9 years, 55% male) underwent RTSA (13) or TSA (51) without the use of a post-operative closed-suction drain; 304 patients (average age 66.7±9.6 years, 55% female) underwent RTSA (179) or TSA (125) with the use of a post-operative closed-suction drain. Average follow up was similar in both groups: 14.95±7.22 months in the drain group and 14.55±6.74 months in the no drain group (p=.723). Using multivariate analysis to control for confounding variables and differences between the two groups, drain usage was correlated with significantly lower postoperative hemoglobin (p=0.0002), longer length of stay (p≤0.0001), and lower postoperative SST (p=0.003). Conclusion: Closed-suction drain usage following RTSA and TSA leads to greater loss of hemoglobin and longer length of stay. No clinically significant differences in transfusion rate and clinical outcome scores were seen with or without drain usage. LEVEL OF EVIDENCE: III: case-control study.

Iliac-Crest Graft and Distal Tibia Allograft Procedure

Glenohumeral stability depends on active and passive restraints as well as coordinated interactions between the rotator-cuff muscles and bony structures to properly maintain the humeral head within the glenoid. Glenohumeral instability is a pathologic state in which excessive translation of the humeral head within the glenoid leads to pain, decreased range of motion, impaired functional status, and subluxation or dislocation. This may be a result of injury to the labrum, capsule, ligaments, rotator-cuff muscles, or bony articular surface. The labrum is an important structure that deepens the glenoid fossa and serves as a static stabilizer and attachment for capsuloligamentous structures, and the glenoid is a critical structure that helps maintain static restraint of the humerus [1]. Traumatic bony insults causing glenoid-bone deficiency are a common reason for recurrent anterior shoulder instability and capsulolabral reconstruction failure. Glenoid reconstruction can be surgically challenging, and there are a number of reconstruction techniques, including coracoid transfer [2], [3], iliac-crest autograft [4], [5], allograft glenoid tissue, and other allograft tissue, such as the femoral head, and osteochondral allografts such as the distal tibia [6].