Technical Notes

In 1996, 大cq9跳高高试玩版进行了第一次医疗经济影响研究.  这项工作是由主要行业议会的医疗委员会赞助的, whose overall charge was to maintain, expand, 并推动圣安东尼奥成为世界级的医疗保健和生物科学中心.  It was widely acknowledged that the Healthcare and Bioscience sector’s contribution to the local economy was substantial, 但此前从未有人试图量化这种影响.

委员会后来决定定期，现在是每两年编制一次这方面的资料.  The present report is the 18^th iteration of the study.

医疗委员会及其目前的继承者, 商会的医疗保健和生物科学委员会, 对医疗保健和生物科学行业的包容性定义.  它不仅包括医院和直接保健提供者(医生), dentists, optometrists and others), 还有医学和生物研究中心, 药品和其他保健相关产品的生产商, health insurance companies and (in the comprehensive version first offered in the 2009 study) medical education.  公共资助的初级保健和与健康有关的社会服务提供者也包括在内, as are military and veterans’ healthcare.  "保健"的定义既包括预防保健，也包括传统的医疗服务.

Information Sources

The information for the “traditional” estimates presented here is derived from the Texas Workforce Commission’s Covered Employment and Wages database.  这些数据(总就业和总工资)是从提交给国家的失业保险报告中收集的.  The data is aggregated by the TWC into the lines of business defined by the North American Industrial Classification System (NAICS) coding framework.   它代表了在每个NAICS子代码中有员工的所有企业的100%样本.

本研究中包含的具体子代码列在报告的末尾.  它们非常详细地涵盖了医疗保健和相关行业.

因为TWC一直在不断修正其历史数据以提高准确性, the data used in this study for 2017 and earlier years reflect many small changes from the data upon which previous Economic Impact Studies were based.  本报告中的数据基于最新发布的TWC数据, so they represent the most accurate measure now available of the industry and its subsectors in those earlier years.

选择要包含哪些NAICS代码并不是一项简单的任务.  Often it is obvious that all (or virtually all) of the businesses classified in a given NAICS category are part of the Healthcare and Bioscience industry (for example, NAICS category 32541, Pharmaceutical and medicine manufacturing).  In other sectors, however, 与健康有关的产品和服务只占该守则所列活动的一小部分.  For example, category 44611 (Pharmacies and drug stores) describes a group of businesses that are an integral part of the healthcare delivery system but which also sell items, like greeting cards, that really do not belong in this sector.

因此，决定哪些行业包括在内，哪些行业排除在外是一个判断问题.  委员会所遵循的规则是将任何5位数或6位数(最窄的定义)的行业包括在内 in San Antonio seems to include a high proportion of medical- or bioscience-related businesses and to exclude other categories for which only a small proportion of the included business activity is medically related.  Thus, industry 54171 (Physical, engineering and biological research) was included even though many of the kinds of research described in the NAICS code book are not health-related, because the Committee believes that in this city the largest share of such research is medical or biological in nature.  Similarly, the Committee excluded code 6113 (Colleges, universities and professional schools), even though it includes the UT Health San Antonio and many other educational and research activities relevant to Healthcare and Bioscience, 因为这些课程只占圣安东尼奥高等教育的一小部分.  The inclusion of The UT Health Science Center and the Baylor College of Medicine in the comprehensive estimates, using data from a different source, is an attempt to address this limitation.  By following this rule, the overall estimates of employment, payroll and economic impact should be approximately correct even though some relevant activity has been left out and some irrelevant activity included.  使用TWC数据库的研究将总是受到这种妥协的限制.  However, 该数据库的优势在于几乎100%覆盖了雇主, 一致的收集程序和可用性是相当重要的.

必要的信息纳入UT健康圣安东尼奥, the Baylor College of Medicine and the military presence in San Antonio’s medical industry was derived from data supplied by these two entities from their own financial reports.  因为这些数据的汇编目的与向TWC报告的目的不同, using different procedures, 归因于这些活动的额外贡献必须被理解为近似值.  尽管如此，它们的影响是如此之大，以至于将它们排除在外是一种严重的轻描淡写.

Methodology

TWC提供历年每个季度的就业和工资信息.  The employment figures for the four quarters in each year were averaged to obtain a representative employment level, 工资数据是通过将四个季度中每个季度报告的工资总和计算出来的.  平均工资是用总工资除以雇员人数来计算的.

将工资信息转化为经济影响涉及到转换因子的应用.   Sales or revenue for each NAICS industry is calculated from the TWC’s payroll figures using the ratio of sales to payroll for the corresponding industry in the San Antonio Metropolitan Statistical Area as reported in the most relevant economic census.  Thus, conversion factors based on the 2012 Economic Census were applied to data from years 2009-2019; factors based on the 2002 Economic Census were used for the 2004 estimates; while conversion factors based on the 1997 Economic Census were used for 1999 and 1994.  这些数字是特定于每个NAICS代码的，并且(在2012年)从最低的1.老年人服务64项，最高达23项.药剂师的商品批发商842.  This conversion factor simply translates payroll information into the amount of economic activity or impact generated for each specific industry.  Sectors in which labor costs are a small portion of total costs will thus have the largest conversion factors.

This conversion factor is not the multiplier often employed in economic impact studies to calculate the total impact of an industry’s export sales on the local economy.  Multiplier effects represent the added impact on a region’s economy from sales or services provided to customers outside that region.  When such sales take place, 新的资金被注入当地经济, 这些钱(部分)又花在了当地的商品和服务上.  This additional spending generates economic activity that would not have taken place if all sales had been internal.  直到2009年，商会的医疗保健和生物科学研究都没有包括乘数效应, 但最近，该委员会决定将它们纳入综合估计.  The committee members consulted experts in the many subsectors of the industry to determine plausible export percentages for each.  因为乘数效应只产生于出口销售, 对出口百分比的可靠估计对于列入这些影响至关重要.  乘数效应的美元价值是通过应用美国RIMS II模型的乘数来计算的. S. 美国商务部经济分析局对出口销售额的估计.  BEA定期更新RIMS II乘法器, 因此，这里给出的估计使用了一组最接近所研究年份的乘数.