Principal Agency Theory and Health Care Utilization

This article uses a principal agent framework to examine the role that monitoring costs faced by an insurer have on health care utilization. We compare hospital lengths of stay for fee-for-service and capitated patients in low and high monitoring cost situations. Monitoring costs associated with a particular procedure are assumed to be high when there is large variation across patients in hospital lengths of stay. The empirical results indicate that differences in utilization between fee-for-service and capitated patients increase as monitoring costs increase. However, we do not find that fee-for-service reimbursement is used less in the difficult to monitor situations. (JEL I1 )     

Estimating minimum adequate foster care costs for children in the United States

Although foster care homes play a crucial role in providing stable placements to children who enter the child welfare system due to maltreatment, there is currently no federal minimum rate nor standard methodology to establish adequate rates to support foster parents to meet these children's needs. Therefore, it is important to establish a model to estimate the real costs associated with caring for children to serve as a foundation for states to set adequate reimbursement rates. The objectives of this study are to: use the methodology of a 2007 study to establish foster care minimum adequate rates for children (MARC) based on the child's age and geographical location in every state; update the MARC with cost of living adjustments to 2016; examine changes in gaps between the MARC and the current foster care rates; and identify states that have made increases to their reimbursement rates, relative to the MARC over time. Results found that all but four states provide lower foster care reimbursement rates than the adequate costs in 2016. This study recommends that, at the federal level, enhanced precision in operational definitions of care categories could increase consistency in the way that states reimburse foster families. Additionally, findings provide policy suggestions to establish a national methodology standard and increase foster care rates to the level that will meet children's needs. This study will enhance the scant body of literature found on establishing an economic model to estimate foster care costs.     

The persistence of cliques in the post‐communist state. The case of deniability in drug reimbursement policy in Poland

This article explores a key question in political sociology: Can post‐communist policy‐making be described with classical theories of the Western state or do we need a theory of the specificity of the post‐communist state? In so doing, we consider Janine Wedel's clique theory, concerned with informal social actors and processes in post‐communist transition. We conducted a case study of drug reimbursement policy in Poland, using 109 stakeholder interviews, official documents and media coverage. Drawing on ‘sensitizing concepts’ from Wedel's theory, especially the notion of ‘deniability’, we developed an explanation of why Poland's reimbursement policy combined suboptimal outcomes, procedural irregularities with limited accountability of key stakeholders. We argue that deniability was created through four main mechanisms: (1) blurred boundaries between different types of state authority allowing for the dispersion of blame for controversial policy decisions; (2) bridging different sectors by ‘institutional nomads’, who often escaped existing conflicts of interest regulations; (3) institutional nomads’ ‘flexible’ methods of influence premised on managing roles and representations; and (4) coordination of resources and influence by elite cliques monopolizing exclusive policy expertise. Overall, the greatest power over drug reimbursement was often associated with lowest accountability. We suggest, therefore, that the clique theory can be generalized from its home domain of explanation in foreign aid and privatizations to more technologically advanced policies in Poland and other post‐communist countries. This conclusion is not identical, however, with arguing the uniqueness of the post‐communist state. Rather, we show potential for using Wedel's account to analyse policy‐making in Western democracies and indicate scope for its possible integration with the classical theories of the state.     

COMPENSATING WAGE DIFFERENTIALS FOR MANDATORY OVERTIME?

This paper examines the extent to which individuals who are employed by firms that require mandatory overtime receive a compensating wage differential for this "distasteful" working condition. While the empirical results indicate that the average worker does not receive a positive differential for this working condition, the results do indicate that unionized workers and (perhaps) newly hired workers receive a positive differential. The paper then develops a framework to determine if any observed compensating differential is, in fact, fully compensating. The application of this framework to the mandatory overtime issue reveals that the fully compensating differential would be relatively small. The methodology developed in this paper should prove useful in a variety of other contexts.     

Essentially Political

The purpose of this article is to examine the gendered politics of social work in the Indian city of Mumbai, locating it in a post-colonial context. In order to do this secondary sources are examined along with empirical data collected by the authors. These are interpreted through the framework of a social constructionist methodology that draws on political sociology as well as elements of post-colonial theory and Foucauldian post-structuralism in order to acknowledge agency within a ‘location’ marked by both constraints and opportunities. The article explores the circumstances in which politicians and administrators find themselves in Mumbai. In considering gender and developing a strategy of what we term ‘political essentialism’, it is shown that those involved have been drawing on experiences in civil society and using imagined dualisms of gender to position themselves as shapers of social work in Mumbai.     

Modeling, Evaluation, and Methodology in the New Century

The modern world has influenced the approach to empirical modeling and consequently the approach to methodology in general. The question of whether to base a model on an economic theory is easier when several models can be constructed, but an empirical evaluation analysis is required. Starting with a widely specified model and using a reduction procedure is currently a popular process; it is unclear if the reduction should be to a single or to a few alternatives. New methodologies are required for conditional predictive distributions, which are the models of the future.     

The minimum wage and poverty among full-time workers

V. Conclusions The empirical evidence is strong that minimum wages have had little or no effect on poverty in the U.S. Indeed, the evidence is stronger that minimum wages occasionally increase poverty. It also suggests that the minimum wage does not even lower poverty for the one group that, almost by definition, one would expect to be helped: full-time, year-round workers. While the empirical results suggest minimum wages do not achieve what is ostensibly their primary goal — relieving poverty among the working poor — minimum wages do seem to impose a real cost on society in terms of lost income and output. The empirical evidence on work hours suggests that a $1 increase in the minimum wage, far from being almost costless, could conceivably impose income losses to American workers in the $12-15 billion range per year — an amount equal to the “income deficit” of millions of persons counted as poor by the U.S. Bureau of the Census.     

Ergonomics and Kaizen as strategies for competitiveness: a theoretical and practical in an automotive industry

With increased international competitiveness in the automotive industry, came the concern of the companies save costs and lower production costs. For this purpose many ways are designed to reduce costs and waste of raw materials and reduce activities that do not aggregate value to manufacturing processes. In the early XVII appears the manufacturing system, which processes were hard with little concern for the health and safety of employees and conditions of the workplace. After the advent of the production system called lean manufacturing, a new paradigm in terms of production system capable of providing high levels of productivity and quality. It is based on waste elimination that occur during the production process. After began a new way of thinking, creating a culture of continuous improvement and lean process with no waste and reducing costs, without neglecting the welfare worker and improving the conditions of their work environment. This paper presents a reflection on the application of ergonomics in a lean production system of an automotive industry, using methodology based on the Kaizen (Continuous Improvement) to gain performance and improving the conditions of the workplace, also will be presented with positive and negative points in using this methodology in relation to ergonomics. The research will be conducted by collecting data 'in loco' and interviews with workers. Some studies show that in companies that are lean system and using the methodology of Kaizen, the results of product quality, levels of absenteeism and accidents are better than those obtained in companies that do not apply the same concept.     

Measuring the impact of prices on inequality: With applications to Thailand and Korea

This paper develops a new methodology to compute social cost of living indices. These indices indicate whether or not price changes have a favourable (or unfavourable) impact on the welfare of the poor. The indices are derived on the basis of two alternative classes of social welfare functions. The methodology developed in the paper is applied to compute social cost of living indices for Thailand and Korea. The empirical results show that changes in prices have generally affected the poor more adversely than the non-poor.     

Researching Race: Identifying a Social Construction through Qualitative Methods and an Interactionist Perspective

Although much of the sociological community now views race as a social construction, empirical research does not always identify it in this way. Many practices of designating a research participant's race approach this process uncritically, implicitly framing race as uncomplicated. Although this is more common in survey‐based work, in this article I explore the tendencies and difficulties of studying race using qualitative methods. I discuss two prevalent but potentially problematic ways of “operationalizing” race in qualitative methodology, and then elaborate on the difficulties of identifying race in practice, using examples from my own ethnographic research. I suggest that symbolic interactionism provides a unique perspective from which to express race as socially situated, as long as this process is approached reflectively.     

EXTERNALITIES, PROPERTY RIGHTS AND THE ALLOCATION OF RESOURCES IN MAJOR LEAGUE BASEBALL

Most economists who have analyzed professional baseball have concluded that two distinctive features of its labor market—the reserve clause and player draft—influence the distribution of wealth between players and owners but do not affect the allocation of playing talent among teams. Such conclusions, which are strongly at variance with laymen's views of such matters, are derived from theoretical considerations rather than empirical examinations. Our paper examines data from the two decades of major league history and concludes that, on the basis of that data, the empirical generalizations of previous economists do not appear to be justified.     

Medicaid nursing facility reimbursement in flux: effects of federal regulatory changes and prevailing fiscal conditions, 1978-1998

Basic concepts and trends are examined in Medicaid nursing facility reimbursements between 1978 and 1998, because Medicaid payment reform is a common budget reduction strategy pursued by state officials. Non-incremental changes in state rate-setting methods, as well as incremental changes in per diem rates and expenditures per recipient, are analyzed. In addition to substantial cross-state variation, results reveal clear trends in reimbursement policy characteristics over time. Not only do these track closely with changes in the federal regulatory environment, but they also track closely with prevailing fiscal and economic conditions. Given the serious ramifications reimbursement policy changes can have for nursing home residents and providers, it is imperative that the impact of federal disengagement from this policy area be understood.     

MULTIPRODUCT PRICING IN MAJOR LEAGUE BASEBALL: A PRINCIPAL COMPONENTS ANALYSIS

The empirical analysis of multiproduct pricing lacks clear theoretical guidance and appropriate data, which often render traditional regression‐based analyses impractical. Under these circumstances the factors underlying price variation can be inferred using a new methodology based on principal components. Analyzing ticket, parking, and concession pricing in Major League Baseball with this methodology demonstrates that general demand shifts are the primary factor, but explain only half of overall price variation. Also important are price interactions deriving from demand interrelationships between goods and attempts to maximize the capture of consumer surplus in the presence of heterogeneous demand. (JEL D40, L11, L13)     

AN EMPIRICAL METHODOLOGY FOR ANALYZING THE PROPERTIES OF PUBLIC GOODS

This paper notes that economists generally accept that locally provided public services behave as Tiebout goods while non-locally provided public services possess the properties described by Samuelson. These beliefs are held despite the absence of empirical evidence supporting this dichotomous categorization. This paper derives an empirical methodology for testing the properties possessed by a public good by noting that only Tiebout goods will necessarily display price/quantity relationships which are consistent with demand theory restrictions. The methodology is applied to a sample of New Jersey suburbs with respect to educational services and non-educational local services.     

Perceived Cultural Distance in Healthcare in Immigrant Intercultural Medical Encounters

This article responds to the paucity of empirical research on the impact of patient-provider ethno-cultural distance and providers' cultural competence on the quality of healthcare service in migrant intercultural medical encounters in Australia. A cross-sectional study was conducted with 447 patients, consisting of 195 Caucasian and 252 non-Caucasian patients from six outpatient clinics in New South Wales, Australia. Structural equation modelling was used for data analysis. The findings demonstrated that cultural distance is an influential factor in perceived quality of outpatient care. Caucasian and non-Caucasian patients' perception of cultural distance between their physicians and themselves affected their service quality ratings of their physicians' professionalism, empathy and expertise. This is the first study on healthcare service quality in outpatient clinics in Australia for Caucasian and non-Caucasian patients. Policy implications suggest intervention strategies and the need for cultural competence education in medical and health curricula in medical schools and clinical practices.     

Ergonomics and design: traffic sign and street name sign

This work proposes a design methodology using ergonomics and anthropometry concepts applied to traffic sign and street name sign projects. Initially, a literature revision on cognitive ergonomics and anthropometry is performed. Several authors and their design methodologies are analyzed and the aspects to be considered in projects of traffic and street name signs are selected and other specific aspects are proposed for the design methodology. A case study of the signs of "Street of Antiques" in Porto Alegre city is presented. To do that, interviews with the population are made to evaluate the current situation of signs. After that, a new sign proposal with virtual prototyping is done using the developed methodology. The results obtained with new interviews about the proposal show the user satisfaction and the importance of cognitive ergonomics to development of this type of urban furniture.     

Understanding and explaining online personal information-sharing behaviours of New Zealanders: a new taxonomy

Although research evidence shows that people have strong concerns about their privacy online, this does not necessarily mean that they do not share their personal information in varying online relationships. This paper presents New Zealand-based empirical research findings into people’s actual online information-sharing behaviours rather than their attitudes: the motivations, extent, and conditions under which individuals share their personal information in varying online relationships with commercial providers, with government, and on social networking sites. A grounded theory methodology and an abductive analysis were used to identify patterns in the findings and construct a new taxonomy of online information-sharing behaviours: contrary to existing taxonomies, all participants in this study are very privacy aware and make quite deliberate choices about what personal information they share online, with whom, to what extent, and under what circumstances. Four distinctive classifications of people’s online information-sharing behaviours were derived from this study: privacy pragmatists, privacy victims, privacy optimists, and privacy fatalists.     

Reply to Sloan [on proxies for birth control

Sloan (1984) argues that annual changes in marital fertility of Swedish wives aged 35-39 between 1911 and 1974 is not a result of annual changes in the use of birth control, but is due to changes in health conditions that increase or decrease marital fertility. As evidence of the lack of effect of contraceptive practice on fertility Sloan cites a study published in 1916 whose author concluded that contraceptive use or nonuse had no effect on family size. Sloan is unaware of the shroud of ignorance that blinded such research in the distant past. There was no accepted methodology to determine contraceptive effectiveness until the 1930s, and scientists did not know key elemental facts about human reproduction. For example, the relationship of ovulation to the risk of pregnancy was unknown in 1916, and was to remain a mystery for more than a decade thereafter. Sloan's "declining health" explanation of low fertility in the West is merely a variant of an older attempt to explain low fertility as a result of high protein intake. Sloan's view that modern couples do not contracept to reach a desired family size and that changes in family size preference will not affect birth control practice among older (or younger it appears as well) couples seems to us to be an idiosyncratic view at best and directly opposed by all survey research. Couples do contracept most effectively when they are trying to prevent an additional birth. The view that failure of some Western couples to reproductively compensate for their child deaths as explained by poor reproductive health seems to assume that couples in non-Western population do so compensate, but this is wrong. The idea that such bereaved couples should have another child is so insensitive to tragedy as to defy further reply. Sloan's acceptance and use of reports that some couples say they wanted more children than they had ignores massive research findings of unwanted fertility among couples in populations with long histories of birth control practice. Further, it is difficult to have much faith in such responses since about 1/2 the couples in the Whelpton el al. study cited by Sloan also said they were fecund. These responses mean that couples may say that they want more than they actually had, but they deliberately did not have such a large and "ideal" family size because of other factors not considered by Sloan. Since it appears that Sloan was unable to find another authority, he cites a 3 page comment of his own in support of the hypothesis of deteriorating environment. He does not actually empirically link age patterns of chronic disease with fecundity loss; his view also ignores research indicating improved health conditions, at least among US women, after the mid-1930s that increased fecundity and then fertility. Thus, his argument that factors other than voluntary birth control could explain annual change in Swedish marital fertility among older couples is unsupported by empirical evidence. His remarks are also irrelevant to the use made in the author's article concerning marital fertility rates as a proxy for the use of annual birth control change among younger unmarried women. The marital rate varies, as does the illegitimacy rate. Annual increases in marital fertility are related to annual increases in illegitimacy; annual declines in marital rates to annual declines in illegitimacy. Sloan's hypothetical trends in fecundity have no bearing on our empirical study of annual change in Swedish illegitimacy rates. Finally, Sloan's claim that social demographers do not view a changing environment as problematic is unsupported and unjustified.     

Equal Division of Estates and the Exchange Motive

Abstract

Although the bequest motive is one of the most important theoretical extensions of the life-cycle hypothesis, few empirical studies have measured determinants of unequal estate division. We estimated whether several proxies that are consistent with exchange and altruism lead to unequal estate division using data from a longitudinal survey of deceased elderly persons linked to probate court records. Equal division was the rule-between 70 and 83% of estates were divided equally, depending on the strictness of the definition of equal division. Several measures of exchange were not significant predictors of unequal division. Two factors that are consistent with both exchange and altruism-writing the last will and testament within five years of death and having more children-predict unequal estate division. The models control for selection, because many decedents do not file a record in probate court.     

The Effect of Mixing Events on the Dynamics of pH1N1 Outbreaks at Small Residential Colleges

Abstract

Objective: The authors examine the dynamics and the impact of all-campus events on pH1N1 spread at Bates College in fall 2009, with comparisons to 3 other campuses. Participants: Students (N = 285) presented or called in to the Bates Health Center with symptoms consistent with influenza-like illness. Methods: Health Center staff at Bates collected data on the outbreak; data from other colleges are from Web sites and journal articles. Data were analyzed using a mathematical model for influenza. Results: Bates held 2 vaccine clinics mid-outbreak. The data are consistent with the hypothesis that the vaccine clinics may have altered routine student interactions, facilitating transmission of pH1N1 among students who otherwise might not have encountered each other. Conclusion: The vaccine clinics, held when vaccine became available, were too late to halt transmission. The disruptions to campus rhythms due to the vaccine clinics may instead have contributed to pH1N1 spread.