Developing and testing a satisfaction survey for nursing home residents: the Ohio Experience

Input from consumers has become an important part of quality improvement in long-term care and for consumer decision-making. This paper documents the development of the Ohio Nursing Home Resident Satisfaction Survey (ONHRSS) through a partnership of state government, research, and industry experts. The instrument was tested and refined through two waves of data--a pretest phase and later with statewide data. Exploratory and confirmatory analyses with statewide data identified eight primary factors along with an underlying, secondary Global Satisfaction factor. Reliability of the domains ranged from .69 to .95. Recommendations for further refinement and testing of the instrument are discussed along with policy and practice implications.     

Public Management at the Ballot Box: Performance Information and Electoral Support for Incumbent English Local Governments

Publishing performance information about local public services,an increasing trend in many Organisation for Economic Co-operationand Development countries, matters politically because it hasan effect on incumbent local governments' electoral support.Voters are able to use performance information to punish orreward incumbents in the elections that follow their publication,which may fill a gap in the chain of accountability betweenvoters and governments. We model the introduction of publishedComprehensive Performance Assessments of local authorities inEngland, which make summary information about performance availableto voters, as a "shock" to the relationship between voters andincumbents. Controlling for an unpublicized measure of performancechange over time, change in the local tax level, change in localeconomic conditions, and whether the local incumbent is theparty of the incumbent government at the national level, wefind negativity bias. Incumbents in local authorities in the"poor" performance category experience a substantial reductionin aggregate vote share at the election following publication,but there is no similarly sized reward for those in the highestperformance category.     

A KNOWLEDGE-BASED DSS FOR MANAGERIAL PROBLEM DIAGNOSIS

A knowledge-based system supporting managerial problem diagnosis is described. The system provides the capability to monitor values of selected variables for problem situations. When problems are located, a list of problem symptoms is delivered to a problem processor for structuring and diagnosis. Problem structuring is based on a combination of concepts from expert systems and structural modeling. User assertions about cause-effect relationships between pairs of variables are maintained in a semantic network. Problem diagnosis uses the relationships in the semantic network to construct causation trees, the branches of which represent potential explanations of the problem symptoms. Mathematical models are constructed based on causation-tree branches, and values from the data base are used to test whether the model confirms the diagnosis. If so, the source of the problem has been located and it is then up to the user to resolve the problem. If the model fails to explain the problem, the model apparently is deficient and the user may perform “what if…” type scenarios in attempts to improve the model and search for problem causes. Realistic applications in the accounting and health care areas are discussed.     

Education CREATIVE THINKING AND INNOVATIVE EDUCATION IN THE DECISION SCIENCES

Creative problem solving is seldom addressed directly in the decision sciences literature. The first half of this paper reviews current thinking about creativity and its educational importance. The remainder addresses creative problem-solving processes and, in particular, the process developed by Parnes, Noller and Biondi [24] and Osborn [23]. This process has been integrated into an OR/MS problem-solving course which is described. Conclusions and implications for decision sciences education and practice in general are discussed.     

Using age and spatial flow structures in the indirect estimation of migration streams

This article outlines a formal model-based approach for inferring interregional age-specific migration streams in settings where such data are incomplete, inadequate, or unavailable. The estimation approach relies heavily on log-linear models, using them to impose some of the regularities exhibited by past age and spatial structures or to combine and borrow information drawn from other sources. The approach is illustrated using data from the 1990 and 2000 U.S. and Mexico censuses.     

Was there compression of disability for older Americans from 1992 to 2003?

Medical advances and the growth of the elderly population have focused interest on trends in the health of the elderly. Three theories have been advanced to describe these trends: compression of morbidity, expansion of morbidity, and dynamic equilibrium. We applied multistate life table methods to the Medicare Current Beneficiary Survey to estimate active and disabled life expectancy from 1992 to 2003, defining disability as having difficulty with instrumental activities of daily living or activities of daily living. We found increases in active life expectancy past age 65 and decreases in life expectancy with severe disability. These trends are consistent with elements of both the theory of compression of morbidity and the theory of dynamic equilibrium.