Racial Disparities in Hospital Length of Stay for Asthma: Implications for Economic Policies

Asthma is one of the most common health burdens on American families. An understanding of how the costs of asthma are distributed across communities is essential to realizing cost savings from preventative care. We model the household’s utilization of hospital services using Grossman’s health production framework. We then test for differences in asthma-related hospitalizations by race using inpatient records from the Massachusetts Division of Health Care Finance. On average black and nonwhite-Hispanic patients stayed between one-third and one-fourth of a day less than similar white patients which translates into a difference in expenditures of $8 million over 1994–2002. The difference in expenditures raises questions for market-based methodologies to value health and for policies directed at reducing inequalities in health outcomes.     

Tests for Structural Changes in Time Series of Counts

We propose methods for detecting structural changes in time series with discrete‐valued observations. The detector statistics come in familiar L2‐type formulations incorporating the empirical probability generating function. Special emphasis is given to the popular models of integer autoregression and Poisson autoregression. For both models, we study mainly structural changes due to a change in distribution, but we also comment for the classical problem of parameter change. The asymptotic properties of the proposed test statistics are studied under the null hypothesis as well as under alternatives. A Monte Carlo power study on bootstrap versions of the new methods is also included along with a real data example.     

A four factor model predicting likelihood of foster carer retention

This study used a self‐report method to test a conceptual model for predicting the likelihood of retention of foster carers for children requiring out‐of‐home care. It was hypothesized that satisfaction levels of foster carers would be determined by locus of control and social support, and that the decision to stay or leave fostering within the next 18 months would be influenced by foster carer satisfaction, and commitment to a child/ren in care. Participants were 185 Queensland foster carers. Results supported the proposed model. Logistic regression analysis revealed that an increase in either satisfaction or commitment would result in foster carers being more likely to decide to stay in fostering. Multiple regression analysis found that both locus of control and social support made a significant contribution to the prediction of carer satisfaction. The findings were further supported by qualitative data. Implications of the findings are discussed.     

Quantitative Risk Assessment of Listeria monocytogenes in French Cold-Smoked Salmon: II. Risk Characterization

A model for the assessment of exposure to Listeria monocytogenes from cold-smoked salmon consumption in France was presented in the first of this pair of articles (Pouillot et al ., 2007, Risk Analysis, 27:683–700). In the present study, the exposure model output was combined with an internationally accepted hazard characterization model, adapted to the French situation, to assess the risk of invasive listeriosis from cold-smoked salmon consumption in France in a second-order Monte Carlo simulation framework. The annual number of cases of invasive listeriosis due to cold-smoked salmon consumption in France is estimated to be 307, with a very large credible interval ([10; 12,453]), reflecting data uncertainty. This uncertainty is mainly associated with the dose-response model. Despite the significant uncertainty associated with the predictions, this model provides a scientific base for risk managers and food business operators to manage the risk linked to cold-smoked salmon contaminated with L. monocytogenes. Under the modeling assumptions, risk would be efficiently reduced through a decrease in the prevalence of L. monocytogenes or better control of the last steps of the cold chain (shorter and/or colder storage during the consumer step), whereas reduction of the initial contamination levels of the contaminated products and improvement in the first steps of the cold chain do not seem to be promising strategies. An attempt to apply the recent risk-based concept of FSO (food safety objective) on this example underlines the ambiguity in practical implementation of the risk management metrics and the need for further elaboration on these concepts.     

Information for Authors

Instructions for Authors

Information for Authors     

Instructions for Authors

Instructions for Authors

Instructions for Authors     

Is the Way Young People Drive a Reflection of the Way Their Parents Drive? An Econometric Study of the Relation Between Parental Risk and Their Children's Risk

This article aims to investigate parental influence on high-risk behavior by young people. Although research on the topic of perception of risk demonstrates that it is socially constructed, the role of the family in this construction has rarely been studied. Using a French national survey of more than 1,200 young drivers between the ages of 18 and 25, and their parents, we attempt to understand the transmission of risk within families. Our econometric study shows that parents influence both the practices and representations of their children. When parental norms and values are transmitted, they are by no means accepted in a wholly passive way. Indeed, the parental model is in competition with other models that originate from both inside the family (brothers and sisters) and outside it (instructors). Furthermore, parental influence decreases over time as young people become more experienced drivers and construct their own identity with regard to risk.