Involvement of Ministries of Health in Health Service Coverage Decisions: Is England an Aberrant Case?

This article examines the involvement of ministries of health in making health service coverage decisions in Denmark, England, France and Germany. The study aims to inform debate in England about the feasibility of reducing perceived ministerial and bureaucratic ‘interference’ in decisions affecting the National Health Service, based on interviews with senior government officials and other health system stakeholders. Ministries of health differ in their involvement in health system governance and coverage decisions (‘the benefits package’), reflecting differences in institutional arrangements. In all four countries, organizations at arm's length or independent from government are either involved in providing technical advice to the ministry of health or have been mandated to take these decisions themselves. However, ministries of health occasionally intervene in the decision‐making process or ignore the advice of these organizations. The Department of Health in England is not an aberrant case, at least in relation to coverage decisions. Indeed, ministries of health in Denmark and France play a larger role in making these decisions. Public pressure, often amplified by the media, is a shared reason for ministerial and ministry involvement in all four countries. This dynamic may thus limit the feasibility of attempts to further separate the NHS from both the Department of Health and wider political pressures.     

Statistical analysis for Kumaraswamy’s distribution based on record data

In this paper we review some results that have been derived on record values for some well known probability density functions and based on m records from Kumaraswamy’s distribution we obtain estimators for the two parameters and the future sth record value. These estimates are derived using the maximum likelihood and Bayesian approaches. In the Bayesian approach, the two parameters are assumed to be random variables and estimators for the parameters and for the future sth record value are obtained, when we have observed m past record values, using the well known squared error loss (SEL) function and a linear exponential (LINEX) loss function. The findings are illustrated with actual and computer generated data.     

Some sampling effects of pairwise correlated observations on likelihood ratio tests for the difference between two means

We study the effects of the inclusion of pairs of correlated observations in a sample on likelihood ratio tests for the difference in two means. In particular, we assess how the inclusion of correlated data pairs (e.g., such as data inadvertently collected from sib-pairs) affects the sample size requirements necessary for the implementation of a Likelihood Ratio (LR) test for the difference between two means. Our results suggest that correlated data pairs beneficially or adversely effect sample size requirements for an LR test to a degree functionally related to the mixture parameters dictating their relative frequencies in the larger sample on which the test will be performed, the strength of the correlation between the observations, and the size of imbalances in the sample with respect to the number of observations in each group. The relevance and implications of the results for genetic and epidemiologic research are discussed.     

Analysis of all-zero binomial outcomes with borderline and equilibrium priors

This article is concerned with the analysis of a random sample from a binomial distribution when all the outcomes are zero (or unity). We discuss how elicitation of the prior can be reduced to asking the expert whether (and which of) the so-called borderline or equilibrium priors are plausible.     

Adaptive Estimation of the Integral of Squared Regression Derivatives

A problem of estimating the integral of a squared regression function and of its squared derivatives has been addressed in a number of papers. For the case of a heteroscedastic model where smoothness of the underlying regression function, the design density, and the variance of errors are known, the asymptotically sharp minimax lower bound and a sharp estimator were found in Pastuchova & Khasminski (1989). However, there are apparently no results on the either rate optimal or sharp optimal adaptive, or data-driven, estimation when neither the degree of regression function smoothness nor design density, scale function and distribution of errors are known. After a brief review of main developments in non-parametric estimation of non-linear functionals, we suggest a simple adaptive estimator for the integral of a squared regression function and its derivatives and prove that it is sharp-optimal whenever the estimated derivative is sufficiently smooth.     

Perceptions of Randomized Security Schedules

Security of infrastructure is a major concern. Traditional security schedules are unable to provide omnipresent coverage; consequently, adversaries can exploit predictable vulnerabilities to their advantage. Randomized security schedules, which randomly deploy security measures, overcome these limitations, but public perceptions of such schedules have not been examined. In this experiment, participants were asked to make a choice between attending a venue that employed a traditional (i.e., search everyone) or a random (i.e., a probability of being searched) security schedule. The absolute probability of detecting contraband was manipulated (i.e., 1/10, 1/4, 1/2) but equivalent between the two schedule types. In general, participants were indifferent to either security schedule, regardless of the probability of detection. The randomized schedule was deemed more convenient, but the traditional schedule was considered fairer and safer. There were no differences between traditional and random schedule in terms of perceived effectiveness or deterrence. Policy implications for the implementation and utilization of randomized schedules are discussed.     

Identification of Nonseparable Models Using Instruments With Small Support

I consider nonparametric identification of nonseparable instrumental variables models with continuous endogenous variables. If both the outcome and first stage equations are strictly increasing in a scalar unobservable, then many kinds of continuous, discrete, and even binary instruments can be used to point‐identify the levels of the outcome equation. This contrasts sharply with related work by Imbens and Newey, 2009 that requires continuous instruments with large support. One implication is that assumptions about the dimension of heterogeneity can provide nonparametric point‐identification of the distribution of treatment response for a continuous treatment in a randomized controlled experiment with partial compliance.