An empirical examination of cost-adjusting in outpatient clinics

This paper presents an empirical methodology for examining cost-adjusting in relation to multiple-output health care providers. The methodology is subsequently implemented using a sample of California outpatient clinics. The empirical evidence is that these clinics do cost-adjust; that is, the clinics respond to low Medicare reimbursement by using lower quality to control the marginal costs of those patient groups not insured under a government-sponsored plan. In addition, clinics do not cost-adjust with respect to Medi-Cal patients, implying that various government reimbursement systems have different effects on a provider’s cost-adjusting behavior.     

Imagined Memories

Most discussions of popular music on the Internet focus on the utopian potential of new file-sharing technologies, yet applications that reproduce existing inequalities also deserve attention. Webcasting is the streaming (transmission) of digital video to multiple recipients in cyberspace. Paul McCartney's Webcast from the Cavern was a landmark case. It was a digital package staged for reproduction, and yet it felt live; in this article I explore why and offer a two-part explanation. The first part is that "live'-ness is based on an increasingly false opposition to recording, but, because that opposition still remains, Little Big Gig could seem live by adopting some trappings associated with it. The second part is that Internet use is mediated by daily life and computer users brought their own desire to the Webcast, in particular desires to see a Beatle play in the Cavern. Webcasting is an unanticipated use of the Internet that is being used to support corporate interests. With its widespread publicity, Little Big Gig helped naturalize that process.     

Asthma Patients' Activities and Air Pollution: A Semiparametric Censored Regression Analysis

Asthma patients' health status may be especially sensitive to some types of air pollution, but the evidence on this is mixed. We explore the effects of ground-level ozone on asthma patient's activities, breaking apart the usual aggregated category of leisure into indoor and outdoor activities, and differentiating those by whether the activities were active or inactive. Applying the semiparametric censored estimation method we demonstrate that even though the period over which activities were observed was relatively low in ozone levels, there is a significant impact of ozone on a few activities. The (non-ozone) economic and demographic variables in the model play significant roles in explaining the allocation of time among seven activities, suggesting the suitability of the approach for other household decision-making contexts.     

Bayesian locally optimal design of knockout tournaments

The elimination or knockout format is one of the most common designs for pairing competitors in tournaments and leagues. In each round of a knockout tournament, the losers are eliminated while the winners advance to the next round. Typically, the goal of such a design is to identify the overall best player. Using a common probability model for expressing relative player strengths, we develop an adaptive approach to pairing players each round in which the probability that the best player advances to the next round is maximized. We evaluate our method using simulated game outcomes under several data-generating mechanisms, and compare it to random pairings, to the standard knockout format, and to two variants of the standard format.     

Improved model selection criteria for SETAR time series models

The purpose of this paper is threefold. First, we obtain the asymptotic properties of the modified model selection criteria proposed by Hurvich et al. (1990. Improved estimators of Kullback-Leibler information for autoregressive model selection in small samples. Biometrika 77, 709–719) for autoregressive models. Second, we provide some highlights on the better performance of this modified criteria. Third, we extend the modification introduced by these authors to model selection criteria commonly used in the class of self-exciting threshold autoregressive (SETAR) time series models. We show the improvements of the modified criteria in their finite sample performance. In particular, for small and medium sample size the frequency of selecting the true model improves for the consistent criteria and the root mean square error (RMSE) of prediction improves for the efficient criteria. These results are illustrated via simulation with SETAR models in which we assume that the threshold and the parameters are unknown.     

Disabled people's attitudes toward other impairment groups: a hierarchy of impairments

This article seeks to explore, through the literature, the notion that a hierarchy of impairment exists from the perspectives of both disabled and non-disabled people. The literature suggests that disabled people, like non-disabled people, do not always wish to be associated with other impairment groups for a variety of complex reasons, including competing for scarce allocations of funding/resources, sexual attraction, stigma, etc. The article concludes that further research is required in relation to disabled people's attitudes toward other disabled people, in general, and other impairment groups. Such research would expand our knowledge with respect to the degree to which disabled people view themselves as a homogenous in-group, as a set of separate impairment groups, or viewing impairment as only one facet of identity. These findings would help the disability movement to achieve greater inclusiveness amongst different impairments.     

Ecocultural Attributes: Evaluating Ecological Degradation in Terms of Ecological Goods and Services Versus Subsistence and Tribal Values

It is becoming increasingly clear that scientists, managers, lawyers, public policymakers, and the public must decide how to value what is provided by, and is a consequence of, natural resources. While “Western” scientists have clear definitions for the goods and services that ecosystems provide, we contend that these categories do not encompass the full totality of the values provided by natural resources. Partly the confusion results from a limited view of natural resources derived from the need to monetize the value of ecosystems and their component parts. Partly it derives from the “Western” way of separating natural resources from cultural resources or values, and partly it derives from the false dichotomy of assuming that ecosystems are natural, and anything constructed by man is not natural. In this article, we explore the previous assumptions, and suggest that because cultural resources often derive from, and indeed require, intact and unspoiled natural ecosystems or settings, that these values are rightly part of natural resources. The distinction is not trivial because of the current emphasis on cleaning up chemically and radiologically contaminated sites, on restoration of damaged ecosystems, on natural resource damage assessments, and on long‐term stewardship goals. All of these processes depend upon defining natural resources appropriately. Several laws, regulations, and protocols depend upon natural resource trustees to protect natural resources on trust lands, which could lead to the circular definition that natural resources are those resources that the trustees feel they are responsible for. Where subsistence or tribal peoples are involved, the definition of natural resources should be broadened to include those ecocultural attributes that are dependent upon, and have incorporated, natural resources. For example, a traditional hunting and fishing ground is less valued by subsistence peoples if it is despoiled by contamination or physical ecosystem degradation; an Indian sacred ground is tarnished if the surrounding natural environment is degraded; a traditional homeland is less valued if the land itself is contaminated. Our argument is that intact natural resources are essential elements of many cultural resources, and this aspect requires and demands adequate consideration (and may therefore require compensation).     

Complex belief-desire reasoning in children

Previous research concerned with children's belief-desire psychology has examined the capacity to predict or interpret action on the basis of the implicit proposition that ‘when an actor desires a particular end and believes that a particular action will achieve that end, he or she will undertake that action’. The limitations of this formulation for understanding acts of omission are outlined and an elaborated version of belief-desire psychology introduced. This version holds that ‘when an actor desires a particular end and believes that a particular action will achieve that end, and when it is believed that there are no co-occurring outcomes of that action whose avoidance is desired more highly than is the originally conceived end, then the actor will undertake the action which will satisfy the original desire’. An experiment is reported which examines 4-, 5, and 7-year-olds' ability to predict story characters' actions on the basis of either their true or false beliefs concerning undesirable outcomes associated with the pursuit of a desired end. Children of all age-groups provided evidence of understanding the elaborated version of belief-desire psychology. However, a significant improvement was noted between the ages of 4 and 7 years in the ability to understand circumstances involving false beliefs.     

Accuracy of the College Majors Finder for Three Majors

The Self-Directed Search was administered to 68 university seniors who were majoring in Chemistry/Chemical Engineering, Elementary Education, and Office Administration. Their resulting three-letter summary codes were compared with three-letter college major codes obtained from the College Majors Finder. A high degree of agreement between the two sets of codes was found for each of the three majors. Effective methods for matching people to jobs have held the interest and occupied much time for career counselors and vocational theorists since the inception of the trait-factor approach to career counseling. More recently, Holland (1985a) broadened and clarified matching procedures through the development of his typological theory of vocational choice. Just as personality types and occupational environments have been organized using Holland's framework to foster an understanding of occupational choice, Holland's theory can also be used to explain other types of choices, such as choice of a college major.