Evidence of Large-Scale Social Interactions in Mammography in the United States

This paper examines the extent of social interactions in an individual’s decision to undergo mammography. Using Behavioral Risk Factors Surveillance System surveys from 1993 to 2016, the effect of other female screening behavior on an individual’s decision to have a routine breast cancer screening was measured by calculating the size of a so called “social multiplier” in mammography. A vector of social multipliers was estimated in the use of mammograms in the past 1–2 years by taking the ratio of group-level effects of exogenous explanatory variables to individual-level effects of the same variables. Peer groups were defined as same-aged women living in the same state. Three age groups of women were considered: 40–49, 50–74, and 75 and older. Several econometric approaches were used to analyze the effect of social interactions on mammography use, including ordinary least squares, fixed effects, and split-sample instrumental variable. For all women, evidence was found of social interactions associated with individual’s education, employment, and poor health. In addition, number of age-group-specific social multipliers was found. The strongest evidence of spillover in mammography was found for women ages 75 and older. Policy makers should be aware that, in the presence of a social multiplier, the value of any type of screening intervention is higher than the one that would be measured at the individual-level.

     

Cost of hospital care for elderly at risk of falling

The variables that relate to cost of hospital care for a large sample of elderly patients at risk for falling are examined. The chief predictors of cost of hospitalization were medical, pharmacy, and nursing interventions. Use of nursing interventions, on average, raised the median hospital cost less than use of medical or pharmacy interventions. Using a standardized nursing language with the hospital's information system can provide nurses with information that demonstrates the cost effectiveness of their interventions.     

SCREENING FOR A CHRONIC DISEASE: A MULTIPLE STAGE DURATION MODEL WITH PARTIAL OBSERVABILITY

We estimate a dynamic multistage duration model to investigate how early detection of diabetes can delay the onset of lower extremity complications and death. We allow for partial observability of the disease stage, unmeasured heterogeneity, and endogenous timing of diabetes screening. Timely diagnosis appears important. We evaluate the effectiveness of two potential policies to reduce the monetary costs of frequent screening in terms of lost longevity. Compared to the status quo, the more restrictive policy yields an implicit value for an additional year of life of about $50,000, whereas the less restrictive policy implies a value of about $120,000.     

A comparison of treatment effects estimators using a structural model of AMI treatment choices and severity of illness information from hospital charts

We compare the performance of various matching estimators using a novel approach that is feasible in the absence of experimental data. We estimate a structural model of hospital choices and catheterization for Medicare heart attack victims using hospital chart data on patient heterogeneity. With the estimated structural parameters, we simulate data for which the treatment effect is known. We find that as measures of individual heterogeneity are added to the controls, matching estimators perform well. However, the estimators do a poor job recovering the true treatment effect when measures of individual heterogeneity are unavailable. Copyright © 2010 John Wiley & Sons, Ltd.     

Equity-worthiness and equity-willingness: Key factors in private equity deals

While access to private equity funds (PEFs) provides a unique opportunity for firms to set up sturdy growth paths, how PEFs select companies is an unknown process to entrepreneurs and business owners. This study aims to offer insights regarding the private equity market to entrepreneurs searching for external capital. We analyzed a novel dataset of 240 pre-deal negotiations between small- and medium-sized Italian companies and a closed-end fund. Results indicate that the successful closing of a deal depends on more than just the target firm's equity-worthiness (i.e., the company's ability to meet the expectations of a private equity investor). In fact, there is another dimension: the target firm's equity-willingness (i.e., the company's motivations to accept an outside equity investor). We summarize the results of our study by building a 2x2 positioning matrix on the basis of the target firm's equity-worthiness and equity-willingness. This matrix enables entrepreneurs to grasp how private equity investors evaluate their firms.     

Are for-profit hospital conversions harmful to patients and to Medicare?

We examine how changes in hospital ownership to and from for-profit status affect quality and Medicare payments per hospital stay. We hypothesize that hospitals converting to for-profit ownership boost post acquisition profitability by reducing dimensions of quality not readily observed by patients and by raising prices. We find that 1-2 years after conversion to for-profit status, mortality of patients, which is difficult for outsiders to monitor, increases while hospital profitability rises markedly and staffing decreases. Thereafter, the decline in quality is much lower. A similar decline in quality is not observed after hospitals switch from for-profit to government or private nonprofit status.     

Medical emergencies and farm productivity in Côte d'Ivoire

The lack of health insurance for smallholder farmers in most sub-Saharan African countries hurts the families and can also negatively affect agriculture production, exports, and tax revenues. This paper analyzes the linkage between medical emergencies and agriculture exports and the corresponding tax revenues for smallholder farmers in Côte d'Ivoire. It uses two complementary datasets: the 2016 Consultative Group to Assist the Poor (CGAP) smallholder survey and the 2015 Côte d'Ivoire living standard survey. The paper finds that a medical emergency is negatively and significantly associated with a decrease in the likelihood that a smallholder farmer cultivates cocoa of 3.9 percentage points, driving them into poverty and reducing productivity at the lower quantiles. The paper then estimates that medical emergencies can be correlated with the decline in cocoa exports of $853 million and in tax revenues of $125 million, representing 0.2% of the Ivorian gross domestic product (GDP) in 2017.