Health IT adoption,productivity and quality in primary care

Within the last decade, there has been a growing push towards the use of electronic medical records and health information technology (IT) within primary care physician practices. Despite financial subsidies, smaller practices remain reluctant to adopt these information systems. Using a nationally representative survey of physicians, this study explores the relationship between physician, practice and area attributes and the adoption of health IT systems. Controlling for these attributes, the analysis subsequently studies the relationship between health IT, physician productivity and perceived quality of care. It finds that smaller practices and physicians with lower incomes are less likely to adopt health IT systems and that adoption varies with the type of medical conditions the practice typically treats. With regards to productivity, health IT adopters are more likely to see fewer patients and spend a larger amount of time on each visit with marginal increases in time on administrative tasks and no differences in perceived ability to deliver quality health care.     

Technology adoption and the impact on average productivity

In this paper, a framework is developed to analyze how the specifications of new technologies and the heterogeneity of micro-units of production affect the input use, the adoption pattern, and the productivity of inputs. It shows that asset-productivity-enhancing (APE) technologies tend to be adopted by micro-units with high-quality assets, while variable-input, efficiency-enhancing (VIEE) technologies tend to be adopted by micro-units with low-quality assets. In both cases, the variable input productivity increases, but the average productivity of the fixed asset may decline in the case of the VIEE technology. The distribution of asset quality and the new technology specifications will therefore determine the impacts of production technology innovations on aggregate behavior and consequently the change in average productivity of the fixed asset.     

Trade costs and productivity in services sectors

This paper provides the first evidence linking lower international trade costs with higher productivity in services sectors. On average, lowering trade costs by 10% is associated with a gain in total factor productivity of around 0.5%, which is an effect of similar magnitude to that for goods sectors.     

Trade costs and the timing of competition policy adoption

Abstract This paper first presents stylized evidence showing how the date of the adoption of competition policy is correlated with country size. Smaller countries tend to adopt competition policy later. We then present a theoretical model with countries of different size, trade costs, and firms competing à la Cournot. In the model we show that reduced trade costs following from increasing globalization affect countries differently depending on their size. This has implications for the incentives to introduce competition policy. The predictions of the model are consistent with the empirical regularity presented.     

Psychological costs of currency transition: evidence from the euro adoption

This paper assesses the perceived individual psychological costs of adhering to the Euro. We use the difference-in-differences approach (DD), comparing individual levels of satisfaction with the economy in Slovakia immediately before and after the introduction of the Euro, with similar individuals in neighboring Czech Republic, which did not adopt the Euro. Both countries were economically and politically integrated for decades, and display similar macroeconomic behavior before and after the currency change in Slovakia. What we assess is not the actual, economic, costs stemming from the Euro adoption, but the change in utility as perceived by the individuals. There is evidence of substantial psychological costs associated with currency transition, especially for the old, the unemployed, the poorly educated and households with children. Our results are robust to the use of alternative control groups and to estimation procedures using the DD matching approach. The significant perceived costs uncovered in this paper suggest policy-makers should not ignore them when considering a sweeping economic change such as the adoption of a new currency.     

Organisational change and the productivity effects of green technology adoption

This study investigates induced productivity effects of firms introducing new environmental technologies. The literature on within-firm organisational change and productivity suggests that firms can achieve higher productivity gains from adopting new technologies if they adapt their organisational structures. Such complementarity effects may be of particular importance for the adoption of greenhouse gas (GHG) abatement technologies. The adoption of these technologies is often induced by public authorities to limit the social costs of climate change, whereas the private returns are much less obvious. This study finds empirical support for complementarity between green technology adoption (either CO₂-reducing or resources and energy efficiency-enhancing technologies) and organisational change. While the sole adoption of green technologies is associated with lower productivity, the simultaneous implementation of green technologies and organisational innovations is not.     

The social costs of gun ownership: a reply to Hayo,Neumeier, and Westphal

We respond to the new article by Hayo, Neumeier, and Westphal (HNW), which is a critique of our 2006 article. The principal contribution of that article wa     

Entry costs and cross-country differences in productivity and output

This paper contributes to the literature on cross-country income differences by studying the effect of entry barriers on productivity and output. Using instrumental variable regressions I show that higher entry costs significantly reduce output per worker and that they do so by lowering total factor productivity. In particular, an increase in entry costs by 80% of income per capita, which is one half of their standard deviation in my sample, is estimated to decrease total factor productivity and output per worker by 22% and 29%, respectively.      

A Luenberger-Hicks-Moorsteen productivity indicator: its relation to the Hicks-Moorsteen productivity index and the Luenberger productivity indicator

Summary. Introducing a new difference-based Luenberger-Hicks-Moorsteen productivity indicator, this contribution establishes theoretically its relations with some existing ratio- and difference-based productivity indexes and indicators. The first main result is an approximation proposition stating that the logarithm of the Hicks-Moorsteen productivity index is about equal to the Luenberger-Hicks-Moorsteen productivity indicator. Secondly, we also establish the specific conditions under which the Luenberger-Hicks-Moorsteen indicator equals the recently introduced Luenberger indicator and compare these to the conditions governing the relations between ratio-based Hicks-Moorsteen and Malmquist indices.Received: 2 May 2002, Revised: 19 May 2003, JEL Classification Numbers: C43, D21, D24.We are grateful for the most constructive remarks of a referee. Obviously, the authors remain solely responsible for any residual shortcomings. Correspondence to: W. Briec     

Loan processing costs,information asymmetries and the speed of technology adoption

This paper presents a simple model in which credit-constrained firms might delay the adoption of new and more productive technologies because of the external financing costs involved. Applying for a loan can be a very costly process by itself. Where there is a high degree of credit rationing, these costs might even deter entrepreneurs from applying for a loan altogether. We argue that the efficiency of the banking system, by affecting such costs, can influence the profitability of new technologies and entrepreneur's investment decisions, which, in turn, influence new technology implementation, capital accumulation and growth.     

A directional analysis of Federal Reserve predictions of growth in unit labor costs and productivity

Existing evidence suggests that the Federal Reserve forecasts of inflation imply asymmetric loss, as the Fed has significantly over‐predicted inflation for the post‐Volcker period. Consistent with such evidence, we show that the Federal Reserve forecasts of growth in both unit labor costs and productivity, while directionally accurate for 1983–2003, imply asymmetric loss. That is, the forecasts of growth in unit labor costs are more (less) accurate in predicting the upward (downward) moves. The forecasts of growth in productivity, however, are less (more) accurate in predicting the upward (downward) moves. The interpretation of our findings may be that, in achieving long‐term price stability, the Fed is cautious not to incorrectly predict the upward (downward) moves in growth in unit labor costs (productivity).