Statistical manipulation of delphi statements: Its success and effects on convergence and stability

This paper discusses the results of an experiment to determine if manipulation of statistical feedback of Delphi statements can significantly shift the responses of a fact-probing and/or a value-probing Delphi. This shift is viewed in terms of the degree of success in achieving a desired value. Also examined was whether fact- probing or value-probing Delphis were more susceptible to statistical manipulation. The effects of the statistical manipulation on the convergence and stability of the Delphis were also investigated.     

The determinants of nursing home costs in Nebraska's proprietary nursing homes.

In the past few years nursing home care expenditures in Nebraska and the U.S. have been the fastest growing component of total health care expenditures. This rate of increase is particularly alarming in view of the fact that nursing home care is financed primarily by the Medicaid program or direct out-of-pocket payments. In fact, given the cutbacks in federal and state funds for this program, consumers will be forced to allocate a larger share of their income to meet the costs of nursing home care. Although nursing home expenditures have grown at an extremely rapid rate, relatively few empirical studies exist which analyze the cost function of nursing home providers. The purpose of this study is to identify factors which have directly influenced the cost of nursing home care in Nebraska and to evaluate the current Nebraska Medicaid reimbursement system in terms of its impact upon nursing home costs. The study was limited to a sample of 40 nursing homes in Nebraska which represents 42% of the total proprietary nursing homes in the state. The sample was limited to those facilities licensed only as an Intermediate Care Facility--I and they had to be receiving some Medicaid revenue. The data were averaged over the period of 1977-79, but the year of analysis corresponded to 1978. Multiple regression analysis was used to measure the effect of the hypothesized independent variables upon two different measures of cost--the average total cost per patient day and the average variable cost per patient day. In the first regression model 76% of the variance was explained and 71% was explained in the second equation. The results of this analysis are basically consistent with the findings of other studies and indicate that the number of staffing hours, patient mix, facility age, administrator experience and administrative intensity are significant determinants of nursing home costs. The most important finding from a policy perspective is that the current retrospective cost-related Medicaid reimbursement system does not provide incentives for minimizing costs. In fact, the present system encourages administrators to overutilize resources and charge higher prices. Considerable evidence exists which suggests that a prospective system would encourage a more efficient allocation of resources without adversely affecting the quality of care. Given the increase in the state's share of the total Medicaid budget, it would appear that a change to a prospective system is critical in order to maintain the financial accessibility to nursing home care by all Nebraska residents.     

Estimated elasticities from regulated and unregulated cost functions

Estimates of the Allen partial elasticities of substitution (AES) for a regulated cost function [Smith (1981)] are compared with those obtained from an unregulated cost function. The AES for capital and variable inputs are reasonably similar, but those between variable inputs differ significantly.     

Residential choice,hedonic prices,and the demand for urban air quality

This paper uses a two-step estimation procedure suggested by Sherwin Rosen to estimate structural demand and supply equations for urban air quality. In the first step, a hedonic price equation is estimated for residential property values for the Washington, D. C., SMSA for 1970. In the second step, a set of marginal hedonic prices is generated. These prices and the quantity of clean air (reciprocal of air pollution) are used as endogenous variables in a simultaneous equation model. Empirical results indicate a price elasticity of demand between ?1.2 and ?1.4 and a unitary income elasticity.     

A new approach to decomposition of economic time series into permanent and transitory components with particular attention to measurement of the ‘business cycle’

This paper introduces a general procedure for decomposition of non-stationary time series into a permanent and transitory component allowing both components to be stochastic. The permanent component is shown to be a random walk with drift and the transitory or cyclical component is a stationary process with mean zero. The decomposition methodology, which depends only on past data and therefore is computable in ‘real time’, is applied to the problem of measuring and dating business ‘cycles’ in the portwar U.S. economy. We find that measured expansions and contractions are of roughly equivalent duration and that our dating of cyclical episodes tends to lead the traditional NBER dating and, to a lesser extent, the ‘growth cycle’ chronology of Zarnowitz and Boschan (1977).