This paper analyzes hospital characteristics that are associated with higher average costs and charges for venipuncture, computed tomography procedures (computerized axial tomography [CAT] scans), and electrocardiograms (EKG). Using data from a Medicare database, our results indicate that higher wages, larger hospital sizes, and greater service quality are associated with higher procedure costs, whereas system membership is generally associated with lower procedure costs. Blinder‐type decompositions, which are the main focus of this study, suggest (a) that venipuncture costs are about 17% to 19% lower at proprietary hospitals than at nonprofit or government hospitals, (b) CAT scan costs are about 6% to 12% lower at nonprofit hospitals than at proprietary and government hospitals, and (c) that EKG costs are about 3% lower at proprietary hospitals than at nonprofit or government hospitals. Lastly, large portions of each of these differences are found to be due to both differences in mean values of the hospitals' characteristics by ownership type and differences in the mechanism by which the hospitals' characteristics are transmitted to procedure costs. 相似文献
Housing tenure choice has been the subject of a very large literature. Many treatments have sought to estimate the effect of household income on the likelihood of home ownership. To date, no study has ever disaggregated the household income of married couples into the separate labor income components to see if one partner’s income has a different effect than the other. Using a derived likelihood function to control for censoring in the wife’s income, this paper estimates the effect of separate incomes on housing tenure choice, accounting for possible endogeneity of the wife’s income. To compare the results of this estimation method, the paper also estimates the standard IV models, 2SLS and IV probit. While the results show that there is no endogeneity of the wife’s income, ignoring the censoring of the endogenous variable (when a large fraction of observations are censored) can possibly lead to biased coefficient estimates. Also, this paper confirms the importance of total household income, which has a larger effect than the total disaggregated components. 相似文献
This article uses a microstructure approach to analyse the effectiveness of capital controls introduced in Brazil to counter an appreciation of the Real. Based on a rich data set from the Brazilian foreign exchange market, we estimate a reduced-form VAR to characterize the interaction of the central bank, financial and commercial customers in times of regulatory policy measures. We find that capital controls change market participants’ behaviour, and that central bank interventions elicit a significant response in financial order flow. Referring to the source of order flow, we find no direct price impact by financial flows and thus no evidence that the appreciation of the Real is driven by financial customers’ activity. Instead, commercial customers seem to be a primary driver of the Real within our model. 相似文献
In this paper, we draw on theory from social worlds to analyze how different organizational contexts affect groupware adoption. We report on a study of the adoption of data conferencing in a large distributed organization. Our data show that the diffusion process, which was driven by the users, was a result of communication and transformation of the technology across different social worlds. We also discovered that membership in multiple social worlds in an organization creates a tension for the potential adopter who is in a distributed team. To function effectively, team members must uniformly adopt the technology, yet some may face resistance from other social worlds to which they belong. Our study showed that adoption was affected by organizational sites having conflicting views of the value of collaboration, different amounts and needs for resources, and different acceptance of technology standards. Potential technology adopters on distributed teams are faced with conflicting loyalties, constraints, and requirements between their distributed collaborations and organizational homes. 相似文献
This paper implements the technique suggested by Den Haan (J Monet Econ 46:3–30, 2000) to investigate contemporaneous as well as lead and lag correlations among economic data for a range of forecast horizons. The lead/lag approach provides a richer picture of the economic dynamics generating the data and allows one to investigate which variables lead or lag others, and whether the lead or lag pattern is short term or long term in nature. This technique is applied to monthly sectoral level employment data for the USA and shows that among the ten industrial sectors followed by the US Bureau of Labor Statistics, six tend to lead the other four. These six have high correlations indicating that the structural shocks generating the data movements are mostly in common. Among the four lagging industries, some lag by longer intervals than others and some have low correlations with the leading industries. These low correlations may indicate that these industries are partially influenced by structural shocks beyond those generating the six leading industries, but they also may indicate that lagging sectors feature a different transmission mechanism of shocks. 相似文献
Employees are increasingly using technology to access content for learning, and theory development has been outpaced by practice. Drawing on a well validated theory of behavior change (the Transtheoretical Model of Change), as well as theories on technology acceptance and employee development, this paper offers an integrative model of factors that influence employee use of e-learning as well as practical recommendations for how use might be increased. Recommendations for future research on e-learning are also offered. 相似文献
Economic Value Added (EVA) is a performance measure that is being used by an increasing number of companies, but academic research on EVA is limited. In addition, all prior empirical academic studies on EVA have used the firm as the unit of analysis. In this study, we examine the effect of EVA on the performance of individual managers. Specifically, we examine whether managers on EVA-based bonus plans outperform managers on traditional accounting-based bonus plans. We are able to test this because we have access to an EVA-focused company that has managers on both EVA and traditional bonus plans. Our results suggest that managers on EVA bonus plans who understand the EVA concept perform better than managers on traditional bonus plans. However, we find some evidence that the increase in performance results from increased consistency or congruence in the manager's evaluation–reward process rather than from superiority of EVA as a performance measure. Also, we find that the effect of EVA bonuses and EVA understanding differs depending on the area of the firm in which the manager is employed. This suggests that EVA may not be a universally appropriate base for reward systems. *Mohan Lal passed away 24 July 2002. This paper is dedicated to him. 相似文献
Aims: To develop a budget impact model (BIM) for estimating the financial impact of formulary adoption and uptake of calcipotriene and betamethasone dipropionate (C/BD) foam (0.005%/0.064%) on the costs of biologics for treating moderate-to-severe psoriasis vulgaris in a hypothetical US healthcare plan with 1 million members.
Methods: This BIM incorporated epidemiologic data, market uptake assumptions, and drug utilization costs, simulating the treatment mix for patients who are candidates for biologics before (Scenario #1) and after (Scenario #2) the introduction of C/BD foam. Predicted outcomes were expressed in terms of the annual cost of treatment (COT) and the COT per member per month (PMPM).
Results: At year 1, C/BD foam had the lowest per-patient cost ($9,913) necessary to achieve a Psoriasis Area and Severity Index (PASI)-75 response compared with etanercept ($73,773), adalimumab ($92,871), infliximab ($34,048), ustekinumab ($83,975), secukinumab ($113,858), apremilast ($47,960), and ixekizumab ($62,707). Following addition of C/BD foam to the formulary, the annual COT for moderate-to-severe psoriasis would decrease by $36,112,572 (17.91%, from $201,621,219 to $165,508,647). The COT PMPM is expected to decrease by $3.00 (17.86%, from $16.80 to $13.80).
Limitations: Drug costs were based on Medi-Span reference pricing (January 21, 2016); differences in treatment costs for drug administration, laboratory monitoring, or adverse events were not accounted for. Potentially confounding were the definition of “moderate-to-severe” and the heterogeneous efficacy data. The per-patient cost for PASI-75 response at year 1 was estimated from short-term efficacy data for C/BD foam and apremilast only.
Conclusions: The introduction of C/BD foam is expected to decrease the annual COT for moderate-to-severe psoriasis treatable with biologics by $36,112,572 for a hypothetical US healthcare plan with 1 million plan members, and to lower the COT PMPM by $3.00. 相似文献