Evaluating cost center productivity

The monthly and yearly productivity summaries were developed and applied to a computer spreadsheet to aid the nurse manager in better understanding and communicating budget issues for diverse ambulatory care departments. A computerized spreadsheet using a commercially available personal computer program, such as Lotus, Quattro Pro, or Excel, can be used to more quickly and accurately track and summarize monthly budget reports. The data can be entered into the spreadsheet either manually or imported by query from the financial mainframe system. Contact your agency's finance or information department for information on how to accomplish this. Periodically acuity and resources should be measured and compared with quality monitors to maintain standards. For the past 10 years, our facility has successfully used this tool to make more informed decisions by identifying trouble spots early, and taking corrective action to avoid crisis management.     

A trivariate model of participation,fertility and wages: the Italian case

Italy has unusually low fertility by OECD standards, accompaniedby unusually low female participation in paid work. This paperaddresses the issue of the empirical relationship between fertility,female participation in the labour market and wages with theseItalian 'peculiarities' as a backcloth. A trivariate model ofparticipation, fertility and wages has been constructed andestimated using three pooled cross-sections of Italian microdata, allowing for the identification of cohort effects. Thismodel follows a 'purist' approach: the participation and fertilitydecisions, as well as the wage equation, are modelled as completelyjoint. The cohort effects turn out to be significant: the pointestimates do not appear to confirm actual trends, which arenegative for fertility and positive for participation. The femalewage is the most important variable influencing the propensityto have children and the propensity to participate in the labourmarket, casting doubt on suggestions that observed trends arethe products of shifts in women's 'tastes'.     

MEDICARE AND INEQUALITIES IN HEALTH OUTCOMES: THE CASE OF BREAST CANCER

This article evaluates whether expanding Medicare to cover those between ages 55 and 64 will improve the health status of these near-elderly individuals. We compare the experiences of near-elderly and elderly women with breast cancer and pay special attention to those demographic groups traditionally thought to be disadvantaged. Using unique individual-level data from the National Cancer Institute, we find that expanding Medicare does not improve the probability that a black woman will have her cancer diagnosed early. However, if she does happen to be diagnosed early, a discretE-time hazard model of survival finds that the price effects of insurance will improve her odds of survival.