Hospital Cost Containment and Length of Stay: An Econometric Analysis

In recent years, concern in the United States over rising health care costs has led to precipitous reductions in the lengths of hospitalizations. While perceptions of compromised medical care quality following this practice and others have prompted policy makers to consider stricter regulation of health insurance organizations, little attention has been given to the extent to which length of stay reductions are responsible for decreasing hospital costs. This paper provides empirical evidence on that point. The method utilizes a hospital total operating cost function estimated on 2792 U.S. hospitals for the period 1987-1992. Three different panel data estimating techniques are applied, including a random effects model that is distinctive in allowing for correlation between hospital effects and observable regressors, circumventing inconsistency problems following from standard generalized least-squares estimations. The cost elasticity of length of stay is calculated from the regression results. This measure is low, falling in the range 0.09-0.12. It suggests that common perceptions regarding the extent of cost savings resulting from length of stay reductions have been overestimated.     

Reliability of recall in agricultural data

Despite the importance of agriculture to economic development, and a vast accompanying literature on the subject, little research has been done on data quality. Due to survey logistics, agricultural data are usually collected by asking respondents to recall the details of events occurring during past agricultural seasons, potentially leading to recall bias. The problem is further complicated when interviews are conducted over the course of several months, thus leading to recall of variable length. To test for recall bias, the length of time between harvest and interview is examined for three African countries with respect to several common agricultural input and harvest measures. The analysis shows little evidence of large recall bias impacting data quality. There is some indication that more salient events are less subject to recall decay. Overall, the results allay some concerns about the quality of some types of agricultural data collected through recall over lengthy periods.     

Exposure Triggers and Allocation Methods: Learning Lessons From Prior Court Rulings

This study provides a review of some of the major court rulings that have shaped and continue to shape the commercial general liability (CGL) market. The evolution of the concepts of "triggers" and allocations systems is examined to gain a perspective on the way in which courts reinterpret contract language to apply to new and emerging exposures. A review of the issues impacting the CGL provides valuable insights into the way court rulings can create a significant impact in the insurance market. A stream of court decisions provides the backdrop for today's challenges, including the reemergence of asbestos claims. The study also fills a gap in the literature related to the crisis in the CGL marketplace and changes in the pricing, regulation, and solvency of insurers operating in those lines. As old risks continue to evolve and new risks emerge, courts have begun to reinterpret liability contracts in much the same way as they reinterpreted contracts with regard to pollution and products in the 1970s and 1980s. Recent rulings related to asbestos and environmental liability underscore the importance of these issues in today's marketplace. By reviewing these events related to the CGL policy, insurers, insureds, and regulators may gain a new perspective on the importance of developing a clear standard wording that will be consistently interpreted in light of new exposures.     

When Should Providers of Recreational Land be Immune from Liability?

This article examines statutes that limit the liability of landowners who open their property for recreational use. We ask whether landowner immunity promotes efficient provision by owners and efficient entry by recreational users. We examine these questions in several contexts, depending on whether the land is developed or undeveloped, privately or publicly owned, and whether or not the owner charges an entry fee. Our main finding is that, for both privately and publicly owned land, owner immunity is more efficient than owner liability when the land is undeveloped, but this is not true when the land is developed.     

Real Estate and the Environment: An Introduction

The Journal of Real Estate Finance and Economics -     

Exploring the efficacy of healthcare quality practices, employee commitment, and employee control

This exploratory study examines healthcare quality program practices, employee commitment and control initiatives, and perceived results by surveying the directors of hospital quality programs. U.S. hospitals are renowned to be among the highest in quality, but recent studies assert that the majority of error-related deaths per year are preventable. In response, healthcare organizations have adopted quality management programs. Employee commitment and control theories propose that employee initiatives are critical to patient safety. However, little research has focused on the efficacy of employee commitment and control initiatives for quality programs at healthcare organizations. This study examines the responses from Quality and Risk Directors of 372 U.S. hospitals. The results of structural equation modeling (SEM) demonstrate that perceived quantitative and qualitative quality program results are more highly related to employee commitment and control initiatives than they are related to quality practices.     

Monitoring by the financial press and forced CEO turnover

This paper examines Wall Street Journal news stories about 79 firms that forced CEO turnover and a matched sample of firms that did not force CEO turnover. In the two years prior to turnover, firms in the forced-turnover sample were the subjects of 76% more news stories about poor firm performance despite being from the same industry, of similar size, and similar performance as a sample of matched firms. Overall, the evidence suggests that scrutiny of poor firm performance by the financial press increases the likelihood of forced CEO turnover.     

Short selling in initial public offerings

Short sale constraints in the aftermarket of initial public offerings (IPOs) are often used to explain short-term underpricing that is subsequently reversed. This paper shows that short selling is integral to aftermarket trading and is higher in IPOs with greater underpricing. Perceived restrictions on borrowing shares are not systematically circumvented by “naked” short selling. Short sellers, on average, do not appear to earn abnormal profits in the near term and our findings are not driven by market makers. Short selling in IPOs is not as constrained as suggested by the literature, implying that other factors may be responsible for underpricing.     

Motivating students to prepare for class and engage in discussion using the hot seat

Accounting accreditation standards place a strong emphasis on student engagement in the learning process (1 and 14). However, budget constraints at many universities are creating larger class sizes, thereby complicating the student-engagement process in two respects. First, it is difficult for professors to motivate students to prepare for class when the students perceive a small probability of being held individually accountable for reading assigned materials. Second, it becomes harder for professors to have one-on-one interactions with students during class as enrollments grow (Litke, 1995). This lack of interaction makes it more difficult to engage students in the learning process. This article describes a teaching approach, called the “hot seat,” that overcomes these challenges by motivating students to prepare for class and engage in the learning process during class. Assessment data suggest that students valued the instructor’s commitment to high-quality instruction and that they believed the hot-seat approach accomplished its intended objectives of increasing student preparation, participation, and learning.