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At least 19 recordsLinked to original sources
PubMed1984

Econometric models and the study of the economic effects of Social Security.

This article provides a relatively nontechnical discussion of previously published research on the use of econometric models in the study of the economic effects of social security. It illustrates the role of econometric model building by focusing on three major applications: forecasting, policy simulation, and hypothesis testing. A series of three macroeconomic examples serves to emphasize that the development and use of such models puts the focus of the analysis on the underlying economic structure. The first example presents a program-specific model of the Social Security system, the second a large-scale model of the U.S. economy, and the third a single-equation analysis of a specific issue.

Employment↗
PubMed1994

The hospital response to Medicare's Prospective Payment System: an econometric model of Blue Cross and Blue Shield plans.

This paper presents an empirical analysis of the impact that resulted from phase-in of Medicare's Prospective Payment System (PPS) on hospital utilization and payments for the Blue Cross and Blue Shield (BCBS) plans. A pooled cross-sectional time series econometric model was specified and estimated using quarterly hospital utilization and payments of the BCBS plans over the period 1980 to 1987. The results indicate that the implementation of PPS was significantly associated with a lower rate of hospital admissions, days and deflated inpatient payments for the BCBS plan members under age 65. A 1% increase in the proportion of hospital days reimbursed under PPS resulted in a .032% decrease in BCBS plan admissions per 1,000 members, a 0.017% decline in days per 1,000 members and a 0.016% decline in deflated inpatient payment per 1,000 members. The reductions in hospital utilization resulted in lower payments by BCBS plans to participating hospitals suggesting a positive spill-over effect of PPS for private insurers. This research underscores the importance of interaction between federal health policy and the private health insurance market.

Blue Cross Blue Shield Insurance Plans↗
PubMedDate not supplied

A study on the cost-effectiveness of coronary revascularization: introducing the simultaneous mimic health status model.

An econometric model is presented to compare the cost-effectiveness of two alternative procedures, percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass surgery (CABG), for the treatment of multivessel coronary artery disease. This study utilizes the MIMIC (multiple indicator multiple cause) health model in a simultaneous equation system to analyse Emory Angioplasty Surgery Trial (EAST) data. This method eliminates the possibility of endogeneity bias, which may have affected the results of previous cost-effectiveness analyses on this topic. The empirical results indicate that neither procedure proves more cost-effective at 3 year follow-up.

Angioplasty, Balloon, Coronary↗
PubMed1994

Econometric mixture models and more general models for unobservables in duration analysis.

This paper considers models for unobservables in duration models. It demonstrates how cross-section and time-series variation in regressors facilitates identification of single-spell, competing risks and multiple spell duration models. We also demonstrate the limited value of traditional identification studies by considering a case in which a model is identified in the conventional sense but cannot be consistently estimated.

Algorithms↗
PubMed1980

A national econometric forecasting model of the dental sector.

The Econometric Model of the the Dental Sector forecasts a broad range of dental sector variables, including dental care prices; the amount of care produced and consumed; employment of hygienists, dental assistants, and clericals; hours worked by dentists; dental incomes; and number of dentists. These forecasts are based upon values specified by the user for the various factors which help determine the supply an demand for dental care, such as the size of the population, per capita income, the proportion of the population covered by private dental insurance, the cost of hiring clericals and dental assistants, and relevant government policies. In a test of its reliability, the model forecast dental sector behavior quite accurately for the period 1971 through 1977.

Dental Health Services↗
PubMed1996

Registered nurse turnover and the changing health care system.

Changes in health care delivery and cyclic fluctuations in the registered nurse (RN) labor market affect health care costs, access, and quality. This study provides insight into one factor central to these issues, the job-change behavior of RNs. The theory of human capital provides the foundation to guide investigation, and econometric modeling is used to explore relationships among study variables. Model results show clear differences in job change behavior of nurses employed in hospital and nonhospital settings. These differences are a reflection, not only of individual nurse preferences, but also of wages, working conditions, and opportunities associated with various health care settings. Understanding these relationships is essential to leaders in the nursing profession as they plan for and respond to changes in health care delivery.

Adult↗
PubMedDate not supplied

Should you eat breakfast? Estimates from health production functions.

This paper uses an econometric specification based on the health production function approach to examine the importance of lifestyles for adult health. The approach treats health practices such as eating breakfast, smoking, and exercise as inputs into the production of good health; several output measures are explored. The econometric models estimated with data from the 1985 Health Interview Survey show broad agreement with conventional wisdom about the importance of healthy lifestyles. This paper also investigates the role schooling plays in the production of good health. Schooling is found to be related to good health even after controlling for differences in observable health inputs. However, lack of support for a plausible specification of the productive efficiency hypothesis casts some doubt on the interpretation that schooling increases the efficiency of the household production of health.

Age Factors↗
PubMedDate not supplied

Infant mortality time series are random walks with drift: are they cointegrated with socioeconomic variables?

Previous time series analyses of infant mortality have failed to provide evidence to support their implicit assumption that infant mortality data used behaved as a stationary time series. The present study applies the augmented Dickey Fuller Test to infant mortality time series for Sweden (1800-1989), United Kingdom (1839-1989) and United States (1915-1989). The null hypothesis that each of these series is non-stationary is accepted at standard levels of significance. A conceptual framework of infant mortality which uses a combination of physical and social overhead capital as factors in a production function is developed to explain the finding of non-stationarity as derivative from the non-stationarity of a stock of health-enhancing capital. Estimation of econometric models of the socioeconomic determinants of infant mortality using differenced data with ARIMA estimation is inconclusive. Estimation of a bivariate cointegration model supports the hypothesis that infant survival and GNP/Capita are cointegrated for 19th century Sweden but not for 19th century UK. Bivariate analysis of 20th century Sweden, UK, and US data demonstrated no cointegration. This may be due to the onset of disequilibrium in the economic determination of infant mortality in the present era as technological advances and demographic shifts began to play a larger role. Supplementing the bivariate analysis with measures of unemployment, and crude birth rate in the 20th century permitted the detection of cointegration in US and UK. The multivariate results may suggest that improvements in 20th century UK GNP/capita have had greater impact on infant survival relative to US GNP/capita.

Birth Rate↗
PubMedDate not supplied

Investigating hospital efficiency in the new NHS: the role of the translog cost function.

The reforms to the United Kingdom's National Health Service (NHS) of recent years have greatly increased the role of economic incentives in the hospital sector. Hospitals now have to compete for the business of GP and health authority purchasers and are assumed to have an incentive to minimise costs. This makes the analysis of cost functions much more relevant than has previously been the case. The objective of this paper is to assess the potential usefulness of the translog cost function applied in the NHS internal market. Three main issues are identified that limit the role of this type of cost function in the internal market: the adequacy of the econometric model (including data quality); the assumptions underlying the model, and; the interpretation of economies of scale, marginal costs and economies of scope that can be derived from such a cost function. It is concluded that at present the application of translog cost function analysis in the NHS is of limited usefulness, but that it does indicate areas for further methodological research.

Economic Competition↗
PubMed1993

The effectiveness of seat belt legislation in reducing various driver-involved injury rates in California.

This study makes use of econometric models to examine the impact of seat belt laws on various driver-involved injury rates in California in both single- and multiple-vehicle accidents. The study makes use of a large data set from the U.S. D.O.T. State Traffic Accident Files and accounts for the general impact of seat belt laws as well as their dynamic effects on injury rates. The models adjust for a wide range of additional contributing factors to injury rates, including the influence of unemployment rates, speed limits, companion effects, and others. Robust results are obtained for the efficacy of seat belt legislation on reducing (moderate to fatal) injury rates in California.

Accidents, Traffic↗
PubMed1992

Quality competition in local hospital markets: some econometric evidence from the period 1982-1988.

This study examines whether American hospitals continued to engage in non-price or quality competition over the recent past as health care markets underwent fundamental structural changes and the economic incentives facing hospital managers were correspondingly altered. It also investigates the degree to which such rivalrous behavior contributes to losses in economic welfare. An econometric model of quality competition is specified that tests, among other things, for the effect of spending by the hospital to enhance the quality of output on annual changes in its share of the local (inpatient) market as well as the effects of competitive conditions in the local market on the annual sum spent on quality enhancement. The model is estimated with panel data on 195 acute care hospitals in the State of Florida for the years 1982-1988. The results suggest that quality competitive behavior continued unabated over this period and that it was stimulated as much by the growth in physician supply and alternative delivery mechanisms as it was by other competing hospitals in the local market. Furthermore, the results show that quality competition yields some inefficiency or waste, but much of it also meets the test of the market.

Economic Competition↗
PubMed1998

Tricyclic antidepressant and selective serotonin reuptake inhibitors antidepressant selection and health care costs in the naturalistic setting: a multivariate analysis.

BACKGROUND: Providers and payers have an interest in the total health care costs following the initiation of antidepressant treatment in the real world of clinical practice. Analyses of these costs can help evaluate the economic consequences of patient management decisions associated with initial antidepressant selection. OBJECTIVE: The purpose of this study was to assess the 1-year total direct health care costs for patients initiating therapy with one of the available tricyclic antidepressants (TCAs) or one of the three most often prescribed selective serotonin reuptake inhibitors (SSRIs) - paroxetine, sertraline, or fluoxetine. METHOD: A two-stage multivariate econometric model and data from fee-for-service private insurance claims between 1990 and 1994 were used to estimate the total direct health care costs following initial antidepressant drug selection for 2693 patients with a 'new' episode of antidepressant treatment. After controlling for both observed and unobserved characteristics, the 1-year total direct health care costs were found to be (1) statistically significantly lower for patients initiating therapy on fluoxetine than for patients initiating therapy on a TCA; (2) statistically significantly lower for patients who initiated therapy on fluoxetine than for patients initiating therapy on sertraline. CONCLUSIONS: Broadly considered, the findings in this study suggest that total direct health care costs differ across initial antidepressant selection after controlling for both observed and unobserved characteristics.

1-Naphthylamine↗
PubMed1994

A study of factors affecting dental expenditures in Quebec: 1962-1991.

The issue of dental manpower planning has received considerable attention in Quebec in recent years. Quebec dentists agree that there is a need for detailed information regarding the impact of economic factors on the supply of and demand for dental care in the province. This study examines the impact of economic factors on dental care expenditures in Quebec between 1962 and 1991. The functional form of the econometric model used by the authors is similar to the one used in a study of the growth of the U.S. dental sector between 1950 and 1989. The dependent variable is per capita dental expenditure, and the three independent variables are: dentist/population ratio, per capita personal disposable income; and percentage of the population with dental insurance coverage. All data come from secondary sources. The findings indicate that per capita dental expenditure has grown substantially in Quebec over the past three decades, with the rate of growth slowing dramatically during the 1980s. Dental insurance coverage, the number of dentists in the community and the disposable income of the population all have a positive impact on dental expenditure in Quebec. However, it is clear that the incomes of Quebec dentists may decrease in the future if: no restrictions are placed on the number of new dental graduates entering the profession; dental insurance programs are curtailed; or dental disease levels continue to fall.

Dentistry↗
PubMed1992

International health spending forecasts: concepts and evaluation.

Health care depends on the organizational and financial decisions which constituted each national system. Since those decisions were made at various times over the preceding years under different macroeconomic conditions, current expenditures are a distributed lag function of GDP growth and inflation rates. The accuracy of forecasts from such causal econometric models are compared to exponential smoothing, moving average, and ARIMA methods. Data fro 19 OECD countries 1965-79 are used for calibration, and then ex ante forecasts are generated for 1980-87 so that actual forecast accuracy can be tested. The greatest reduction in mean absolute error was obtained with the econometric model estimated in aggregate across all 19 countries, although single-country models, exponential smoothing and international averaging were also effective. A combination of all four forecasts was more accurate than any one alone, reducing MAE by 25% relative to a constant growth projection.

Delivery of Health Care↗
PubMed1979

A time series approach to forecasting Australian total live-births.

The relationship between classical demographic deterministic forecasting models, stochastic structural econometric models and time series models is discussed. Final equation autoregressive moving average (ARMA) models for Australian total live-births are constructed. Particular attention is given to the problem of transforming the time series to stationarity (and Gaussianity) and the properties of the forecasts are analyzed. Final form transfer function models linking births to females in the reproductive age groups are also constructed and a comparison of actual forecast performance using the various models is made. Long-run future forecasts are generated and compared with available projections based on the deterministic cohort model after which some policy implications of the analysis are considered.

Australia↗
PubMed1992

Model for predicting egg output and metabolisable energy intake of laying pullets.

1. The data compiled by Marsden and Morris (1987) to examine the relationships between environmental temperature and the long-term, adapted responses of laying pullets were divided at random into two subsets of 99 and 113 observations. The first subset was used to estimate regression coefficients for an econometric model, and the second subset to validate the model. 2. Equations to predict inputs (costs) and outputs (returns) were estimated with a three-stage least-squares regression model. Three stage least-squares estimation is a technique which corrects for the simultaneity of variables within the model and correlation across equations of the model. This results in more efficient estimates of the regression coefficients. 3. The final output and output equations were: MEI = 253.86-190.31EM+5.766EM2-0.546EM3 + 0.7034T-0.004388T3 + 695.08BW-120.23BW2 + 397.37ME-13.132ME2-1.06MEXT; R2 = 0.86; EO = 119 + 0.025MEI -0.0000045MEI2-1.462T-0.0791T2-135.3BW + 38.31BW2-1.483T X BW + 0.0288T2 X BW + 0.673 delta BW; R2 = 0.59 where MEI = daily metabolisable energy intake (kJ/bird d), T = environmental temperature (degree C), EO = egg output (g/bird d), BW = body weight, and ME = metabolisable energy concentration (kJ/g). The values for R2 indicate very good fits considering that the data were recorded over a 26-year period in 14 different laboratories. 4. This statistical model can serve as the basis for an econometric model of egg production to determine the environmental temperature that maximises profits from laying pullets of different body weights.

Animals↗
PubMed1996

Physical medicine and rehabilitation workforce study: the supply of and demand for physiatrists.

OBJECTIVE: Analysis, results, and implications of a supply and demand workforce model for physical medicine and rehabilitation. Explicit issues addressed include: (1) the supply implications of maintaining current (1994-1995) output of physiatrists from residency programs; (2) the implications of continued growth in managed care on the demand for the services of physiatrists; (3) likely future supply and demand conditions; and (4) strategies to adapt to future conditions. DESIGN: A workforce model of the supply and demand for physiatrists was developed. Parameters of the model are estimated using econometric models and by applying the judgments of a consensus panel. The model evaluated several different scenarios regarding managed care growth, competition from other providers and other factors. RESULTS: Based on the analysis, physiatrists will continue to be in excess demand through the year 2000. More aggressive growth in managed care can affect this result. CONCLUSIONS: Based on an overall assessment of supply and demand conditions, and under the assumption that the supply of new entrants each year remains in the range of 1994-1995 levels, demand for physiatrists will continue to exceed supply, on average, through the year 2000. Excess supply has, and will, emerge in selected geographic areas. If the profession is successful in informing the market regarding the advantages of physiatry, the profession can continue to grow without experiencing excess supply, in the aggregate, for the foreseeable future.

Forecasting↗