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Percentage Points (percentage + point)
Terms modified by Percentage Points Selected AbstractsPercentage Points of the Multivariate t DistributionINTERNATIONAL STATISTICAL REVIEW, Issue 1 2006Saralees Nadarajah Summary The known methods for computing percentage points of multivariate t distributions are reviewed. We believe that this review will serve as an important reference and encourage further research activities in the area. Résumé Les méthodes connues pour estimer des points de pourcentage de distributions t multivarées sont passées en revue. Nous croyons que cette étude servira de référence importante et encouragera de nouvelles activiés de recherche dans le domaine. [source] Tests for an Epidemic Change in a Sequence of Exponentially Distributed Random VariablesBIOMETRICAL JOURNAL, Issue 8 2003Asoka Ramanayake Abstract Consider a sequence of independent exponential random variables that is susceptible to a change in the means. We would like to test whether the means have been subjected to an epidemic change after an unknown point, for an unknown duration in the sequence. The likelihood ratio statistic and a likelihood ratio type statistic are derived. The distribution theories and related properties of the test statistics are discussed. Percentage points and powers of the tests are tabulated for selected values of the parameters. The powers of these two tests are then compared to the two statistics proposed by Aly and Bouzar. The tests are applied to find epidemic changes in the set of Stanford heart transplant data and air traffic arrival data. [source] Expansionary Fiscal Shocks and the US Trade Deficit,INTERNATIONAL FINANCE, Issue 3 2005Christopher J. Erceg In this paper, we use a dynamic general equilibrium model of an open economy to assess the quantitative effects of fiscal shocks on the trade balance in the United States. We examine the effects of two alternative fiscal shocks: a rise in government consumption, and a reduction in the labour income tax rate. Our salient finding is that a fiscal deficit has a relatively small effect on the US trade balance, irrespective of whether the source is a spending increase or tax cut. In our benchmark calibration, we find that a rise in the fiscal deficit of 1 percentage point of gross domestic product (GDP) induces the trade balance to deteriorate by 0.2 percentage point of GDP or less. Noticeably larger effects are only likely to be elicited under implausibly high values of the short-run trade price elasticity, or of the share of liquidity-constrained households in the economy. From a policy perspective, our analysis suggests that even reducing the current US fiscal deficit (of 3% of GDP) to zero would be unlikely to narrow the burgeoning US trade deficit significantly. [source] Tracking the Euro's ProgressINTERNATIONAL FINANCE, Issue 3 2000Menzie D. Chinn The evolution of the euro since its inception has appeared inexplicable. This paper develops a monetary model of the euro/US dollar exchange rate to track the progress of the currency, both before and after Stage 3 EMU. The relationship between the exchange rate, money stocks, GDP, interest and inflation rates, and prices is identified. The observed patterns of behaviour during the 1990s are used to predict the euro's value up to mid-2000; a consistent finding is that the euro is over-predicted by 23,30%. This finding is robust to the use of alternative sample periods and alternative estimation methodologies, as long as each of the variables is treated as endogenous. This monetary model does not give much weight to factors such as productivity. However, the past evolution of European exchange rates suggests that productivity trends are indeed important. Some estimates suggest that an annual one percentage point in the intercountry differential in tradable-nontradable productivity causes a 0.85'1.7% real appreciation of a currency. [source] Cost numerical optimization of the triple-pressure steam-reheat gas-reheat gas-recuperated combined power cycle that uses steam for cooling the first GTINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 15 2008A. M. Bassily Abstract Optimization is an important method for improving the efficiency and power of the combined cycle. In this paper, the triple-pressure steam-reheat gas-reheat gas-recuperated combined cycle that uses steam for cooling the first gas turbine (the regular steam-cooled cycle) was optimized relative to its operating parameters. The optimized cycle generates more power and consumes more fuel than the regular steam-cooled cycle. An objective function of the net additional revenue (the saving of the optimization process) was defined in terms of the revenue of the additional generated power and the costs of replacing the heat recovery steam generator (HRSG) and the costs of the additional operation and maintenance, installation, and fuel. Constraints were set on many operating parameters such as air compression ratio, the minimum temperature difference for pinch points (,Tppm), the dryness fraction at steam turbine outlet, and stack temperature. The net additional revenue and cycle efficiency were optimized at 11 different maximum values of turbine inlet temperature (TIT) using two different methods: the direct search and the variable metric. The optima were found at the boundaries of many constraints such as the maximum values of air compression ratio, turbine outlet temperature (TOT), and the minimum value of stack temperature. The performance of the optimized cycles was compared with that for the regular steam-cooled cycle. The results indicate that the optimized cycles are 1.7,1.8 percentage points higher in efficiency and 4.4,7.1% higher in total specific work than the regular steam-cooled cycle when all cycles are compared at the same values of TIT and ,Tppm. Optimizing the net additional revenue could result in an annual saving of 21 million U.S. dollars for a 439,MW power plant. Increasing the maximum TOT to 1000°C and replacing the stainless steel recuperator heat exchanger of the optimized cycle with a super-alloys-recuperated heat exchanger could result in an additional efficiency increase of 1.1 percentage point and a specific work increase of 4.8,7.1%. The optimized cycles were about 3.3 percentage points higher in efficiency than the most efficient commercially available H-system combined cycle when compared at the same value of TIT. Copyright © 2008 John Wiley & Sons, Ltd. [source] Analysis and cost optimization of the triple-pressure steam-reheat gas-reheat gas-recuperated combined power cycleINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 2 2008A. M. Bassily Abstract Increasing the inlet temperature of gas turbine (TIT) and optimization are important methods for improving the efficiency and power of the combined cycle. In this paper, the triple-pressure steam-reheat gas-reheat recuperated combined cycle (the Regular Gas-Reheat cycle) was optimized relative to its operating parameters, including the temperature differences for pinch points (,TPP). The optimized triple-pressure steam-reheat gas-reheat recuperated combined cycle (the Optimized cycle) had much lower ,TPP than that for the Regular Gas-Reheat cycle so that the area of heat transfer of the heat recovery steam generator (HRSG) of the Optimized cycle had to be increased to keep the same rate of heat transfer. For the same mass flow rate of air, the Optimized cycle generates more power and consumes more fuel than the Regular Gas-Reheat cycle. An objective function of the net additional revenue (the saving of the optimization process) was defined in terms of the revenue of the additional generated power and the costs of replacing the HRSG and the additional fuel. Constraints were set on many operating parameters such as the minimum temperature difference for pinch points (,TPPm), the steam turbines inlet temperatures and pressures, and the dryness fraction at steam turbine outlet. The net additional revenue was optimized at 11 different maximum values of TIT using two different methods: the direct search and variable metric. The performance of the Optimized cycle was compared with that for the Regular Gas-Reheat cycle and the triple-pressure steam-reheat gas-reheat recuperated reduced-irreversibility combined cycle (the Reduced-Irreversibility cycle). The results indicate that the Optimized cycle is 0.17,0.35 percentage point higher in efficiency and 5.3,6.8% higher in specific work than the Reduced-Irreversibility cycle, which is 2.84,2.91 percentage points higher in efficiency and 4.7% higher in specific work than the Regular Gas-Reheat cycle when all cycles are compared at the same values of TIT and ,TPPm. Optimizing the net additional revenue could result in an annual saving of 33.7 million US dollars for a 481 MW power plant. The Optimized cycle was 3.62 percentage points higher in efficiency than the most efficient commercially available H-system combined cycle when compared at the same value of TIT. Copyright © 2007 John Wiley & Sons, Ltd. [source] The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic reviewJOURNAL OF INTERNAL MEDICINE, Issue 1 2004M. G. Wulffelé Abstract. Background., The UKPDS 34 showed that intensive treatment with metformin significantly reduces macrovascular end-points and mortality in individuals with newly diagnosed type 2 diabetes compared with intensive treatment with insulin or sulphonylurea derivatives, despite similar glycaemic control. How this should be explained is as yet unclear. We hypothesized that metformin may have a glucose-lowering independent effect on blood pressure and lipid profile. In order to test this hypothesis we systematically reviewed the literature and pooled the data obtained in a meta-analysis. Methods., Included were randomized-controlled trials in patients with type 2 diabetes mellitus and metformin treatment lasting at least 6 weeks. To identify all eligible trials we conducted electronic searches using the bibliographic databases Medline and Embase, contacted the manufacturer and checked obtained publications for cross-references. Results., Forty-one studies (3074 patients) provided data on blood pressure and/or lipid profile. When compared with control treatment, metformin associated effects on systolic and diastolic blood pressure and HDL cholesterol were small and statistically not significant [,1.09 mmHg 95% confidence interval (,3.01,0.82), P = 0.30; ,0.97 (,2.15,0.21) mmHg, P = 0.11 and +0.01 (,0.02,0.03) mmol L,1, P = 0.50, respectively]. Compared with control treatment, however, metformin decreased plasma triglycerides, total cholesterol and LDL cholesterol significantly [,0.13 (,0.21,,0.04) mmol L,1, P = 0.003; ,0.26 (,0.34,,0.18) mmol L,1, P < 0.0001 and ,0.22 (,0.31,,0.13) mmol L,1, P < 0.00001, respectively]. We found no indications for publication bias. Of note, glycaemic control as assessed by HbA1c was better with metformin than with control treatment [,0.74 (,0.84,,0.65) percentage point; P < 0.00001]. When studies were subdivided into tertiles according to increasing difference in glycaemic control between metformin and control treatment, it appeared that in case of near similar glycaemic control metformin had no effect versus control treatment on triglycerides, whereas still there was a significant effect on total and LDL cholesterol. Conclusions., This meta-analysis of randomized-controlled clinical trials suggests that metformin has no intrinsic effect on blood pressure, HDL cholesterol and triglycerides in patients with type 2 diabetes. This drug, however, independent of its effect on glycaemia, reduces total and LDL cholesterol significantly, but the reductions in these variables are relatively small. [source] Inter-temporal and Inter-industry Effects of Population Ageing: A General Equilibrium Assessment for CanadaLABOUR, Issue 4 2009Nabil Annabi In addition to the impact of slower labour force growth, the model captures the shift in sectoral composition of final demand of older individuals. The simulation results indicate that the growth in real GDP per capita could decline by nearly one percentage point between 2006 and 2050. The results also suggest that the equilibrium unemployment rate is likely to decline by more than two percentage points in the long run. However, the impact varies significantly at the occupational level. [source] Household diversity and migration in mid-life: understanding residential mobility among 45,64 year olds in Melbourne, AustraliaPOPULATION, SPACE AND PLACE (PREVIOUSLY:-INT JOURNAL OF POPULATION GEOGRAPHY), Issue 4 2010Maryann Wulff Abstract This paper focuses on the residential mobility of middle-aged persons, not yet retired, an understudied cohort in mobility research. From the 1950s to the 1980s, mobility studies pointed to mid-life as a settled stage in terms of family, work and housing. Recent demographic and social changes, however, have led to these years being typified by a wide gamut of living arrangements that have complicated decisions about, and patterns of, residential mobility. Using the life-course perspective, this paper suggests that the transition to ,empty nester' status will heighten mobility among this group of middle-aged persons relative to their counterparts in other living arrangements. The analysis uses a customised migration matrix from the Australian 2006 Census and identifies segments of 45,64 year olds most likely to have changed address since the previous census in 2001. CHAID statistical method partitioned the 45,64 year old population in Melbourne, Australia, into eight statistically significant segments based on life-course factors and mobility levels. Younger (45,54 years) mid-life empty-nesters changed residence at 1.4 times the mobility rate of all mid-life persons. For couples in this age group, empty nest status conferred a 13 percentage point ,mobility premium' compared with couples that still had children at home. The results contribute to a better understanding of housing consumption among mid-life households and broader debates on access to affordable housing and processes of urban growth. Copyright © 2009 John Wiley & Sons, Ltd. [source] How Big Was the Effect of Budget Consolidation on the Australian Economy in the 1990s?THE AUSTRALIAN ECONOMIC REVIEW, Issue 1 2006Lei Lei Song This article evaluates the effects of budget consolidation on the Australian economy in the 1990s. As the economy recovered from the 1991,92 recession, the need to improve the fiscal balance to lift national saving became the dominant influence on fiscal policy. The article argues that spending cuts by the Australian federal government announced in 1996 had immediate effects on financial markets, with reduced long-term interest rates of about 50 basis points in 1996,97. Using a modified version of the Treasury macroeconometric model of the Australian economy (TRYM), the article simulates the net macroeconomic effects of the expenditure cuts, fiscal consolidation and lower long-term interest rates. The article finds that the program of budget consolidation had a sizeable short- and medium-term impact on the economy, raising Gross Domestic Product by up to three-quarters of a percentage point and reducing unemployment by 0.3 percentage points over the next two to three years. [source] Short versus Long Coalitions: Electoral Accountability and the Size of the Public SectorAMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 2 2006Kathleen Bawn This article examines the policy consequences of the number of parties in government. We argue that parties externalize costs not borne by their support groups. Larger parties thus internalize more costs than small parties because they represent more groups. This argument implies that the public sector should be larger the more parties there are in the government coalition. We test this prediction using yearly time-series cross-sectional data from 1970 to 1998 in 17 European countries. We find that increasing the number of parties in government increases the fraction of GDP accounted for by government spending by close to half a percentage point, or more than one billion current dollars in the typical year. We find little support for the alternative claim that the number of legislative parties affects the size of the public sector, except via the number of parties in government. [source] Some Fiscal Implications of Monetary PolicyBULLETIN OF ECONOMIC RESEARCH, Issue 1 2003Harris Dellas We study the implications of alternative monetary targeting procedures for real interest rates and economic activity. We find that countercyclical monetary policy rules lead to higher real interest rates, higher average tax rates, lower output but lower variability of tax rates and consumption relative to procyclical rules. For a country with a high level of public debt (e.g. Italy), the adoption of a countercyclical procedure such as interest rate pegging may conceivably raise public debt servicing costs by more than half a percentage point of GNP. Our analysis suggests that the current debate on the targeting procedures of the European Central Bank ought to be broadened to include a discussion of the fiscal implications of monetary policy. [source] The Effectiveness of Jobs Reservation: Caste, Religion and Economic Status in IndiaDEVELOPMENT AND CHANGE, Issue 3 2007Vani K. Borooah ABSTRACT This article investigates the effect of jobs reservation on improving the economic opportunities of persons belonging to India's Scheduled Castes (SC) and Scheduled Tribes (ST). Using employment data from the 55th NSS round, the authors estimate the probabilities of different social groups in India being in one of three categories of economic status: own account workers; regular salaried or wage workers; casual wage labourers. These probabilities are then used to decompose the difference between a group X and forward caste Hindus in the proportions of their members in regular salaried or wage employment. This decomposition allows us to distinguish between two forms of difference between group X and forward caste Hindus: ,attribute' differences and ,coefficient' differences. The authors measure the effects of positive discrimination in raising the proportions of ST/SC persons in regular salaried employment, and the discriminatory bias against Muslims who do not benefit from such policies. They conclude that the boost provided by jobs reservation policies was around 5 percentage points. They also conclude that an alternative and more effective way of raising the proportion of men from the SC/ST groups in regular salaried or wage employment would be to improve their employment-related attributes. [source] EDUCATIONAL BENEFITS AND MILITARY SERVICE: AN ANALYSIS OF ENLISTMENT, REENLISTMENT, AND VETERANS' BENEFIT USAGE 1991,2005,ECONOMIC INQUIRY, Issue 4 2010CURTIS J. SIMON Montgomery GI Bill (MGIB) educational benefits are a prime recruiting tool in today's all-volunteer military. This paper studies the effects of changes in education benefits using data of the period 1990,2005. Higher benefits lead to higher separation due to both pure incentive effects and by attracting more college-oriented youth into military service. We deal with potential selection issues by distinguishing between anticipated and unanticipated benefit changes. Higher education benefits are associated with higher separation from the Army and Air Force, but not the other services. A $10,000 increase in MGIB benefits is estimated to increase usage by about 5 percentage points, but the duration of usage is estimated to be insensitive to benefit levels. (JEL H52, I21, J24) [source] Unemployment, growth and taxation in industrial countriesECONOMIC POLICY, Issue 30 2000Francesco Daveri To the layman, the upward trend in European unemployment is related to the slowdown of economic growth. We argue that the layman's view is correct. The increase in European unemployment and the slowdown in economic growth are related, because they stem from a common cause: an excessively rapid growth in the cost of labour. In Europe, labour costs have gone up for many reasons, but one is particularly easy to identify: higher taxes on labour. If wages are set by strong and decentralized trade unions, an increase in labour taxes is shifted onto higher real wages. This has two effects. First, it reduces labour demand, and thus creates unemployment. Secondly, as firms substitute capital for labour, the marginal product of capital falls; over long periods of time, this in turn diminishes the incentive to invest and to grow. The data strongly support this view. According to our estimates, the observed rise of 14 percentage points in labour tax rates between 1965 and 1995 in the EU could account for a rise in EU unemployment of roughly 4 percentage points, a reduction of the investment share of output of about 3 percentage points, and a growth slowdown of about 0.4 percentage points a year. [source] Immigration and the Economic Status of African-American MenECONOMICA, Issue 306 2010George J. Borjas The employment rate of black men, and particularly of low-skilled black men, fell precipitously between 1960 and 2000. At the same time, their incarceration rate rose. This paper examines the relation between immigration and these trends in employment and incarceration. Using data from the 1960,2000 US censuses, we find that a 10% immigration-induced increase in the supply of workers in a particular skill group reduced the black wage of that group by 2.5%, lowered the employment rate by 5.9 percentage points, and increased the incarceration rate by 1.3 percentage points. [source] TERRORISM AND THE RETURNS TO OILECONOMICS & POLITICS, Issue 3 2009BROCK BLOMBERG The effect of terrorism on global oil prices has been largely explained through demand-side effects. We estimate an empirical model to re-examine the effect of terrorism on the price of global oil stocks across oil market regimes that reflect different supply constraints. We believe that terrorism will have larger impacts when global capacity is tight (i.e. when global demand is close to global supply). This means that any shock to capacity (say by conflict) should have the largest impact on profits before the first OPEC shock in the early 1970s. Since then, conflict shocks would not allow firms to exploit production in the same way, thus reducing the available profits that could be garnered by such production manipulation. If capacity constraints are binding when a conflict occurs, then we predict that a positive stock price reaction can be expected for oil firms from such a shock. We exploit a new panel dataset to investigate the relationship between oil profitability and conflict, using conflict data from the top 20 oil producing and exporting countries in the world. We show that in the later part of our sample, 1974,2005, as cartel behavior of OPEC member countries has diminished and as conflict has become more regular and thus the information surrounding it noisier, oil stock prices do not increase in response to conflict. However, in earlier capacity constrained eras, we find that oil stocks can in fact increase in response to conflict. In some cases, the impact of conflict may cause the return of oil stocks to increase by as much as 10 percentage points. [source] Inflation, Inflation Variability, and CorruptionECONOMICS & POLITICS, Issue 1 2004Miguel Braun We present a model where agents can inflate the cost of goods needed to start an investment project and inflation variability increases monitoring costs. We show that inflation variability can lead to higher corruption and lower investment. We document a positive relationship between corruption and inflation variability in a sample of 75 countries. The effect is robust to the inclusion of country fixed effects, other controls, and 2SLS estimation. The results are economically significant: a one standard deviation increase in inflation variance from the median increases corruption by 12 percent of a standard deviation and reduces growth by 0.33 percentage points. Our paper highlights a new channel through which inflation reduces investment and growth, thus bridging the perception gap over the costs of inflation between economists and the public. We also find evidence that political competition reduces corruption and that corruption is pro-cyclical. [source] The Dependence of Growth-Model Results on Proficiency Cut ScoresEDUCATIONAL MEASUREMENT: ISSUES AND PRACTICE, Issue 4 2009Andrew D. Ho States participating in the Growth Model Pilot Program reference individual student growth against "proficiency" cut scores that conform with the original No Child Left Behind Act (NCLB). Although achievement results from conventional NCLB models are also cut-score dependent, the functional relationships between cut-score location and growth results are more complex and are not currently well described. We apply cut-score scenarios to longitudinal data to demonstrate the dependence of state- and school-level growth results on cut-score choice. This dependence is examined along three dimensions: 1) rigor, as states set cut scores largely at their discretion, 2) across-grade articulation, as the rigor of proficiency standards may vary across grades, and 3) the time horizon chosen for growth to proficiency. Results show that the selection of plausible alternative cut scores within a growth model can change the percentage of students "on track to proficiency" by more than 20 percentage points and reverse accountability decisions for more than 40% of schools. We contribute a framework for predicting these dependencies, and we argue that the cut-score dependence of large-scale growth statistics must be made transparent, particularly for comparisons of growth results across states. [source] How Did the 2003 Dividend Tax Cut Affect Stock Prices?FINANCIAL MANAGEMENT, Issue 4 2008Gene Amromin We test the hypothesis that the 2003 dividend tax cut boosted US stock prices and thereby lowered the cost of equity capital. Using an event-study methodology, we attempt to identify an aggregate stock market effect by comparing the behavior of US common stock prices with that of foreign equities and the equities of real estate investment trusts (REITs). We also examine the relative cross-sectional response of prices of high- and low-dividend-paying stocks. We do not find any imprint of the dividend tax cut news on the value of the aggregate US stock market. On the other hand, high-dividend stocks outperformed low-dividend stocks by a few percentage points over the event windows, suggesting that the tax cut may have induced asset reallocation within equity portfolios. Finally, the positive abnormal return on nondividend paying US stocks in 2003 does not appear to be tied to tax cut news. [source] The Labour Market Impact of the Working Families' Tax CreditFISCAL STUDIES, Issue 1 2000RICHARD BLUNDELL Abstract In October 1999, the working families' tax credit (WFTC) replaced family credit as the main package of in-work support for families with children. Among a range of stated aims, the WFTC is intended to,, improve work incentives, encouraging people without work to move into employment'. In this paper, we consider the impact of WFTC on hours and participation. To simulate labour supply responses, we use a discrete behavioural model of household labour supply with controls for fixed and childcare costs, and unobserved heterogeneity. In simulation, we experiment with a number of scenarios regarding the take-up of the credit, entry wage level and hourly childcare price. We find participation rates among single mothers to increase by around 2.2 percentage points for the base-case scenario, while for married women participation rates are modelled to fall. Our simulation results indicate a small increase in overall participation of around 30,000 individuals. [source] Pension Reform, Capital Markets and the Rate of ReturnGERMAN ECONOMIC REVIEW, Issue 2 2003Axel Börsch-Supan Aging; pension reform; rates of return Abstract. This paper discusses the consequences of population aging and a fundamental pension reform , that is, a shift towards more pre-funding , for capital markets in Germany. We use a stylized closed-economy, overlapping-generations model to compare the effects of the recent German pension reform with those of a more decisive reform that would freeze the current pay-as-you-go contribution rate and thus result in a larger funded component of the pension system. We predict rates of return to capital under both reform scenarios over a long horizon, taking demographic projections as given. Our main finding is that the future decrease in the rate of return is much smaller than often claimed in the public debate. Our simulations show that the capital stock will decrease once the baby-boom generations enter retirement, even if there were no fundamental pension reform. The corresponding decrease in the rate of return, the direct effect of population aging, is around 0.7 percentage points. While the capital market effects of the recent German pension reform are marginal, the rate of return to capital would decrease by an additional 0.5 percentage points under the more decisive reform proposal. [source] The role of private providers in treating child diarrhoea in Latin AmericaHEALTH ECONOMICS, Issue 1 2008Hugh R. Waters Abstract Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries , where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001). However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available. Copyright © 2007 John Wiley & Sons, Ltd. [source] Prenatal drug use and the production of infant healthHEALTH ECONOMICS, Issue 4 2007Kelly Noonan Abstract We estimate the effect of illicit drug use during pregnancy on two measures of poor infant health: low birth weight and abnormal infant health conditions. We use data from a national longitudinal study of urban parents that includes postpartum interviews with mothers, hospital medical record data on the mothers and their newborns, and information about the neighborhood in which the mother resides. We address the potential endogeneity of prenatal drug use. Depending on how prenatal drug use is measured, we find that it increases low birth weight by 4,6 percentage points and that it increases the likelihood of an abnormal infant health condition by 7,12 percentage points. Copyright © 2006 John Wiley & Sons, Ltd. [source] SCHIP's Impact on Dependent Coverage in the Small-Group Health Insurance MarketHEALTH SERVICES RESEARCH, Issue 1 2010Eric E. Seiber Objective. To estimate the impact of State Children's Health Insurance Program (SCHIP) expansions on public and private coverage of dependents at small firms compared with large firms. Data Sources. 1996,2007 Annual Demographic Survey of the Current Population Survey (CPS). Study Design. This study estimates a two-stage least squares (2SLS) model for four insurance outcomes that instruments for SCHIP and Medicaid eligibility. Separate models are estimated for small group markets (firms with fewer than 25 employees), small businesses (firms under 500 employees), and large firms (firms 500 employees and above). Data Collection/Extraction Methods. We extracted data from the 1996,2007 CPS for children in households with at least one worker. Principal Findings. The SCHIP expansions decreased the percentage of uninsured dependents in the small group market by 7.6 percentage points with negligible crowd-out in the small group and no significant effect on private coverage across the 11-year-period. Conclusions. The SCHIP expansions have increased coverage for households in the small group market with no significant crowd-out of private coverage. In contrast, the estimates for large firms are consistent with the substantial crowd-out observed in the literature. [source] The Impact of CHIP on Children's Insurance Coverage: An Analysis Using the National Survey of America's FamiliesHEALTH SERVICES RESEARCH, Issue 6 2009Lisa Dubay Objective. To assess the impact of the Children's Health Insurance Program (CHIP) on the distribution of health insurance coverage for low-income children. Data Source. The primary data for the study were from the 1997, 1999, and 2002 National Survey of America's Families (NSAF), which includes a total sample of 62,497 children across all 3 years, supplemented with data from other data sources. Study Design. The study uses quasi-experimental designs and tests the sensitivity of the results to using instrumental variable and difference-in-difference approaches. A detailed Medicaid and CHIP eligibility model was developed for this study. Balanced repeated replicate weights were used to account for the complex sample of the NSAF. Descriptive and multivariate analyses were conducted. Principle Findings. The results varied depending on the approach utilized but indicated that the CHIP program led to significant increases in public coverage (14,20 percentage points); and declines in employer-sponsored coverage (6,7 percentage points) and in uninsurance (7,12 percentage points). The estimated share of CHIP enrollment attributable to crowd-out ranged from 33 to 44 percent. Smaller crowd-out effects were found for Medicaid-eligible children. Conclusions. Implementation of the CHIP program resulted in large increases in public coverage with estimates of crowd-out consistent with initial projections made by the Congressional Budget Office. This paper demonstrates that public health insurance expansions can lead to substantial reductions in uninsurance without causing a large-scale erosion of employer coverage. [source] Managed Care Quality of Care and Plan Choice in New York SCHIPHEALTH SERVICES RESEARCH, Issue 3 2009Hangsheng Liu Objective. To examine whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care. Data Sources. 2001 New York SCHIP evaluation data; 2001 New York State Managed Care Plan Performance Report; 2000 New York State Managed Care Enrollment Report. Study Design. Each market was defined as a county. A final sample of 2,325 new enrollees was analyzed after excluding those in markets with only one SCHIP plan. Plan quality was measured using seven Consumer Assessment of Health Plans Survey (CAHPS) and three Health Plan Employer Data and Information Set (HEDIS) scores. A conditional logit model was applied with plan and individual/family characteristics as covariates. Principle Findings. There were 30 plans in the 45 defined markets. The choice probability increased 2.5 percentage points for each unit increase in the average CAHPS score, and the association was significantly larger in children with special health care needs. However, HEDIS did not show any statistically significant association with plan choice. Conclusions. Low-income parents do choose managed care plans with higher CAHPS scores for their newly enrolled children, suggesting that overall quality could improve over time because of the dynamics of enrollment. [source] Welfare Reform and Health Insurance of ImmigrantsHEALTH SERVICES RESEARCH, Issue 3 2005Neeraj Kaushal Objective. To investigate the effect of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) on the health insurance coverage of foreign- and U.S.-born families headed by low-educated women. Data Source. Secondary data from the March series of the Current Population Surveys for 1994,2001. Study Design. Multivariate regression methods and a pre- and post-test with comparison group research design (difference-in-differences) are used to estimate the effect of welfare reform on the health insurance coverage of low-educated, foreign- and U.S.-born unmarried women and their children. Heterogenous responses by states to create substitute Temporary Aid to Needy Families or Medicaid programs for newly arrived immigrants are used to investigate whether the estimated effect of PRWORA on newly arrived immigrants is related to the actual provisions of the law, or the result of fears engendered by the law. Principal Findings. PRWORA increased the proportion of uninsured among low-educated, foreign-born, unmarried women by 9.9,10.7 percentage points. In contrast, the effect of PRWORA on the health insurance coverage of similar U.S.-born women is negligible. PRWORA also increased the proportion of uninsured among foreign-born children living with low-educated, single mothers by 13.5 percentage points. Again, the policy had little effect on the health insurance coverage of the children of U.S.-born, low-educated single mothers. There is some evidence that the fear and uncertainty engendered by the law had an effect on immigrant health insurance coverage. Conclusions. This research demonstrates that PRWORA adversely affected the health insurance of low-educated, unmarried, immigrant women and their children. In the case of unmarried women, it may be partly because the jobs that they obtained in response to PRWORA were less likely to provide health insurance. The research also suggests that PRWORA may have engendered fear among immigrants and dampened their enrollment in safety net programs. [source] The Unintended Impact of Welfare Reform on the Medicaid Enrollment of Eligible ImmigrantsHEALTH SERVICES RESEARCH, Issue 5 2004Namratha R. Kandula Background. During welfare reform, Congress passed legislation barring legal immigrants who entered the United States after August 1996 from Medicaid for five years after immigration. This legislation intended to bar only new immigrants (post-1996 immigrants) from Medicaid. However it may have also deterred the enrollment of legal immigrants who immigrated before 1996 (pre-1996 immigrants) and who should have remained Medicaid eligible. Objectives. To compare the Medicaid enrollment of U.S.-born citizens to pre-1996 immigrants, before and after welfare reform, and to determine if variation in state Medicaid policies toward post-1996 immigrants modified the effects of welfare reform on pre-1996 immigrants. Data Source/Study Design. Secondary database analysis of cross-sectional data from 1994,2001 of the U.S. Census Bureau, Annual Demographic Survey of March Supplement of the Current Population Survey. Subjects. Low-income, U.S.-born adults (N=116,307) and low-income pre-1996 immigrants (N=24,367) before and after welfare reform. Measures. Self-reported Medicaid enrollment. Results. Before welfare reform, pre-1996 immigrants were less likely to enroll in Medicaid than the U.S.-born (OR=0.55; 95 percent CI, 0.51,0.59). After welfare reform, pre-1996 immigrants were even less likely to enroll in Medicaid. The proportion of immigrants in Medicaid dropped 3 percentage points after 1996; for the U.S.-born it dropped 1.6 percentage points (p=0.012). Except for California, state variation in Medicaid policy toward post-1996 immigrants did modify the effect of welfare reform on pre-1996 immigrants. Conclusions. Federal laws limiting the Medicaid eligibility of specific subgroups of immigrants appear to have had unintended consequences on Medicaid enrollment in the larger, still eligible immigrant community. Inclusive state policies may overcome this effect. [source] Improving Care for Minorities: Can Quality Improvement Interventions Improve Care and Outcomes For Depressed Minorities?HEALTH SERVICES RESEARCH, Issue 2 2003Controlled Trial, Results of a Randomized Objective. Ethnic minority patients often receive poorer quality care and have worse outcomes than white patients, yet practice-based approaches to reduce such disparities have not been identified. We determined whether practice-initiated quality improvement (QI) interventions for depressed primary care patients improve care across ethnic groups and reduce outcome disparities. Study Setting. The sample consists of 46 primary care practices in 6 U.S. managed care organizations; 181 clinicians; 398 Latinos, 93 African Americans, and 778 white patients with probable depressive disorder. Study Design. Matched practices were randomized to usual care or one of two QI programs that trained local experts to educate clinicians; nurses to educate, assess, and follow-up with patients; and psychotherapists to conduct Cognitive Behavioral Therapy. Patients and physicians selected treatments. Interventions featured modest accommodations for minority patients (e.g., translations, cultural training for clinicians). Data Extraction Methods. Multilevel logistic regression analyses assessed intervention effects within and among ethnic groups. Principal Findings. At baseline, all ethnic groups (Latino, African American, white) had low to moderate rates of appropriate care and the interventions significantly improved appropriate care at six months (by 8,20 percentage points) within each ethnic group, with no significant difference in response by ethnic group. The interventions significantly decreased the likelihood that Latinos and African Americans would report probable depression at months 6 and 12; the white intervention sample did not differ from controls in reported probable depression at either follow-up. While the intervention significantly improved the rate of employment for whites and not for minorities, precision was low for comparing intervention response on this outcome. It is important to note that minorities remained less likely to have appropriate care and more likely to be depressed than white patients. Conclusions. Implementation of quality improvement interventions that have modest accommodations for minority patients can improve quality of care for whites and underserved minorities alike, while minorities may be especially likely to benefit clinically. Further research needs to clarify whether employment benefits are limited to whites and if so, whether this represents a difference in opportunities. Quality improvement programs appear to improve quality of care without increasing disparities, and may offer an approach to reduce health disparities. [source] | ||||||||||||||||||||||||||||||||||||||||