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This paper develops a model of the nursing home industry to investigate the quality effects of policies that either raise regulated reimbursement rates or increase local competition. Using data from Pennsylvania, I estimate the parameters of the model. The findings indicate that nursing homes increase the quality of care, measured by the number of skilled nurses per resident, by 8.8% following a universal 10% increase in Medicaid reimbursement rates. In contrast, I find that pro-competitive policies lead to only small increases in skilled nurse staffing ratios, suggesting that Medicaid increases are more cost effective in raising the quality of care.

Zonder onderwerpscode: economie

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The Handbook of Chemical Technology and Pollution Control (3rd Edition) provides a detailed review of the chemistry and operating conditions of many of the present large-scale chemical processes important to our economy and high standards of living. The processes that could lead to emissions affecting our air, soil, and water are considered, together with ways in which it may be possible to reduce or eliminate these pollutants. Focusing on cleaner production concepts without neglecting 'end of pipe' measures. With an increase in the awareness of corporate and social responsibility among business and industry leaders, the pressure to reduce harmful emissions and the desire to increase efficiencies and energy utilization, this book provides an essential resource. Suitable for researchers, practitioners and postgraduate students in the fields of chemical and biochemical engineering and environmental science, as well as government monitoring and regulatory agencies and industry leaders who want to stay one step ahead, this book will be a valuable addition to any library. * Integrated treatment of chemical technology with emission control chemistry * Introductory outline of the causes and effects of air and water pollution chemistry * Outline of the operating features and efficiency of basic emission control devices * Historical background of developments in industrial chemistry to 2004 in a single volume * Organized for easy access to chemical technology, new developments, or emission control details * Referenced to current additional sources of information in each area covered * Review questions provide working experience with the material provided.

Environmental protection. Environmental technology --- Chemical technology

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Nurses comprise the largest health profession. In this paper, we measure the effect of nurses on health care delivery and patient health outcomes across sectors. Our empirical strategy takes advantage of a parental leave program, which led to a sudden, unintended, and persistent 12% reduction in nurse employment. Our findings indicate detrimental effects on hospital care delivery as indicated by an increase in 30-day readmission rates and a distortion of technology utilization. The effects for nursing home care are more drastic. We estimate a persistent 13% increase in nursing home mortality among the elderly aged 85 and older. Our results also highlight an unintended negative consequence of parental leave programs borne by providers and patients.

Zonder onderwerpscode: economie

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How do patient and provider incentives affect mode and cost of long-term care? Our analysis of 1 million nursing home stays yields three main insights. First, Medicaid-covered residents prolong their stays instead of transitioning to community-based care due to limited cost-sharing. Second, nursing homes shorten Medicaid stays when capacity binds to admit more profitable out-of-pocket payers. Third, providers react more elastically to financial incentives than patients, so moving to episode-based provider reimbursement is more effective in shortening Medicaid stays than increasing resident cost-sharing. Moreover, we do not find evidence for health improvements due to longer stays for marginal Medicaid beneficiaries.

Zonder onderwerpscode: economie

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We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection.

Zonder onderwerpscode: economie