Browsing by Author "Sloan, FA"
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Item Open Access Are Alcohol Excise Taxes Good for Us? Short and Long-Term Effects on Mortality Rates(2005-02) Cook, PJ; Ostermann, J; Sloan, FAItem Open Access Competition between non-profit and for-profit health insurers.(J Health Econ, 1983-12) Adamache, KW; Sloan, FAThis study investigates the effects of tax, regulatory, and reimbursement policies and other factors exogenous to the health insurance market on the relative price (to commercial insurers) paid by Blue Cross plans for hospital care, their administrative expense and accounting profits, premiums, and ultimately Blue Cross market share. We specify and estimate a simultaneous equation model to assess interrelationships among these variables. We conclude that premium tax advantages enjoyed by the Blues have virtually no effect on the Blues' premiums or their market shares. A Blue Cross plans' market share has a positive effect on the discount it obtains from hospitals as does coverage of Blue Shield charges by a state-mandated rate-setting plan. An upper bound on the effect on the Blue Cross market share of covering Blue Cross under rate-setting but excluding the commercials from such coverage is seven percentage points. Tests for administrative slack in the operation of Blue Cross plans yield mixed results.Item Open Access Cost of capital to the hospital sector.(J Health Econ, 1988-03) Sloan, FA; Valvona, J; Hassan, M; Morrisey, MAThis paper provides estimates of the cost of equity and debt capital to for-profit and non-profit hospitals in the U.S. for the years 1972-83. The cost of equity is estimated using, alternatively, the Capital Asset Pricing Model and Arbitrage Pricing Theory. We find that the cost of equity capital, using either model, substantially exceeded anticipated inflation. The cost of debt capital was much lower. Accounting for the corporate tax shield on debt and capital paybacks by cost-based insurers lowered the net cost of capital to hospitals.Item Open Access Determinants of Physicians' Fees(Journal of Business, 1974-10) Sloan, FA; Steinwald, BItem Metadata only Diffusion of surgical technology. An exploratory study.(J Health Econ, 1986-03) Sloan, FA; Valvona, J; Perrin, JM; Adamache, KWThe study presents an empirical analysis of the diffusion patterns of five surgical procedures. Roles of payer mix, regulatory policies, physician diffusion, competition among hospitals, and various hospital characteristics such as size and the spread of technologies are examined. The principal data base is a time series cross-section of 521 hospitals based on discharge abstracts sent to the Commission on Professional and Hospital Activities. Results on the whole are consistent with a framework used to study innovations in other contexts in which the decisions of whether to innovate and timing depend on anticipated streams of returns and cost. Innovation tends to be more likely to occur in markets in which the more generous payers predominate. But the marginal effects of payer mix are small compared to effects of location and hospital characteristics, such as size and teaching status. Hospital rate-setting sometimes retarded diffusion. Certificate of need programs did not.Item Open Access Do smokers respond to health shocks?(Review of Economics and Statistics, 2001-11-01) Smith, VK; Taylor, DH; Sloan, FA; Johnson, FR; Desvousges, WHThis paper reports the first effort to use data to evaluate how new information, acquired through exogenous health shocks, affects people's longevity expectations. We find that smokers react differently to health shocks than do those who quit smoking or never smoked. These differences, together with insights from qualitative research conducted along with the statistical analysis, suggest specific changes in the health warnings used to reduce smoking. Our specific focus is on how current smokers responded to health information in comparison to former smokers and nonsmokers. The three groups use significantly different updating rules to revise their assessments about longevity. The most significant finding of our study documents that smokers differ from persons who do not smoke in how information influences their personal longevity expectations. When smokers experience smoking-related health shocks, they interpret this information as reducing their chances of living to age 75 or more. Our estimated models imply smokers update their longevity expec-tations more dramatically than either former smokers or those who never smoked. Smokers are thus assigning a larger risk equivalent to these shocks. They do not react comparably to general health shocks, implying that specific information about smoking-related health events is most likely to cause them to update beliefs. It remains to be evaluated whether messages can be designed that focus on the link between smoking and health outcomes in ways that will have comparable effects on smokers' risk perceptions.Item Open Access Does higher hospital cost imply higher quality of care?(Review of Economics and Statistics, 2003-02-01) Picone, GA; Sloan, FA; Chou, SY; Taylor, DHThis study investigates whether higher input use per stay in the hospital (treatment intensity) and longer length of stay improve outcomes of care. We allow for endogeneity of intensity and length of stay by estimating a quasi-maximum-likelihood discrete factor model, where the distribution of the unmeasured variable is modeled using a discrete distribution. Data on elderly persons come from several waves of the National Long-Term Care Survey merged with Medicare claims data for 1984-1995 and the National Death Index. We find that higher intensity improves patient survival and some dimensions of functional status among those who survive.Item Open Access Effects of regulation on hospital costs and input use.(J Law Econ, 1980) Sloan, FA; Steinwald, BItem Open Access Effects of teaching on hospital costs.(J Health Econ, 1983-03) Sloan, FA; Feldman, RD; Steinwald, ABThis study estimates effects of undergraduate and graduate medical education on hospital costs, using a national sample of 367 U.S. community hospitals observed in 1974 and 1977. Data on other cost determinants, such as casemix, allow us to isolate the influence of teaching with greater precision than most previous studies. Non-physician expense in major teaching hospitals is at most 20 percent higher than in non-teaching hospitals; the teaching effect is about half this for hospitals with more limited teaching programs. Results for ancillary service departments are consistent with those for the hospital as a whole.Item Open Access Equity and accuracy in medical malpractice insurance pricing.(J Health Econ, 1990-11) Sloan, FA; Hassan, MThis study examines alternative classification approaches for setting medical malpractice insurance premiums. Insurers generally form risk classification categories on factors other than the physician's own loss experience. Our analysis of such classification approaches indicates different but no more categories than now used. An actuarially-fair premium-setting scheme based on the frequency and severity of the individual physician's losses would substantially penalize adverse experience. Alternatively, premiums could be set for groups of physicians, such as hospital medical staffs. Our simulations suggest that even staffs at rather small hospitals may be large enough to be experience-rated.Item Open Access Estimation of seemingly unrelated tobit regressions via the em algorithm(Journal of Business and Economic Statistics, 1987-01-01) Sloan, FA; Huang, C; Adamache, KAn expectation-maximum (EM) likelihood algorithm is used to estimate two seemingly unrelated Tobit regressions in which the dependent variables are truncated normal. An illustrative example on the determination of the life-health insurance and pension benefits is also given. © 1987 American Statistical Association.Item Restricted Experience rating: does it make sense for medical malpractice insurance?(Pap Proc Annu Meet Am Econ Assoc, 1990-05) Sloan, FAItem Restricted Government and the regulation of hospital care.(Pap Proc Annu Meet Am Econ Assoc, 1982-05) Sloan, FAItem Open Access Hospital Investment Decisions and the Cost of Capital(Journal of Business, 1989-10) Sloan, FA; Wedig, G; Hassan, MItem Open Access Hospital rate review: a theory and an empirical review.(J Health Econ, 1984-04) Sloan, FAItem Open Access Liability, risk perceptions, and precautions at bars(Journal of Law and Economics, 2000-12-01) Sloan, FA; Liang, L; Stout, EM; Whetten Goldstein, KAre state laws, regulatory practices, and allocation of public resources for enforcement reflected in perceptions by bar owners/managers that they will be cited or sued if they fail to exercise care? Among policies, which ones have the greatest impact on risk perceptions and, in turn, on such behaviors? We used data on laws, law enforcement, and regulations in the same areas as the bars to determine risk perceptions of bar owners/managers of threats of being sued or cited if they were to serve minors or obviously intoxicated adults. We found that many of the laws and regulations related systematically to risk perceptions of bar owners/managers. This was particularly true of tort. Precautionary measures were more likely to be taken by owners/managers when the risk was perceived to be high.Item Open Access Lifetime Earnings and Physicians' Choice of Specialty(Industrial and Labor Relations Review, 1970-10) Sloan, FAItem Open Access Longevity expectations and death: Can people predict their own demise?(American Economic Review, 2001-09-01) Smith, VK; Taylor, DH; Sloan, FAItem Open Access Physician Supply Behavior on the Short Run(Industrial and Labor Relations Review, 1975-06) Sloan, FA