scispace - formally typeset
Search or ask a question
Institution

Urban Institute

NonprofitWashington D.C., District of Columbia, United States
About: Urban Institute is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Medicaid & Population. The organization has 927 authors who have published 2330 publications receiving 86426 citations.


Papers
More filters
Journal ArticleDOI
TL;DR: In this article, the authors examined whether key dimensions of opportunity theory are empirically associated with the likelihood of victimization and also examined factors associated with farmers' use of guardianship measures, concluding that the theory partially accounts for variation in agricultural crime victimization, depending on the type of crime.
Abstract: A growing body of research lends support to opportunity theory and its variants, but has yet to focus systematically on a number of specific offenses and contexts. Typically, the more crimes and contexts to which a theory applies, the broader its scope and range, respectively, and thus generalizability. In this paper, we focus on agricultural crime victimization— including theft of farm equipment, crops, livestock, and chemicals—an offense that opportunity theory appears well-situated to explain. Specifically, we examine whether key dimensions of the theory are empirically associated with the likelihood of victimization and also examine factors associated with farmers' use of guardianship measures. In contrast to much previous research, we combine multiple individual-level measures of these dimensions. We conclude that the theory partially accounts for variation in agricultural crime victimization, depending on the type of crime, and that greater work is needed investigating how key dimensions of opportunity theory should be conceptualized and operationalized in rural contexts. The study's implications for theory and practice are discussed.

28 citations

Journal ArticleDOI
TL;DR: This paper focuses on disentangling the effects of the special provisions implemented in Massachusetts to expand coverage to young adults, and how important are the special Provisions for Young Adults.
Abstract: Massachusetts enacted a comprehensive health care reform bill in 2006 that has moved the state to near universal health insurance coverage. In 2008, uninsurance in Massachusetts was at 4.1 percent, well below the national average of 15.1 percent and below the rate of 6.7 percent in the next lowest state—Hawaii (Joanna Turner, Michel Boudreaux, and Victoria Lynch 2009). The Massachusetts law included expanded eligibility for public coverage, subsidized insurance coverage, an insurance purchase exchange, market reforms, expanded coverage options for young adults, requirements for employers, and, most controversial, an individual mandate that requires all adults who have access to affordable coverage to obtain health insurance (John E. McDonough et al. 2008). Although estimates to date have focused on the overall effect of the Massachusetts health reform package (e.g., Sharon K. Long, Karen Stockley, and Alshadye Yemane 2009), there is substantial policy interest in determining the effects of the different components of the reform effort. In this paper, we focus on disentangling the effects of the special provisions implemented in Massachusetts to expand coverage to young adults. Compared to older adults, young adults are much less likely to be insured, reflecting their access to fewer coverage options and, when coverage options are available, lower probability Disentangling the Effects of Health Reform in Massachusetts: How Important Are the Special Provisions for Young Adults?

28 citations

Journal ArticleDOI
TL;DR: Among older women with localized breast cancer, financial incentives appear to influence the use of mastectomy and breast conserving surgery with radiation therapy, consistent with the hypothesis that physicians are responsive to financial incentives when the alternative procedures have clinically equivalent outcomes and the patient's clinical condition does not dominate the treatment choice.
Abstract: Despite an increasing trend in the use of breast conserving surgery (BCS) to treat early-stage breast cancer (Silliman et al. 1997; Guadagnoli et al. 1998), substantial variability exists in use of BCS among older women (Nattinger et al. 1996; Wennberg and Cooper, 1996), with the oldest women receiving less BCS, and when treated by BCS, receiving radiotherapy less often than others (Mandelblatt et al. 2000; Busch et al. 1996; Ballard-Barbash et al. 1996). Numerous studies have examined the roles of factors such as underlying health (Silliman et al. 1997; Albain et al. 1996), age, or socioeconomic biases (Lazovich et al. 1991; Albain et al. 1996; Michalski and Nattinger 1997), physicians' attitudes toward treatment, and patient involvement in treatment decisions (Silliman et al. 1989; Liberati et al. 1987; Liberati et al. 1991), geographic variations or barriers in access to services (Farrow, Hunt, and Samet 1992; Nattinger et al. 1992; Nattinger et al. 1996; Albain et al. 1996; Osteen et al. 1994; Hand et al. 1991), and different care delivery systems (Riley et al. 1999; Potosky et al. 1997). Only one study (Hadley, Mitchell, and Mandelblatt 2001) has investigated whether variations in Medicare's fees for BCS and mastectomy (MST) influence the surgical treatment received by elderly Medicare beneficiaries who had breast surgery. Analyzing small-area data on the percentage of elderly Medicare breast surgery patients receiving BCS in 1994, that study found that a 10 percent higher fee for BCS was associated with a 7–10 percent increase in the percentage of beneficiaries receiving BCS in an area, while a 10 percent lower MST fee increased the BCS percentage by 2–3 percent. While suggestive of a fee effect, these findings may have been influenced by several potential limitations. The results may reflect an ecological fallacy because the analysis was conducted at the area level—the same results may not hold for individual patients. The Medicare claims data used in the analysis were not limited to confirmed cases of newly diagnosed localized breast cancer. Thus, it was not possible to exclude cases where minimally invasive surgery was used to rule out a cancer diagnosis from those where the procedure was used as a treatment. Nor was it possible to distinguish women who received breast conserving surgery only (BCSO) from those who received breast conserving surgery plus radiation therapy (BCSRT). If there are differences in the factors that determine the receipt of either of these treatments relative to mastectomy, then the inability to distinguish between them may have biased the earlier result. In particular, it is not clear that the potential effects of the MST and BCS fees should be the same in considering these two treatments relative to mastectomy. This research brief extends that research, offering several improvements in methodology. We analyze data for individual elderly Medicare beneficiaries with confirmed cases of newly diagnosed early-stage breast cancer. Using data on individual patients avoids the ecological fallacy. In addition, we treat BCSO and BCSRT as distinct surgical outcomes relative to MST, which allows fee effects to differ among the three possible treatment choices. We also use more refined measures of Medicare fees than the prior study. Adjusting average fees across areas for the use of modifiers and variations in specific procedure codes provides a more accurate measure of the true variation in Medicare fees for these procedures.

28 citations

Journal ArticleDOI
TL;DR: The authors used longitudinal panel analyses and five waves of data from the Korean Youth Panel Survey to examine the influence of nine measures of social bonding on delinquent behavior and found some support for social bonds as indicators of within-and between-individual variation in delinquency.
Abstract: Social bonds theory is one of the most influential and tested perspectives for explaining juvenile delinquency, yet tests have often been methodologically limited. Prior research has failed to examine how intra- and interindividual variation in social bonding influences delinquency. In addition, there are few applications of this theory to non-Western contexts. Thus, the current study attempts to test the cross-cultural generalizability of social bonds theory and overcome weaknesses of prior research. We use longitudinal panel analyses and five waves of data from the Korean Youth Panel Survey to examine the influence of nine measures of social bonding on delinquent behavior. By estimating different panel models, we find some support for social bonds as indicators of within- and between-individual variation in delinquency. Specifically, the emphasis on education in Korea and the role of parents in supervising their children play an integral role in reducing the delinquency of Korean youth.

28 citations

Journal ArticleDOI
TL;DR: A clear trend over the past decade toward an increasing share of household income devoted to health care is found, including those becoming eligible for Medicaid or subsidized private insurance and those with expensive medical conditions, which will affect health care spending for subgroups of the population differently.
Abstract: Context: Over the past decade, health care spending increased faster than GDP and income, and decreasing affordability is cited as contributing to personal bankruptcies and as a reason that some of the nonelderly population is uninsured. We examined the trends in health care affordability over the past decade, measuring the financial burdens associated with health insurance premiums and out-of-pocket costs and highlighting implications of the Affordable Care Act for the future financial burdens of particular populations. Methods: We used cross sections of the Medical Expenditure Panel Survey Household Component (MEPS-HC) from 2001 to 2009. We defined financial burden at the health insurance unit (HIU) level and calculated it as the ratio of expenditures on health care—employer-sponsored insurance coverage (ESI) and private nongroup premiums and out-of-pocket payments—to modified adjusted gross income. Findings: The median health care financial burden grew on average by 2.7% annually and by 21.9% over the period. Using a range of definitions, the fraction of households facing high financial burdens increased significantly. For example, the share of HIUs with health care expenses exceeding 10% of income increased from 35.9% to 44.8%, a 24.8% relative increase. The share of the population in HIUs with health care financial burdens between 2% and 10% fell, and the share with burdens between 10% and 44% rose. Conclusions: We found a clear trend over the past decade toward an increasing share of household income devoted to health care. The ACA will affect health care spending for subgroups of the population differently. Several groups’ burdens will likely decrease, including those becoming eligible for Medicaid or subsidized private insurance and those with expensive medical conditions. Those newly obtaining coverage might increase their health spending relative to income, but they will gain access to care and the ability to spread their expenditures over time, both of which have demonstrable economic value.

28 citations


Authors

Showing all 937 results

NameH-indexPapersCitations
Jun Yang107209055257
Jesse A. Berlin10333164187
Joseph P. Newhouse10148447711
Ted R. Miller97384116530
Peng Gong9552532283
James Evans6965923585
Mark Baker6538220285
Erik Swyngedouw6434423494
Richard V. Burkhauser6334713059
Philip J. Held6211321596
George Galster6022613037
Laurence C. Baker5721111985
Richard Heeks5628115660
Sandra L. Hofferth5416312382
Kristin A. Moore542659270
Network Information
Related Institutions (5)
RAND Corporation
18.5K papers, 744.6K citations

83% related

National Bureau of Economic Research
34.1K papers, 2.8M citations

80% related

Bocconi University
8.9K papers, 344.1K citations

79% related

London School of Economics and Political Science
35K papers, 1.4M citations

79% related

World Bank
21.5K papers, 1.1M citations

78% related

Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20232
202214
202177
202080
2019100
2018113