Urban Institute

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.

The Net Economic Value of Recreation on the National Forests: Twelve Types of Primary Activity Trips Across Nine Forest Service Regions

Abstract: The PARVS survey was used to estimate demand models on Forest Service land; for 12 activities in 9 Forest Service retions. A reverse multinomial logit gravity model was used. A first stage estimates probablity that a trip observed at a recreation site originated from a county. A second state uses traditional travel cost models to derive site demand, and used to estimate consumer surplus. Relative values for different primary activity trips across different regions, and within regions, are examined.

The Effect of Nursing Home Use on Medicaid Eligibility

Abstract: Presented are results of a descriptive analysis of the effects of nursing home use on Medicaid eligibility status. Data from the 1982 and 1984 National Long-Term Care Surveys were used to track a cohort of disabled elderly persons residing in the community in 1982 over the 2 years that followed. Although 12% spent some time in nursing homes between 1982 and 1984, about 40% was for short stays. In contrast to persons who did not use nursing homes, persons who entered nursing homes had a 4- to 5-fold risk of spending down to Medicaid eligibility.

Income Risk in 30 Countries

Abstract: We present a measure of income risk that decomposes income dynamics into long-run inequality, volatility (inter-temporal variability around individual-specific growth rates), and mobility risk (variation in individual-specific growth rates). We measure these income risk components in panel data from 30 rich democracies. We use this comprehensive collection of panel data to analyze long-terms trends in income dynamics for four countries (Canada, Germany, Great Britain, and the United States), and cross-national patterns of income dynamics for an additional 26 countries. We find that tax and transfer systems lower income risk, but less so in the United States than in other comparable countries. We find that higher incomes tend to grow faster and to be more volatile than lower incomes. We find that the United States is exceptional in its level of, and increase in, each type of income risk. Various other measures of mobility are positively correlated with mobility risk.

Introducing more transparent and efficient land management in post-socialist cities: lessons from kyrgyzstan

Abstract: The Urban Institute (UI) worked with fi ve cities in post-Soviet Kyrgyzstan to apply better management practices through the development of Strategic Land Management Plans. Kyrgyzstan transferred property to local governments, but municipal land management had remained poor owing to a proliferation of responsible agencies, lack of rule of law, cor- ruption, and passiveness on the part of local governments. UI worked with local governments to make an inventory of municipal land, publicize the results, and develop a strategy that articulated principles for land management and an implementation plan. This led to several improvements including proper registration of parcels and proactive policies to lease and sell land through open competition. It also established a model for determining public policy that countered corruption and public deliberation of costs and benefi ts in the use of local assets. Donor involvement to promote good land legislation, the property registration system, and decentralization was also critical to success.

Medical Spending and the Health of the Elderly

Abstract: A significant body of recent research reports wide variations in Medicare spending per beneficiary across geographic areas, but with little apparent variation in the quality of care or health outcomes (Skinner, Fisher, and Wennberg 2005; Wennberg et al. 2008; Fisher et al. 2009). Based on this research, policy makers have considered proposals that would limit Medicare payments in high-cost areas or pay bonuses in low-cost areas (Congressional Budget Office [CBO] 2008; U.S. Senate Committee on Finance 2009; Abelson and Harris 2010). Although prior research has studied people who age into Medicare and found that greater medical care use following Medicare coverage improved health (Lichtenberg 2002; McWilliams et al. 2007a, b, 2003; Card, Dobkin, and Maestas 2009), none of these studies is directly relevant to the question of whether variations in medical spending for people already covered by Medicare affect their health. Earlier studies that found a positive relationship between medical spending and health at the geographic level may be out of date (Hadley 1982; Hadley 1988). More recently, studies by Doyle (2008) and Martin, Rice, and Smith (2008) used instrumental variable (IV) analysis and found that people treated in higher spending areas had better health outcomes, but neither focused only on the Medicare population. Kaestner and Silber (2010) estimated a positive relationship between Medicare spending and health outcomes, but only for hospitalized patients with particular medical conditions. Like these recent studies, we use IV analysis to investigate the relationship between medical spending and health using data on individual Medicare beneficiaries. If a person-level analysis also finds no relationship between medical spending and health of the elderly, it will reinforce the finding of Medicare inefficiencies drawn from geographic analyses (Fisher et al. 2009).