Suchergebnisse

ObjectiveThis study examines the effect of negative publicity that arose from public notices of child abuse allegations in the Catholic Church on the enrollment share and number of Catholic schools in the United States.MethodFitting least square regressions using diocese‐level panel data of Catholic school enrollment share and number of Catholic schools.ResultsI show that the reports of abuse prior to 2002 had no effect on enrollment. Yet, reports since 2002 have had a negative and long‐lasting effect and explain about two‐thirds of the decline in Catholic schooling. These are substantially larger declines than suggested in previous studies.ConclusionI argue that the differing responses to the public notices of child abuse between these two periods are derived from the availability heuristic. This is driven from a fundamental difference in media coverage of the scandal prior to 2002 and afterward. Allegations of child abuse in the Catholic Church received emphatic coverage only after 2002.

Immunization can lead to moral hazard by reducing the cost of risky behaviors and reducing preventive efforts. In this study, we examine the effect of HPV (human papillomavirus) vaccination on participation in the Pap test, which is a diagnostic screening test to detect HPV and non-HPV-related cancerous processes. The HPV vaccination is explicitly recommended for women up to age 26 years who were not previously vaccinated. Pap tests are strongly recommended for women between 21 and 65 years old even after having the HPV vaccine. To study the effect of HPV vaccination on Pap test uptake, we construct a fuzzy regression discontinuity design, centered on the vaccination threshold age. The results suggest that moral hazard was not the dominant effect. The estimates show that women who have been vaccinated, if anything, are actually more likely to have a Pap test, possibly due to increased awareness of its benefits at the time of vaccination.

Over the last decades, scope-of-practice laws for nurse practitioners (NPs) have changed rapidly, allowing for increased practice and prescribing autonomy. Despite this trend toward enhanced autonomy, scope-of-practice laws vary widely by state. At the federal level, Medicare implemented legislation in 1998 that began reimbursing NPs at a rate of 85% of a physician's fee regardless of site of practice or geographic location, a change from previous versions that restricted NP reimbursement to rural areas and sites specific to long-term or follow-up care2. Since then, the number of NPs who have been billing on their own, has been increasing over time. The current study examined whether a change in scope-of-practice law toward more autonomous practice changed the rate at which NPs billed independently for their services. This project used a 5% sample of Medicare claims data from 1999 to 2014 to track the number of NPs who were billing Medicare for their services. Unique National Provider Identifier numbers were totaled and plotted over time by state to evaluate the change in trends. State changes to NP laws were catalogued through use of West Law, a legal research service that archives state legislative and regulatory changes. After identifying all relevant changes to scope-of-practice laws for NPs by state, NP billing trends were evaluated at times before and after these had gone into effect. Changes in scope-of-practice laws for NPs did not change the trends in the number or rate of these providers billing for their services. In a given state, a change toward more autonomy in practice did not affect the rate of the increase. The same trend was also seen in states that had the most dramatic changes in their laws. In 2005 in Wyoming and 2010 in Maryland, each state passed legislation removing the requirement for NPs to have a collaborative agreement with a physician, effectively allowing for independent practice. Yet, the figures show the trends in NPs billing independently was consistent with rates seen before ...

The Medicaid expansions made addiction treatment more accessible but they also made it less costly to obtain the prescription opioids that can trigger an addiction. We investigated the association between the Medicaid expansions and drug-related deaths. We add to the literature by explicitly accounting for the properties of illicit drug markets and by conducting a simulation-based power analysis to assess whether a plausible change in drug-related mortality could be detected with our data. We identify three main challenges in isolating the effect of the Medicaid expansions on drug-related mortality that cannot be sufficiently addressed with current data: (a) nonparallel preexpansion trends in drug-related mortality, (b) the contemporaneous surge in the supply of illicitly manufactured fentanyl, and (c) lack of statistical power. We argue that more comprehensive data are needed to answer this question.