Jeanne Wendel

University of Nevada, Reno | UNR · Department of Economics

Psychologists delivering integrated care to VA patients may work in VA facilities, or they may work in private sector provider organizations under the Community Care Program. In either situation, these clinicians may provide care to patients who receive some types of care covered by the VA and other types of care covered by Medicare, Medicaid, or p...

Evaluation study results equip clinicians and program administrators to quantify impacts of their programs on patient health. Comparative effectiveness research (CER) studies quantify program impacts on patient health, health behaviors, and/or healthcare utilization. Cost-effectiveness analysis (CEA) studies quantify both health impacts and financi...

Background: Analyze intrarater and interrater reliability for evaluating endoscopic images of velopharyngeal (VP) physiology. Method: Speakers produced 9 speech stimuli representing 4 stimulus types: sustained phonemes, repetitions of "puh," single words, and short phrases. The 37-speaker participants included 16 patients with VP dysfunction and...

Augmenting incentives for juveniles with separate incentives for parents could boost juvenile efforts to reduce BMI. However, financing a parent incentive by reducing the incentives offered to adolescents could attenuate the juvenile response. In a field experiment, Medicaid-covered juveniles enrolled in a cardiac wellness program were randomly ass...

Poverty is associated with both low education and adverse health outcomes for all demographic groups. This chapter examines the federal definition of poverty and recent statistics on the incidence of poverty rates within the United States. Section I of the chapter examines statistical evidence relevant to the causes, duration, and consequences of p...

Computer-based information technology (IT) is used in many industries to help people and organizations collect and analyze data more effectively. Health policy makers in the U.S. hoped that more effective and ubiquitous IT could generate similar efficiencies in the health care industry producing the dual miracles of strengthening health care qualit...

Governments face pressure to act when coordination and learning externalities block development of otherwise-profitable industries that would produce merit goods for the domestic market. A short-term subsidy that offsets these externalities could potentially jump-start a multi-firm industry, if the subsidy induces a pioneer firm to enter and then t...

The implementation of the Government Accounting Standards Board’s Statement 45 mandates disclosure of “other post-employment benefits” (OPEB) in a standardized format. The mandate provides an opportunity to analyze noninformation impacts of mandatory disclosures, as key components of the information were already publicly available. We find that thi...

Total quality management (TQM) was developed to strengthen quality and productivity in manufacturing firms prior to World War II. After successful—and visible—application of these methods in large US firms during the 1980s, some healthcare providers began to explore strategies for using TQM principles and strategies to increase quality and reduce c...

Behavioral health conditions, including both mental health and substance use conditions, are prevalent and costly. Full implementation of the Patient Protection and Affordable Care Act (PPACA) is expected to lead to both increased utilization of behavioral health care due to the reduction in financial barriers to access, and continued evolution of...

Providers and payers are exploring care delivery innovations that strengthen care coordination or reduce inefficient utilization of care. Collecting and analyzing data to assess whether specific integration or coordination strategies actually produce the promised outcomes in specific care settings is useful for two reasons: These analyses provide e...

Some states used Health Information Technology for Economic and Clinical Health Act funds to create Public-Private Partnerships to deliver health information exchange services to end users. As these entities work to identify sustainable business models within increasingly competitive markets, the states and partnerships face three issues. First, wh...

Implementing a statewide health information exchange (HIE) provides the opportunity to explore the application of IS planning methods to complex inter-organizational systems (IOS). This study describes the HIE planning process followed by one state. The traditional planning steps recommended by the U.S. federal government did not compel project sta...

What criteria should be used to evaluate the impact of a new employee wellness program when the initial vendor contract expires? Published academic literature focuses on return-on-investment as the gold standard for wellness program evaluation, and a recent meta-analysis concludes that wellness programs can generate net savings after one or two yea...

While the Surgeon General's Consumer Guide lists weight-gain as an important relapse trigger, the 2001 Surgeon General's Report on Women and Smoking concludes, paradoxically, that actual weight-gain during cessation does not appear to predict relapse. This dichotomous view reflects longstanding scientific uncertainty about the role of weight-gain i...

Recent work raises questions about the input and output measures typically used to estimate the impact of prenatal care on infant health: self-reported prenatal care may generate biased estimates of the impact of prenatal care on infant health, and birthweight may be a narrow measure of infant health that leads to underestimation of the impact of p...

The Institute for Clinical Systems Improvement recommends reducing the number of prenatal care visits recommended for low-risk women, citing evidence from a randomized clinical trial indicating that the reduction would not adversely impact infant health. We investigate the implicit hypothesis that prenatal care resources are not distributed efficie...

Most states have adopted high school economics standards, but implementation efforts face two hurdles: evidence indicates that five or six college-level economics courses are needed for high school economics teachers and that stand-alone high school economics classes are more effective than strategies that infuse economics into history or civics cl...

Studies indicating that prenatal care has minimal impact sparked additional work to assess whether this is a correct conclusion or a statistical artifact. Recent work highlights the importance of including medical diagnoses as regression variables, developing inclusive measures for health outcomes, and using providergenerated measures of prenatal c...

This paper describes an analytical methodology for obtaining statistically unbiased outcomes estimates for programs in which participation decisions may be correlated with variables that impact outcomes. This methodology is particularly useful for intraorganizational program evaluations conducted for business purposes. In this situation, data is li...

Why are bank card interest rates sticky? One explanation is bank card consumer irrationality, a potentially significant market failure requiring government intervention. Alternate explanations focus on efficient market forces. The 1989 Federal Reserve Survey of Consumer Finances data are not consistent with the consumer irrationality hypothesis. Th...

Using the model of Banks, Parker, and Wendel (2001), we analyze how the design of payment systems affects the strategic interaction between sequential health care providers. We find that this model explains why the implementation of prospective payments led to reduced efficiency and increased vertical integration, and why expanding prospective paym...

Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by...

Milkman and Mitchell (1995) extend Rosen’s (1969) threat-effect hypothesis to suggest that the threat of unionization can induce inefficient underutilization of labor by nonunion firms. If firms follow this strategy, the apparent paradox of competitive coexistence in the face of higher union wages reflects induced nonunion firm inefficiency rather...

Provision of hospital uncompensated care is generally assumed to be adversely affected as increased healthcare competition decreases demand for compensated hospital services. Economic theory, however, suggests the question is more complex. Non-profit hospitals are assumed in this paper to maximize utility as a function of uncompensated care, subjec...

As an example of the many pronouncements on this subject, Deng Xiaoping said that the SOE "must remain the mainstay" of China's emerging Socialist Market Economy (Lam 1994). ABSTRACT China's strategy to maintain state control of State-Owned Enterprises within the emerging competitive market economy raises questions that parallel the U.S. debate ove...

This article examines the information requirements and other strategies needed to manage business and financial risk in health care organizations. The business and financial risk of providers in the changing health care market is defined. The major factors that are increasing risk are outlined, and strategies for measuring and managing risk are dis...

The paper presents a simple, realistic, and cost-effective methodology for estimating net fiscal impacts that does not require input-output or structural model frameworks. The methodology is most appropriate for projects in rural areas where analytical methods are constrained by limited data. The method is illustrated in the context of additions to...

The objective was to test the safety and efficacy of a pulsatile oxytocin infusion protocol in which a computer-controlled pump adjusts the oxytocin dose rate on the basis of uterine activity. A total of 358 women were enrolled in, and 310 completed, a prospective, randomized clinical trial comparing three protocols for the induction of labor with...

Is quality improvement (QI) reducing healthcare costs while improving patient care? Researchers find that QI has improved employee satisfaction and morale, but it was designed to do more. One solution is to use problem-solving techniques to help teams identify the level at which they want to address a problem, whether that be the subinstitutional,...

Soil texture and plants are understood to be important determinants of erosion. However, there is a paucity of research on the quantitative effect of various soils, plants, or the interaction of the two, on streambank erosion. This study measures the influence of herbaceous plant communities and sandy loam, loam and clay loam soils on particle eros...

Multivariate VAR models estimated with non-stationary data raise difficult econometric questions because differencing to achieve stationary can introduced distortions into multivariate models. Three approaches have been suggested for estimating such models:(1) Vector error correction (VEC) models difference the data to achieve stationary and use an...

Hospital cost per day (COST), annual admissions per capita (ADMIT), and average length of stay (ALOS) are important health policy variables because each variable provides important information about hospital industry performance. This study uses country-level data to explore the empirical relationships between COST, ADMIT, and ALOSin three steps: O...

A recent survey (Rhoades, 1977b) of Structure-Conduct-Performance studies in banking lists twelve studies of the effect of concentration on checking-account prices. All twelve rely on proxies for price instead of actual price. Here we evaluate this practice by comparing the three most widely used proxies with the prices actually charged by a sample...

AbstractA recent survey (Rhoades, 1977b) of Structure‐Conduct‐Performance studies in banking lists twelve studies of the effect of concentration on checking‐account prices. All twelve rely on proxies for price instead of actual price. Here we evaluate this practice by comparing the three most widely used proxies with the prices actually charged by...

Revised by 78-05

In the literature which has developed and expanded the Averch-Johnson approach to regulation, it is commonly assumed that the firm routinely maximizes profit subject to an exogenously determined regulatory control parameter. In reality, however, the firm's expected reaction to regulatory decisions affects those decisions so that the firm is able to...

This paper examines the econometric methodology used by World Health Organization (WHO) researchers to develop a template for ranking health system efficiency in 191 countries, as reported in the World Health Report 2000 (WHR). Complementing recent critiques on the quality of the WHR data, we ask whether the methodology would be appropriate for acc...

Revises 78-01

Utility stock and bond prices will be increasingly sensitive to differences between allowed rates of return and market rates for comparable investments. Allowed rates of return on equity (ROE) are traditionally set at a level commensurate with the returns on alternative investments of comparable risk. This focus on financial market conditions is be...