Resources and student achievement – evidence from a Swedish policy reform

This paper utilizes a policy change to estimate the effect of teacher density on student performance. We find that an increase in teacher density has a positive effect on student achievement. The baseline estimate – obtained by using the grade point average as the outcome variable – implies that resource increases corresponding to the class-size reduction in the STAR-experiment (i.e., a reduction of 7 students) improves performance by 2.6 percentile ranks (or 0.08 standard deviations). When we use test score data for men, potentially a more objective measure of student performance, the effect of resources appears to be twice the size of the baseline estimate.Student performance; teacher/student ratio; policy reform; differences-in-differences

Implementation of the WIN Workforce Stability Tool Kit

Precise and accurate staffing is vital to healthcare organizations. Comprehensive workforce planning is the foundation for successful staffing. Healthcare leaders need workforce data and tools that provide visibility and actionable intelligence to drive the best possible resource decisions. A workforce tool kit that nurse leaders can use to maintain visibility into their overall workforce picture can drive cost savings and provide operational wins. Lack of visibility into workforce metrics and tools drove the development of a tool kit that would aid in addressing some of these issues. The tools included provided real-time, market-specific data that was used to drive decisions on how best to use contingent resources to fill gap times in the core schedule. Other tools aided the leadership in tracking contingent resources and using flexible contract terms to more efficiently use the resources, rather than being committed to longer assignments. In addition, applications allowed staff nurses to communicate with each other regarding their schedules and receive instant notifications about open shifts, increasing their ability to step in and pick up shifts, preventing reliance on expensive contract labor resources. This application also provided staff with easy access to scheduling information, creating an online environment in which to propose shift trades in lieu of calling in sick and negatively affecting the organization. Testing of the tool kit took place in an inner-city Level II Trauma Center validated that the use of these tools had a positive impact on reducing and avoiding costs and reducing sick calls on two different units reporting to the same department director

Teacher Shocks and Student Learning: Evidence from Zambia

Following a tradition that relates household-level shocks to educational attainment, we examine the impact of teacher-level shocks on student learning. As a plausible measure for these shocks, we use teacher absenteeism during a 30-day recall period. A 5-percent increase in teacher absence rate reduced learning by 4 to 8 percent of average gains over the year, for both Mathematics and English. The estimated impacts are substantial and, in addition to the losses due to time away from class, likely reflect lower teaching quality when in class and less lesson-preparation when at home. Health problems-primarily their own illness and the illnesses of family members-account for more than 60 percent of teacher absenteeism. This suggests both that households are unable to substitute adequately for school-level teaching inputs and that, to support human capital formation, insurance at the school-level may be a policy priority that is worth exploring further

Resources and student achievement – evidence from a Swedish policy reform

This paper utilizes a policy change to estimate the effect of teacher density on student performance. We find that an increase in teacher density has a positive effect on student achievement. The baseline estimate – obtained by using the grade point average as the outcome variable – implies that resource increases corresponding to the class-size reduction in the STAR-experiment (i.e., a reduction of 7 students) improves performance by 2.6 percentile ranks (or 0.08 standard deviations). When we use test score data for men, potentially a more objective measure of student performance, the effect of resources appears to be twice the size of the baseline estimate.Student performance; teacher/student ratio; policy reform; differences-in-differences

Sick of Your Colleagues' Absence?

We utilize a large-scale randomized social experiment to identify how coworkers affect each other's effort as measured by work absence. The experiment altered the work absence incentives for half of all employees living in Göteborg, Sweden. Using administrative data we are able to recover the treatment status of all workers in more than 3,000 workplaces. We first document that employees in workplaces with a high proportion treated coworkers increase their own absence level significantly. We then examine the heterogeneity of the treatment effect in order to explore what mechanisms are underlying the peer effect. While a strong effect of having a high proportion of treated coworkers is found for the nontreated workers, no significant effects are found for the treated workers. These results suggest that pure altruistic social preferences can be ruled out as the main motivator for the behaviour of a nonnegligible proportion of the employees in our sample.social interactions, employer employee data, work absence, fairness, reciprocal preferences

Sick of your colleagues' absence?

We utilize a large-scale randomized social experiment to identify how coworkers affect each other’s effort as measured by work absence. The experiment altered the work absence incentives for half of all employees living in Göteborg, Sweden. Using administrative data we are able to recover the treatment status of all workers in more than 3,000 workplaces. We first document that employees in workplaces with a high proportion treated co-workers increase their own absence levels significantly. We then examine the heterogeneity of the treatment effect in order to explore what mechanisms are underlying the peer effect. While a strong effect of having a high proportion of treated coworkers is found for the nontreated workers, no significant effects are found for the treated workers. These results suggest that pure altruistic social preferences can be ruled out as the main motivator for the behaviour of a nonnegligible proportion of the employees in our sample.Social interactions; employer emkloyee data; work absence; fairness; reciprocal preferences

Pay and performance in a customer service centre - principal and agents or principally angels?

We have followed a pay for performance reform in the phone based customer service centre of an insurance company, from its introduction in 2001 until the end of 2004. We use hard and soft data from the design and impact of the reform to contrast two theories of work motivation; the traditional self interest hypothesis that the principal-agent model builds on, with the hypothesis that fairness and reciprocity are significant motivational forces at workplaces. The reform was initiated to increase sales of insurance in the customer service centre and it gave the operators both economic incentives and fairness- and reciprocity incentives to increase their sales effort. The reform had a positive effect on sales; the operators answered more calls and sold insurance to a higher fraction of customers after the reform. This observation alone does not help us identify the importance of the motivational hypothesis we compare. However, when we look closer at the evolution of the design and impact of the payment plan, we conclude that our data correspond best with the standard principal-agent model.Team incentives; multitask; fairness; reciprocity.

Missing Pieces in Health Services Cost Analysis: Consensus on Modeling, Magnitude, and Micro-Costing

Cost and cost savings have become an important focus for health policy administrators. However, there are missing pieces in our approach to cost analysis; there is no consensus on multivariable methods, no indicators of minimally acceptable values, and no specification of process costing. In this dissertation, I propose to fill the gaps in the literature by 1) identifying which methods are appropriate for large claims data, 2) examine existing methods to establish minimally important difference (MID) in health outcomes to identify MID in costs, and 3) determine differences in sick visit clinic costs using a modified micro-costing method. Most models that were compared to the generalized linear models Gamma distribution with log link found it to be the superior model in both simulated data and real administrative data. We recommend that in cases where acceptable anchors are not available to establish an MID, both the Delphi and the distribution-method of MID for costs be explored for convergence. Our micro-costing approach is feasible to use under virtual working conditions; requires minimal provider time; and generates detailed cost estimates that have “face validity” with providers and are relevant for economic evaluation