Skill Formation among Vocational Rehabilitation Clients – Public Policy vs Private Incentives

In this paper we analyse individual vocational rehabilitation clients’ decisions to enter active training or not. Although the Government pays the direct costs of training, the composition of the total costs of training may be decisive for individual choices. Based on labour market theory, we relate background characteristics of the clients to monetary opportunity costs and non-monetary costs of training, arguing that training choices are a consequence of differences in costs of training. We use a ten percent sample of participants in educational programs, work related training and non-participants who entered the Norwegian vocational rehabilitation sector in the period from 1989 to 1993, a total of 6653 persons. We find that the background characteristics of persons investing in educational training differ along several dimensions compared both to persons attending work related training and to clients not participating in training at all.Public policy; private incentives; costs of training; educational training; work related training; vocational rehabilitation

Do Collective Actions Clear Common Air? The Effect of International Environmental Protocols on Sulphur Emissions

We consider the effects of voluntary international environmental protocols on emissions with regard to the 1985 Helsinki Protocol and the 1994 Oslo Protocol on the reduction of sulphur oxides. Our analysis utilizes panel data from 30 European countries for the period 1960–2002. We divide these countries into “participants” and “non-participants”, i.e., those that did and those that did not ratify the specific protocol. We use a difference-in-difference estimator that focuses on the difference in emissions before and after signing a specific protocol and compares it with this difference for non-participant countries. Difference-in-difference estimation methods rely on annual data and may induce serial correlations in the variables. We use randomly generated placebo protocols to test the estimated effects. In a panel data regression model, where we include country and year dummies, the effect of the Helsinki agreement in reducing sulphur emissions is around three per cent per year, and the effect of the Oslo agreement is around four per cent per year. Correcting the standard errors for serial correlation in both dependent and independent variables is important and overlooked in the previous empirical literature on the evaluation of international agreements.International agreements; programme evaluation; placebo; serial correlation

Transitions to Employment from Labour Market Enterprises in Norway

We analyse a labour market programme for partly disabled workers that involves the transition from Labour Market Enterprises to a job in the ordinary labour market. We find that the percentage of these people finding jobs after a maximum two-year programme period has increased over time. In 1995, 28 per cent became employed in the ordinary job market in that year after they have left the programme. Exit rates to employment increased to 36 per cent in 1998 and to 39 per cent in 1999. We also find heterogeneity in the job transitions. Employment ratios for men are relatively stable over time, varying between 30 and 40 per cent over the period 1995–1999. For women, however, we find a significant change in employment ratios, with 21 per cent finding a job in 1995 and 40 per cent in 1999. In 1995, employment ratios for female participants were below those of male participants, although there was no difference over the whole period studied (1995–1999). In 1999, the average transition rate to employment was higher for female than for male participants.labour market enterprises; vocational rehabilitation; disability; employment

Access to Primary Health Care and Health Outcomes: The Relationships between GP Characteristics and Mortality Rates

This paper analyses the impact of economic conditions and access to primary health care on health outcomes in Norway. Total mortality rates, grouped into four causes of death, were used as proxies for health, and the number of general practitioners (GPs) at the municipality level was used as the proxy for access to primary health care. Dynamic panel data models that allow for time persistence in mortality rates, incorporate municipal fixed effects, and treat both the number and types of GPs in a district as endogenous were estimated using municipality data from 1986 to 2001. We reject the significant relationship between mortality and the number of GPs per capita found in most previous studies. However, there is a significant effect of the composition of GPs, where an increase in the number of fee-for-service GPs reduces mortality rates when compared with GPs employed directly by the municipality.general practitioners (GPs); mortality; morbidity; simultaneity; endogeneity; municipalities; dynamic panel data models

Overworked? The relationship between workload and health worker performance in rural Tanzania

The current shortage of health workers in many low-income countries poses a threat to the quality of health services. When the number of patients per health worker grows sufficiently high, there will be insufficient time to diagnose and treat all patients adequately. This paper tests the hypothesis that a high caseload reduces the level of effort per patient in the diagnostic process, using a new data set from rural Tanzania. Tanzania has a severe shortage of health workers, and previous research has pointed at high workload as a main reason for sub-standard clinical performance. We observed and evaluated the level of effort of 159 clinicians in 2,095 outpatient consultations at 126 health facilities with different levels of caseload per clinician. Surprisingly, we find no association between caseload and the level of effort per patient in the diagnostic process. In fact, clinicians appear to have ample amounts of idle time. We conclude that health workers are not overworked and that scaling up the number of health workers in this setting is unlikely to raise the quality of health services. A more promising measure for improved quality is to raise the level of formal clinical training among the clinicians, although training alone seems far from enough to raise quality to adequate levels.Human Resources; Quality health services; Workload; Tanzania

Overworked? The relationship between workload and health worker performance in rural Tanzania

The current shortage of health workers in many low-income countries poses a threat to the quality of health services. When the number of patients per health worker grows sufficiently high, there will be insufficient time to diagnose and treat all patients adequately. This paper tests the hypothesis that a high caseload reduces the level of effort per patient in the diagnostic process, using a new data set from rural Tanzania. Tanzania has a severe shortage of health workers, and previous research has pointed at high workload as a main reason for sub-standard clinical performance. We observed and evaluated the level of effort of 159 clinicians in 2,095 outpatient consultations at 126 health facilities with different levels of caseload per clinician. Surprisingly, we find no association between caseload and the level of effort per patient in the diagnostic process. In fact, clinicians appear to have ample amounts of idle time. We conclude that health workers are not overworked and that scaling up the number of health workers in this setting is unlikely to raise the quality of health services. A more promising measure for improved quality is to raise the level of formal clinical training among the clinicians, although training alone seems far from enough to raise quality to adequate levels.Health personnel Tanzania

A Low-key Social Insurance Reform - Treatment Effects for Back Pain Patients in Norway

This paper estimates treatment effects for back pain patients using observational data from a low-key social insurance reform in Norway. Using a latent variable model we estimate the average treatment effects (ATE), the average effect of treatment on the treated (TT), and the distribution of treatment effects for outpatient treatment at three different locations. To estimate these parameters and the distribution of treatment effects we use a discrete choice model with unobservables generated by a factor structure model. Distance to nearest hospital (in kilometers) is used as an instrument in estimating the different treatment effects. We find a positive effect of treatment of 6 percentage points on the probability of leaving sickness benefits after allowing for selection effects and full heterogeneity in treatment effects. We also find that there are sound arguments for increasing the outpatient program of treating back pain patients.Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Project Evaluation; Social Discount Rate; General; Unemployment: Models; Duration; Incidence; and Job Search.

Late careers and career exits in Norway

We used matched employer-employee data for the period 1992-1997 to analyse the transition from work to early retirement in Norway. We focus on the effect of a new early retirement scheme ("AFP") of which some 60 percent of the population is eligible. We thus observe individuals in two different incentive systems and estimate the reallocation effect between employment and different early retirement, notably AFP and disability pension. There is a substantial drop in employment for the group entitled to AFP. However, while AFP has an increasingly negative effect on the labour supply, there seem to be almost no corresponding reduction in the incidence of disability pension during the period of investigation. Our data includes a broad range of individual, workplace and industry characteristics. We report a relatively high degree of heterogeneity in the retirement behaviour, notably between genders, but also between industries and sectors. Push as well as pull factors are identified. The former appears to be more relevant for the disability pathway, while the latter turns out to be significant when retiring to AFP.early retirement; social security

Educational Attainment and Family Background

This paper analyses the effect of aspects of family background, such as family income and parental education, on the educational attainment of persons born from 1967 to 1972. Family income is measured at different periods of a child’s life to separate longterm versus short-term effects of family income on educational choices. We find that permanent income matters to a certain degree, and that family income when the child is 0-6 years old is an important explanatory variable for educational attainment later in a child’s life. We find that short-term credit constraints have only a small effect on educational attainment. Long term factors, such as permanent family income and parental education are much more important for educational attainment than are shortterm credit constraints. Public interventions to alleviate the effects of family background should thus also be targeted at a child's early years, the shaping period for the cognitive and non-cognitive skills important later in life.credit constraints; education; Norway; family background

Measuring Heterogeneity in the Returns to Education in Norway Using Educational Reforms

The decision to take more education is complex, and is influenced by individual ability, financial constraints, family background, preferences, etc. Such factors, normally unobserved by the researcher, introduce endogeneity and heterogeneity problems into estimating the returns to education. In this paper, these problems are addressed by estimating a comparative advantage model for schooling, in which the returns to education vary at different levels of education. The model requires that instruments must be specified at each level of education, and we suggest that different school reforms in Norway can serve as suitable instruments. In particular, we exploit the staged implementation of a major reform in the comprehensive school system in the 1960s. We find that the returns to education are strongly nonlinear. In particular, we find that the returns to upper secondary school and shorter programs at regional colleges, together with master’s programs at universities, have high returns as measured by wages. Also, we find that the average treatment effect is surprisingly high for medium-length educations (up to two years of college education). This means that increasing the general level of education, which was the intention of the comprehensive school reform of the 1960s and of other school reforms, has the potential to generate a high return in wages, although we do not consider the cost to society. We also find that there is a substantial difference between the average treatment effect and the effect of treatment on the treated for bachelor’s and master’s degrees at universities.Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models (Updated); Analysis of Education