Technical efficiency in primary health care: does quality matter?

The accuracy required in the measurement of output is an issue that has as yet still not been satisfactorily addressed in empirical research on efficiency in primary health care. We exploit information retrieved from a newly constructed database (APEX06) for the Spanish region of Extremadura. The richness of our dataset allows us to consider original synthetic measures of output that take into account both the quantity and the quality of services provided by 85 primary care centres (PCCs) in 2006. We provide evidence that neglecting the issue of properly accounting for the quality of health services can lead to misleading results. Our main finding is that adjusting output for quality influences efficiency analysis in three senses. First, inefficiency now explains relatively more of the deviation from the potential output. Second, the average technical efficiency in the sector is lower, while its dispersion among PCCs is significantly higher. And third, the efficiency ranking of the PCCs is also affected.Primary Health Care; Stochastic Frontier Analysis; Technical Efficiency; Quality

Pair-distribution functions of two-temperature two-mass systems: Comparison of MD, HNC, CHNC, QMC and Kohn-Sham calculations for dense hydrogen

Two-temperature, two-mass quasi-equilibrium plasmas may occur in electron-ion plasmas,nuclear-matter, as well as in electron-hole condensed-matter systems. Dense two-temperature hydrogen plasmas straddle the difficult partially - degenerate regime of electron densities and temperatures which are important in astrophysics, in inertial-confinement fusion research, and other areas of warm dense matter physics. Results from Kohn-Sham calculations and QMC are used to benchmark the procedures used in classical molecular-dynamics simulations, HNC and CHNC methods to derive electron-electron and electron-proton pair - distribution functions. Then, nonequilibrium molecular dynamics for two -temperature, two-mass plasmas are used to obtain the pair distribution. Using these results, the correct HNC and CHNC procedures for the evaluation of pair-distribution functions in two-temperature two-mass two-component charged fluids are established. Results for a mass ratio of 1:5, typical of electron-hole fluids, as well as for compressed hydrogen are presented. PACS Numbers: 52.25.Kn, 52.25Gj, 71.10.-w, 52.27.Gr, 26.30.+kComment: 17 pages, four figure

Non-hermitian approach to decaying ultracold bosonic systems

A paradigm model of modern atom optics is studied, strongly interacting ultracold bosons in an optical lattice. This many-body system can be artificially opened in a controlled manner by modern experimental techniques. We present results based on a non-hermitian effective Hamiltonian whose quantum spectrum is analyzed. The direct access to the spectrum of the metastable many-body system allows us to easily identify relatively stable quantum states, corresponding to previously predicted solitonic many-body structures

The geography, economics, and politics of lottery adoption

Since New Hampshire introduced the first modern state-sponsored lottery in 1964, 41 other states plus the District of Columbia have adopted lotteries. Lottery ticket sales in the United States topped $48 billion in 2004, with state governments reaping nearly$14 billion in net lottery revenue. In this paper the authors attempt to answer the question of why some states have adopted lotteries and others have not. First, they establish a framework for analyzing the determination of public policies that highlights the roles of individual voters, interest groups, and politicians within a state as well as the influence of policies in neighboring states. The authors then introduce some general explanations for the adoption of a new tax that stress the role of economic development, fiscal health, election cycles, political parties, and geography. Next, because the lottery adoption decision is more than simply a tax decision, a number of factors specific to this decision are identified. State income, lottery adoption by neighboring states, the timing of elections, and the role of organized interest groups, especially the opposition of certain religious organizations, are significant factors explaining lottery adoption.Gambling industry

Spatial dependence in models of state fiscal policy convergence

We apply spatial econometric techniques to models of state and local fiscal policy convergence. Total tax revenue and expenditures, as well as broad tax and expenditure categories, of state and local governments in each of the 48 contiguous U.S. states are examined. We extend work by Scully (1991) and Annala (2003) in much the same way that Rey and Montouri (1999) extended the literature dealing with income convergence among U.S. states. Our results indicate that most fiscal policies have been converging and exhibit spatial dependence. A more specific interpretation of our general spatial results is that the finding of spatial dependence indicates that the growth paths of state and local fiscal policies are not independent. In addition, we find that total expenditures have been converging faster than output, whereas total tax revenues have been converging slower that output. Our models further demonstrate that state expenditure growth is dependent upon expenditure growth in economically and demographically similar states, while output growth and revenue growth in a state are dependent on output growth and revenue growth, respectively, in contiguous states.Fiscal policy

Differences in subprime loan pricing across races and neighborhoods

We investigate whether race and ethnicity influenced subprime loan pricing during 2005, the peak of the subprime mortgage expansion. We combine loan-level data on the performance of non-prime securitized mortgages with individual- and neighborhood- level data on racial and ethnic characteristics for metropolitan areas in California and Florida. Using a model of rate determination that accounts for predicted loan performance, we evaluate the differences in subprime mortgage rates in terms of racial and ethnic groups and neighborhood characteristics. We find evidence of adverse pricing for blacks and Hispanics. The evidence of adverse pricing is strongest for purchase mortgages and mortgages originated by non-depository institutions.Subprime mortgage; Housing policy; Discrimination in mortgage loans

Spatial probit and the geographic patterns of state lotteries

We implement a spatial probit model to differentiate states with a lottery from those without a lottery. Our analysis extends the basic spatial probit model by allowing spatial dependence to vary across geographic regions. We also separate the spatial effects of neighbors versus non-neighbors. The methodology provides consistent and efficient coefficient estimation in light of the simultaneity in spatial dependence. We find evidence of spatial dependence and spatial heterogeneity in lottery usage, and we find that spatial patterns differ significantly by geographic region. The importance of spatial dependence in state lottery usage suggests the need to consider spatial effects in empirical models examining the use of any policy tool by subnational governmental units.Regional economics