The Cost of Substance Abuse to America’s Health Care System; Report 2: Medicare Hospital Costs

Background This report is one in a series of reports evaluating the cost of addiction to America’s health care system. It focuses on costs of substance abuse to inpatient hospital services under Medicare. Methods This analysis involved a review of research studies, all meeting predetermined inclusion criteria that identified substance abuse (tobacco, alcohol or drugs) as a major risk factor for acquiring a given disease/condition. Based on this research, statistical analyses were conducted to evaluate the risk of a particular health condition that can be attributed to substance abuse or addiction, in whole or in part, and the cost of these conditions to Medicare programs. To determine the Medicare hospital costs for treating substance-abuse-related illnesses, CASAColumbia used Medicare data reported on the 1991 National Hospital Discharge Survey (NHDS). Results In 1991, there were 2.2 million tobacco-, alcohol- or drug-related Medicare admissions, which accounted for 20% of all Medicare hospitalizations. Because these substance-abuse-related cases tended to be more expensive to treat than the average hospital case, the amount actually paid out by Medicare for substance-abuse-related care was even higher, accounting for 23% of the total Medicare payments for hospital care. Medicare spent over $13 billion of its$57 billion inpatient short-stay hospital expenditures on substance-abuse-related care. Nearly 1 out of every 4 Medicare dollars spent on inpatient hospital care and 1 out of every 5 Medicare hospital admissions were attributable to substance abuse. These amounts exceeded the 1 out of 5 dollars spent in the Medicaid program for substance-abuse-related conditions. Based on these results, it is estimated that for 1994, substance-abuse-related Medicare hospital costs will rise to $20 billion. Recommendations The report found that any health reform that hopes to offer care to all Americans at a reasonable cost must mount an all-fronts attack on all substance abuse—involving both legal and illegal drugs. It recommends that preventing diseases that result from substance abuse and prolonging a healthy life for the elderly could be much more potent weapons against rising Medicare expenditures than the multitude of other, more frequently discussed cost-containment measures or benefit deductions. It further states that debating the broader issues surrounding health care reform without either acknowledging the impact of substance abuse or including the prevention and treatment of this problem as an integral part of that reform will be a costly mistake

Finding Balance in a Family of One: Time Use in Single Person Households

This project examines the lives of people living alone, particularly their efforts to negotiate and create social boundaries to support a healthy work-life balance. The findings show that people living alone are a diverse segment of the U.S. population and that these individuals work more hours, spend less time on activities at home, and more time with people outside of their home than individuals living with others. People living alone are their own primary caregivers and must find time for self-care and household maintenance in the midst of working and developing meaningful relationships. Without traditional external obligations to structure their time, tensions develop between the desires to construct autonomous lives and establish connections with others. To develop a healthy balance between work and life, people living alone must find ways to sustain their lives outside of work; limit the influence of work on their time; negotiate competing demands among family, relatives, friends, and personal needs; and develop supportive relationships. This project begins to address a gap in the study of work-life balance that neglects individuals living alone. The number of people living alone in the United States continues to grow; yet they are an unstudied population in sociology. People in single person households have rich lives of multiple connections and provide much to our workforce and social networks. They are part of complex social networks that provide social, psychological and sometimes economic support, and sometimes struggle to integrate their social and family life with their work life. Utilizing the American Time Use Survey (ATUS) and twenty-two in-depth interviews, this mixed method study examines how individuals living alone spend time differently than those living with partners and children, and how people living alone understand and feel about their time. These findings have implications beyond this study to suggest that our national and workforce policies should be realigned to support individuals living alone, as well as those who live with others

Explaining Gender Differentials In Scholarly Productivity: The Case Of Academic Economists

The purpose of this study is to examine the impact of personal characteristics, institutional factors, and time-competing workplace requirements on scholarly productivity in peer-reviewed economics journals.  The study utilizes a unique data set of individual-specific information for 714 academic economists.  The multivariate regression analysis shows that both teaching and service commitments reduce scholarly work in peer reviewed journals.  The paper also presents an analysis of the data disaggregated by gender.  While the impact of teaching and service on productivity appears roughly similar, the results indicate that collaborative efforts, whether formal or informal, benefit women’s publication efforts more than their male counterpart

Isn’t It Ironic? Research Rewards And Teaching Taxes

The use of person-specific data for economists across all types of public academic institutions provides several insights into the academic wage equation for economists.   First, this study confirms the alignment of the academic incentive structure with the underlying value of scholarship in an academic institution, i.e. scholarship pays off.  Interestingly, though, the richness of this data set allows for a better understanding of that payoff.  For while economists at doctoral granting institutions earn more on average than their counterparts at non-doctoral granting institutions, the marginal benefit for additional publications is higher for those economists at non-doctoral granting institutions.Most importantly, the study validates the recent findings of Binder et al. (2012) that the incentive structure at academic institutions imposes a teaching tax.  Whether at doctoral or non-doctoral granting institutions, the marginal cost of teaching undergraduates is significant although there is a positive return to award-winning teaching.  Thus, despite the inherent educational mission of the Academy, this study supports the ironic conclusion teaching imposes a tax on the academic economist.

Resuscitating The Dormant Accounting Scholar

Despite the fundamental importance of publication to the academic institution, there are a significant number of dormant accounting scholars who simply do not publish.  Building upon an existing literature on the determinants of academic productivity, this paper identifies factors which have the potential to revive scholarly productivity.  Specifically, the current research reinforces the positive impact of scholarly presentations, sabbatical leave, and teaching assistants on reviving the dormant scholar.  Similarly, reducing activities which compete for the academic’s time (teaching undergraduate courses, consulting, and service to the institution) will increase the odds of publication.&nbsp