Are bigger nursing homes better?

Larger nursing homes appear to have lower mortality than smaller facilities. It is well known that larger homes tend to be lower cost, so we can ask whether economies of scale translate somehow into better quality. Is nursing home size related to quality of care

An investigation of the value of symmetry in forecasting

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Meteorology, 1943.Includes bibliographical references (leaf 22).by Edward Norton Lorenz.M.S

Autonomous Shuttles in Santa Fe Springs

The urban planning implications of AV Shuttles and how they could be incorporated into Santa Fe Springs, Los Angeles, California

Long‐term care and pay‐for‐performance programs

Pay‐for‐performance programs are gradually spreading across Asia. This paper builds on the longer experience in the United States to offer lessons for Asia. The Center for Medicare and Medicaid Services has introduced several pay‐for‐performance programs since 2012 to encourage hospitals to improve quality of care and reduce costs. Some state Medicaid programs have also introduced pay‐for‐performance for nursing homes. Long‐term care providers play an important role in hospital pay‐for‐performance programs because they can affect the readmission rate and also total episode payments. A good pay‐for‐performance program will focus on improving quality of care that affects health outcomes. In addition, that quality must vary across providers and be measurable. Furthermore, it is important that the measures be reported in a timely way, that both demand and supply respond to the measures, and that the measures be risk adjusted. Empirical data from Medicare beneficiaries in the state of Michigan show that mean episode payments and readmission rates in skilled nursing facilities vary widely and are sensitive to the number of observations. These practical matters create challenges for implementing pay‐for‐performance in practice. There is an extensive literature review of pay‐for‐performance in long‐term care in the United States and in Asia.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145582/1/rode12359.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145582/2/rode12359_am.pd

How Home Health Agencies’ Ownership Affects Practice Patterns

This study explores whether for‐profit home health agencies responded differently from non‐profit agencies to financial incentives embedded in the Medicare prospective payment system. Agencies were able to receive higher reimbursement per patient under the prospective payment system if they adjusted the number of therapy visits or the type of visits for a two‐month‐long episode. Agencies could also increase reimbursement by treating a patient for multiple episodes of care, because prospective payments were made on a per‐episode basis. Using the Medicare Claims and Provider of Services Files from 2001 to 2009, we examine differences between for‐profit and non‐profit agencies in these practice patterns during the first nine years of the prospective payment system. We find that for‐profit agencies were more likely to adopt most of these practice patterns than were non‐profit agencies. This finding suggests that for‐profit agencies were more responsive to financial incentives, and therefore disproportionately contributed to the increase in Medicare home health spending under the prospective payment system. Policymakers could consider revising the current prospective payment system that gives agencies incentives to distort practice patterns regardless of a patient’s health care needs.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138406/1/fisc12136_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138406/2/fisc12136-sup-0001-text.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138406/3/fisc12136.pd

The "Unfriending" Problem: The Consequences of Homophily in Friendship Retention for Causal Estimates of Social Influence

An increasing number of scholars are using longitudinal social network data to try to obtain estimates of peer or social influence effects. These data may provide additional statistical leverage, but they can introduce new inferential problems. In particular, while the confounding effects of homophily in friendship formation are widely appreciated, homophily in friendship retention may also confound causal estimates of social influence in longitudinal network data. We provide evidence for this claim in a Monte Carlo analysis of the statistical model used by Christakis, Fowler, and their colleagues in numerous articles estimating "contagion" effects in social networks. Our results indicate that homophily in friendship retention induces significant upward bias and decreased coverage levels in the Christakis and Fowler model if there is non-negligible friendship attrition over time.Comment: 26 pages, 4 figure

International Health Economics Association Seventeenth Annual Kenneth J. Arrow Award in Health Economics

No AbstractPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60907/1/1406_ftp.pd

Wind Tunnel Balances

Report embodies a description of the balance designed and constructed for the use of the National Advisory Committee for Aeronautics at Langley Field, and also deals with the theory of sensitivity of balances and with the errors to which wind tunnel balances of various types are subject

Design of Wind Tunnels and Wind Tunnel Propellers II

This report is a continuation of National Advisory Committee for Aeronautics report no. 73. The variations in velocity and direction of the wind stream were studied by means of a recording air speed meter and a recording yawmeter. The work was carried on both in a 1-foot diameter model tunnel and in a 5-foot full-size tunnel, and wherever possible comparison was made between them. It was found that placing radial vanes directly before the propeller in the exit cone increased the efficiency of the tunnel to a considerable extent and also gave a steadier flow