Are Hospital Pharmacies More Efficient if They Employ Nurses?

This paper assesses the efficiency of utilizing nurses in Washington State hospital pharmacies. We take the perspective of a pharmacy department manager and model an input oriented hospital pharmacy production process. Data envelopment analysis (DEA) is used to examine both scale efficiency and technical efficiency, and differences across hospital pharmacies that use and do not use nurse staffing are analyzed using cross-tabulations and nonparametric hypothesis tests. The results indicate that the use of nurse staffing does not significantly impact either scale or technical efficiency. Thus, permitting nurses to play a greater role in hospital pharmacies does not adversely affect efficiency. This paper has important policy implications for hospital administrators and pharmacists.

Unintended Migration Consequences of US Welfare Reform

Researchers have analyzed whether US welfare reform has induced interstate migration. Empirical results are inconclusive because methodologies are based on pre-reform thinking. This paper presents a post-reform migration model. We find that recipients move to avoid harsh sanction policies, seek lenient work requirements, and extend time limits. Unlike the first two behavioral responses, the latter is controversial. Critics will argue that such moves are illegal, and violators can be prosecuted because states share data. However, only active cases are being shared, meaning violators cannot be caught. Our model produces testable hypotheses which are consistent with (and reconcile) previous empirical results.Migration, Welfare reform

The Impact of the COVID-19 Pandemic on Consumer Bankruptcies

This manuscript conducts a simple, exploratory analysis to test whether the use of the consumer bankruptcy process fundamentally differed during the COVID-19 pandemic compared to previous years. Data were drawn from the Public Access to Court Electronic Records (PACER) database maintained by the U.S. Bankruptcy Court’s Eastern District of Washington for the years 2007, 2011, 2016, and 2020. KruskalWallis tests indicate that filers in 2020 had lower average real monthly incomes than in previous years. However, household incomes were not statistically different from previous years. Filers in 2020 has significantly more debt in collections compared to 2007, but no more or less debt than in 2011 or 2016. Chi-square tests report a significantly greater proportion of filings with debts owed to collections agencies in 2020 compared to previous years. Overall, the findings suggest that the pandemic did significantly alter the use, and intensity of use, of the consumer bankruptcy process

Turning a Problem into a Solution: Instructional Benefits of Using ExamSoft to Map Multiple-Choice Responses

In this paper, we propose a simple method to minimize the effects of each of the previously mentioned issues associated with the design and administration of assessments that use multiple-choice items. We analyzed multiple-choice questions with possible responses to express fundamentally different thought processes and/or knowledge. A case study built around an introductory health care course shows how a specialized assessment software platform helped map assessment questions back to curricular outcomes identifying where the curriculum was effective, and where needed improvement. Our results indicate that incorrect responses were more informative in identifying and addressing curricular gaps than the correct responses

Impact of COVID-19 Pandemic on Pharmacy Teaching at a Midwestern University

The coronavirus (COVID-19) pandemic severely impacted higher education institutions. In March 2020, the North Dakota State University School of Pharmacy notified faculty and students that the remainder of the semester would be taught using remote learning. The study objective is to determine how the change from the traditional classroom to remote learning impacted students and faculty. Pharmacy students were surveyed to ascertain how the transition to remote learning have impacted their learning. Additionally, faculty were surveyed using a semi-structured interview to assess their instructional efforts. The student survey findings identify several challenges impacting instruction, including online exam-taking and balancing time constraints. Faculty survey responses collected include themes of decreased student engagement, technology use and access, and transitions in the learning environment. Curriculum areas facing significant challenges during the pandemic include hands-on laboratory skills and experiential education which required multiple changes. Despite the challenges, faculty made the teaching transitions that they might not have otherwise tried. Assessing the impact of remote learning will continue to be important as the pandemic continues

What Factors Influence a Welfare Recipient’s Spell Length and Recidivism?

The Personal Responsibility and Work Reconciliation (PRWORA) Act of 1997 marked a significant change in US welfare policy. Under the terms of this legislation, welfare recipients are limited to 24 consecutive months of monetary benefits, not to exceed 60 months over an individual’s lifetime. The primary intent of PRWORA is to force people off of welfare roles and into the work force. However, it may also have created a second effect; namely that wel-fare recipients treat the 60 months of welfare benefits as a stockpile of wealth. If so, recipients might strategically move on and off of the welfare roles in order to increase the length of time before one exhausts his or her total lifetime benefits. This leads to a high number of “welfare spells”, each relatively short in duration. We present an empirical analysis using data from three counties in Washington State to test whether (and how) an individual’s ability to maxim-ize welfare spells varies by their potential employment opportunities and their socio-economic characteristics. We find that socio-economic characteristics such as race and gender, family structure and educational attainment all significantly influence welfare spells. Additionally, welfare spells differed significantly by county, indicating that local labor market conditions specific to those counties are also important in decisions to “bank” welfare benefits

Are Hospitals Seasonally Inefficient? Evidence from Washington State Hospitals

Efficiency measurement has been one of the most extensively explored areas of health services research over the past two decades. Despite this attention, few studies have examined whether a provider's efficiency varies on a monthly, quarterly or other, sub-annual basis. This paper presents an empirical study that looks for evidence of seasonal inefficiency. Using a quarterly panel of general, acute-care hospitals from Washington State, we find that hospital efficiency does vary over time; however, the nature of this dynamic inefficiency depends on the type of efficiency being measured. Our results suggest that technical and cost efficiency vary by quarter. Allocative and scale efficiency also vary on a quarterly basis, but only if the data are jointly disaggregated by quarter and another, firm-specific factor such as size or operating status. Thus, future research, corporate decisions and government policies designed to improve the efficiency of hospital care need to account for seasonal trends in hospital efficiency

Do In-Kind Benefits Influence Pharmacists’ Labor Supply Decisions?

This paper explores whether in-kind benefits influence the labor supply decisions of pharmacists. Particular attention is paid to decisions to supply more than thirty hours of labor per week, when in-kind benefits are usually standard. A distinction is also made between pharmacists in managerial and/or ownership positions and those in traditional staff positions. Using survey data from registered pharmacists in North Dakota, we find that the labor supply determinants for owners/managers and employees are significantly different. We also find that while in-kind benefits do not appear to influence the typical staff pharmacist’s decision of how many hours to work each week, certain, but not all, types of these benefits do influence the decision of the representative owner/manager. Furthermore, the determinants of hours worked, in general, do not differ across the thirty hour per week threshold

Focusing your walking intervention’s message: For mature audiences only

Public policy makers seek to launch initiatives and preventive measures that reduce spiraling healthcare costs. One way they can do this is by encouraging their constituencies to engage in physical activity, such as walking. Although the health benefits of walking have been well documented, the factors that contribute to such behavior are not well understood. We analyzed the effect of factors that the literature has identified on walking behavior for “mature” adults, aged 40 to 65, and find that the “physical” infrastructure of a community, such as the presence of sidewalks, crosswalks, and signals for pedestrians, affects walking significantly. Our study suggests that policy makers would be well-advised to channel their efforts in building and improving the physical infrastructure that enable walking in their communities and to communicate the presence of these to their constituencies without explicitly recommending walking to them