R-3 Repository :: Browsing by Author "Baker Institute for Public Policy"

Browsing by Author "Baker Institute for Public Policy"

Now showing 1 - 15 of 15

Association of Level I and II Trauma Center Expansion With Insurer Payments in Texas From 2011 to 2019
(American Medical Association, 2022) Ho, Vivian; Short, Marah N.; Coughlin, Maura; McClure, Shara; Suliburk, James W.; Baker Institute for Public Policy
Balancing economic and epidemiological interventions in the early stages of pathogen emergence
(AAAS, 2023) Dobson, Andy; Ricci, Cristiano; Boucekkine, Raouf; Gozzi, Fausto; Fabbri, Giorgio; Loch-Temzelides, Ted; Pascual, Mercedes; Baker Institute for Public Policy
The global pandemic of COVID-19 has underlined the need for more coordinated responses to emergent pathogens. These responses need to balance epidemic control in ways that concomitantly minimize hospitalizations and economic damages. We develop a hybrid economic-epidemiological modeling framework that allows us to examine the interaction between economic and health impacts over the first period of pathogen emergence when lockdown, testing, and isolation are the only means of containing the epidemic. This operational mathematical setting allows us to determine the optimal policy interventions under a variety of scenarios that might prevail in the first period of a large-scale epidemic outbreak. Combining testing with isolation emerges as a more effective policy than lockdowns, substantially reducing deaths and the number of infected hosts, at lower economic cost. If a lockdown is put in place early in the course of the epidemic, it always dominates the “laissez-faire” policy of doing nothing.
Competition in Business Taxes and Public Services: Are Production-Based Taxes Superior to Capital Taxes?
(National Tax Association, 2015) Gugl, Elisabeth; Zodrow, George R.; Baker Institute for Public Policy
Although most of the tax competition literature focuses on the provision of local public services to households, several papers analyze tax competition when capital taxes are used to finance local public services provided to businesses, examining the conditions under which such services are provided efficiently, under-provided, or over-provided. In addition, several prominent observers have noted that “benefit-related” business taxation is desirable on both efficiency and equity grounds and argued that such taxation should take the form of a tax based on production, such as an origin-based value-added tax. We evaluate this contention in this paper, comparing the relative efficiency properties of these alternative business taxes. Our simulation results suggest that under many, but not all, circumstances it is more efficient to finance business public services with an origin-based production tax rather than a source-based capital tax.
Do earthquakes increase or decrease crime?
(Elsevier, 2024) Silverio-Murillo, Adan; Balmori-de-la-Miyar, Jose; Sobrino, Fernanda; Prudencio, Daniel; Baker Institute for Public Policy
Theories on the relationship between earthquakes and crime present mixed predictions. On the one hand, earthquakes improve individual cooperation, social trust, and crime reduction. On the other hand, earthquakes impact state capacity and enhance the prevalence of motivated offenders such as street gangs. This study empirically analyzes the effects of the September 2017 earthquakes in Mexico on personal crimes (assault and aggravated assault) and property crimes (vehicle theft, residential burglary, and vandalism). Using official police data, a difference-in-differences technique, and an event-study design, the results show that earthquakes increased assault by 14 percent and vandalism by 8 percent.
Electricity grids and geopolitics: A game-theoretic analysis of the synchronization of the Baltic States’ electricity networks with Continental Europe
(Elsevier, 2024) Fang, Songying; Jaffe, Amy Myers; Loch-Temzelides, Ted; Lo Prete, Chiara; Baker Institute for Public Policy
Can supply of electricity be used as an energy weapon? This question rises in importance as more countries trade electricity across borders to smooth out grid stability issues and improve cost-efficient dispatching across large geographic areas. In the context of the Baltics’ disentanglement from the BRELL (Belarus, Russia, Estonia, Latvia, and Lithuania) electricity grid and synchronization with Europe, we develop a game-theoretic model and examine the strategies of the involved parties in light of the potential for electricity trade to be used as a geopolitical weapon. We conceptualize the process of the synchronization project as a sequential-move game between three actors (Russia, the Baltic states, and the EU-U.S.). Our findings suggest that, in large part due to reputational concerns, Russia is unlikely to cooperate in the synchronization process. Instead, our model predicts that Russia will not wait for the Baltic states to complete their synchronization with the European grid before disconnecting them from the BRELL system. Direct Russian cyberattacks against Baltic grids are not implemented and the Baltics do not have to make concessions, provided that Western allies signal a strong likelihood of deterrent retaliation. We offer policy recommendations for Europe, Russia and the Baltic states.
Employment among Patients Starting Dialysis in the United States
(American Society of Nephrology, 2018) Erickson, Kevin F.; Zhao, Bo; Ho, Vivian; Winkelmayer, Wolfgang C.; Baker Institute for Public Policy
BACKGROUND AND OBJECTIVES: Patients with ESRD face significant challenges to remaining employed. It is unknown when in the course of kidney disease patients stop working. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined employment trends over time among patients ages 18-54 years old who initiated dialysis in the United States between 1996 and 2013 from a national ESRD registry. We compared unadjusted trends in employment at the start of dialysis and 6 months before ESRD and used linear probability models to estimate changes in employment over time after adjusting for patient characteristics and local unemployment rates in the general population. We also examined employment among selected vulnerable patient populations and changes in employment in the 6 months preceding dialysis initiation. RESULTS: Employment was low among patients starting dialysis throughout the study period at 23%-24%, and 38% of patients who were employed 6 months before ESRD stopped working by dialysis initiation. However, after adjusting for observed characteristics, the probability of employment increased over time; patients starting dialysis between 2008 and 2013 had a 4.7% (95% confidence interval, 4.3% to 5.1%) increase in the absolute probability of employment at the start of dialysis compared with patients starting dialysis between 1996 and 2001. Black and Hispanic patients were less likely to be employed than other patients starting dialysis, but this gap narrowed during the study period. CONCLUSIONS: Although working-aged patients in the United States starting dialysis have experienced increases in the adjusted probability of employment over time, employment at the start of dialysis has remained low.
Hemodialysis Versus Peritoneal Dialysis Drug Expenditures: A Comparison Within the Private Insurance Market
(Elsevier, 2023) Bhatnagar, Anshul; Niu, Jingbo; Ho, Vivian; Winkelmayer, Wolfgang C.; Erickson, Kevin F.; Baker Institute for Public Policy
Rationale and Objective Recent initiatives aim to improve patient satisfaction and autonomy by increasing the use of peritoneal dialysis (PD) in the United States. However, limited knowledge is available about the costs of different dialysis modalities, particularly those incurred by private insurers. In this study, we compared the costs of injectable dialysis drugs (and their oral equivalents) paid by insurers between privately insured patients receiving hemodialysis and PD. Study Design A retrospective cohort study. Setting and Participants From a private insurance claims database, we identified patients who started receiving PD or in-center hemodialysis between January 1, 2017, and December 31, 2020. Exposure Patients started receiving PD. Outcomes Average annual injectable drug and aggregate expenditures and expenditure subcategories. Analytical Approach Patients who started receiving PD were propensity matched to similar patients who started receiving hemodialysis based on the year of dialysis initiation, patient demographics, health, geography, and comorbidities. Cost ratios (CRs) were estimated from generalized linear models. Results We matched 284 privately insured patients who started receiving PD 1:1 with patients started receiving in-center hemodialysis. The average annual injectable drug expenditures for hemodialysis were 2-fold higher (CR: 1.99; 95% CI, 1.62-2.44) than that for PD. Compared those receiving PD, patients receiving hemodialysis incurred significantly lower nondrug dialysis-related expenditures (0.85; 95% CI, 0.76-0.94). The average annual expenditures for non–dialysis-dependent outpatient services were significantly higher among patients who underwent in-center hemodialysis (CR: 1.44; 95% CI, 1.10-1.90). Although aggregate and inpatient hospitalization expenditures were higher for in-center hemodialysis, these differences did not reach statistical significance. Limitations Small sample sizes may have restricted our ability to identify differences in some cost categories. Conclusions Compared with privately insured patients who started receiving PD, patients starting in-center hemodialysis incurred higher expenditures for injectable dialysis drugs, whereas differences in other expenditure categories varied. Recent increases in the use of PD may lead to reductions in injectable dialysis drug costs among privately insured patients. Plain Language Summary Recent initiatives aim to improve patient satisfaction and autonomy by increasing the use of peritoneal dialysis (PD) in the United States. However, limited knowledge is available about the costs of different dialysis modalities, particularly those incurred by private insurers. In this study, we compared the costs of injectable dialysis drugs (and their oral equivalents) provided by insurers between privately insured patients receiving hemodialysis and PD. We found that the average annual injectable drug expenditures for hemodialysis were 2.0-fold higher compared with those for PD. These findings suggest that the recent increase in the use of PD may lead to reductions in injectable dialysis drug costs among privately insured patients.
The ‘inherent vulnerability’ of women on the move: A gendered analysis of Morocco’s migration reform
(Oxford University Press, 2024) Norman, Kelsey P; Reiling, Carrie; Baker Institute for Public Policy
Beginning in the 1990s, Morocco increasingly became a de facto host country for sub-Saharan migrants and asylum seekers originally intending to reach Europe. While the government’s treatment toward these groups was characterized by informality and violence throughout the early 2000s, Morocco embarked on a reform process in 2013 that included a regularization process for irregular migrants. During the regularization process, the Moroccan government automatically granted all women applicants residency status due to their presumed ‘vulnerability’. This paper asks: What are the implications of assuming that women are ‘inherently vulnerable’? Drawing on in-person interviews and an analysis of policy documents, this article adds to the gendered migration and refugee literature by demonstrating that supposedly humanitarian policies toward women can also victimize them, stereotype male migrants and refugees as threatening, and strengthen the patriarchal role of the state and its ability to carry out violence in the name of protection.
Language Matters: Effective Communication and Connections for Firearm Injury Prevention
(Elsevier, 2024) McKay, Sandra; Aitken, Mary E.; Baker Institute for Public Policy
Leveraging Selective State Capacity: Understanding Changing Responses to Migration and Refugees
(Oxford University Press, 2024) Norman, Kelsey P; Baker Institute for Public Policy
State capacity is seen as one of the central elements determining whether countries have “strong” or “weak” systems of immigration and asylum. An underlying assumption of the global refugee regime is that countries of the Global South—thought to have less state capacity—do not have the ability to respond and host asylum seekers and refugees and must be financially supported by countries of the Global North in order to do so. But how can we understand “strong” migration responses from an otherwise “weak” state, as well as responses that change over time without corresponding alterations to underlying state capacity? This paper analyzes the case of Egypt, which, over the course of a decade, alternated between three types of migration policies requiring a range of state resources. Drawing on more than 70 in-person interviews and an analysis of public documents, this paper presents a theory of selective state capacity and argues that infrastructural weakness does not imply a lack of strategic decision-making in the field of migration, or an unwillingness to expend state resources, when the political incentives are in place.
Navigating a stable transition to the age of intelligence: A mental wealth perspective
(Elsevier, 2024) Occhipinti, Jo-An; Prodan, Ante; Hynes, William; Eyre, Harris A.; Schulze, Alex; Ujdur, Goran; Tanner, Marcel; Baker Institute for Public Policy
In the grand narrative of technological evolution, we are transitioning from the “Age of Information” to the “Age of Intelligence.” Rapid advancements in generative artificial intelligence (AI) are set to reshape society, revolutionize industries, and change the nature of work, challenging our traditional understanding of the dynamics of the economy and its relationship with human productivity and societal prosperity. As we brace for this transformative shift, promising advancements in healthcare, education, productivity, and more, there are concerns of large-scale job loss, mental health repercussions, and risks to social stability and democracy. This paper proposes the concept of Mental Wealth as an action framework that supports nations to proactively position themselves for a smooth transition to the Age of Intelligence while fostering economic and societal prosperity.
Patient Perspectives on Using Telemedicine During In-Center Hemodialysis: A Qualitative Study
(Elsevier, 2024) Haltom, Trenton M.; Lew, Susie Q.; Winkelmayer, Wolfgang C.; Chertow, Glenn M.; Jaure, Allison; Erickson, Kevin F.; Baker Institute for Public Policy
Rationale & Objective In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the United States federal government expanded originating telemedicine sites to include outpatient dialysis units. For the first time, nephrology practitioners across the United States could replace face-to-face visits with telemedicine for patients receiving in-center hemodialysis. This study describes patients’ perspectives on the use of telemedicine during in-center hemodialysis. Study Design A qualitative study. Setting & Participants Thirty-two patients from underserved populations (older, less educated, unemployed, persons of color) receiving in-center hemodialysis who used telemedicine with their nephrologist during the COVID-19 pandemic. Analytical Approach Telephone semistructured interviews were conducted in English or Spanish. Transcripts were thematically analyzed. Results We identified 6 themes with subthemes: adapting to telemedicine (gaining familiarity and confidence, overcoming and resolving technical difficulties, and relying on staff for communication); ensuring availability of the physician (enabling an immediate response to urgent medical needs, providing peace of mind, addressing patient needs adequately, and enhanced attention and contact from physicians); safeguarding against infection (limiting COVID-19 exposures and decreasing use); straining communication and physical interactions (loss of personalized touch, limited physical examination, and unable to reapproach physicians about forgotten issues); maintaining privacy (enhancing privacy and projecting voice enables others to hear); and supporting confidence in telemedicine (requiring established rapport with physicians, clinical stabilty of health, and ability to have in-person visits when necessary). Limitations Interviews were conducted later in the pandemic when some nephrology care providers were using telemedicine infrequently. Conclusions Patients receiving in-center hemodialysis adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits. However, further considerations regarding communication, privacy, and physical assessments are necessary. Integrating telemedicine into future in-center hemodialysis care using a hybrid approach could potentially build trust, optimize communication, and augment care. Plain-Language Summary This study describes patients’ perspectives on the use of telemedicine while receiving in-center hemodialysis during the coronavirus disease 2019 (COVID-19) pandemic. Data are derived from semistructured interviews with thirty-two patients from underserved populations (older, less educated, unemployed, persons of color). We identified 6 major themes including adapting to telemedicine, ensuring availability of the physicians, safeguarding against infection, straining communication and physical interactions, maintaining privacy, and supporting confidence in telemedicine. These findings suggest that patients receiving in-center hemodialysis adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits. However, further considerations regarding communication, privacy, and physical assessments are necessary. Integrating telemedicine into future in-center hemodialysis care using a hybrid approach could potentially build trust, optimize communication, and augment care.
Refinement of the Affordable Care Act
(Annual Reviews, 2018) Ho, Vivian; Baker Institute for Public Policy
Regardless of what legislation the federal government adopts to address health insurance coverage for nonelderly Americans, private insurance will likely play a major role. This article begins by listing some of the major reasons critics dislike the Affordable Care Act (ACA), then discusses the validity of these concerns from an economics perspective. Criticisms of the ACA include the increased role of government in health care, the ACA's implicit income redistribution, and concern about high and rising insurance premiums. Suggestions for refining the ACA and its market-based insurance system are then offered, with the goals of lowering insurance premiums, improving coverage rates, and/or addressing the concerns of ACA critics. Americans favor the increase in insurance coverage that has occurred under the ACA. In order to sustain this level of coverage, steps to lower Marketplace premiums through a variety of strategies affecting potential enrollees, insurers, and healthcare providers are offered.
The determinants of nonprofit hospital CEO compensation
(Public Library of Science, 2024) Jenkins, Derek; Short, Marah N.; Ho, Vivian; Baker Institute for Public Policy
Hospital CEO salaries have grown quickly over the past two decades. We investigate correlates of rising nonprofit hospital CEO pay between 2012 and 2019 by merging compensation data from Candid’s IRS 990 forms with hospital data from the National Academy for State Health Policy Hospital Cost Tool. Almost half of the measured increase in CEO compensation (44.5%) accrued to a “base case” CEO, who was leading a non-teaching hospital system or independent hospital with fewer than 100 beds that earned 0 profits and provided no charity care. Another 28.5% of the measured salary increase resulted from changes in the generosity with which observable metrics were rewarded, particularly the reward for heading a system with 500 or more beds. The remaining 27% resulted mostly from hospital systems or single hospitals that increased their profits or bed size over time. The increase in CEO compensation associated with leading larger healthcare systems and earning greater profits may explain the increase in healthcare system consolidation which has occurred over the last several years.
The Perils of Complacency: America at a Tipping Point in Science & Engineering
(American Academy of Arts & Sciences, 2020) American Academy of Arts & Sciences; Baker Institute for Public Policy
This consensus report jointly published by the American Academy of Arts & Sciences and Rice University's Baker Institute for Public Policy examines current and historical challenges to America's leadership in scientific research and development and makes recommendations for improving the U.S. science, technology, and innovation policy.

Browsing by Author "Baker Institute for Public Policy"

Results Per Page

Sort Options