Darren P. Grant

Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project

This paper replicates Gruber et al.s [Gruber, J., Kim, J., Mayzlin, D., 1999. Physician fees and procedure intensity: the case of cesarean delivery. Journal of Health Economics, 18 (4), 473-490] analysis of the effect of physician financial incentives on cesarean delivery rates, using their data, sample selection criteria, and specification. Coincident trends explain much of their estimated positive relation between fees and cesarean utilization, which also falls somewhat upon the inclusion of several childbirth observations that had been inadvertently excluded from their estimation sample. The data ultimately indicate that a

Malpractice Experience and the Incidence of Cesarean Delivery: A Physician-Level Longitudinal Analysis:

1000 increase, in current dollars, in the reimbursement for a cesarean section increases cesarean delivery rates by about one percentage point, one-quarter of the effect estimated originally.

Sanctions and Recidivism: An Evaluation of Physician Discipline by State Medical Boards

This study examines the influence of malpractice claims on the practice behavior of a panel of obstetricians in Florida during the period 1992–1995 to determine whether physicians respond to malpractice events by performing more cesareans, consistent with the notion that cesarean sections are employed as “defensive medicine.” Findings indicate that clinical events resulting in claims that lead to substantial indemnity payments have a significant, modest effect on physician practice behavior: physicians experiencing those claims increase their risk-adjusted cesarean rates by about one percentage point. Malpractice experience does not appear to affect patient mix, but claims with large payouts may affect patient volume.

Dead on Arrival: Zero Tolerance Laws Don't Work

This article descriptively assesses how physicians are disciplined by state medical boards throughout the United States, drawing on a nationwide database of sanctions delivered during the period 1994-2002. We identify the frequency and severity of disciplinary actions, the offenses leading to actions, and the degree to which sanctioned physicians are subsequently sanctioned again in the future. The most significant finding is that there are a very large number of repeat offenders among physicians who have received board sanctions, indicating a possible need for greater monitoring of disciplined physicians or less reliance upon rehabilitative sanctions.

Recycling and market power: A more general model and re-evaluation of the evidence1

By 1998 all states had passed laws lowering the legal blood alcohol content for drivers under 21 to effectively zero. Theory shows these laws have ambiguous effects on overall fatalities and economic efficiency, and the data show they have little effect on driver behavior. A panel analysis of the 1988-2000 FARS indicates that zero tolerance laws have no material influence on the level of fatalities, while quantile regression reveals virtually no change in the distribution of BAC among drivers involved in fatal accidents.

Grades as Incentives

Abstract This paper presents a more general model of the “recycling problem” and uses it to re-examine the Alcoa antitrust case of 1945. There are three primary empirical results: 1) in the Alcoa scenario, the recycling problem had been in a steady state since the early 1920s, 2) the primary source of Alcoas market power, in contrast to previous work, was that most of the aluminum sold by Alcoa was used in goods that were not economical to recycle, and 3) the existing, competitive secondary market was welfare-reducing, relative to a monopoly in all aluminum production.

Multiproduct Pricing in Major League Baseball: A Principal Components Analysis

This paper examines how grade incentives affect student learning across a variety of courses at two universities, using for identification the discrete rewards offered by the standard A–F letter-grade system. We develop and test five predictions about the provision of study effort and the distribution of numerical course averages in the presence of the thresholds that separate these discrete rewards. Surprisingly, all are rejected in our data. There is no evidence that exam performance is improved for those students that stand to gain the most from additional study. Copyright Springer-Verlag 2013

Searching for the Downsian Voter with a Simple Structural Model

The empirical analysis of multiproduct pricing suffers from a lack of clear theoretical guidance and appropriate data, limitations which often render traditional regression-based analyses impractical. This paper analyzes ticket, parking, and concession pricing in Major League Baseball for the period 1991-2003 using a new methodology based on principal components, which allows inferences to be formed about the factors underlying price variation without strong theoretical guidance or abundant information about costs and demand. While general demand shifts are the most important factor, they explain only half of overall price variation. Also important are price interactions that derive from demand interrelationships between goods and the desire to maximize the capture of consumer surplus in the presence of heterogeneous demand.

WHAT MAKES A GOOD ECONOMY? EVIDENCE FROM PUBLIC OPINION SURVEYS

Studies of voter turnout consistently find that turnout responds to the closeness of the election, yet it is widely claimed that the probability of casting the deciding vote is too minute to be of consequence. We provide evidence on this puzzle by deriving a structural rational voting model in the form of a relatively simple regression equation, and fitting it to data from a large sample of US congressional elections. Copyright 1998 Blackwell Publishers Ltd..

WHAT MAKES A GOOD ECONOMY? EVIDENCE FROM PUBLIC OPINION SURVEYS: WHAT MAKES A GOOD ECONOMY?

This study analyzes nearly twenty-five years of U.S. survey data to determine the macroeconomic conditions associated with economies the public considers “good.” These surveys are correlated with, but distinct from, other frequently-studied, expectations-oriented indices of consumer sentiment. The primary findings are as follows: 1) inflation and unemployment, the variables in the Phillips curve, explain much of the variation in the survey data; 2) consumers’ implied loss function is nearly linear in these two variables; 3) the public is willing to trade off four percentage points of (increased) inflation for one percentage point of (decreased) unemployment.