Jennifer L. Kohn

Cost of Hospital-Acquired Infection

Abstract The authors assessed the costs of hospital-acquired infections using rigorous econometric methods on publicly available data, controlling for the interdependency of length of stay and the incidence of hospital acquired infection, and estimated the cost shares of different payers. They developed a system of equations involving length of stay, incidence of infection, and the total hospital care cost to be estimated using simultaneous equations system. The main data came from the State of New Jersey UB 92 for 2004, complimented with data from the Annual Survey of Hospitals by the American Hospital Association and the Medicare Cost Report of 2004. The authors estimated that an incidence of hospital acquired infection increases the hospital care cost of a patient by

Hospital length of stay and probability of acquiring infection

10,375 and it increases the length of stay by 3.30 days, and that a disproportionately higher portion of the cost is attributable to Medicare. They conclude that reliable cost estimates of hospital-acquired infections can be made using publicly available data. Their estimate shows a much larger aggregate cost of

The effect of relationship status on health with dynamic health and persistent relationships

16.6 billion as opposed to

Immigration, Obesity and Labor Market Outcomes in the UK

5 billion reported by the Centers for Disease Control and Prevention but much less than

Health and Wealth: A Dynamic Demand for Medical Care

29 billion as reported elsewhere in the literature.

Federalist #10 in Management #101 What Madison Has To Teach Managers

Purpose – Hospital‐acquired infection (HAI) poses important health and financial problems for society. Understanding the causes of infection in hospital care is strategically important for hospital administration for formulating effective infection control programs. The purpose of this paper is to show that hospital length of stay (LOS) and the probability of developing an infection are interdependent.Design/methodology/approach – A two‐equation model was specified for hospital LOS and the incidence of infection. Using the patient‐level data of hospital discharge in the State of New Jersey merged with other data, the parameters of the two equations were estimated using a simultaneous estimation method.Findings – It was found that extending the LOS by one day increases the probability of catching an infection by 1.37 percent and the onset of infection increases average LOS by 9.32 days. The estimation indicates that HAI elongates LOS increasing the cost of a hospital stay.Research limitations/implications ...

The Marriage Myth

The dynamic evolution of health and persistent relationship status pose econometric challenges to disentangling the causal effect of relationships on health from the selection effect of health on relationship choice. Using a new econometric strategy we find that marriage is not universally better for health. Rather, cohabitation benefits the health of men and women over 45, being never married is no worse for health, and only divorce marginally harms the health of younger men. We find strong evidence that unobservable health-related factors can confound estimates. Our method can be applied to other research questions with dynamic dependent and multivariate endogenous variables.

Reference Health and the Demand for Medical Care

We estimate the dual effects of immigration and obesity on labor market outcomes in the UK using the British Household Panel Survey. We find support for the “healthy immigrant hypothesis” and evidence that immigrants’ weights increase with time in the UK. While overweight and obese men enjoy a wage premium, overweight and obese immigrant men face a wage penalty and are less likely to work in a white collar job. Overweight immigrant women are substantially more likely to suffer work limitations. While data limitations preclude efforts to address endogeneity, these associations suggest that immigrants have not been spared from the obesity epidemic.

Who Are the Big Medical Care Spenders

We generalize extant health capital models to provide an economic explanation for why individuals invest in health when survival and/or longevity prospects are poor. We allow relative health to impact utility and model depreciation as an amount rather than a rate. As a result, the decline in health causes an inevitable disequilibrium between an increasing marginal benefit from health and a declining cost of health capital that individuals can only resolve with increasing investment in medical care. A central implication is that individuals will demand more medical care the greater their decline in health at any level of health. We develop additional testable hypotheses about what drives medical care spending.

What is Health? A Multiple Correspondence Health Index

Business students typically do not read James Madison’s Federalist #10, a seminal work in political theory on the causes of and remedies for factions. I make the case that they should and offer suggestions for teaching and assessment. Factions are a subset of stakeholders that have interests adverse to the organization. Madison cogently argues that the causes of factions are rooted in human nature; therefore, managers should embrace diversity and not try to eliminate factions by surrounding themselves with “yes men.” Rather, he urges managers to focus on organizational design to channel ambition in a positive way and constrain the more corrosive effects of factions. Madison emphasizes a critical lesson for negotiation by focusing on adverse interests rather than positions or characteristics. Beyond these management lessons, Federalist #10 exposes business students to the foundations of American politics and helps to inform the ongoing debate about the relationship between business and government. Finally, Federalist #10 takes business students out of their comfort zone, changing their reading workout and strengthening their ability to learn management lessons from the broader world around them.