Jennifer Schultz

Social capital and self-rated health: Results from the US 2006 social capital survey of one community

Using data from the 2006 Social Capital Community Survey in Duluth, Minnesota, and Superior, Wisconsin, USA, we investigate associations between individual social capital measures (attitudes on trust, formal group involvement, informal socializing, organized group interaction, social support and volunteer activity) and self-rated health after controlling for individual and economic characteristics. In particular, we address issues of social capital as an endogenous determinant of self-reported health using instrumental variables probit estimation. After accounting for the endogeneity of these various measures of individual social capital, we find that individual social capital is a significant predictor of self-rated health.

The Impact of Contextual Factors on the Decision to Imprison in Large Urban Jurisdictions: A Multilevel Analysis

This study examines the influence of social and legal contextual factors on the processing of individual felony cases in large urban jurisdictions for 1998. Results of hierarchical logistic regression analyses that control for the effects of individual case-level factors show that three jurisdictional characteristics—use of sentencing guidelines, level of crime, and racial composition—influence the decision to imprison. These findings suggest that the type of sentence one receives and the reason one receives it partially depend on where it is meted out. This research demonstrates the importance of accounting for case-level factors in studies of cross-jurisdictional differences in punitiveness.

Measuring consumer perceptions of quality differences among competing health benefit plans

In this paper, we combine revealed preference and survey data on attribute importance to estimate parameters that represent average perceived differences in the quality and convenience of competing health benefit plans. We find that consumers do not perceive differences in provider quality across options. though they do perceive differences related to waiting time and access to specialists. In order to validate our approach, we estimate parameters representing perceived premiums and compare the estimates to actual premium differences. The results suggest that consumers correctly perceive the high-premium option to cost more than the low-premium option. These results increase our confidence in the use of stated importance data to identify and interpret parameters measuring the effect of otherwise unobservable attributes of choice alternatives.

Do Consumers Use Information to Choose a Health-Care Provider System?

This study examines the use of information by employees in the Buyers Health Care Action Group, a purchasing coalition of large employers in Minneapolis. BHCAG employers contract directly with multiple health-care provider systems and attempt to inform employees about those choices. Shortly after the close of the 1998 open-enrollment period, a survey of 927 BHCAG employees with single-coverage health insurance was conducted. Seventy-six percent of the employees relied on information from their employer when selecting their current care system. Use of information from the employer was positively related to education and years of residence in the Twin Cities. Previous experience with doctors and hospitals in the care system also was a common information source. Older and low-income workers were more likely to use information from advertisements. The survey results suggest that employers can predict which information sources their employees will use.

Costs Associated With Changes in Antidepressant Treatment in a Managed Care Population With Major Depressive Disorder

OBJECTIVE This study determined whether persons with major depressive disorder who switch or augment antidepressant therapy have higher health care costs and productivity losses than those who do not. METHODS Data from July 1, 2002, through June 30, 2006, were taken from a national employment-based medical and pharmacy claims database. Participants were required to have filled an antidepressant prescription, be treatment naïve six months before the index prescription, be continuously enrolled in the benefits plan at least six months before and 12 months after the index prescription, and have at least one outpatient-based medical claim for major depressive disorder. Participants were categorized according to whether they switched, augmented, or maintained (that is, neither switched nor augmented) their antidepressant therapy in the 12 months after the index prescription. Productivity losses were defined as days absent from work for medical visits multiplied by average daily wage. Multivariate analyses (generalized linear models) were used to compare costs per person in the year after the index prescription, and univariate analyses (Wilcoxon tests) were used to compare productivity losses per person. RESULTS Of the 7,273 individuals who met study criteria, 40.3% switched, 1.5% augmented, and 58.2% maintained the index antidepressant therapy. After the analyses controlled for baseline characteristics, mean total and depression-related health care costs, respectively, in the year after the index prescription were significantly greater for switchers (

Regulation, Financial Incentives, and the Production of Quality

9,288 and

Who uses flexible spending accounts: effects of employee characteristics and employer strategies.

1,388 per person) and for augmenters (

Determinants of Compliance With Statin Therapy and Low-Density Lipoprotein Cholesterol Goal Attainment in a Managed Care Population

9,350 and

Do employees use report cards to assess health care provider systems

1,027) than for maintainers (

Patterns and effectiveness of lipid-lowering therapies in a managed care environment

6,151 and