Luisa Franzini

Serial Correlation and the Fixed Effects Model

This paper generalizes the Durbin-Watson type statistics to test the OLS residuals from the fixed effects model for serial independence. Also generalized are the tests proposed by Sargan and Bhargava for the hypothesis that the residuals form a random walk. A method for efficient estimation of the parameters is also developed. Finally, an earnings function is estimated using the Michigan Survey of Income Dynamics in order to illustrate the uses of the tests and the estimation procedures developed in this paper.

Contributions of social context to inequalities in years of life lost to heart disease in Texas, USA

Several recent articles have pointed to the effect of social context on heart disease mortality after adjusting for individual level indicators. This study investigates the contributions of individual socioeconomic factors (sex, race, and education) and social context at the neighborhood level (wealth, education, social capital, and racial/ethnic composition), and the county level (social inequality, human and social capital, economic and demographic characteristics) on premature cardiovascular mortality. Death certificate information was obtained for all those who died of heart disease in Texas, USA, in 1991. Deaths were geocoded to obtain block-group, census tract, and county social context from the census. Multilevel hierarchical models quantified the contributions of individual characteristics and block-group, tract, and county social context on years of potential life lost to heart disease. Cross-level analyses investigated the interaction between individual and contextual factors. Being female, having more education, and residing in areas with higher median house value were associated with less premature mortality. Although blacks and Hispanics lost more years of life to heart disease than whites, blacks and Hispanics living in tracts with higher own racial/ethnic group density lost fewer years of life than their peers living in less homogenous tracts. At the county level, premature mortality was negatively associated with social capital. The tract and county level variances were statistically significant indicating the importance of social context to premature heart disease mortality. Plausible mechanisms through which these effects operate are explored. Social context at the block-group, tract, and county level played an important role, though a smaller role than individual factors, in explaining years of life lost to heart disease.

Neighborhood characteristics favorable to outdoor physical activity: Disparities by socioeconomic and racial/ethnic composition

This paper uses a socioecological framework to investigate socioeconomic and racial/ethnic disparities in neighborhood characteristics that are associated with outdoor physical activity. We surveyed 632 parents of 5th graders about perceptions of their neighborhood social processes and collected systematic observations of the physical environment on their block-face of residence. Higher poverty neighborhoods and non-White neighborhoods have better accessibility; however, they are less safe, less comfortable, and less pleasurable for outdoor physical activity, and have less favorable social processes. Interventions to reduce disparities in physical activity should address not only the physical environment, but also social processes favorable to physical activity.

Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer.

Few studies have addressed racial disparities in survival for colon cancer by adequately incorporating both treatment and socioeconomic factors, and the findings from those studies have been inconsistent. The objectives of the current study were to systematically review the existing literature and provide a more stable estimate of the measures of association between socioeconomic status and racial disparities in survival for colon cancer by undertaking a meta‐analysis.

Effect of an Enhanced Medical Home on Serious Illness and Cost of Care Among High-Risk Children With Chronic Illness A Randomized Clinical Trial

IMPORTANCE Patient-centered medical homes have not been shown to reduce adverse outcomes or costs in adults or children with chronic illness. OBJECTIVE To assess whether an enhanced medical home providing comprehensive care prevents serious illness (death, intensive care unit [ICU] admission, or hospital stay >7 days) and/or reduces costs among children with chronic illness. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of high-risk children with chronic illness (≥3 emergency department visits, ≥2 hospitalizations, or ≥1 pediatric ICU admissions during previous year, and >50% estimated risk for hospitalization) treated at a high-risk clinic at the University of Texas, Houston, and randomized to comprehensive care (n = 105) or usual care (n = 96). Enrollment was between March 2011 and February 2013 (when predefined stopping rules for benefit were met) and outcome evaluations continued through August 31, 2013. INTERVENTIONS Comprehensive care included treatment from primary care clinicians and specialists in the same clinic with multiple features to promote prompt effective care. Usual care was provided locally in private offices or faculty-supervised clinics without modification. MAIN OUTCOMES AND MEASURES Primary outcome: children with a serious illness (death, ICU admission, or hospital stay >7 days), costs (health system perspective). Secondary outcomes: individual serious illnesses, medical services, Medicaid payments, and medical school revenues and costs. RESULTS In an intent-to-treat analysis, comprehensive care decreased both the rate of children with a serious illness (10 per 100 child-years vs 22 for usual care; rate ratio [RR], 0.45 [95% CI, 0.28-0.73]), and total hospital and clinic costs (

Effects of race and socioeconomic status on survival of 1,332 black, hispanic, and white women with breast cancer

16,523 vs

Racial disparities in colorectal cancer survival: to what extent are racial disparities explained by differences in treatment, tumor characteristics, or hospital characteristics?

26,781 per child-year, respectively; cost ratio, 0.58 [95% CI, 0.38-0.88]). In analyses of net monetary benefit, the probability that comprehensive care was cost neutral or cost saving was 97%. Comprehensive care reduced (per 100 child-years) serious illnesses (16 vs 44 for usual care; RR, 0.33 [95% CI, 0.17-0.66]), emergency department visits (90 vs 190; RR, 0.48 [95% CI, 0.34-0.67]), hospitalizations (69 vs 131; RR, 0.51 [95% CI, 0.33-0.77]), pediatric ICU admissions (9 vs 26; RR, 0.35 [95% CI, 0.18-0.70]), and number of days in a hospital (276 vs 635; RR, 0.36 [95% CI, 0.19-0.67]). Medicaid payments were reduced by

The Effects of Income Inequality and Income Level on Mortality Vary by Population Size in Texas Counties

6243 (95% CI,

Mediators of Maternal Depression and Family Structure on Child BMI: Parenting Quality and Risk Factors for Child Overweight

1302-

Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system

11,678) per child-year. Medical school losses (costs minus revenues) increased by