Paul Heaton

Information Technology, Organization, and Productivity in the Public Sector: Evidence from Police Departments

We examine the relationship between information technology (IT), productivity, and organization using a new panel data set of police departments that covers 1987–2003. When considered alone, increases in IT are not associated with reductions in crime rates, increases in clearance rates, or other productivity measures, and computing technology that increases reported crime actually generates the appearance of lower productivity. These results persist across various samples, specifications, and IT measures. IT investments are, however, linked to improved productivity when they are complemented with particular organizational and management practices, such as those associated with the Compstat program.

Unraveling the IT Productivity Paradox — Lessons for Health Care

Debate is ongoing about the wisdom of the

Measuring Crack Cocaine and Its Impact

27 billion federal investment driving the adoption of health information technology (IT). Debate about ITs productivity yield echoes earlier debates from other sectors of the economy, which carry important lessons.

The effects of medical marijuana laws on potency.

Numerous social indicators turned negative for Blacks in the 1980s and rebounded a decade later. We explore whether crack cocaine explains these patterns. Absent a direct measure, we construct a crack prevalence index using multiple proxies. Our index reproduces spatial and temporal patterns described in ethnographic accounts of the crack epidemic. It explains much of the 1980s rise in Black youth homicide and more moderate increases in adverse birth outcomes. Although our index remains high through the 1990s, cracks deleterious social impact fades. Changes over time in behavior, crack markets, and the user population may have mitigated cracks damaging impacts.

Does Religion Really Reduce Crime

BACKGROUND Marijuana potency has risen dramatically over the past two decades. In the United States, it is unclear whether state medical marijuana policies have contributed to this increase. METHODS Employing a differences-in-differences model within a mediation framework, we analyzed data on n=39,157 marijuana samples seized by law enforcement in 51 U.S. jurisdictions between 1990 and 2010, producing estimates of the direct and indirect effects of state medical marijuana laws on potency, as measured by Δ(9)-tetrahydrocannabinol content. RESULTS We found evidence that potency increased by a half percentage point on average after legalization of medical marijuana, although this result was not significant. When we examined specific medical marijuana supply provisions, results suggest that legal allowances for retail dispensaries had the strongest influence, significantly increasing potency by about one percentage point on average. Our mediation analyses examining the mechanisms through which medical marijuana laws influence potency found no evidence of direct regulatory impact. Rather, the results suggest that the impact of these laws occurs predominantly through a compositional shift in the share of the market captured by high-potency sinsemilla. CONCLUSION Our findings have important implications for policymakers and those in the scientific community trying to understand the extent to which greater availability of higher potency marijuana increases the risk of negative public health outcomes, such as drugged driving and drug-induced psychoses. Future work should reconsider the impact of medical marijuana laws on health outcomes in light of dramatic and ongoing shifts in both marijuana potency and the medical marijuana policy environment.

Efficacy of frequent monitoring with swift, certain, and modest sanctions for violations: insights from South Dakota's 24/7 sobriety project

Considerable research in sociology, criminology, and economics aims to understand the effect of religiosity on crime. Many sociological theories positing a deterrent effect of religion on crime are empirically examined using ordinary least squares (OLS) cross‐sectional regressions of crime measures on measures of religiosity. Most previous studies have found a negative effect of religion on crime using OLS, a result I am able to replicate using county‐level data on religious membership and crime rates. If crime affects religious participation, however, OLS coefficients in this context suffer from endogeneity bias. Using historic religiosity as an instrument for current religious participation, I find a negligible effect of religion on crime and a negative effect of crime on religion. To further explore the relationship between religion and crime, I examine variation in crime incidence before and after Easter. Consistent with the instrumental variables results, I find no evidence of a decrease in crime following Easter.

The Effect of Malpractice Reform on Emergency Department Care

OBJECTIVES We examined the public health impact of South Dakotas 24/7 Sobriety Project, an innovative program requiring individuals arrested for or convicted of alcohol-involved offenses to submit to breathalyzer tests twice per day or wear a continuous alcohol monitoring bracelet. Those testing positive are subject to swift, certain, and modest sanctions. METHODS We conducted differences-in-differences analyses comparing changes in arrests for driving while under the influence of alcohol (DUI), arrests for domestic violence, and traffic crashes in counties to the program with counties without the program. RESULTS Between 2005 and 2010, more than 17,000 residents of South Dakota-including more than 10% of men aged 18 to 40 years in some counties-had participated in the 24/7 program. At the county level, we documented a 12% reduction in repeat DUI arrests (P = .023) and a 9% reduction in domestic violence arrests (P = .035) following adoption of the program. Evidence for traffic crashes was mixed. CONCLUSIONS In community supervision settings, frequent alcohol testing with swift, certain, and modest sanctions for violations can reduce problem drinking and improve public health outcomes.

How Much Difference Does the Lawyer Make? The Effect of Defense Counsel on Murder Case Outcomes

BACKGROUND Many believe that fear of malpractice lawsuits drives physicians to order otherwise unnecessary care and that legal reforms could reduce such wasteful spending. Emergency physicians practice in an information-poor, resource-rich environment that may lend itself to costly defensive practice. Three states, Texas (in 2003), Georgia (in 2005), and South Carolina (in 2005), enacted legislation that changed the malpractice standard for emergency care to gross negligence. We investigated whether these substantial reforms changed practice. METHODS Using a 5% random sample of Medicare fee-for-service beneficiaries, we identified all emergency department visits to hospitals in the three reform states and in neighboring (control) states from 1997 through 2011. Using a quasi-experimental design, we compared patient-level outcomes, before and after legislation, in reform states and control states. We controlled for characteristics of the patients, time-invariant hospital characteristics, and temporal trends. Outcomes were policy-attributable changes in the use of computed tomography (CT) or magnetic resonance imaging (MRI), per-visit emergency department charges, and the rate of hospital admissions. RESULTS For eight of the nine state-outcome combinations tested, no policy-attributable reduction in the intensity of care was detected. We found no reduction in the rates of CT or MRI utilization or hospital admission in any of the three reform states and no reduction in charges in Texas or South Carolina. In Georgia, reform was associated with a 3.6% reduction (95% confidence interval, 0.9 to 6.2) in per-visit emergency department charges. CONCLUSIONS Legislation that substantially changed the malpractice standard for emergency physicians in three states had little effect on the intensity of practice, as measured by imaging rates, average charges, or hospital admission rates. (Funded by the Veterans Affairs Office of Academic Affiliations and others.).

Cash Incentives and Military Enlistment, Attrition, and Reenlistment

One in five indigent murder defendants in Philadelphia are randomly assigned representation by public defenders while the remainder receive court-appointed private attorneys. We exploit this random assignment to measure how defense counsel affect murder case outcomes. Compared to appointed counsel, public defenders in Philadelphia reduce their clients’ murder conviction rate by 19% and lower the probability that their clients receive a life sentence by 62%. Public defenders reduce overall expected time served in prison by 24%. We find no difference in the overall number of charges of which defendants are found guilty. When we apply methods used in past studies of the effect of counsel that did not use random assignment, we obtain far more modest estimated impacts, which suggests defendant sorting is an important confounder affecting past research. To understand possible explanations for the disparity in outcomes, we interviewed judges, public defenders, and attorneys who took appointments. Interviewees identified a variety of institutional factors in Philadelphia that decreased the likelihood that appointed counsel would prepare cases as well as the public defenders. The vast difference in outcomes for defendants assigned different counsel types raises important questions about the adequacy and fairness of the criminal justice system.

Understanding the Effects of Antiprofiling Policies

Abstract : Between FY 2000 and FY 2008, the real Department of Defense (DoD) budget for enlistment and reenlistment bonuses increased substantially, from