Determinants of states' allocations of the master settlement agreement payments

To determine which factors influence states' allocation decisions for the tobacco Master Settlement Agreement and the four individual settlements' annual payments, including the decision to securitize, we analyzed the effects of voter characteristics, political parties, interest groups, prior spending on public tobacco control programs, and state fiscal health on per capita settlement funds allocated to tobacco-control, health, and other programs. Tobacco-producing states and those with high proportions of conservative Democrats or elderly, black, Hispanic, or wealthy people tended to spend less on tobacco control. Education and medical lobbies had strong positive influences on per capita allocations for tobacco-control and health-related programs. State fiscal crises affected amounts spent by states from settlement funds as well as the probability of securitizing future cash flows from the settlements.     

Variations in appointment delays for physicians' services: Theory and empirical evidence

Waiting times for physician appointments have been used in past studies as a measure of access to, or excess demand pressure on, local ambulatory care systems. This paper offers an alternative view—that short appointment delays are one of several types of amenities produced by physicians in combination with health services. Empirical evidence is presented that illuminates some previously unknown relationships between appointment delays, patient diagnosis, site of care, and family income. A model is developed with the capability of predicting short-run responses to changes in demand for physicians' services. The model and empirical evidence are used as the basis for interpreting recent experience in Canada with its system of national health insurance (NHI) and for predicting potential consequences regarding the production of amenities of NHI in the US.This research has been supported in part by a grant (HS—00825) from the Center for Health Services Research, US Department of Health, Education, and Welfare, to the University of Florida. We are indebted to John B. Wayne and to Paula Sloan for their assistance and to University of Florida colleague Gary Shannon for comments on an earlier draft.     

Perceptions of jury duty: Satisfaction and overall impression

A jury service exit questionnaire that was designed to measure satisfaction with and overall impression of jury duty was administered to a saturation sample of 2,947 respondents by court clerks serving District or Circuit courts in nine counties in southeastern Michigan. For those sworn to jury duty, global satisfaction with the jury experience is found to be influenced by perceptions of trial characteristics and by the extent of participation in the jury system. The significant predictors of overall impression with the jury system are respondent age, being elected jury foreman, and deliberating a criminal rather than civil case. An earlier draft of this paper was presented at the 1985 Meetings of the North Central Sociological Association. This research was funded in part by the Michigan State Supreme Court. We acknowledge the contributions made to this paper by members of the Sorrento Seminar and by anonymous reviewers. Patrick C. Easto provided the inspiration for writing the first as well as the final draft of this paper.     

Can We Feel Their Presence? A New Framework for Investigating Minor Parties in English Local Government

Minor parties in English local government have largely been neglected by the research literature because of their lack of electoral success at the aggregate level. However, over the past decade minor party candidates have contested an increasing number of wards and this rise is disproportionate to their share of the vote. Developing the concept of ‘presence’ and a focus on wards rather than seats we use newly reworked data from the Elections Centre Database (University of Plymouth) to plot the proportion of wards contested by minor party candidates from 1973–2008. We argue that whilst changes in vote share are minimal throughout the period, the magnitude of the recent increase in minor party activity at the ward level is unprecedented and justifies further study. We also explore the variation in minor party activity between authority types, concluding that the explanation for the recent rise in contestation is not constant across similar authorities and electoral systems. We suggest that the explanation for minor party activity is much more complex and relative.     

Is there a rationale for regionalizing organ transplantation services?

This paper explores issues in the designation of centers to provide organ transplantation procedures and aftercare, a decision faced increasingly by policymakers, planners, and payers. As background for consideration of the regionalization of organ transplantation services, an array of models of regionalization of health services, ranging from full-scale vertical integration to market-enhancing information provision, is described. In the United States, regionalization has mainly followed the designation model within the certificate-of-need system; vertical integration has been adopted only in limited ways. Next, the authors' review of current approaches to the regionalization of organ transplantation centers by public and private payers indicates that designation of centers is increasing, although the empirical evidence concerning the classes of hospitals upon which designation decisions rest is weak. The authors then review the literature on the relationship between volumes and outcomes on surgical services with particular reference to organ transplantation, which on the whole suggests that a relationship between volumes and outcomes exists. Original empirical analysis of data on kidney transplants that were secured from the Health Care Financing Administration is then presented. The study of the effects of hospital and surgeon volumes on graft and patient survival and of the effect of volume on charges found no systematic influence of hospital or surgeon volumes on graft or patient survival. Some evidence that charges are lower for larger centers was found. The authors conclude that the evidence implies that using volume as the provider characteristic upon which to base designation of transplantation centers is problematic, at least for kidney transplants. Steps policymakers might take to ensure quality of transplantation services is discussed in the final section.