Adolescent Violent Delinquency Associated With Increased Emergency Department Usage in Young Adulthood

2021 ◽  
pp. 0306624X2110668
Author(s):  
Jill Portnoy ◽  
Joseph A. Schwartz
Keyword(s):  
Emergency Department ◽  
Young Adulthood ◽  
Fixed Effects ◽  
Unobserved Heterogeneity ◽  
Healthcare Providers ◽  
Adolescent Delinquency ◽  
Adult Health ◽  
Fixed Effects Models ◽  
Sibling Fixed Effects ◽  
Ed Visits

Limited research has examined the extent to which adolescent delinquency predicts healthcare usage in young adulthood, including emergency department (ED) visits. This study used data from 3,310 adolescents (52.05% female; mean age at Wave I = 16.04 years) from the sibling subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health). We examined whether adolescent delinquency at Wave I predicted ED visits at Wave III using sibling fixed effects models to adjust estimates for within-family unobserved heterogeneity. Increased violent, but not nonviolent, delinquency predicted a higher number of ED visits in early adulthood in the sibling fixed effects models. To our knowledge, this is the first study to examine the relationship between delinquency and ED usage using a sibling fixed effects design. Findings demonstrate that violent adolescent delinquency may increase healthcare usage and suggest the potential role of healthcare providers in improving outcomes for delinquent youth.

Limitations of Fixed-Effects Models for Panel Data

2019 ◽  
Vol 63 (3) ◽  
pp. 357-369 ◽  
Author(s):  
Terrence D. Hill ◽  
Andrew P. Davis ◽  
J. Micah Roos ◽  
Michael T. French
Keyword(s):  
Panel Data ◽  
Fixed Effects ◽  
Statistical Power ◽  
Unobserved Heterogeneity ◽  
Critical Discussion ◽  
Causal Inferences ◽  
Cross Sectional ◽  
Fixed Effects Models ◽  
Time Invariance ◽  
Type Ii Errors

Although fixed-effects models for panel data are now widely recognized as powerful tools for longitudinal data analysis, the limitations of these models are not well known. We provide a critical discussion of 12 limitations, including a culture of omission, low statistical power, limited external validity, restricted time periods, measurement error, time invariance, undefined variables, unobserved heterogeneity, erroneous causal inferences, imprecise interpretations of coefficients, imprudent comparisons with cross-sectional models, and questionable contributions vis-à-vis previous work. Instead of discouraging the use of fixed-effects models, we encourage more critical applications of this rigorous and promising methodology. The most important deficiencies—Type II errors, biased coefficients and imprecise standard errors, misleading p values, misguided causal claims, and various theoretical concerns—should be weighed against the likely presence of unobserved heterogeneity in other regression models. Ultimately, we must do a better job of communicating the pitfalls of fixed-effects models to our colleagues and students.

scholarly journals Inpatient and emergency department costs from sports injuries among youth aged 5–18 years

2019 ◽  
Vol 5 (1) ◽  
pp. e000491 ◽  
Author(s):  
Jessica L Ryan ◽  
Etienne E Pracht ◽  
Barbara Langland Orban
Keyword(s):  
Emergency Department ◽  
Fixed Effects ◽  
Sports Injuries ◽  
Health Care Administration ◽  
Sports Injury ◽  
American Football ◽  
Contact Sport ◽  
Older Athletes ◽  
Prevention Programmes ◽  
Ed Visits

ObjectiveTo analyse the financial costs from sports injuries among inpatients and emergency department (ED) patients aged 5–18 with a focus on Medicaid patients.MethodsFixed-effects linear regression was used to assess the association of patient factors with cost of injury from sports. Florida Agency for Health Care Administration data from 2010 to 2014 were used, which included all inpatient and ED patients aged 5–18 years who had a sports injury.ResultsOver 5 years, sports injuries in Florida youth cost $24 million for inpatient care and $87 million for ED care. Youth averaged $6039 for an inpatient visit and $439 for an ED visit in costs from sports injuries. Sports injuries for Medicaid-insured youth cost $10.8 million for inpatient visits and $44.2 million for ED visits.ConclusionOlder athletes and males consistently have higher healthcare costs from sports. Baseball, basketball, bike riding, American football, roller-skating/skateboarding and soccer are sports with high costs for both ED patients and inpatients and would benefit from prevention programmes. Injuries from non-contact sport participants are few but can have high costs. These athletes could benefit from prevention programmes as well.

Estimating the influence of adolescent delinquent behavior on adult health using sibling fixed effects

2020 ◽  
Vol 265 ◽  
pp. 113397
Author(s):  
Jinho Kim ◽  
Rockli Kim ◽  
Hannah Oh ◽  
Adam M. Lippert ◽  
S.V. Subramanian
Keyword(s):  
Fixed Effects ◽  
Delinquent Behavior ◽  
Adult Health ◽  
Sibling Fixed Effects

scholarly journals Younger Dual-Eligibles Who Use Federally Qualified Health Centers Have More Preventable Emergency Department Visits, but Some Have Fewer Hospitalizations

2016 ◽  
Vol 8 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Andrew J. Potter ◽  
Amal N. Trivedi ◽  
Brad Wright
Keyword(s):  
Emergency Department ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Care Service ◽  
Emergency Department Visits ◽  
Health Centers ◽  
Fee For Service ◽  
Federally Qualified Health Centers ◽  
Dual Eligibles ◽  
Ed Visits

Objective: To determine whether younger dual-eligibles receiving care at federally qualified health centers (FQHCs) have lower rates of ambulatory care sensitive (ACS) hospitalization and emergency department (ED) visits. Data Sources: We used the 100% Medicare Part A and Part B institutional claims from 2007 to 2010 for dual-eligibles younger than 65 years, enrolled in traditional fee-for-service Medicare, who received care at an FQHC or lived in a primary care service area with an FQHC. Methods: Our cross-sectional analysis used negative binomial regressions to model ACS hospitalizations and ED visits as a function of prior year FQHC use. The model adjusted for beneficiary age, gender, race, and chronic diseases, as well as county fixed effects, time trends, and race-FQHC use interactions. Results: FQHC use is associated with a decrease in ACS hospitalization rates for whites (2.8 per 1000 persons), but an increase among blacks (2.5 per 1000 persons). FQHC use is also associated with an increase in ACS ED visits, from 27 to 33 more visits per 1000 persons per year, depending on patient race. Conclusions: ACS hospital use is higher for FQHC users than nonusers, but white FQHC users have fewer ACS hospitalizations. More research is needed to understand how this relationship varies within and between centers.

scholarly journals The Normativity of Marriage and the Marriage Premium for Children’s Outcomes

2021 ◽  
Author(s):  
Florencia Torche ◽  
Alejandra Abufhele
Keyword(s):  
Fixed Effects ◽  
Infant Health ◽  
Marital Fertility ◽  
Multilevel Models ◽  
Contextual Effects ◽  
Weak Effect ◽  
Marriage Premium ◽  
Fixed Effects Models ◽  
Sibling Fixed Effects ◽  
Positive Effect

Children born to married parents have better health, behavioral, educational, and economic outcomes than children of unmarried mothers. This association, known as the "marriage premium," has been interpreted as emerging from the selectivity of parents who marry and from a positive effect of marriage. The authors suggest that the positive effect of marriage could be contextual, emerging from the normativity of marriage in society. They test this hypothesis using the case of Chile, where marital fertility dropped sharply from 66% of all births in 1990 to 27% in 2016. The authors find that the benefit of marriage for infant health was large in the early 1990s but declined as marital fertility became less normative in society, to fully disappear in 2016. Multivariate analysis of temporal variation, multilevel models of variation across place, sibling ?fixed effects models, and a falsification test consistently indicate that marriage has a beneficial effect when marital fertility is normative and a weak effect when is not. Generalizing from this case, the authors discuss contextual effects of diverse practices and statuses.

scholarly journals A General Panel Model for Unobserved Time Heterogeneity with Application to the Politics of Mass Incarceration

2021 ◽  
pp. 008117502110160
Author(s):  
Scott W. Duxbury
Keyword(s):  
Fixed Effects ◽  
Unobserved Heterogeneity ◽  
Panel Data Analysis ◽  
Time Varying ◽  
Cross Sectional ◽  
Common Trends ◽  
Varying Coefficients ◽  
Panel Model ◽  
Fixed Effects Models ◽  
Time Varying Coefficients

Panel data analysis is common in the social sciences. Fixed effects models are a favorite among sociologists because they control for unobserved heterogeneity (unexplained variation) among cross-sectional units, but estimates are biased when there is unobserved heterogeneity in the underlying time trends. Two-way fixed effects models adjust for unobserved time heterogeneity but are inefficient, cannot include unit-invariant variables, and eliminate common trends: the portion of variance in a time-varying variable that is invariant across cross-sectional units. This article introduces a general panel model that can include unit-invariant variables, corrects for unobserved time heterogeneity, and provides the effect of common trends while also allowing for unobserved unit heterogeneity, time-varying coefficients, and time-invariant variables. One-way and two-way fixed effects models are shown to be restrictive forms of this general model. Other restrictive forms are also derived that offer all the usual advantages of one-way and two-way fixed effects models but account for unobserved time heterogeneity. The author uses the models to examine the increase in state incarceration rates between 1970 and 2015.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

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