scholarly journals Social Support Substitution and the Earnings Rebound: Evidence from a Regression Discontinuity in Disability Insurance Reform

2014 ◽  
Vol 6 (4) ◽  
pp. 34-70 ◽  
Author(s):  
Lex Borghans ◽  
Anne C. Gielen ◽  
Erzo F. P. Luttmer
Keyword(s):  
Social Support ◽  
Strong Evidence ◽  
Regression Discontinuity ◽  
Social Assistance ◽  
Disability Insurance ◽  
Substitution Effect ◽  
Assistance Programs ◽  
Insurance Reform ◽  
Over Time

We exploit a cohort discontinuity in the stringency of Dutch disability reforms to estimate the effects of decreased DI (disability insurance) generosity on behavior of existing recipients. We find evidence of social support substitution: individuals on average offset €1.00 of lost DI benefits by collecting €0.30 more from other social assistance programs, but this benefit-substitution effect declines over time. Individuals also exhibit a rebound in earnings: earnings increase by € 0.62 on average per euro of lost DI benefits and this effect remains roughly constant over time. This is strong evidence of substantial remaining earnings capacity among long-term claimants of DI. (JEL I38, J14, J22, J28, J31)

scholarly journals Moral Hazard and Claims Deterrence in Private Disability Insurance

2014 ◽  
Vol 6 (4) ◽  
pp. 110-141 ◽  
Author(s):  
David Autor ◽  
Mark Duggan ◽  
Jonathan Gruber
Keyword(s):  
Moral Hazard ◽  
Empirical Analysis ◽  
Time Variation ◽  
Rate Increase ◽  
Disability Insurance ◽  
Severe Disabilities ◽  
Replacement Rate ◽  
Waiting Period ◽  
Over Time

Exploiting within-firm, over-time variation in plan parameters for nearly 10,000 Long Term Disability (LTD) policies held by US employers, we present the first empirical analysis of the determinants of private LTD spells. We find that a shorter waiting period and a higher replacement rate increase the incidence of LTD spells. Sixty percent of the latter effect is due to the mechanical censoring of shorter spells, with the remainder due to the deterrence of spells that would have continued beyond the waiting period. Deterrence is driven primarily by a reduction in the incidence of shorter duration spells and less severe disabilities. (JEL D82, G22, J28, J32)

scholarly journals Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

2020 ◽  
Vol 32 (7) ◽  
pp. 849-861
Author(s):  
Darina V. Petrovsky ◽  
Karen B. Hirschman ◽  
Miranda Varrasse McPhillips ◽  
Justine S. Sefcik ◽  
Alexandra L. Hanlon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Daytime Sleepiness ◽  
Daily Living ◽  
Services And Supports ◽  
Over Time

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

scholarly journals Quality of Life Among Long-Term Survivors of Non-Hodgkin Lymphoma: A Follow-Up Study

2013 ◽  
Vol 31 (2) ◽  
pp. 272-279 ◽  
Author(s):  
Sophia K. Smith ◽  
Deborah K. Mayer ◽  
Sheryl Zimmerman ◽  
Christianna S. Williams ◽  
Habtamu Benecha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Hodgkin Lymphoma ◽  
Symptom Burden ◽  
Non Hodgkin Lymphoma ◽  
The Impact ◽  
Long Term Survivors ◽  
Over Time

Purpose Little is known about change in quality of life (QOL) among long-term cancer survivors. We examined change over time in QOL among long-term survivors of non-Hodgkin lymphoma and identified demographic, clinical, and psychosocial risk factors for poor outcomes. Methods Surveys were mailed to 682 lymphoma survivors who participated in a study 5 years earlier, when on average they were 10.4 years postdiagnosis. Standardized measures of QOL, perceptions of the impact of cancer, symptoms, medical history, and demographic variables were reported at both time points and examined using linear regression modeling to identify predictors of QOL over time. Results A total of 566 individuals participated (83% response rate) who were a mean of 15.3 years postdiagnosis; 52% were women, and 87% were white. One third of participants (32%) reported persistently high or improved QOL, yet a notable proportion (42%) reported persistently low or worsening QOL since the earlier survey. Participants who received only biologic systemic therapy reported improvement in physical health despite the passage of time. Older age, more comorbidity, and more or increasing negative and decreasing positive perceptions of cancer's impact were independent predictors of poor QOL. Lymphoma symptom burden, less social support, and having received a transplantation were related to negative perceptions of cancer's impact. Conclusion Moderate to severe symptom burden, limited social support, or having received a transplantation should alert the clinician to potential need for supportive services. Perceptions of cancer's impact are associated with QOL cross-sectionally and longitudinally; modifying these perceptions may thus provide a strategy for improving QOL.

Trends in the informal and formal home-care use of older adults in the Netherlands between 1992 and 2012

2015 ◽  
Vol 36 (9) ◽  
pp. 1870-1890 ◽  
Author(s):  
JOUKJE C. SWINKELS ◽  
BIANCA SUANET ◽  
DORLY J. H. DEEG ◽  
MARJOLEIN I. BROESE VAN GROENOU
Keyword(s):  
Logistic Regression ◽  
Home Care ◽  
Informal Care ◽  
Long Term Care ◽  
Substitution Effect ◽  
Large Decrease ◽  
Term Care ◽  
Multi Level ◽  
Over Time

ABSTRACTThis study investigates trends in, and the interdependence of, the use of informal and formal home care of community-dwelling older people over the last two decades in the context of governmental reform of long-term care services and modernisation of informal relationships. Seven observations of the Longitudinal Aging Study Amsterdam covering the time span between 1992 and 2012 were analysed using multi-level logistic regression analysis. The sample entailed 9,585 observations from 3,574 respondents, aged between 65 and 85 years and living independently at each time of measurement. Measures included formal and informal care use, health, physical and cognitive limitations, socio-demographics, partner status, social network, privately paid help and sense of mastery. Results showed that between 1992 and 2012, formal home-care use increased slightly while there was a large decrease in the use of informal care. Multivariate multi-level logistic regression analyses showed a substitution effect between formal and informal care use which decreased over time. Analyses also showed improved cognitive functioning, increased partner availability and social network size, as well as increased use of privately paid care over time. Nevertheless, these positive trends did not explain the large decrease in informal care use. The results regarding informal care use suggest a societal trend of weakened informal solidarity, reflecting increased individualisation and increased availability of formal home care. The decreased substitution effect suggests that, in agreement with current reforms of long-term care, complementary or supplementary forms of care use may be more common in the near future.

Smoking Abstinence Twelve Months after an Acute Coronary Syndrome

2017 ◽  
Vol 20 ◽  
Author(s):  
Vânia Rocha ◽  
Marina P. Guerra ◽  
Marina S. Lemos ◽  
Júlia Maciel ◽  
Geoffrey C. Williams
Keyword(s):  
Social Support ◽  
Smoking Cessation ◽  
Acute Coronary Syndrome ◽  
Depressive Symptoms ◽  
Nicotine Dependence ◽  
Meaning In Life ◽  
Perceived Competence ◽  
Coronary Syndrome ◽  
Over Time

AbstractStudies on the cognitive working mechanism of smoking cessation in high-risk populations are few and much needed, and identifying long-term psychosocial factors to smoking cessation are relevant to improve intervention for cardiac patient groups. This longitudinal study followed patients who smoked and suffered an acute coronary syndrome from hospitalization to 12 months after clinical discharge. Questionnaires were administered to assess nicotine dependence, behavioral dependence, autonomous self-regulation, perceived competence, social support, anxiety, depressive symptoms and meaning in life at baseline, six months and twelve months after clinical discharge. The results showed that anxiety (F(2, 62) = 28.10, p < .001, ηp2 = .48) and depressive symptoms (F(2, 62) = 10.42, p < .001, ηp2 = .25) decreased over time, whereas meaning in life (F(2, 61) = 44.77, p < .001, ηp2 = .59) and social support increased (t(63) = –4.54, p < .001, 95% IC[–11.05, 4.29], η2 =.25). Smoking dependence was negatively predicted by change in perceived competence (B = –2.25, p = .011, 95% IC[.02, .60]) and positively by change in depressive symptoms (B =.37, p = .042, 95% IC[1.01, 2.05]) 12 months after clinical discharge. Nicotine dependence (t(17) = 2.76, p = .014, 95% IC[.39, 2.94], η2 =.31) and the number of cigarettes smoked per day (t(17) = 4.48, p < .001, 95% IC[5.49, 15.29], η2 =.54) decreased over time, whereas behavioral dependence increased among smokers (t(17) = –2.37, p = .030, 95% IC[–4.30, 2.54], η2 =.25). This study suggests that long term abstinence in cardiac patients may be enhanced by psychological interventions addressing perceived competence, depressive symptoms and behavioral dependence.

Long-Term Consequences of Election Results

2015 ◽  
Vol 47 (2) ◽  
pp. 351-372 ◽  
Author(s):  
Anthony Fowler ◽  
Andrew B. Hall
Keyword(s):  
Regression Discontinuity ◽  
State Legislatures ◽  
Regression Discontinuity Design ◽  
Roll Call ◽  
The Us ◽  
Long Term Consequences ◽  
Election Results ◽  
Us Senate ◽  
Over Time

Voters in US elections receive markedly different representation depending on which candidate they elect, and because of incumbent advantages, the effects of this choice persist for many years. What are the long-term consequences of these two phenomena? Combining electoral and legislative roll-call data in a dynamic regression discontinuity design, this study assesses the long-term consequences of election results for representation. Across the US House, the US Senate and state legislatures, the effects of ‘coin-flip’ elections persist for at least a decade in all settings, and for as long as three decades in some. Further results suggest that elected officials do not adapt their roll-call voting to their districts’ preferences over time, and that voters do not systematically respond by replacing incumbents.

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