scholarly journals Causal Effect of Honorary Titles on Physicians’ Service Volumes in Online Health Communities: Retrospective Study

10.2196/18527 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e18527
Author(s):  
Haiyan Yu ◽  
Yali Wang ◽  
Jying-Nan Wang ◽  
Ya-Ling Chiu ◽  
Hang Qiu ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Causal Effect ◽  
Home Page ◽  
Differential Treatment ◽  
Control Group ◽  
Data Set ◽  
Incentive Policy ◽  
Before And After ◽  
Health Communities ◽  
The Impact

Background An OHC online health community (OHC) is an interactive platform for virtual communication between patients and physicians. Patients can typically search, seek, and share their experience and rate physicians, who may be involved in giving advice. Some OHC providers provide incentives in form of honorary titles to encourage the web-based involvement of physicians, but it is unclear whether the award of honorary titles has an impact on their consultation volume in an OHC. Objective This study is designed to identify the differential treatment effect of the incentive policy on the service volumes for the subgroups of treatment and control in an OHC. This study aims to answer the following questions: Does an honorary title for physicians impact their service volumes in an OHC? During the period of discontinuity, can we identify the sharp effect of the incentive award on the outcomes of physicians’ service volumes? Methods We acquired the targeted samples based on treatment, namely, physicians with an honorary title or not and outcomes measured before and after the award of the 2 subgroups. A regression discontinuity design was applied to investigate the impact of the honorary titles incentive as a treatment in an OHC. There was a sharply discontinuous effect of treatment on physicians’ online health service performance. The experimental data set consisted of 346 physicians in the treatment group (with honorary titles). Applying the propensity score matching method, the same size of physicians (n=346) was matched and selected as the control group. Results A sharp discontinuity was found at the time of the physician receiving the honorary title. The results showed that the parametric estimates of the coefficient were significantly positively (P<.001) associated with monthly home page views. The jump in the monthly volumes of home page views was much sharper than that of the monthly consultations. Conclusions The changes in the volumes of monthly consultations and home page views reflect the differential treatment effect of honorary titles on physicians’ service volumes. The effect of the incentive policy with honorary titles is objectively estimated from both the perspective of online and offline medical services in an OHC. Being named with honorary titles significantly multiplied monthly home page views, yet it did not significantly impact monthly consultations. This may be because consultation capacity is limited by the physician's schedule for consultations.

scholarly journals Causal Effect of Honorary Titles on Physicians’ Service Volumes in Online Health Communities: Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Haiyan Yu ◽  
Yali Wang ◽  
Jying-Nan Wang ◽  
Ya-Ling Chiu ◽  
Hang Qiu ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Causal Effect ◽  
Home Page ◽  
Differential Treatment ◽  
Control Group ◽  
Data Set ◽  
Incentive Policy ◽  
Before And After ◽  
Health Communities ◽  
The Impact

BACKGROUND An OHC online health community (OHC) is an interactive platform for virtual communication between patients and physicians. Patients can typically search, seek, and share their experience and rate physicians, who may be involved in giving advice. Some OHC providers provide incentives in form of honorary titles to encourage the web-based involvement of physicians, but it is unclear whether the award of honorary titles has an impact on their consultation volume in an OHC. OBJECTIVE This study is designed to identify the differential treatment effect of the incentive policy on the service volumes for the subgroups of treatment and control in an OHC. This study aims to answer the following questions: Does an honorary title for physicians impact their service volumes in an OHC? During the period of discontinuity, can we identify the sharp effect of the incentive award on the outcomes of physicians’ service volumes? METHODS We acquired the targeted samples based on treatment, namely, physicians with an honorary title or not and outcomes measured before and after the award of the 2 subgroups. A regression discontinuity design was applied to investigate the impact of the honorary titles incentive as a treatment in an OHC. There was a sharply discontinuous effect of treatment on physicians’ online health service performance. The experimental data set consisted of 346 physicians in the treatment group (with honorary titles). Applying the propensity score matching method, the same size of physicians (n=346) was matched and selected as the control group. RESULTS A sharp discontinuity was found at the time of the physician receiving the honorary title. The results showed that the parametric estimates of the coefficient were significantly positively (<i>P</i>&lt;.001) associated with monthly home page views. The jump in the monthly volumes of home page views was much sharper than that of the monthly consultations. CONCLUSIONS The changes in the volumes of monthly consultations and home page views reflect the differential treatment effect of honorary titles on physicians’ service volumes. The effect of the incentive policy with honorary titles is objectively estimated from both the perspective of online and offline medical services in an OHC. Being named with honorary titles significantly multiplied monthly home page views, yet it did not significantly impact monthly consultations. This may be because consultation capacity is limited by the physician's schedule for consultations.

scholarly journals Associations Between In-Hospital Mortality, Health Care Utilization, and Inpatient Costs With the 2011 Resident Duty Hour Revision

2019 ◽  
Vol 11 (2) ◽  
pp. 146-155 ◽  
Author(s):  
Shaker M. Eid ◽  
Lucia Ponor ◽  
Darcy A. Reed ◽  
May A. Beydoun ◽  
Hind A. Beydoun ◽  
...  
Keyword(s):  
Improve Patient Safety ◽  
National Level ◽  
Interrupted Time Series ◽  
Teaching Hospitals ◽  
Care Utilization ◽  
Control Group ◽  
Data Set ◽  
Before And After ◽  
Nationally Representative ◽  
The Impact

ABSTRACT Background  The Accreditation Council for Graduate Medical Education (ACGME) has mandated revisions to residents' work hours to improve patient safety and enhance resident education and wellness. The impact on clinical outcomes on a national level is poorly understood. Objective  We examined data from before and after the ACGME 2011 duty hour revision and looked for differences between teaching and nonteaching US hospitals. Methods  A retrospective observational study of patients admitted to hospitals in the 2-year periods before and after the 2011 duty hour revision was conducted, utilizing a nationally representative data set. We compared patient and hospital characteristics using standardized differences. With nonteaching hospitals serving as the control group, we used multiple group interrupted time series segmented regression analysis to test for postrevision level and trend changes in mortality, length of stay (LOS), and costs. Results  We examined more than 117 million hospitalizations. At teaching and nonteaching hospitals, trends in mortality and LOS in prerevision and postrevision periods were not significantly different (all P &gt; .05). A significant monthly reduction in cost per hospitalization was noted postrevision at teaching hospitals (P = .019) but not at nonteaching hospitals (P = .62). In the 2 years following the 2011 revision, there was a monthly reduction in cost per hospitalization (–$52.28; 95% confidence interval –$116.90 to –$12.32; P = .026) at teaching relative to nonteaching hospitals. Conclusions  There were no differences in mortality or LOS between teaching and nonteaching hospitals. However, there was a small decrease in cost per hospitalization at teaching hospitals following the 2011 revision.

The impact of a music education program on meta-musical awareness, logical-mathematical, and notational skills in preschoolers

2021 ◽  
pp. 025576142110272
Author(s):  
Oriana Incognito ◽  
Laura Scaccioni ◽  
Giuliana Pinto
Keyword(s):  
Music Education ◽  
Education Program ◽  
Cognitive Abilities ◽  
Musical Training ◽  
Control Group ◽  
Transfer Of Knowledge ◽  
General Domain ◽  
Music Program ◽  
Before And After ◽  
The Impact

A number of studies suggest a link between musical training and both specific and general cognitive abilities, but despite some positive results, there is disagreement about which abilities are improved. This study aims to investigate the effects of a music education program both on a domain-specific competence (meta-musical awareness), and on general domain competences, that is, cognitive abilities (logical-mathematical) and symbolic-linguistic abilities (notational). Twenty 4- to 6-year-old children participated in the research, divided into two groups (experimental and control) and the measures were administered at two different times, before and after a 6-month music program (for the experimental group) and after a sports training program (for the control group). Children performed meta-musical awareness tasks, logical-mathematical tasks, and emergent-alphabetization tasks. Non-parametric statistics show that a music program significantly improves the development of notational skills and meta-musical awareness while not the development of logical-mathematical skills. These results show that a musical program increases children’s meta-musical awareness, and their ability to acquire the notational ability involved in the invented writing of words and numbers. On the contrary, it does not affect the development of logical skills. The results are discussed in terms of transfer of knowledge processes and of specific versus general domain effects of a musical program.

Eviction and Voter Turnout: The Political Consequences of Housing Instability

2021 ◽  
pp. 003232922110507
Author(s):  
Gillian Slee ◽  
Matthew Desmond
Keyword(s):  
Voter Turnout ◽  
Causal Effect ◽  
Additive Model ◽  
The United States ◽  
Data Set ◽  
Endogeneity Bias ◽  
Political Consequences ◽  
Housing Costs ◽  
Election Results ◽  
The Impact

In recent years, housing costs have outpaced incomes in the United States, resulting in millions of eviction filings each year. Yet no study has examined the link between eviction and voting. Drawing on a novel data set that combines tens of millions of eviction and voting records, this article finds that residential eviction rates negatively impacted voter turnout during the 2016 presidential election. Results from a generalized additive model show eviction’s effect on voter turnout to be strongest in neighborhoods with relatively low rates of displacement. To address endogeneity bias and estimate the causal effect of eviction on voting, the analysis treats commercial evictions as an instrument for residential evictions, finding that increases in neighborhood eviction rates led to substantial declines in voter turnout. This study demonstrates that the impact of eviction reverberates far beyond housing loss, affecting democratic participation.

scholarly journals The Use of Procalcitonin as a Sepsis Marker in a Community Hospital

2019 ◽  
Vol 3 (4) ◽  
pp. 545-552
Author(s):  
Nathalia De Oro ◽  
Maria E Gauthreaux ◽  
Julie Lamoureux ◽  
Joseph Scott
Keyword(s):  
Lactic Acid ◽  
Length Of Stay ◽  
Community Hospital ◽  
Unit Length ◽  
Hospital Setting ◽  
Control Group ◽  
Before And After ◽  
Quasi Experimental ◽  
Current Cutoff ◽  
The Impact

Abstract Background Procalcitonin (PCT) is a biomarker that shows good sensitivity and specificity in identifying septic patients. Methods This study investigated the diagnostic accuracy of PCT in a community hospital setting and how it compared to that of lactic acid. It explored the impact on patient care before and after PCT implementation regarding costs and length of stay. Two comparative groups were analyzed using an exploratory descriptive case–control study with data from a 19-month period after PCT implementation and a retrospective quasi-experimental study using a control group of emergency department patients diagnosed with sepsis using data before PCT implementation. Results Post-procalcitonin implementation samples included 165 cases and pre-procalcitonin implementation sample included 69 cases. From the 165 sepsis cases who had positive blood cultures, PCT had a sensitivity of 89.7%. In comparison, lactic acid's sensitivity at the current cutoff of 18.02 mg/dL (2.0 mmol/L) was 64.9%. There was a 32% decrease in median cost before and after PCT implementation, even with the length of stay remaining at 5 days in both time periods. Conclusions There was a significant decrease after the implementation of PCT in cost of hospitalization compared to costs before implementation. This cost is highly correlated with length of stay; neither the hospital nor the intensive care unit length of stay showed a difference with before and after implementation. There was a positive correlation between lactic acid and PCT values. PCT values had a higher predictive usefulness than the lactic acid values.

scholarly journals The Impact of Teachers Unions on Teachers’ Well-Being Under Various Legal Institutions: Evidence From District–Teacher Matched Data

AERA Open ◽  
2019 ◽  
Vol 5 (3) ◽  
pp. 233285841986729 ◽  
Author(s):  
Eunice S. Han
Keyword(s):  
Multilevel Models ◽  
Causal Effect ◽  
Well Being ◽  
Legal Environment ◽  
Legal Institutions ◽  
Data Set ◽  
Teachers Unions ◽  
The Difference ◽  
Matched Data ◽  
The Impact

This article examines how teachers unions affect teachers’ well-being under various legal institutions. Using a district–teacher matched data set, this study identifies the union effects by three approaches. First, I contrast teacher outcomes across different state laws toward unions. Second, I compare the union–nonunion differentials within the same legal environment, using multilevel models and propensity score matching. Finally, unexpected legal changes restricting the collective bargaining of teachers in four states form a natural experiment, allowing me to use the difference-in-difference estimation to identify the causal effect of weakening unionism on teacher outcomes. I find that (a) many teachers join unions even when bargaining is rarely or never available, and meet-and-confer or union membership rate affects teachers’ lives in the absence of a bargaining contract; (b) how unions influence teacher outcomes vary greatly by different legal environment; and (c) the changes in public policy limiting teachers’ bargaining rights significantly decrease teacher compensation.

scholarly journals Controlled Study of the Impact of a Virtual Program to Reduce Stigma Among University Students Toward People With Mental Disorders

2021 ◽  
Vol 12 ◽  
Author(s):  
Matías E. Rodríguez-Rivas ◽  
Adolfo J. Cangas ◽  
Daniela Fuentes-Olavarría
Keyword(s):  
Mental Disorders ◽  
University Students ◽  
Intervention Group ◽  
Project Based Learning ◽  
Controlled Study ◽  
Control Group ◽  
Global Score ◽  
Stigma Reduction ◽  
Before And After ◽  
The Impact

Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p &lt; 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p &lt; 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.

scholarly journals (A296) Psychosocial Disaster Preparedness Program Form School Children

2011 ◽  
Vol 26 (S1) ◽  
pp. s83-s83 ◽  
Author(s):  
E.A. Raj ◽  
K. Sekar
Keyword(s):  
School Children ◽  
Disaster Preparedness ◽  
Tamil Nadu ◽  
Control Group ◽  
Care Givers ◽  
Effective Manner ◽  
Before And After ◽  
Teachers And Students ◽  
The Individual ◽  
The Impact

The impact of natural disasters on individuals is substantial. Among the affected population in any disaster, children are identified as the most vulnerable group along with women, aged and disabled people. An estimated 77 million children under 15, on average, had their lives severely disrupted by a natural disaster or an armed conflict, each year, between 1991 and 2000 (Plan UK, 2003). Children are most affected since they loose the familiar environment, loss of parents, witness death of their loved ones, fear of reoccurrence of the disaster event. The impact of disaster on children of different age group is multiple times greater than that of the adults. This leads to various psychological problems in children (Dave et al., 2003). Disaster preparedness, through care givers, is one among the ways to reduce the distress of individuals followed by any disaster because it reduces the vulnerability factor that minimizes the impact of any disaster on the individual. A disaster preparedness program with special reference to psychosocial aspects was developed and implemented among the school children through teachers in Kanniyakumari District, Tamil Nadu, India, one of the severely affected areas in Tsunami. The current attempt was to standardize a disaster preparedness module focusing on preparing children to deal with their psychosocial issues before and after disaster in an effective manner. The outcome of disaster preparedness input through teachers and its reach out to the students was determined through an experimental research. The results reveal that the teachers and students from the experimental group gained significantly more knowledge on psychosocial disaster preparedness after implementation of the program in comparison to control group where the program was not implemented. The implications of the study points out the need to integrate psychosocial component of disaster preparedness in to the broader Community Based Disaster Preparedness (CBDP) programs.

Effects of Comorbid Alcohol Use Disorder on the Clinical Outcomes of Schizophrenia: A Nationwide Population-based Study

2021 ◽  
Author(s):  
Soojin Ahn ◽  
Youngjae Choi ◽  
Woohyeok Choi ◽  
Young Tak Jo ◽  
Harin Kim ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Clinical Outcomes ◽  
Alcohol Use Disorder ◽  
Medication Possession Ratio ◽  
Small Sample ◽  
Control Group ◽  
Diagnostic Code ◽  
Psychiatric Admissions ◽  
Before And After ◽  
The Impact

Abstract BackgroundAlcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. Most previous studies on the effect of alcohol use in patients with schizophrenia had limitations of small sample size and a cross-sectional design. Therefore, this study aimed to use a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia.MethodsData from the Health Insurance Review Agency database in South Korea from January 1, 2007 to December 31, 2016 was used. Among 64,442 patients with incident schizophrenia, 1,598 with comorbid AUD were selected based on the diagnostic code F10. We performed between- and within-group analyses to compare the rates of psychiatric admissions and emergency room (ER) visits and medication possession ratio (MPR) with control patients having schizophrenia matched for the onset age, sex, and observation period.ResultsThe rates of psychiatric admissions and ER visits decreased after the diagnosis of AUD in both groups; however, the decrease was significantly greater in patients with comorbid AUD compared to the control group. While the case group showed an increase in MPR after the diagnosis of AUD, MPR decreased in the control patients. The rates of psychiatric admissions, ER visits and MPR were worse in the schizophrenia group with comorbid AUD both before and after the diagnosis of AUD.ConclusionsClinical outcomes were worse in the comorbid AUD group than in the control group before and after the diagnosis of AUD. Considering that patients with schizophrenia with comorbid AUD had poorer clinical outcomes even before the diagnosis of AUD, schizophrenia with comorbid AUD could be a distinct subtype of schizophrenia.

The Impact of US Monetary Growth on Bitcoin Trading Volume in the Current Economic Uncertainty

2020 ◽  
pp. 493-509
Author(s):  
İsmail Canöz
Keyword(s):  
Causal Relationship ◽  
Trading Volume ◽  
Causal Effect ◽  
Study Data ◽  
Time Interval ◽  
Time Varying ◽  
Economic Uncertainty ◽  
Causality Test ◽  
Data Set ◽  
The Impact

This study examines the effect of US monetary growth on Bitcoin trading volume. To achieve this purpose, firstly, the symmetric causality test is used. Following this test, another symmetric causality test is used to reveal a time-varying causal effect between variables. The data set covers the period from July 2010 to July 2019. The results of the first symmetric causality test, which considers the time interval of the study data as a whole, show that there is no causal relationship between variables. According to the results of the second causality test, these support the previous results substantially. However, an interesting detail is the causal relationship between variables for the period between April 2019 and July 2019. The reason for this relationship could be that investors who are indecisive during the current economic uncertainty add Bitcoin to their portfolios in response to the Federal Reserve's decisions.

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