THE EFFECTS OF COST-SHARING ON USE OF SERVICES AND CONSUMER CHARACTERISTICS IN A STATE'S CRIPPLED CHILDREN'S DIVISION

The present study analyzed some of the effects of imposing a cost-sharing requirement on users of a state's health service program. The study population consisted of people who were in diagnosed medical need and included, but was not limited to, people in financial need.^ The purpose of the study was to determine if the cost-sharing requirement had any detrimental effects on the service population. Changes in the characteristics of service consumers and in utilization patterns were analyzed using time-series techniques and pre-post policy comparisons.^ The study hypotheses stated that the distribution of service provided, diagnoses serviced, and consumer income levels would change following the cost-sharing policy.^ Analysis of data revealed that neither the characteristics of service users (income, race, sex, etc.) nor services provided by the program changed significantly following the policy. The results were explainable in part by the fact that all of the program participants were in diagnosed medical need. Therefore, their use of "discretionary" or "less necessary" services was limited.^ The study's findings supported the work of Joseph Newhouse, Charles Phelps, and others who have contended that necessary service use would not be detrimentally affected by reasonable cost-sharing provisions. These contentions raise the prospect of incorporating cost-sharing into programs such as Medicaid, which, at this writing, do not demand any consumer payment for services.^ The study concluded with a discussion of the cost-containment problem in health services. The efficacy of cost-sharing was considered relative to other financing and reimbursement strategies such as HMO's, self-funding, and reimbursement for less costly services and places of service. ^

Analysis of the Technical Efficiency of Urban Bus Services in Spain Based on SBM Models

During the first decade of the new millennium, fueled by the economic development in Spain, urban bus services were extended. Since the years 2008 and 2009, the root of the economic crisis, the improvement of these services is at risk due to economic problems. In this paper, the technical efficiency of the main urban bus companies in Spain during the 2004–2009 period are studied using SBM (slack-based measures) models and by establishing the slacks in the services' production inputs. The influence of a series of exogenous variables on the operation of the different services is also analyzed. It is concluded that only the 24% of the case studies are efficient, and some urban form variables can explain part of the inefficiency. The methodology used allows studying the inefficiency in a disaggregated way that other DEA (data envelopment analysis) models do not.

SOA-Based Model for Value-Added ITS Services Delivery

Integration is currently a key factor in intelligent transportation systems (ITS), especially because of the ever increasing service demands originating from the ITS industry and ITS users. The current ITS landscape is made up of multiple technologies that are tightly coupled, and its interoperability is extremely low, which limits ITS services generation. Given this fact, novel information technologies (IT) based on the service-oriented architecture (SOA) paradigm have begun to introduce new ways to address this problem. The SOA paradigm allows the construction of loosely coupled distributed systems that can help to integrate the heterogeneous systems that are part of ITS. In this paper, we focus on developing an SOA-based model for integrating information technologies (IT) into ITS to achieve ITS service delivery. To develop our model, the ITS technologies and services involved were identified, catalogued, and decoupled. In doing so, we applied our SOA-based model to integrate all of the ITS technologies and services, ranging from the lowest-level technical components, such as roadside unit as a service (RS S), to the most abstract ITS services that will be offered to ITS users (value-added services). To validate our model, a functionality case study that included all of the components of our model was designed.

Legal Services Corporation : grantee attorneys' handling of migrant farmworker disputes with growers.

At head of title: Report to Congressional requesters.

Engineering control of occupational safety and health hazards : recommendations for improving engineering practice, education and research : summary report of the Engineering Control Technology Workshop Technical Panel.

Mode of access: Internet.

An evaluation of accident surrogates for safety analysis of rural highways. Volume 2 - technical report. Final report.

Federal Highway Administration, Traffic Safety Research Division, McLean, Va.

Diabetes in the United States : a strategy for prevention : a report to the Technical Advisory Committee for Diabetes Translation and Community Control Programs.

"May 1991"--Leaf [1].

Legal Services Corporation [microform] : activities of the chairman and replacement of the president : hearing before the Subcommittee on Courts, Civil Liberties, and the Administration of Justice of the Committee on the Judiciary, House of Representatives, One Hundredth Congress, second session, August 4, 1988.

"Serial no. 106."

Technical issues related to the use of LORAN-C in terrestrial applications. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Exchange list : organizations having publication exchange agreements with the AEC Division of Technical Information.

Cover title.

Exchange list : organizations having publication exchange agreements with the AEC Division of Technical Information.

"October 1, 1961."