Search results

Purpose: While COVID-19 has upended lives, it has also catalyzed innovation with potential to advance health delivery. Yet, we know little about how the delivery system, and primary care in particular, has responded and how this has impacted vulnerable patients. We aimed to understand the impact of COVID-19 on primary care practice sites and their vulnerable patients and to identify explanations for variation. Approach: We developed and administered a survey to practice managers and physician leaders from 173 primary care practice sites, October-November 2020. We report and graphically depict results from univariate analysis and examine potential explanations for variation in practices' process innovations in response to COVID-19 by assessing bivariate relationships between seven dependent variables and four independent variables. Findings: Among 96 (55.5%) respondents, primary care practice sites on average took more safety (8.5 of 12) than financial (2.5 of 17) precautions in response to COVID-19. Practice sites varied in their efforts to protect patients with vulnerabilities, providing care initially postponed, and experience with virtual visits. Financial risk, practice size, practitioner age, and emergency preparedness explained variation in primary care practices' process innovations. Many practice sites plan to sustain virtual visits, dependent mostly on patient and provider preference and continued reimbursement. Value: While findings indicate rapid and substantial innovation, conditions must enable primary care practice sites to build on and sustain innovations, to support care for vulnerable populations, including those with multiple chronic conditions and socio-economic barriers to health, and to prepare primary care for future emergencies.

This chapter examines social variations in parent dissatisfaction with children’s medical care and tests whether greater dissatisfaction is associated with less preventive care and unmet medical need.

The 2007 National Survey of Children’s Health (NSCH) is a nationally representative cross-sectional sample of parents of U.S. children age 0–17 years (N=78,523). We use a combination of ordinary least squares (OLS) and binary logistic regression to analyze parent dissatisfaction, preventive care, and unmet medical need.

Our results indicate that parents’ dissatisfaction scores are significantly higher for racial/ethnic minorities, non-English speakers, lower socioeconomic status (SES) respondents, and the uninsured. Furthermore, parent dissatisfaction has a significant and robust association with lack of preventive care and reports of unmet medical need.

Due to the cross-sectional research design, we were unable to determine whether dissatisfaction caused parents to delay children’s medical care, thus resulting in a lack of annual preventive care and greater unmet needs.

Although there is extensive research on adult perceptions of their own medical care, few sociological studies have examined parents’ perceptions about their children’s care. Yet, there is substantial evidence that parents transmit health-related attitudes, beliefs, and behaviors to their children. As with adult patients, parent satisfaction with their child’s medical care is stratified by social characteristics; however, we also find a strong association between dissatisfaction and use of other important health services. It may be the case that when parents feel that they did not receive satisfactory care, they are more likely to delay, or to forgo, preventive and other health services.

Taking an international comparative approach, this chapter investigates the variance in the adoption of employee share ownership and stock option arrangements across countries. In particular, we investigate the influence of multinational enterprises (MNEs), industrial relations factors, HRM strategies, and market economies on the adoption and spread of the arrangements across countries. We find that industrial relations factors do not explain the variance in adoption by companies in their respective countries. MNEs and HRM strategies are important drivers of adoption. Market economy does not moderate the influence of MNEs on adoption, suggesting that MNEs universally apply the arrangements across borders.

It is estimated that we spend at least a third of our working lives in the workplace and the duration of this, due to the extension of working lives through legislative changes and increased pension ages, is set to increase. Ageing of the workforce is a growing concern but health and safety issues cannot be used as an excuse for not employing older workers. A healthy workplace is one where the risks are managed and where workers and their managers work together to improve the work environment and protect the health of the workers. Furthermore, linking this to personal health resources and the local community can improve the health of all involved. Within the workplace this includes both the psychosocial and physical work environment. To create a healthy workplace there is a need to ensure risk management measures are in place and our older workers participation in risk assessment and risk reduction programmes. In addition to this, targeted occupational health promotion programmes may be beneficial. There are few integrated policies with regard to age and work but research does identify good practice, including participation of employees in change measures, senior management commitment and taking a life-course approach. While there are challenges in relation to age-related change, the work ability concept can improve understanding. The use of a comprehensive approach such as Age Management can help employers who have a critical role in making the workplace age-ready.

In this chapter we perform a Monte Carlo simulation study of the errors-in-variables model examined in Ramsey, Gallegati, Gallegati, and Semmler (2010) by using a wavelet multiresolution approximation approach. Differently from previous studies applying wavelets to errors-in-variables problem, we use a sequence of multiresolution approximations of the variable measured with error ranging from finer to coarser scales. Our results indicate that multiscale approximations to the variable observed with error based on the coarser scales provide an unbiased asymptotically efficient estimator that also possess good finite sample properties.

Though it is one of the strongest predictors of vaccine initiation, few studies have examined the social correlates of health care professional (HCP) recommendations of the human papillomavirus (HPV) vaccination. This study employs a “fundamental causes” framework to examine whether family socioeconomic status is associated with parent reports of HPV vaccine uptake and HCP recommendation of the vaccine among female youth aged 12–17.

Using the 2007 National Survey of Children’s Health, a nationally representative sample of parents in the United States, this study documents a clear socioeconomic gradient in HCP recommendation of the HPV vaccine.

Results from a set of logistic regression models demonstrate that lower income families have significantly lower odds of vaccine initiation; however, the effect of household income is mediated by HCP recommendation. Further analyses reveal that lower income and poor families have reduced odds of receiving a HCP recommendation even when other health care related factors such as insurance status, annual preventive care, and a usual source of care are controlled.

The findings suggest that low income and poor families are less likely to receive needed health information regarding the HPV vaccine, thereby reducing the likelihood of vaccine uptake.

Much of the discussion surrounding the antivaccine movement focuses on the decision of parents to not vaccinate their children and the resulting danger posed to others. However, the primary risk is borne by the child left unvaccinated. Although living in a developed country with high vaccination rates provides a certain amount of protection through population immunity, the unvaccinated child is still exposed to a considerably greater risk of preventable diseases than one who is vaccinated. I explore the tension between parental choice and the child’s right to be free of preventable diseases. The chapter’s goal is twofold: to advocate for moving from a dyadic framework – considering the interests of the parents against those of the state – to a triadic one, in which the interests of the child are given as much weight as those of the parent and the state; and to discuss which protections are available, and how they can be improved. Specific legal tools available to protect that child are examined, including tort liability of the parents to the child, whether and to what degree criminal law has a role, under what circumstances parental choice should be overridden, and the role of school immunization requirements in protecting the individual child.

The experimental parliamentary subsidy on knights' fees and freehold incomes from lands and rents of 1431 was the only English direct lay tax of the Middle Ages which broke down. As such, this subsidy has a clear historiographical significance, yet previous scholars have tended to overlook it on the grounds that parliament's annulment act of 1432 mandated the destruction of all fiscal administrative evidence. Many county assessments from 1431–1432 do, however, survive and are examined for the first time in this article as part of a detailed assessment of the fiscal and administrative context of the knights' fees and incomes tax. This impost constituted a royal response to excess expenditures associated with Henry VI's “Coronation Expedition” of 1429–1431, the scale of which marked a decisive break from the fiscal-military strategy of the 1420s. Widespread confusion regarding whether taxpayers ought to pay the feudal or the non-feudal component of the 1431 subsidy characterized its botched administration. Industrial scale under-assessment, moreover, emerged as a serious problem. Officials' attempts to provide a measure of fiscal compensation by unlawfully double-assessing many taxpayers served to increase administrative confusion and resulted in parliament's annulment act of 1432. This had serious consequences for the crown's finances, since the regime was saddled with budgetary and debt problems which would ultimately undermine the solvency of the Lancastrian state.

A recent change to audit workpaper review has been the movement toward delegating more review tasks to senior auditors and including more staff auditors in the review process. This study investigates the efficiency and effectiveness implications of this change. It considers the calibration of reviewers of different levels of experience on both conceptual and mechanical errors. The results reveal that reviewers are miscalibrated (overconfident) in their workpaper error judgments. No differences are found in the calibration of staff and senior auditors across hierarchical level or type of error. The implications for audit effectiveness are discussed in the paper.

In crafting Auditing Standard No.3 (AS3), a primary objective of the PCAOB was to reduce auditors' exposure to litigation by raising the standard of care for audit documentation. We examine whether the increased documentation requirements of AS3 affect legal professionals' perceptions of audit quality and auditor responsibility in the event of an audit failure. Our experiment consists of a 3 × 2 between-participants design with law students serving as proxies for legal professionals. The results of our experiment indicate that when an audit procedure, namely the investigation of inconsistent evidence, is not required to be documented, legal professionals perceive the performance of the work itself but not its documentation to significantly increase audit quality and reduce the auditor's responsibility for an audit failure. When documentation of the procedure is required, as per AS3, legal professionals perceive enhanced audit quality and reduced auditor responsibility only if the performance of the work is documented.