Non-cognitive Skills and the Gender Disparities in Test Scores and Teacher Assessments: Evidence from Primary School We extend the analysis of early-emerging gender differences in academic achievement to include both (objective) test scores and (subjective) teacher assessments. Using data from the 1998-99 ECLS-K cohort, we show that the grades awarded by teachers are not aligned with test scores, with the disparities in grading exceeding those in testing outcomes and uniformly favoring girls, and that the misalignment of grades and test scores can be linked to gender differences in non-cognitive development. Girls in every racial category outperform boys on reading tests and the differences are statistically significant in every case except for black fifth-graders. Boys score at least as well on math and science tests as girls, with the strongest evidence of a gender gap appearing among whites. However, boys in all racial categories across all subject areas are not represented in grade distributions where their test scores would predict. Even those boys who perform equally as well as girls on reading, math and science tests are nevertheless graded less favorably by their teachers, but this less favorable treatment essentially vanishes when non-cognitive skills are taken into account. White boys who perform on par with white girls on these subject-area tests and exhibit the same non-cognitive skill level are graded similarly. For some specifications there is evidence of a grade "bonus" for white boys with test scores and behavior like their girl counterparts. While the evidence is a little weaker for blacks and Hispanics, the message is essentially the same.
When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992 to 2014, we decompose practice style into two components: The provider's probability of conducting invasive procedures on the average patient (which we characterize as aggressiveness), and the responsiveness of the choice of procedure to the patient's characteristics. We show that within hospitals and years, patients with more aggressive providers have consistently higher costs and better outcomes. Since all patients benefit from higher utilization of invasive procedures, targeting procedure use to the most appropriate patients benefits these patients at the expense of the less appropriate patients. We also find that the most aggressive and responsive physicians are young, male, and trained in top 20 schools.
Using data from the 1998-99 ECLS-K cohort, we show that the grades awarded by teachers are not aligned with test scores. Girls in every racial category outperform boys on reading tests, while boys score at least as well on math and science tests as girls. However, boys in all racial categories across all subject areas are not represented in grade distributions where their test scores would predict. Boys who perform equally as well as girls on reading, math and science tests are graded less favorably by their teachers, but this less favorable treatment essentially vanishes when non-cognitive skills are taken into account. For some specifications there is evidence of a grade "bonus" for boys with test scores and behavior like their girl counterparts.Cornwell, Mustard, and Van Parys 2
IMPORTANCEThe average health outcomes in the US are not as good as the average health outcomes in other developed countries. However, whether high-income US citizens have better health outcomes than average individuals in other developed countries is unknown. OBJECTIVE To assess whether the health outcomes of White US citizens living in the 1% and 5% richest counties (hereafter referred to as privileged White US citizens) are better than the health outcomes of average residents in other developed countries. DESIGN, SETTING, AND PARTICIPANTSThis comparative effectiveness study, conducted from January 1, 2013, to December 31, 2015, identified White US citizens living in the 1% (n = 32) and 5% (n = 157) highest-income counties in the US and measured the following 6 health outcomes associated with health care interventions: infant and maternal mortality, colon and breast cancer, childhood acute lymphocytic leukemia, and acute myocardial infarction. The study used Organisation for Economic Co-operation and Development data, CONCORD-3 cancer data, and Medicare data to compare their outcomes with all residents in 12 other developed countries: Australia,
When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992-2014, we decompose practice style into two components: The provider's probability of conducting invasive procedures on the average patient (which we characterize as aggressiveness), and the responsiveness of the choice of procedure to the patient's characteristics. We show that within hospitals and years, patients with more aggressive providers have consistently higher costs and better outcomes. Since all patients benefit from higher utilization of invasive procedures, targeting procedure use to the most appropriate patients benefits these patients at the expense of the less appropriate patients. We also find that the most aggressive and responsive physicians are young, male, and trained in top 20 schools.
Health improvements for patients with acute myocardial infarction varied across hospitals and were associated with the diffusion of cost-effective care, such as early percutaneous coronary intervention and, to a lesser extent, postacute care, rather than overall expenditure growth. Interventions designed to promote hospital adoption of cost-effective care could improve patient outcomes and, if accompanied by cuts in cost-ineffective care (inside and outside of the hospital setting), also reduce expenditures.
Premiums have increased rapidly in the two most recent years of the health insurance Marketplaces, with notable variation across state rating areas. Some experts have speculated that these increases are due to greater enrollment among sicker patients, the expiration of market stabilization policies, or the federal government's discontinuation of funding for cost-sharing subsidies. However, these factors do not explain why some rating areas have experienced rapid premium growth, while others have experienced more modest increases. I used a comprehensive database of information about premiums and market characteristics for rating areas in states with federally facilitated Marketplaces to demonstrate that higher premiums are associated with local health insurance monopolies. In 2018, Marketplace premiums were 50 percent ($180) higher, on average, in rating areas with monopolist insurers, compared to those with more than two insurers. This was driven by large premium increases for the monopolist insurers' lowest-cost plans. Understanding how insurer competition has affected enrollment, costs, and quality will help guide future individual-market reforms.
Despite the significant responsibility that physicians have in healthcare delivery, we know surprisingly little about why physician practice styles vary within or across institutions. Estimating variation in physician practice styles is complicated by the fact that patients are rarely randomly assigned to physicians. This paper uses the quasi-random assignment of patients to physicians in emergency departments (EDs) to show how physicians vary in their treatment of patients with minor injuries. The results reveal a considerable degree of variation in practice styles within EDs; physicians at the 75th percentile of the spending distribution spend 20% more than physicians at the 25th percentile. Observable physician characteristics do not explain much of the variation across physicians, but there is a significant degree of sorting between physicians and EDs over time, with high-cost physicians sorting into high-cost EDs as they gain experience. The results may shed light on why some EDs remain persistently higher-cost than others.
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