This study investigates collaborative memory performance in very old married couples working in two types of participant constellations, and with two types of memory tasks, i.e. working as couples, or as individuals in episodic or semantic memory tasks. Sixty-two old married couples were a priori classified as high or low on two dimensions suggested to be important for successful collaboration, i.e. responsibility (how division of responsibility was organized) and agreement (how they mutually agreed on each other's view). The episodic memory task was immediate recall of short stories. The semantic memory tasks were to answer questions about names, places, and concepts. The results suggested that: (1) groups outperformed a single individual, but (2) groups in general suffered from collaboration relative to the predicted potential in episodic tasks only, thus replicating earlier results. Nevertheless, (3) the couples scoring high on division of responsibility achieved the same productivity as nominal pairs (i.e. the predicted potential); (4) the couples scoring high on the agreement dimension showed that they were not as affected by collaboration, but then performed less well in "absolute" performance. Finally, the results were discussed in terms of optimal compensation strategies, especially for elderly couples.

BackgroundDifferences in health care utilization across geographical areas are well documented within several countries. If the variation across areas cannot be explained by differences in medical need, it can be a sign of inefficiency or misallocation of public health care resources.MethodsIn this observational, longitudinal panel study we use regional level data covering the 21 Swedish regions (county councils) over 13 years and a random effects model to assess to what degree regional variation in outpatient physician visits is explained by observed demand factors such as health, demography and socio-economic factors.ResultsThe results show that regional mortality, as a proxy for population health, and demography do not explain regional variation in visits to primary care physicians, but explain about 50% of regional variation in visits to outpatient specialists. Adjusting for socio-economic and basic supply-side factors explains 33% of the regional variation in primary physician visits, but adds nothing to explaining the variation in specialist visits.Conclusion50–67% of regional variation remains unexplained by a large number of observable regional characteristics, indicating that omitted and possibly unobserved factors contribute substantially to the regional variation. We conclude that variations in health care utilization across regions is not very well explained by underlying medical need and demand, measured by mortality, demographic and socio-economic factors.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3210-y) contains supplementary material, which is available to authorized users.

We estimate the price sensitivity in health care among adolescents and young adults, and assess how it varies across income groups and gender, using a regression discontinuity design. We use the age differential cost-sharing in Swedish primary care as our identification strategy. At the 20th birthday, the copayment increases from €0 to approx. €10 per primary care physician visit and close to this threshold the copayment faced by each person is distributed almost as good as if randomized. The analysis is performed using high-quality health care and economic register data of 73,000 individuals aged 18–22. Our results show that the copayment decreases the average number of visits by 7%. Among women visits are reduced by 9%, for low-income individuals by 11%, and for low-income women by 14%. In conclusion, modest copayments have significant utilization effects, and even in a policy context with relatively low income inequalities, the effect is substantially larger in low-income groups and among women.Electronic supplementary materialThe online version of this article (10.1007/s10198-019-01095-6) contains supplementary material, which is available to authorized users.

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