Inference in Regression Discontinuity Designs with a Discrete Running Variable

Kolesár, Michal; Rothe, Christoph

doi:10.1257/aer.20160945

Cited by 251 publications

(224 citation statements)

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β_{RDD}^{AM}

compares pupils with age at school entry of either 76 or 77 months. BSD and BME CI refer to the bounded second derivative and bounded misspecification error “honest” confidence intervals as discussed in Kolesar and Rothe (). BSD and BME normalized standard errors also reported.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, as a robustness check, we also report bounded misspecification error (BME) honest CIs. These are based on the assumption that the specification bias at zero is no worse at the cutoff than away from it (see Section 5.2 of Kolesar and Rothe ). Although this type of CI is specifically designed for discrete running variables, it tends to be quite conservative and, in practice, uninformative if there is substantial uncertainty about the magnitude of the specification errors.…”

Section: Resultsmentioning

confidence: 99%

“…Lee and Card (2008) discuss the use of a discrete rating variable in RD designs. A very important recent contribution on the topic is Kolesar and Rothe (2017). and test scores, since the regression discontinuity (RD) setup would not be internally valid.…”

Section: A Step 1: Evaluating Two Discontinuitiesmentioning

confidence: 99%

“…Indeed, a common practice to determine CI is to use standard errors that are clustered by the running variable (CRV standard errors) as suggested by Lee and Card (2008). However, as recently pointed out by Kolesar and Rothe (2017), this procedure is likely to generate CIs that are not actually reliable. In particular, discreteness of the running variable causes problems if the number of support points close to the cutoff is small and, in this case, using a small bandwidth is not sufficient to make the bias of the estimator negligible vis-àvis its standard deviation.…”

Section: B Evaluating Discontinuitiesmentioning

confidence: 99%

“…Lee and Card () discuss the use of a discrete rating variable in RD designs. A very important recent contribution on the topic is Kolesar and Rothe ().…”

mentioning

confidence: 99%

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PARENTS KNOW THEM BETTER: THE EFFECT OF OPTIONAL EARLY ENTRY ON PUPILS' SCHOOLING ATTAINMENT

2018

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The effect of optional early school entry on pupils' educational outcomes is investigated using data covering the entire population of Italian primary school students and exploiting exogenous thresholds imposed by norms regulating first enrollment. Results highlight the fact that pupils whose parents can choose when their children start school perform better than those who are bounded by terms imposed by law. These findings suggest that parental choice leads to a better match between pupils' characteristics and the beginning of formal learning. Results show that giving parents the option to anticipate or delay school entry could be a beneficial measure. (JEL I20, H52)

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β_{RDD}^{AM}

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: A Step 1: Evaluating Two Discontinuitiesmentioning

confidence: 99%

Section: B Evaluating Discontinuitiesmentioning

confidence: 99%

“…Lee and Card () discuss the use of a discrete rating variable in RD designs. A very important recent contribution on the topic is Kolesar and Rothe ().…”

mentioning

confidence: 99%

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PARENTS KNOW THEM BETTER: THE EFFECT OF OPTIONAL EARLY ENTRY ON PUPILS' SCHOOLING ATTAINMENT

2018

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Association Between Medicaid Prescription Drug Limits and Access to Medications and Health Care Use Among Young Adults With Disabilities

2021

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IMPORTANCE Prescription drugs are necessary for managing complex physical and mental health conditions for more than 10 million Medicaid beneficiaries with disabilities. However, some state Medicaid programs limit the number of prescription drugs that beneficiaries can obtain monthly, which may decrease access to essential medications.OBJECTIVE To examine the association between exposure to the 3-drug limit at age 21 years in Arkansas and Texas and prescription drug and health care use among beneficiaries with disabilities enrolled in Medicaid. DESIGN, SETTING, AND PARTICIPANTSIn this cohort study of 28 046 young adults with disabilities, difference-in-differences analysis was performed using Medicaid Analytic eXtract claims data from January 1, 2007, to December 31, 2012. Analyses were completed December 1, 2020. The analyses included Medicaid beneficiaries with disabilities in Arkansas and Texas (ie, drug cap states) or 15 comparison states without drug cap policies who became age 21 years during the study period and were continuously enrolled in fee-for-service Medicaid in the year before and after that point.EXPOSURES Exposure to the 3-drug prescription limit at age 21 years in 2 drug cap states. MAIN OUTCOMES AND MEASURESMonthly total prescriptions and prescriptions for drugs to treat mental health conditions, total prescription drug spending, and inpatient and emergency department visits and spending in the 12 months before and after becoming age 21 years. RESULTS Among 28 046 young adults with disabilities, 8214 (29.3%) resided in drug cap states and were subject to the 3-drug limit at age 21 years. Most individuals were male (drug cap states: 61.4%, comparison states: 60.6%), and the minority were White individuals (drug cap states: 36.7%, comparison states: 49.4%). More than one-half of individuals with disabilities were diagnosed with a mental health condition before age 21 years (drug cap states: 57.0%, comparison states: 60.0%). In the year before the analyzed individuals became aged 21 years, the mean (SD) number of prescriptions per beneficiary per month was 1.58 (2.16) in drug cap states vs 1.82 (1.91) in comparison states. The drug cap policy was associated with 19.6% (95% CI, −21.3% to −17.8%; P < .001) fewer monthly prescriptions and 16.5% (95% CI, −21.9% to −10.8%; P < .001) fewer prescriptions for drugs for mental health conditions but was not associated with total prescription drug spending. The drug cap policy was associated with 13.6% (95% CI, 1.9% to 26.6%; P = .02) more inpatient admissions. CONCLUSIONS AND RELEVANCEIn this cohort study of young adults with disabilities, drug cap policies were associated with lower rates of access to important medications and higher rates of hospitalization among individuals in states with drug cap policies vs those without these policies.

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Medicare Eligibility and Changes in Coverage, Access to Care, and Health by Sexual Orientation and Gender Identity

Gavulic,

Wallace

2024

JAMA Health Forum

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ImportanceMedicare provides nearly universal insurance coverage at age 65 years. However, how Medicare eligibility affects disparities in health insurance coverage, access to care, and health status among individuals by sexual orientation and gender identity is poorly understood.ObjectiveTo assess the association of Medicare eligibility with disparities in health insurance coverage, access to care, and self-reported health status among individuals by sexual orientation and by gender identity.Design, Setting, and ParticipantsThis cross-sectional study used the age discontinuity for Medicare eligibility at age 65 years to isolate the association of Medicare with health insurance coverage, access to care, and self-reported health status, by their sexual orientation and by their gender identity. Data were collected from the Behavioral Risk Factor Surveillance System for respondents from 51 to 79 years old from 2014 to 2021. Data analysis was performed from September 2022 to April 2023.ExposuresMedicare eligibility at age 65 years.Main Outcomes and MeasuresProportions of respondents with health insurance coverage, usual source of care, cost barriers to care, influenza vaccination, and self-reported health status.ResultsThe study population included 927 952 individuals (mean [SD] age, 64.4 [7.7] years; 524 972 [56.6%] females and 402 670 [43.4%] males), of whom 28 077 (3.03%) identified as a sexual minority—lesbian, gay, bisexual, or another sexual minority identity (LGB+) and 3286 (0.35%) as transgender or gender diverse. Respondents who identified as heterosexual had greater improvements at age 65 years in insurance coverage (4.2 percentage points [pp]; 95% CI, 4.0-4.4 pp) than those who identified as LGB+ (3.6 pp; 95% CI, 2.3-4.8 pp), except when the analysis was limited to a subsample of married respondents. For access to care, improvements in usual source of care, cost barriers to care, and influenza vaccination were larger at age 65 years for heterosexual respondents compared with LGB+ respondents, although confidence intervals were overlapping and less precise for LGB+ individuals. For self-reported health status, the analyses found larger improvements at age 65 years for LGB+ respondents compared with heterosexual respondents. There was considerable heterogeneity by state in disparities by sexual orientation among individuals who were nearly eligible for Medicare (close to 65 years old), with the US South and Central states demonstrating the highest disparities. Among the top-10 highest-disparities states, Medicare eligibility was associated with greater increases in coverage (6.7 pp vs 5.0 pp) and access to a usual source of care (1.4 pp vs 0.6 pp) for LGB+ respondents compared with heterosexual respondents.Conclusions and RelevanceThe findings of this cross-sectional study indicate that Medicare eligibility was not associated with consistently greater improvements in health insurance coverage and access to care among LGBTQI+ individuals compared with heterosexual and/or cisgender individuals. However, among sexual minority individuals, Medicare may be associated with closing gaps in self-reported health status, and among states with the highest disparities, it may improve health insurance coverage, access to care, and self-reported health status.

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Inference in Regression Discontinuity Designs with a Discrete Running Variable

Cited by 251 publications

References 41 publications

PARENTS KNOW THEM BETTER: THE EFFECT OF OPTIONAL EARLY ENTRY ON PUPILS' SCHOOLING ATTAINMENT

PARENTS KNOW THEM BETTER: THE EFFECT OF OPTIONAL EARLY ENTRY ON PUPILS' SCHOOLING ATTAINMENT

Association Between Medicaid Prescription Drug Limits and Access to Medications and Health Care Use Among Young Adults With Disabilities

Medicare Eligibility and Changes in Coverage, Access to Care, and Health by Sexual Orientation and Gender Identity

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