Melbourne Institute of Applied Economic and Social Research - Research Publications

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    Differences in the quality of primary medical care for CVD and diabetes across the NHS: evidence from the quality and outcomes framework
    McLean, G ; Guthrie, B ; Sutton, M (BMC, 2007-05-29)
    BACKGROUND: Health policy in the UK has rapidly diverged since devolution in 1999. However, there is relatively little comparative data available to examine the impact of this natural experiment in the four UK countries. The Quality and Outcomes Framework of the 2004 General Medical Services Contract provides a new and potentially rich source of comparable clinical quality data through which we compare quality of primary medical care for coronary heart disease (CHD), stroke, hypertension and diabetes across the four UK countries. METHODS: A cross-sectional analysis was undertaken involving 10,064 general practices in England, Scotland, Wales and Northern Ireland. The main outcome measures were prevalence rates for CHD, stroke, hypertension and diabetes. Achievement on 14 simple process, 3 complex process, 9 intermediate outcome and 5 treatment indicators for the four clinical areas. RESULTS: Prevalence varies by up to 28% between the four UK countries, which is not reflected in resource distribution between countries, and penalises practices in the high prevalence countries (Wales and Scotland). Differences in simple process measures across countries are small. Larger differences are found for complex process, intermediate outcome and treatment measures, most notably for Wales, which has consistently lower quality of care. Scotland has generally higher quality than England and Northern Ireland is most consistently the highest quality. CONCLUSION: Previously identified weaknesses in Wales related to waiting times appear to reflect a more general quality problem within NHS Wales. Identifying explanations for the observed differences is limited by the lack of comparable data on practice resources and organisation. Maximising the value of cross-jurisdictional comparisons of the ongoing natural experiment of health policy divergence within the UK requires more detailed examination of resource and organisational differences.
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    Academic performance, childhood economic resources, and the choice to leave school at age 16
    Maani, SA ; Kalb, G (Pergamon Press Ltd., 2007-06-01)
    A general international observation is that adolescents from disadvantaged families are more likely to leave school at age 16. In this paper we extend the literature on school-leaving decisions by using a new and extensive panel data set from New Zealand; and by examining the effect of family income, and personal and environmental characteristics since childhood on both academic performance and subsequent schooling choices. Results obtained from single equations and joint estimation, allowing for possible endogeneity of academic performance, reveal the importance of the role of academic performance in models of demand for education. Several factors that are at work for a long time, such as household income at different points in time, influence the school-leaving decision through academic performance. These results point to the role that stimulating academic performance can play in breaking cycles of disadvantage. © 2006 Elsevier Ltd. All rights reserved.
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    Work and family directions in the USA and australia: A policy research agenda
    Drago, R ; Pirretti, A ; Scutella, R (SAGE PUBLICATIONS INC, 2007-02)
    This article provides a comparative glimpse of work/family issues in Australia and the USA. It begins with a summary of an emerging vision of ideal policies and practices for work and family. The article then provides historical background for the recent emergence of a ‘care gap’ in both countries, focusing on key commonalities and differences. The current status of the gap and the related ‘default solution’ to the gap are then outlined. Key commonalities here include an increasing diversity of family forms, a rise in delayed and denied childbearing, and substantial gender inequality. Significant current divergence across the societies includes relatively more family-responsive governmental policies in Australia, more attractive part-time opportunities for mothers in Australia, a relatively more equal division of labor in the home in the USA, a greater prevalence of corporate-sponsored work/family policies in the USA, and greater coverage of Australian employees by work/family policies negotiated through enterprise agreements. A tentative research agenda is provided in conclusion, focusing on part-time employment options, work incentives and childcare for single parents, the causes of delayed and denied childbearing, and enterprise bargaining and corporate policies.
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    The changing socio-demographic composition of poverty in Australia: 1982 to 2004
    Wilkins, R (WILEY, 2007-01-01)
    The extent of income poverty and its socio‐demographic composition are examined using all ABS income surveys conducted over the period 1982 to 2004. There has been some increase in the proportion of the population in poverty, particularly since 1997, but of more note are the substantial changes in the socio‐demographic composition of those in poverty. Compared with the start of the sample period, persons in poverty at the end of the period were much more likely to be older, in families without dependent children, holding post‐school qualifications and/or foreign‐born. In part, these changes reflect broader changes in the composition of the population. However, changes in the risks of poverty associated with different characteristics have also produced large changes in the composition of the poor, and have in some cases counteracted or reversed effects of demographic change. Specifically, the risk of poverty has increased for the elderly, non‐dependent youth, single people, foreign‐born persons and those without post‐school qualifications, and it has decreased for sole parent families and residents of Queensland, the ACT and the Northern Territory.
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    The consequences of underemployment for the underemployed
    Wilkins, R (SAGE PUBLICATIONS INC, 2007-04)
    Underemployment is generally conceived as excess labour supply associated with employed persons — that is, as a situation where employed persons would like to work more hours at prevailing wage rates. Using information collected by the 2001 Household, Income and Labour Dynamics in Australia survey, this study examines the effects of underemployment on outcomes such as income, welfare dependence and subjective well-being. Results obtained imply that, while unemployment clearly has greater adverse consequences, underemployment is nonetheless associated with significant detrimental effects on the outcomes examined. Negative effects are found for both part-time employed and full-time employed workers who would prefer to work more hours, but effects are greater for underemployed part-time workers, and are particularly large for part-time workers who would like to work full-time. Indeed, for part-time workers seeking full-time employment, adverse effects attributable to underemployment are, for some outcomes, not far short of those attributable to unemployment.
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    Does a minimum job search requirement reduce time on unemployment payments? Evidence from the Jobseeker Diary in Australia
    Borland, J ; Tseng, Y-P (INDUSTRIAL LABOR RELAT REV, 2007-04)
    This study examines the impact of the Jobseeker Diary (JSD), a program designed to increase the job search effort of unemployed persons in Australia. The JSD program is distinguished by combining a focus on work search verification with large scale implementation. Applying a quasi-experimental matching method to data on unemployment spells occurring in 1997–98, the authors find that JSD participation was associated with an increased rate of exit from unemployment payment recipiency and a shorter total time spent on payments. Payment receipt duration is estimated to have fallen for about one-half of JSD participants. The largest effects of the JSD occurred for payment recipients for whom labor demand conditions were the most favorable. Cost-benefit analysis suggests a fairly large net societal gain per program participant.
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    Disagreement in Australian partners’ reports of Material Hardship
    Breunig, R ; Cobb-Clark, D ; Gong, X ; Venn, D ( 2007)
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