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Soiled: An Environmental Podcast is a six episode series where common environmental topics are discussed and misconceptions surrounding these topics are debunked.
500 Days of Summer, released in 2009 and written by Scott Neustadter and Michael H. Weber, is an American film told through the perspective of Tom Hansen, the male lead. It is a story that begins with a third-person narrator, explaining that “This is a story of boy meets girl.” The narration then finishes with a warning that “you should know up front, this is not a love story” (Neustadter & Weber, 2009). As the movie continues, however, it becomes increasingly challenging to believe this warning. Tom sees Summer Finn, falls in love, and their relationship ends with him broken-hearted. It is only natural for the audience to view it as a story of Tom’s failed love, and without a deeper analysis, to perceive Summer as the antagonist. <br/> This tendency to view the movie as a love story motivated me to question why the discrepancy between the beginning narration and the common audience perception occurs. My thesis addresses this discrepancy by focusing on the idea that the natural gravitation towards the belief that 500 Days of Summer is a love story exists due to the unreliable narration given by Tom Hansen throughout the movie. I wrote three songs, an interlude, a duet, and a solo, based on the themes and lead characters of the movie to help validate the warning provided in the beginning and provide a deeper insight into Summer’s version of the story.
Emerging Information Technology, Storage and Evaluation within Healthcare: A Discerning IMT Analysis
Data Sources: I use the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) from 2000 to 2011. The NIS is a 20% sample of all inpatient claims. The Manhattan Institute supplied data on the availability of health savings accounts in each state. State PTR implementation dates were gathered by Hans Christensen, Eric Floyd, and Mark Maffett of University of Chicago’s Booth School of Business by contacting the health department, hospital association, or website controller in each state.
Study Design: The NIS data was collapsed by procedure, hospital, and year providing averages for the dependent variable, Cost, and a host of covariates. Cost is a product of Total Charges within the NIS and the hospital’s Cost to Charge ratio. A new binary variable, PTR, was defined as ‘0’ if the year was strictly less than the disclosure website’s implementation date, ‘1’ for afterwards, and missing for the year of implementation. Then, using multivariate OLS regression with fixed effect modeling, the change in cost from before to after the year of implementation is estimated.
Principal Findings: The analysis estimates the effect of PTR to decrease the average cost per procedure by 7%. Specifications identify within state, within hospital, and within procedure variation, and reports that 78% of the cost decrease is due to within-hospital, within-procedure price discounts. An additional model includes the interaction of PTR with the prevalence of health savings accounts (hereafter, HSAs) and procedure electivity. The results show that PTR lowers costs by an additional 3 percent with each additional 10 percentage point increase in the availability of HSAs. In contrast, the cost reductions from PTR were much smaller for procedures more frequently coded as elective.
Conclusions: The study concludes price transparency regulations can lead to a decrease in a procedure’s costs on average, primarily through price discounts and slightly through lower cost procedures, but not due to patients moving to cheaper hospitals. This implies that hospitals are taking initiative and lowering prices as the competition’s prices become publically available suggesting that hospitals – not patients – are the biggest users of price transparency websites. Hospitals are also finding some ways to provide cheaper alternatives to more expensive procedures. State regulators should evaluate if a better metric other than charge prices, such as expected out-of-pocket payments, would evoke greater patient participation. Furthermore, states with higher prevalence of HSAs experience greater effects of PTR as expected since patients with HSAs have greater incentives to lower their costs. Patients should expect a shift towards plans that offer these types of savings accounts since they’ve shown to have a reduction of health costs on average per procedure in states with higher prevalence of HSAs.