Allocation Of Federal Resources Research Articles

Advancing federal resource allocation: HPSA and the GME impact factor

Health Professional Shortage Areas (HPSA) is a new Graduate Medical Education (GME) resource allocation approach by the US Health and Human Services aimed at producing physicians who practice in these areas. We investigated evidence whether HPSA—an ecological index—is associated with closing physician shortage gaps and the added value of a performance-based index. Using linked administrative data from 1) the American Medical Association's Masterfile (2016 and 2021); 2) the Accreditation Council for Graduate Medical Education sponsoring institutions roster (2021–2022), and the primary care geographic HPSA designation (2021), we assembled a prospective cohort and collapsed these data to the organizational level (N = 622). The diagnostic test is the GME Impact Factor, a performance-based index quantifying the proportion of physicians who practice in a HPSA following medical residency. The reference test is HPSA designation of the sponsoring institution. We assessed sensitivity, specificity, and likelihood ratio test of a positive test (LRT) to appraise HPSA utility on outcome, and the Interclass Coefficient (ICC) to assess similarity, where <0.5 indicates considered poor reliability. Sensitivity is 86.2% (95% CI: 81.9–89.7), specificity is 45.1 (95% CI: 39.7–50.5). LRT is 1.57 (95% CI: 1.55–1.59) and ICC is 0.45 (95% CI: 0.37–0.51). Partial evidence that training sites located within HPSAs are associated with producing physicians who will practice in health professional shortage area following residency training. A performance-based approach — the GME Impact Factor—which utilizes historical production, holds added value in distributing fiscal and personnel resources that yields population-level results. ( Fig. 1 ).

High-Tech Entrepreneurship in the Russian Regions: Conditions for the Emergence of New Companies

—The main goal of this study was to identify the environmental factors at the regional level that influence the emergence of high-tech companies and to assess the direction of this impact. The empirical basis of the study was the data on the state of companies in high-tech and knowledge-intensive industries by regions of the Russian Federation contained in the definitive SPARK database, indicators of economic development of the regions published by Rosstat, as well as open information provided by public authorities. The processes of setting up new companies were estimated by the number of firms with nonzero revenue whose age did not exceed 3 years. In addition, the ratio of this number to size of the regional employment was analyzed. The factors of the regional environment were considered in the context of five blocks: i.e., innovation potential, human resources, general characteristics of industrial production, state support for innovation activity, and partnership interactions between innovative companies. Particular attention was paid to the last two blocks. An analysis of the general characteristics of the sample shows that young companies are distributed extremely unevenly throughout Russia; 47.8% operate in five regions. At the same time, 96% of all firms can be rated as microenterprises. The results of econometric calculations reveal that federal financing of innovation activities in general at the regional level is positively significant, as is the involvement of organizations in joint R&D projects. At the same time, the participation of the regional budget and the allocation of federal resources in support of innovative infrastructure for small and medium-sized businesses, as well as the participation of regional firms in clusters and technology parks, have not yet had a significant impact on the emergence of new high-tech enterprises.

Regional inequalities and the role of federal resources in the SUS: do political factors affect the allocation of funds?

The research problem in this paper is a discussion of the political factors affecting the allocation of federal resources in the SUS (Unified Health System) and its effects on regional inequalities in Brazil. The main objective was to explore the influence of political factors as criteria for the distribution of federal funds, considering the regional inequalities of the country. A mixed method was used by collecting quantitative data to study the allocation of resources for each unit of the Federation, from 2003 to 2017, in search of outliers, which require more in-depth explanation based on qualitative research methods. The fuzzy-set QCA software was applied in the qualitative research phase for identification of technical and political conditions, where required and/or sufficient, for an atypical distribution of resources from one year to another. The quantitative analysis demonstrated the decrease of regional inequalities in allocation of resources to States in the North and Northeast. However, when studying the constraints of the distribution of the funds for the States of these regions, qualitative analysis demonstrated the influence of political factors on the allocation of resources, rather than purely technical factors.

More federal legislators lead to more resources for their constituencies: Evidence from exogenous differences in seat allocations

Electoral district magnitude varies across German electoral constituencies and over legislative periods due to Germany's electoral system. The number of seats in parliament per constituency is effectively random. This setting permits us to investigate institutionally driven variations in the magnitude of individual constituencies on the allocation of federal resources to these constituencies. We analyze the causal effect of having more than one federal legislator per constituency on federal government resources by exploiting information from 1,379 constituencies from 1998 to 2017. More federal legislators per constituency lead to statistically significantly more employment of federal civil servants. The size of the effect is large and corresponds to about 3.5% of average employment once a constituency is represented by additional legislators from party lists. Robustness tests support our results. Further evidence points to heterogeneity of the effect: Constituencies represented by additional legislators who are experienced and who are members of larger, competing parties obtain more federal resources.

Deciphering the surgical treatment gap for drug-resistant epilepsy (DRE): A literature review.

Patients with drug-resistant epilepsy (DRE) rarely achieve seizure freedom with medical therapy alone. Despite being safe and effective for select patients with DRE, epilepsy surgery remains heavily underutilized. Multiple studies have indicated that the overall rates of surgery in patients with DRE have stagnated in recent years and may be decreasing, even when hospitalizations for epilepsy-related problems are on the rise. Ultimately, many patients with DRE who might otherwise benefit from surgery continue to have intractable seizures, lacking access to the full spectrum of available treatment options. In this article, we review the various factors accounting for the persistent underutilization of epilepsy surgery and uncover several key themes, including the persistent knowledge gap among physicians in identifying potential surgical candidates, lack of coordinated patient care, patient misconceptions of surgery, and socioeconomic disparities impeding access to care. Moreover, factors such as the cost and complexity of the preoperative evaluation, a lack of federal resource allocation for the research of surgical therapies for epilepsy, and difficulties recruiting patients to clinical trials all contribute to this multifaceted dilemma.

Análise das transferências financeiras federais para as ações laboratoriais de vigilância sanitária no Brasil: 2007 a 2016

Introduction: Laboratory analyzes, which are fundamental to the SNVS, aim to minimize the risks from health-related products, services, and environments, requiring available and timely financial resources for laboratories to perform their activities. Objective: The study describes and analyzes the federal funding of laboratory health surveillance actions in Brazil, from 2007 to 2016. Method: This is a study of bibliographic and documentary analysis using federal financial transfer orders, besides agreements, terms cooperation and other voluntary transfers present in Management Reports of the National Health Surveillance Agency (Anvisa). Results: The transfers were classified into two categories: (i) automatic transfers of fund-to-fund resources, intended for the execution of the set of laboratory actions at regular intervals (monthly or quarterly) or for specific purposes (annual); and (ii) voluntary transfers of resources comprising covenants and the like. The repercussions of federal funding on laboratories and their activities were discussed. The laboratories of SP, PE, INCQS, BA and MG were awarded, respectively, with the largest amounts. In the analysis of the total values transferred from fund to fund according to regions, the Northeast is highlighted, followed by the Southeast. Conclusions: In spite of the relevance of the allocation of federal resources and the specific destination for some laboratory activities, we highlight the need to construct a solid financing policy for the Public Health Surveillance Laboratory.

Eficiência da alocação de recursos públicos nas unidades da federação nos governos Lula e Dilma

A eficiência nos gastos constitui um dos principais desafios da gestão pública. Neste artigo, analisa-se a eficiência na alocação de recursos públicos nas 27 Unidades da Federação (UF) durante os governos Lula e Dilma. Para tanto, utilizou-se a Análise Envoltória de Dados (Data Envelopment Analysis – DEA), no modelo Retornos Constantes à Escala, proposto por Charnes, Cooper e Rhodes (1978) e conhecido como modelo CCR, e no modelo Retornos Variáveis à Escala, proposto por Banker, Charnes e Cooper (1984) e nomeado BCC, com orientação de output, para o cálculo de eficiência das 27 UFs. Como entrada para os dois modelos, foram utilizados os gastos com saúde e educação de cada UF, assim como a renda média familiar. Como saída, utilizou-se a média do Índice FIRJAN de Desenvolvimento Municipal (IFDM) dos municípios de cada UF. Foram feitas correlações entre a eficiência de cada UF obtida pela DEA e o respectivo Produto Interno Bruto (PIB). Com base no CCR, em que a eficiência é calculada considerando-se o axioma da proporcionalidade entre inputs e outputs, houve maior número de UFs eficientes no governo Dilma. Em relação ao BCC, o qual admite que a eficiência máxima varie em função da economia de escala, os resultados são semelhantes entre os dois governos, apresentando o governo Lula maior número de UFs eficientes. Há correlação entre os modelos CCR e BCC, assim como entre o modelo CCR e o PIB, mas não há correlação entre o modelo BCC e o PIB.

The Relevance of the Voluntary Transfers of Federal Resources for the Consolidation of the Government’s Support Base in the Brazilian Congress

The literature on coalition presidentialism in Brazil considers the allocation of federal resources to the electoral bases of parliamentarians as an available tool for the Presidency to obtain support for initiatives of its interest in the National Congress. This article aims to verify the relationship between the transfer of these resources, the voluntary transfers, and the support to the Government. Two groups of deputies were separated to find out this behavior: those that vote following the Government’s orientation and those that systematically vote against it. From each group a sample of 50 deputies was selected, from which the percentage of votes obtained in the 2014 elections in each municipality was inferred. The four municipalities in which a deputy reaches proportionately more votes belong to his electoral base. Crossing this base of municipalities with data on voluntary transfers from the Federal Government, statistical tests found that the volume of federal voluntary resources received by a given municipality is related to the supportive alignment of the mayor and the governor with the Federal Government and also with the institutional capacity of the municipality administration. However, the volume of transfers received cannot be explained by virtue of whether or not the municipality is the electoral base of a federal deputy aligned or facing opposition to the Federal Executive.

Strategic spending in federal governments: theory and evidence from the US

ABSTRACTPast research on the allocation of federal resources to localities has failed to account for the interaction between federal and state governments. Here a sequential-move game of such interaction is developed, where state governments behave like political surrogates for the federal government when they are politically aligned, while they engage in political competition when not. The model predicts that aligned states increase the funding of aligned localities, while the federal government increases the funding of aligned localities only within nonaligned states. Using data from the Census of Governments 1982–2002 and a difference-in-difference strategy reveals that such predictions are upheld by the data. My findings find a limit to the benefits of decentralization. Although the standard view is that it removes political power from the center, I find that decentralization could concentrate such power more at local level, which may give the President political advantages within unaligned states through aligned localities.

Presidential pork barrel politics with polarized voters

Despite strong theoretical claims that politicians should target swing voters with distributive benefits, empirical evidence in the United States is inconclusive. This paper addresses the puzzle by focusing on two factors overlooked in previous work. First, I show that, owing to the bimodal distribution of partisanship among the U.S. public, swing voters can be targeted efficiently through the allocation of federal resources to areas where the opposition is strong. Secondly, I hypothesize that presidents limit swing-voter targeting to times when they are actually up for reelection; thus, the opposition county advantage appears only in first presidential terms. An analysis of the geographic distribution of federal project grants awarded between 1986 and 2009 supports the theory. Presidents target swing voters within competitive states; they do so only in the years when they seek reelection, however, and they channel benefits to counties where the opposition party maintains a stronghold.

Inaccuracies in the 2020 Census Enumeration Could Create a Misalignment Between States' Needs.

As the most accurate reflection of the United States population, the US decennial census is vital to health policymakers and others at all levels of government. Competing priorities related to cost containment and the introduction of new reforms raise concerns about the resources available to the US Census Bureau to conduct an accurate population enumeration in 2020. We examined the state of the Census Bureau's preparations for the 2020 Census and how inaccuracies in the coming census enumeration could influence public health and health equity in the coming decade. The results of the 2020 Census will be used to allocate trillions of dollars in federal funding to states, including support for programs vital to public health such as Medicaid and the Special Supplemental Nutrition Program for Women, Infants, and Children. Inaccuracies in the census enumeration could create a misalignment between states' needs and allocation of federal resources. Also, a census miscount of the population could create challenges for public health surveillance and research activities that inform public health policies and interventions.

A Educação Pública e as Corporações: avanços e contradições em uma década de ampliação de investimento no Brasil

Com base em pesquisas a fontes primárias e secundárias, o texto busca contribuir para a reflexão crítica sobre opções de políticas governamentais que implicaram na ampliação da simbiose entre governos e segmentos do setor privado corporativo ou a este associado. Para efeito desse intento, considera-se a destinação de recursos federais no período de 2002 a 2014, quando se ampliaram os gastos com a educação em relação ao PIB e o período de escolaridade obrigatória, paralelamente ao fortalecimento da “filantropia de risco” e de corporações na prestação de serviços aos sistemas públicos de ensino. Tratando-se de trabalho de natureza exploratória, os dados levantados apontam para a necessidade de pesquisas mais detalhadas sobre o repasse de fundos públicos para o setor privado.

A Federal Resource Allocation and Social Sector Development: Evidence from Nigeria

A Federal Resource Allocation and Social Sector Development: Evidence from Nigeria

A POLÍTICA NACIONAL DE ATENÇÃO BÁSICA NO PIAUÍ: uma análise com foco na equidade

O estudo analisa a implementação da Política Nacional de Atenção Básica no Estado do Piauí com o objetivo de discutir a equidade do acesso à saúde no Piauí, nos anos de 2006 a 2011, a partir da alocação dos recursos federais em saúde e o acesso a ações de Atenção Básica, em especial as consultas médicas para a população geral, infantil e de gestantes. Utiliza estatística descritiva para analisar os indicadores municipais agregados em quintis de renda média domiciliar per capita municipal. Analisa a evolução das transferências federais do Bloco da Atenção Básica do Piauí e utiliza um modelo de regressão linear múltipla para estimar se parâmetros socioeconômicos orientaram a alocação dos recursos federais. Verifica melhoria dos indicadores de acesso avaliados, mas a principal mudança observada foi o aumento da disponibilidade de recursos federais para os municípios, especialmente no componente variável do financiamento da Atenção Básica. Não foi possível identificar associação entre as transferências de recursos federais da saúde e critérios de alocação equitativa, com base em indicadores socioeconômicos.Palavras-chave: Política de saúde, SUS, Atenção básica, Financiamento em saúde, Equidade.NATIONAL POLICY OF PRIMARY HEALTH CARE IN PIAUÍ: an analysis focused on equity Abstract: The implementation of the National Policy of Primary Care in Piauí State was analyzed with the objective to discuss equity to access health, in 2006 to 2011, taking the allocation of federal resources and access to Primary Health Care, especially medical appointments for the general population, children and pregnant women. Was used descriptive statistics to analyze municipal indicators aggregated into quintiles of household income. The study analyzed the evolution of federal transfers for the Primary Health Care in Piauí and used a linear regression model to estimate the effect of socioeconomic parameters on the allocation of federal resources. It has been found improving in the evaluated access indicators but the main change was the increased availability of federal resources for the municipalities, especially in the variable component financing of Primary Health Care. It was not possible to identify association between the federal transfers and the analyzed socioeconomic criteria for an equitable allocation based on the socioeconomic indicators. Key words: Health policy, SUS, Primary health care, Health financing, Equity.

Diagnoses, prevalence, and state-based federal spending for HIV prevention and treatment in the United States, 2006–2009

BackgroundIn response to an article published in 2012 by officials at the US Department of Health and Human Services (DHHS), an independent analysis of state-based federal resource allocation for HIV was conducted to determine if the funding accurately reflected diagnosis and prevalence rates.MethodsTotal state-based federal funding for HIV, state-based funding for HIV prevention, and state-based funding for HIV treatment were compared to state-based HIV diagnosis and prevalence rates from 2006-2009.ResultsTotal state-based federal funding for HIV and funding for HIV prevention and treatment were highly correlated with HIV diagnosis and prevalence rates during the time horizon of the study; however, correlations between state-based HIV prevention funding and state-based HIV diagnosis rates were lower than the correlations between state-based HIV treatment funding and HIV prevalence.ConclusionsOur findings suggest that state-based federal resource allocation for HIV prevention and treatment may be better aligned with HIV diagnosis and prevalence rates than previously reported; however resource allocation for HIV prevention is less aligned than funding for HIV treatment signaling the need to reexamine state-based federal funding for HIV prevention.

Limited Involvement of Socially Vulnerable Populations in Federal Programs to Mitigate Wildfire Risk in Arizona

Currently, biophysical risk factors figure prominently in federal resource allocation to communities threatened by wildfire. Yet, disaster research demonstrates that socioeconomic characteristics impact disaster risk and resilience. Consequently, this study evaluates whether federal wildfire program resources are reaching socially vulnerable populations. Biophysical and social vulnerability indicators were included in a series of regressions to identify predictors of participation in three wildfire mitigation programs in Arizona. Findings indicate that mitigation activities are closely correlated with biophysical risk to wildfire, but socially vulnerable communities are less likely to participate even when exposed to high wildfire risk. This finding suggests a need for a more strategic and equitable distribution of federal resources to mitigate wildfire risk.

Regionalizing Patronage? Federal Resource Allocation and Party Politics in Spain

Does federalism enhance patronage practices? To the degree that subnational governments are responsible for significant portions of total public spending in politically decentralized systems, the study of the institutional facilitators of patronage can be fruitfully advanced by mapping out the territorial distribution of political and economic resources. Using data from intergovernmental transfers in Spain—an often-cited case of patronage-driven electoral mobilization—we find that, unexpectedly, Spanish regions that have a regional-party dominant system do not necessarily ‘over-fish’ patronage resources. This apparent inconsistency is explained by the fact regionalist parties are more likely to flourish in economically advantaged regions, which are normally more interested in deepening fiscal co-responsibility (which makes the reliance on patronage and pork-barrelling less likely).

Partisanship, Blame Avoidance, and the Distribution of Legislative Pork

majority party advantage in the allocation of federal resources, a relation? ship seemingly at odds with the bipartisan support often enjoyed by distributive policies and pragrams. We reconcile this disjuncture by developing a partisan blame avoidance account of the distribution of legisla? tive pork. According to this account, the majority party inoculates itself against minority party charges of wasteful spending by including the minority in pork barrel coalitions. At the same time, the majority party, mindful of the electoral benefits of

Prosecutorial Limits on Overlapping Federal and State Jurisdiction

Historically, debates over the wisdom of expanding the reach of federal power have reflected the tension between competing notions: the idea that responsibilities for the business of government can be allocated neatly into fixed federal and state spheres, and the idea that the federal government, including the federal courts, must have the flexibility to expand its reach to respond to changing national problems and concerns. In recent years, Congress has enacted several statutes expanding the criminal jurisdiction of the federal courts into areas previously the sole responsibility of the states. This article argues that three such expansions—the Violence Against Women Act, the Freedom of Access to Clinic Entrances Act, and the Child Support Recovery Act of 1992—fit within a traditional rationale for exercises of federal jurisdiction. In addition, this article suggests that, as a practical matter, these expansions do not signal an attempt to supplant state authority but, rather, are an effort to supplement state authority by invoking federal power and applying federal resources in strategic, limited ways. The wise allocation of federal resources in areas of overlapping state and federal jurisdiction depends on the selective exercise of federal prosecutorial discretion.

Investigating Misconduct in Science: The National Science Foundation Model

Reports in the popular press,(1) as well as recent studies by organizations,(2) make clear that the problem of misconduct in science(3) is real and persistent. integrity is not always ensured by science's self-correcting mechanisms.(4) The effects of misconduct go beyond distortion of data. Misconduct can also undermine the proper and fair allocation of federal resources when it involves peer review of grant proposals, a process that depends on honesty and integrity. The public faith in science that is necessary to ensure sufficient funding for the progress of science depends on honest applications for federal funding and honest use of public funds. Therefore, both the government and the academic community need effective procedures for dealing with misconduct in science. Despite the need for effective procedures for establishing whether misconduct in science has occurred, considerable controversy has arisen over which procedures should be used. Most universities have only recently put in place procedures for dealing with misconduct in science and have not yet fully tested them.(5) According to an American Association for the Advancement of Science survey, scientists lack confidence in university handling of misconduct cases.(6) This article presents our study of the principles underlying NSF's procedures for handling misconduct in science, as well as the results of NSF's experience in handling allegations of misconduct. By presenting the rationale for NSF's procedures, we hope not only to persuade the community of the applicability of these procedures to misconduct in science cases but also to stimulate comment and criticism. The Scientific Dialogue Model Many early cases of misconduct in science have been handled according to procedures developed at the Public Health Service (PHS) and referred to as the scientific model.(7) This model emulates the peer review process by assembling a panel of scientists who investigate allegations and reach a consensus on whether misconduct has occurred.(8) Although the familiarity of the procedures initially appealed to some scientists, the community itself has criticized handling of cases under the dialogue model for not meeting standards of confidentiality and fairness.(9) Applying methods developed for the evaluation of manuscripts, grant proposals, or tenure qualifications to the determination of ethically acceptable conduct leaves unfulfilled expectations. When proceedings may lead to sanctions, both accused scientists and observers expect certain protections. Nonetheless, some scientists resisted application of traditional American investigative and adjudicative procedures, which offer such protections, to misconduct in science cases. Perhaps this was due to concerns that issues would get lost in such a setting.(10) However, theory and practice in the handling of misconduct cases has brought out the importance of procedural fairness. PHS has shown an increased awareness of procedural protections in handling misconduct in science cases by introducing the opportunity for a hearing.(11) NSF's Model for Handling Misconduct in Science Cases Since 1987 NSF has based its policies and procedures for handling misconduct in science cases on well-established administrative, civil, and criminal methods of investigation and adjudication.(12) NSF believes that traditional investigative and adjudicative procedures are appropriate when the issue is culpability for misconduct. These traditional procedures are preferable to alternatives adapted from the process of peer review. Peer reviewers necessarily assume that authors are truthful. Because the central issue to be resolved in a misconduct case is whether an individual has been truthful, a system like peer review is inappropriate because it lacks the investigative, adjudicatory, and due process mechanisms to evaluate that issue accurately and fairly. …