Impact Of Reforms Research Articles

Utilisation of nursing home care before and after the 2015 Dutch national reform: an interrupted time series analysis.

The Netherlands introduced abrupt, large-scale, long-term care (LTC) reforms in 2015 that promoted ageing-in-place. However, there has been no comprehensive population-level study evaluating how these reforms have impacted nursing home (NH) utilisation. This study examines the association between the 2015 reforms with national monthly rates of NH admissions and survival time amongst newly admitted older adults. We analysed population data from Statistics Netherlands (2011-2019), conducting an interrupted time-series analysis to compare monthly NH admission rates before and after the 2015 reforms amongst adults aged 65 and older (N = 402350). A Cox proportional hazards model was used to assess the reform's impact on mortality risk amongst newly admitted residents. The adjusted NH admission rate before the reform was 88.80 per 100000 older adults (95% CI (confidence interval): 82.36-95.83), compared to 69.82 per 100000 after the reform (95% CI: 65.91-73.78), indicating a significant reduction (incident rate ratio: 0.80, 95% CI: 0.74-0.86). Over a 3-year follow-up, the average survival time for those admitted after the reform was 608days (95% CI: 608.72-610.74), compared to 622.52days (95% CI: 620.59-624.45) for those admitted before the reform. The reform was associated with a slightly increased mortality risk (hazard ratio: 1.05, 95% CI: 1.02-1.07). The 2015 Dutch LTC reform is associated with a reduction in national NH admissions and a decrease in average survival time of 2weeks.

Cross‐border E‐commerce Reform and Entrepreneurial Activity in Urban Services – Evidence from Chinese Service Industry Enterprise Registration Data

AbstractCross‐border e‐commerce (CBEC) significantly stimulates foreign trade development and the flow of goods and services. This study, using Chinese city‐level data and a multiperiod difference‐in‐differences model based on CBEC comprehensive pilot zones, explores the impact of CBEC reform on urban service industry entrepreneurship. The results show that CBEC reform increased entrepreneurial activity, and this is confirmed by robustness tests. The mechanisms driving this effect include the attraction of foreign direct investment, improved information infrastructure, and talent development. Regional analysis reveals stronger effects in central, western, and noncoastal cities, and industry analysis highlights public and consumer services. Spatial heterogeneity shows that the reform's impact diminished with distance from pilot zones, with potential inhibitory effects in remote areas. This study demonstrates how CBEC reform can stimulate entrepreneurship and foster economic growth.

Land allocation and industrial agglomeration: Evidence from the 2007 reform in China

This paper highlights the crucial role of land allocation mechanisms in fostering industrial agglomeration by examining China's 2007 industrial land market reform. By introducing transparency into the land-selling process, the reform facilitated more buyers to compete for land (as evidenced by increased land sale prices), enabling local governments to allocate land to the most suitable users. Utilizing comprehensive data sets that include information on initial local industrial structure, new industrial establishments, and industrial land transactions, the empirical analysis finds that the reform significantly increased the entry of firms from industries aligned with local specialization, particularly in regions that implemented the reform more strictly. Industries characterized by substantial unrealized agglomeration economies or highly localized spillover effects experienced amplified effects. A well-functioning capital market further enhanced the land market reform's impact. Supporting evidence demonstrates the reform's positive effect on economic growth (as evidenced by changes in nighttime luminosity), potentially through increasing local firms' TFP.

Turning the page on energy poverty? Quasi-experimental evidence on education and energy poverty in Zimbabwe

We investigate the long-term causal effects of education on energy poverty among households headed by men and women, leveraging the 1980 Zimbabwe school reform as a quasi-experiment. This reform, which significantly expanded educational opportunities for all children, serves as an ideal setting for assessing the impact of education on energy poverty within a regression discontinuity design, with age at reform determining exposure. Exposure to the reform resulted in a 2.08-year average increase in schooling and a 28.3 percentage point (pp) increase in the probability of completing secondary schooling. The reform's impact was more pronounced for women, increasing their schooling by 2.35 years (compared to 1.68 years for men) and for rural residents, with a 2.53-year increase (compared to 1.00 year for urban residents). A one-year increase in education reduces the risk of energy poverty by an estimated 8.56%, more pronounced among male-head families (5 pp) than among female-headed households (4.6 pp). This increased education enhances labour market outcomes, household economic status, infrastructure quality, and access to information and promotes progressive societal norms. These findings underscore education's crucial role in sustainable and gender-inclusive economic development, highlighting the potential of educational policy in reducing energy poverty and advancing gender equality in low-income countries.

Value‐added Tax and Leverage: Evidence from China's Value‐added Tax Rate Reform

AbstractThis paper uses China's value‐added tax (VAT) rate reform as a quasi‐natural experiment to identify the impacts of VAT rate shocks on corporate financial leverage. The results indicate that the reform reduced corporate total leverage significantly. There was a decrease in short‐term leverage, but long‐term leverage showed no significant change. These results remained robust across a series of robustness checks. Mechanism analysis shows that increasing profitability and improving cash flows acted as intermediary channels for the reform's impact on leverage. The reform also contributed to the mitigation of the asset–liability mismatch problem and the reduction of debt risk, while having no apparent impact on corporate investments. Finally, enterprises with more elastic demand and those with lower intermediate input ratios were affected most by the deleveraging effect of the VAT rate reform. This study suggests how the VAT rate cut shaped corporate capital structure. It thus helps to explain the economic consequences of VAT rate shocks.

Reassessing the relationship between women's empowerment and fertility: Evidence from India

AbstractAn overwhelming body of evidence supports a negative relationship between women's empowerment and fertility. In this paper, we evaluate whether this relationship holds in a setting with a high degree of son preference and limited access to abortion services by focusing on rural India. We exploit the reforms to the Hindu Succession Act that improved female empowerment by mandating equal inheritance rights for women to assess the reform's impact on women's fertility. Using NFHS‐3 data and a difference‐in‐differences estimation, our results show that women who benefitted from the reform had more children than their counterparts. We attribute this increase in fertility to women's ability to use the stopping rule to achieve son preference. Finally, women impacted by the reform had a higher proportion of sons for a given family size, indicating stronger inherent son preference among treated women.

Tax reform and investment efficiency: evidence from China's replacement of business tax with VAT

PurposeExtensive macro- and micro-economics research has been conducted on China's tax reform, which replaced business tax with value-added tax (VAT). However, existing studies have not clarified the reform's impact on firm-level investment decisions. Hence, this study explored the effect of replacing business tax with VAT on firms' investment efficiency.Design/methodology/approachThe study used 2010–2018 data from China's A-share listed companies and a difference-in-differences (DID) model to explore the effect of the reform on firm-level investment decisions.FindingsThe authors found that China's tax reform has improved investment efficiency in underinvested firms, increased liquidity and decreased the level of reliance on external financing. The tax reform had a greater effect on investment efficiency in firms with lower liquidity and higher external financing reliance. Its effect was also more significant among non-state-owned and small companies.Originality/valueThis study fills the aforementioned research gap by exploring the effects of China's tax reform, thus providing a theoretical reference and a basis for policymaking.

Are firms with 'deep pockets' more responsive to tort liability? Evidence from nursing homes.

We provide time series evidence of tort reform's impact on inputs and quality in the nursing home industry. Between 2000 and 2010, 11 state reforms capped noneconomic damages for health care services. Small chain and unaffiliated nursing homes enjoyed "judgment proof standing" and were less apt to be sued, prior to reform. We find that the managers of such homes were relatively unresponsive to the implementation of state caps on noneconomic damages. Large "deep-pocketed" chain-affiliated homes lacked judgment proof standing and implemented greater reductions in their nursing inputs in the aftermath of tort relief. However, we find little evidence of service quality erosion across four measured dimensions of care outcomes. Our findings are consistent with a "defensive care" model in which large chain homes employ unproductive inputs in an effort to meet a negligence standard of care.

Beyond donors: Toward a sociology of campaign expenditures

AbstractThe sociology of campaign finance overwhelmingly focuses on donation patterns and ties between donors, lobbyists, and candidates. However, less attention has been paid to ideological influences on campaign finance reform and other forms of expenditures. As a result, the sociological understanding of the role of money in democracy has great potential for development. This paper suggests that the new institutionalist perspective, particularly when treating ideas as a causal force, allows for a stronger understanding of campaign finance reform's impact on the public sphere. It does so by linking campaign finance law, political organizing, and campaign spending, specifically for the purpose of political advertising, together. The Citizens United v. FEC Supreme Court ruling provides an empirical example of these institutionalizing effects, tracking its impact across all three components of the public sphere. Approaches to new institutionalist analysis of campaign finance are also discussed.

To educate a woman and to educate a man: Gender-specific sexual behavior and human immunodeficiency virus responses to an education reform in Botswana.

This study analyses mechanisms that link education to human immunodeficiency virus (HIV) with a focus on gender differences, using data from four nationally representative surveys in Botswana. To estimate the causal effect, an exogenous 1‐year increase of junior secondary school is used. The key finding is that women and men responded differently to the reform. Among women, it led to delayed sexual debut and reduced time between first sex and marriage by up to a year. Among men, risky sex, measured by the likelihood of concurrent sexual partnerships and paying for sex, increased. The increase in risky sex among men is likely to be due to the education reform's positive impact on income. The reform reduced the likelihood of HIV infection sharply among women, especially among relatively young women age 18–24. The impact on men's likelihood of HIV infection is uncertain.

Formalising the jeepney industry in the Philippines – A confirmatory thematic analysis of key transitionary issues

Jeepneys are paratransit vehicles which constitute the bulk of urban transport in many cities in the Philippines. There are around 179,000 jeepneys of which 90% are fifteen years or older. However, this is not without so many other issues on the road. To address this, the government issued a landmark policy enabling the Public Utility Vehicle Modernization Program (PUVMP), a transformational large-scale initiative focused on land-based public transport in which the majority are jeepneys. The program brings about a comprehensive reform covering new policies in the franchising process, vehicle modernization, operator consolidation and changes in the current business model, financing and a more structured route planning process, among others. This is an ambitious undertaking, not merely because of its scale, but the likely disruption to the current, relatively informal model by which jeepneys are regulated. This paper uses deductive thematic analysis, based upon a review of the literature on informal/formal hybridised urban transport regulatory models, to investigate the reform's likely impact on the dynamics of the sector. As such it tentatively confirms the likely issues arising when transitioning from an informal model to a more formalised one. The paper raises imperatives for the global informal transport sector as a whole.

What Health Reform Tells Us about American Politics.

The passage and initial implementation of the Affordable Care Act (ACA) were imperiled by partisan divisions, court challenges, and the quagmire of federalism. In the aftermath of Republican efforts to repeal the ACA, however, the law not only carries on but also is changing the nature of political debate as its benefits are facilitating increased support for it, creating new constituents who rely on its benefits and share intense attachments to them, and lifting the confidence of Americans in both their individual competence to participate effectively in politics and that government will respond. Critics from the Left and the Right differ on their favored remedy, but both have failed to appreciate the qualitative shifts brought on by the ACA; this myopia results from viewing reform as a fixed endpoint instead of a process of evolution over time. The result is that conservatives have been blind to the widening network of support for the ACA, while those on the left have underestimated health reform's impact in broadening recognition of medical care as a right of citizenship instead of a privilege earned in the workplace. The forces that constrained the ACA's development still rage in American politics, but they no longer dictate its survival as they did during its passage in 2010.

Failed Policy? The Effects of Kenya's Education Reform: Use of Natural Experiment and Regression Discontinuity Design

ObjectiveKenya's 1985 education reform implemented curriculum changes to prepare children for the job market and changed the instructional language from English to local ethnic languages during the first three years of primary education. This article examines the reform's impact on (i) level of education completed, (ii) income level, and (iii) preference for national versus ethnic interests.MethodsUsing survey data collected from randomly selected Kenyan citizens in Nairobi, this article uses a regression discontinuity (RD) design comparing the first cohort exposed to the reform to those who were not.ResultsThe education and income levels of those beginning their education under the reform were higher. The reform did not influence preference for national or ethnic interests.ConclusionsThe reform partially increased children's job market preparation but was unsuccessful in addressing unemployment. Teaching children in local languages exhibited no negative effects on ethnic as opposed to national interests.

Study on the Impact of Fair Value Measurement on Commercial Bank's Stock Price

The commercial banks of listed companies in the financial sector are larger, their operating performance not only represent the level of managers, more representative of the overall economic situation in China and strong representative. Implemented in 2014, the 39th of accounting standards for business enterprises, since the new criteria of fair value measurement, there are still some problems in the financial markets, based on fair value reform's impact on commercial bank performance in China, and its impact on the commercial banks' stock price volatility, and gives recommendations.

Free Primary Education, Schooling, and Fertility: Evidence from Ethiopia

This paper investigates the causal relationship between women's education and fertility by exploiting variation generated by the removal of school fees in Ethiopia. The increase in schooling caused by this reform is identified using both geographic variation in the intensity of the reform's impact and the temporal variation generated by the implementation of the reform. The model finds that the removal of school fees in Ethiopia led to an increase of over 1.5 years of schooling for women affected by the reform. A two-stage least squares approach is used to measure the impact of the exogenous increase in schooling on fertility. Each additional year of schooling led to a reduction in fertility, a delay in sexual activity, marriage, and the timing of at least their first, second, and third births. There is also evidence that the increase in schooling led to improved labor market outcomes, and a reduction in the desired number of children. Additionally, there is evidence of strategic use of hidden forms of contraception, only after family size becomes sufficiently large or after two sons have been born.

Reforms in Public Bus Services in Israel

This research presents the main results of tendering bus services in Israel from 2000 to 2014. The article discusses the impact of different tender characteristics on reform results in general, and in Israel, in particular. The article also examines the reform's impact on the quality of government regulation of public bus services. Since many countries are facing issues related to bus service regulation, the issues discussed in this article, combined with the Israeli experience in this field, are likely to be relevant to other countries in which similar reforms have been implemented.

Strengthening Economic Rights and Women’s Occupational Choice: The Impact of Reforming Ethiopia’s Family Law

This paper evaluates the impact of strengthening legal rights on the types of economic opportunities that are pursued. Ethiopia changed its family law, requiring both spouses' consent in the administration of marital property, removing the ability of a spouse to deny permission for the other to work outside the home, and raising women's minimum age of marriage. Thus both access to resources and the removal of restrictions on employment served to strengthen women's bargaining position within the household and their ability to pursue economic opportunities. Although this reform now applies nationally, it was initially rolled out in the two chartered cities and three of Ethiopia's nine regions. Using nationally representative household surveys from just prior to the reform and five years later allows for a difference-in-difference estimation of the reform's impact. The analysis finds that women were relatively more likely to work in occupations that require work outside the home, employ more educated workers, and in paid and full-time jobs where the reform had been enacted, controlling for time and location effects. As the relative increase in women's participation in these activities was 15-24 percent higher in areas where the reform was carried out, the magnitude of the impact is significant too.

Hukou's impact on labor occupation segmentation

Purpose– The purpose of this paper is to take occupation opportunity as an indicator to examine the impact of hukou on labor market segmentation in China. It estimates the scale of the impact and identifies the way of the impact. Especially, the paper takes hukou uniform reform as an example and tests whether hukou reforms helped in eliminating labor market segmentation.Design/methodology/approach– The data sets this paper adopted are the 2000 Census and 2005 Mini Census data in China. Linear model and Probit model are used in estimating hukou's impact. Oaxaca/Blinder decomposition is used in decomposing the difference in occupation distribution among hukou statuses. DID evaluation method is used in comparing the region with hukou uniform reform and the region without to capture the influence of the reform.Findings– The result shows that occupation segmentation based on hukou significantly exists in urban labor market. Hukou uniform reform improved the occupation opportunity of local rural workers but migrating rural workers were somehow crowded out. Migrating urban workers did not benefit from the reform. To conclude these, the reform released employment segmentation between rural and urban workers within the reformed region but strengthened the segmentation between the local residents and outcomers which could influence future labor source and scale in reformed area.Originality/value– The paper evaluates the hukou uniform reform's impact on the labor market using an empirical way for the first time and makes concrete policy recommendations based on these findings.

Need Is Urgent for Better Dementia Care

Need Is Urgent for Better Dementia Care

The transition to medication adoption in publicly funded substance use disorder treatment programs: organizational structure, culture, and resources.

Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform's impact on this sector of the treatment system.