Further analysis showed that HSAs were not selected equally by traveling patients. New York City ... more Further analysis showed that HSAs were not selected equally by traveling patients. New York City (HSA 7), received the bulk of the patient traffic over the 30 year time period while visits to other HSAs remained at a steady state. The majority of patients traveled over 100 miles for each of the surgeries (RP: 133.5 mi, RC: 133.2 mi, RN: 134.6 mi, PN: 106.8 mi). CONCLUSIONS: Traveling distance has previously been a significant deterrent for hospital choice. Today a greater proportion of patients are willing to travel well over 100 mi to undergo RP, RC, RN and PN. Further research is required for the development of models that more accurately predict the health care utilization patterns in New York State.
All press releases and the articles they feature are under strict embargo until uncorrected proof... more All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date.
Business writers and academics have suggested keeping an investing diary to avoid hindsight bias.... more Business writers and academics have suggested keeping an investing diary to avoid hindsight bias. In the diary, investors justify their predictions of future events, e.g., "This stock will go up because…" Eliminating hindsight bias should improve future returns. However, psychological research on the "explanation effect" suggests that justifying one's predictions in writing induces overconfidence and, by consequence, reduces current returns. We test these propositions in a set of prediction markets populated by two types of traders: forecasters who completed a required investing diary task and non-forecasters who did not. The portfolios of forecasters were significantly over-invested in securities associated with the forecaster's prediction. This is consistent with prior psychological research and a clear sign of investor over-confidence. We further find that forecasters with accurate predictions have higher returns than those with inaccurate predictions. However, the returns for forecasters with inaccurate predictions were generally no worse than the returns of the nonforecasters. Our results suggest that while keeping an investing diary may lead to biased portfolios, it does not have an overall negative effect on current returns. Therefore, contrary to expectations, there is not a trade-off between the longterm and short-term effects of an investing diary.
INTRODUCTION AND OBJECTIVES: As the general population continues to age and the number of practic... more INTRODUCTION AND OBJECTIVES: As the general population continues to age and the number of practicing urologists continues to decrease, advanced practice providers (APP) will be expected to play a larger role delivering urologic care. There is considerable debate regarding the role of APPs in urologic procedural care (UPC). The purpose of this study was to examine how APPs are currently being utilized to deliver UPC in a state where the density of urologists is considerably lower than the national average. METHODS: We analyzed data from the Iowa Hospital Association (IHA) database, which tracks all outpatient hospital procedural data within the state, for procedures being performed by APPs. The number and type of procedure was analyzed and then compared to the number of procedures being performed by urologists as well as the population over 65 over the corresponding time period. RESULTS: The number of APPs increased significantly (171 to 231) over the study period. A total of 5517 urologic procedures were performed by APPs from 2010-2013, and increased by 56% from 2010 to 2013 (Figure 1). This rise was statistically higher than the corresponding rise seen by urologists (16.6%), the rise in population over 65 (6%) and represented 6.7% of all procedures performed in the state. The most common procedures billed by APPs were catheter placement (78.5%), post-void residual measurement (7.6%), urodynamics (5.4%) and incision and drainage of wounds/abscesses (3.4%). More advanced/technically demanding procedures were performed less often (suprapubic tube placement (0.8%), cystoscopy (0.6%), ureteral stent placement (0.24%) and circumcision (0.11%)). CONCLUSIONS: APPs perform a significant percentage of the total UPC in our state. The numbers of procedures are increasing faster than those provided by urologists, though the procedures remain relatively non-complex in nature. In states with large rural populations and low urologic provider densities, we expect that the utilization of APPs for UPC will continue to increase as the demand increases. The implications of this shift for both providers and patients will need to be studied further.
Background and objectives: States are seeking ways to retain primary care physicians trained with... more Background and objectives: States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)-eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). Methods: Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression. A second model used rural location in Iowa as the dependent variable. Independent variables included graduation year cohort, IMG status, sex, undergraduate medical training in Iowa, medical degree, and residency location. Results: Undergraduate medical training in Iowa was strongly related to retention. Compared to graduates of the AMC residency, graduates of six of the seven community-based programs were significantly more likely to be practicing in Iowa. While the overall proportion of graduates practicing in rural Iowa was high (47.3%), women and IMGs were significantly less likely to practice in rural areas. Graduates of the Mason City program were significantly more likely to practice in a rural area after graduation. Conclusions: The experience of the IFMTN suggests that educating family physicians in community-based programs contributes significantly to in-state retention even 5 years after graduation. While all programs contribute to the rural FM workforce in Iowa, the residency program located in a rural community (Mason City) has a disproportionately positive impact.
The strong relationship between market share and other metrics (i.e., penetration rate, purchase ... more The strong relationship between market share and other metrics (i.e., penetration rate, purchase frequency, share of requirements) is well-documented in the marketing literature. However, there is no systematic meta-analysis of this important empirical generalization. This study quantifies the category-level correlations between market share and the aforementioned brand metrics. The category-level effects of promotional intensity, existence of sub-segments, purchase volume variation, and competition from private label and niche brands on these correlations are tested using grocery data from more than 400 categories. These factors have a negative effect all in three observed correlations with one exception. Promotional activity increases the correlation between market share and share of requirements. These results further generalize our knowledge of "Double Jeopardy" in FMCG markets and support the advice to brand managers to concentrate on increasing penetration rather than purchase frequency or share of requirements.
OBJECTIVE-To identify factors associated with nonmuscle invasive bladder cancer (NMIBC) American ... more OBJECTIVE-To identify factors associated with nonmuscle invasive bladder cancer (NMIBC) American Urological Association (AUA) guideline compliance in a rural state, to evaluate compliance rates over time, and to assess the impact of patient and provider rurality on delivery of NMIBC care. METHODS-We identified 847 Iowans in Surveillance, Epidemiology, and End Results-Medicare from 1992 to 2009 with high-grade NMIBC who survived 2 years and were not treated with cystectomy or radiation during this period. Compliance with AUA guidelines was assessed over time and compared to patient demographic, tumor, and treatment institution variables. Impact of rurality was analyzed using Surveillance, Epidemiology, and End Results ZIP code data travel distance of patient to nearest urologist practice location. RESULTS-Overall compliance with AUA guidelines was low (<1%), and did not markedly improve over the study period. In the multivariable model, only care at an academic medical center (OR 11.68, 95% CI 7.07-19.29) and tumor stage (Tis; OR 3.24, 95% CI 1.86-5.63) increased the odds of compliance. Patients living closer (<10 miles) to their urologists underwent more cystoscopies than patients living further (>30 miles) but distance did not affect compliance with other measures. Compliance was not associated with cancer-specific survival. CONCLUSION-Compliance with post-Transurethral Resection of Bladder Tumor (TURBT) NMIBC treatment guidelines has improved but remains suboptimal in our rural state, and is highly associated with treatment at an academic cancer center for reasons that could not be fully explained with these data. Bladder cancer represents the second most common urologic malignancy 1 and the most expensive cancer on a per patient basis. 2,3 Patients with high grade nonmuscle invasive
The aging of the US population, the obesity epidemic, and insurance reforms are increasing the de... more The aging of the US population, the obesity epidemic, and insurance reforms are increasing the demand for primary care services. 1,2 At the same time, the number of adult primary care physicians is not expected to grow at a pace sufficient to meet this expected increase. 3,4 High levels of professional burnout among family medicine physicians 5 and an increasing number of primary care doctors
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Endowment effect has typically been conceptualized as a phenomenon that occurs within a transacti... more Endowment effect has typically been conceptualized as a phenomenon that occurs within a transaction at a specific point in time wherein the buyer and seller have differing perspectives that result in different reservation prices: the buyer's willingness-to-pay (hereafter WTP) and the seller's willingness-to-accept (hereafter WTA). There is little in prospect theory to predict any carry-over of the endowment effect to another transaction. However, recent research (e.g., Nayakankuppam and Mishra 2005) has affirmed that the endowment effect is not due to shifts in response language (e.g., buy low, sell high) but reflect actual differences in mental representations of the item by sellers and buyers. Since mental representations are associative networks in memory (Anderson 1983), such associations that have been primed in memory are more accessible. Greater accessibility is likely to bias subsequent information processing and influence subsequent judgments (Houston and Fazio 1989). Therefore, we propose that an endowment, once experienced, can exert an influence the valuations of similar objects in a subsequent transaction. Recent research documents the differences in mental representations of the object in transaction (e.g., Carmon and Ariely 2000;
PurposeThe purpose of this paper is to examine the relationship of immediate workspace satisfacti... more PurposeThe purpose of this paper is to examine the relationship of immediate workspace satisfaction (IWS) and environmental workplace quality (EWQ) on perceived organizational support (POS), engagement and organizational citizenship behaviors (OCBs). In this paper, we draw on social exchange theory and environmental psychology to propose IWS and EWQ as drivers of employee OCBs.Design/methodology/approachA survey was conducted with 1,206 full-time employees. The EWQ measure was assessed with a randomly selected calibration sample (n = 603). Structural equation modeling was used to analyze the hypothesized model (n = 603).FindingsIWS and EWQ both are positively related to employees’ OCBs. For IWS, the effect was fully mediated by POS while POS and engagement partially mediated the EWQ–OCB relationship.Research limitations/implicationsThe survey was conducted at one point in time and may introduce common method variance.Practical implicationsHigh-quality, satisfying workspace and workp...
Customer loyalty is a key concern of marketing managers due to its potential impact on brand and ... more Customer loyalty is a key concern of marketing managers due to its potential impact on brand and firm performance. Share of category requirements (SCR) is one of the most widely used (and available) metrics of behavioural loyalty. We replicate existing research indicating that the Dirichlet model is an accurate predictor of a brand's SCR using a broad set of brands and categories in consumer packaged goods (CPG) markets across multiple retail channels in the United States. However, systematic deviations between the observed SCR and that predicted by the Dirichlet benchmark (i.e. "excess loyalty") remain. Excess loyalty is positively related to market share in most CPG categories (86%), a circumstance labelled by some authors as Triple Jeopardy. A cross-category analysis suggests that excess loyalty is significantly influenced by a brand's market share and average purchase volume while measures of the brand's marketing mix provide comparatively little explanatory power. By better understanding the drivers of excess loyalty, managers can more accurately evaluate a brand's performance with respect to SCR, a key behavioural loyalty metric.
This study examines the empirical relationship between four broad antecedents of brand equity (br... more This study examines the empirical relationship between four broad antecedents of brand equity (branding strategy, brand structure, brand positioning and target market) and two separate dimensions of revenue premium: price premium and volume premium. Our modeling framework aims to explain how different antecedents of brand equity influence the realized velocity and margin of branded product sales, key drivers of operating cash flow. Our generalizable empirical analyses are based on a representative dataset of over 6,500 brands, across 200 consumer-packaged goods categories, spanning three years. We find that only 20% of brands command revenue premiums, for which volume premiums are the critical determinant. Branding strategies and brand structure primarily impact volume premium. In contrast, brand positioning has little effect. Target market substantially affects both premiums. Overall, these four elements account for 73% and 69% of the explained variations in price and volume premiums, respectively. This study provides generalizable, important, and novel insights for the theory and practice of brand management regarding price positioning and extending brands into new categories.
Further analysis showed that HSAs were not selected equally by traveling patients. New York City ... more Further analysis showed that HSAs were not selected equally by traveling patients. New York City (HSA 7), received the bulk of the patient traffic over the 30 year time period while visits to other HSAs remained at a steady state. The majority of patients traveled over 100 miles for each of the surgeries (RP: 133.5 mi, RC: 133.2 mi, RN: 134.6 mi, PN: 106.8 mi). CONCLUSIONS: Traveling distance has previously been a significant deterrent for hospital choice. Today a greater proportion of patients are willing to travel well over 100 mi to undergo RP, RC, RN and PN. Further research is required for the development of models that more accurately predict the health care utilization patterns in New York State.
All press releases and the articles they feature are under strict embargo until uncorrected proof... more All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date.
Business writers and academics have suggested keeping an investing diary to avoid hindsight bias.... more Business writers and academics have suggested keeping an investing diary to avoid hindsight bias. In the diary, investors justify their predictions of future events, e.g., "This stock will go up because…" Eliminating hindsight bias should improve future returns. However, psychological research on the "explanation effect" suggests that justifying one's predictions in writing induces overconfidence and, by consequence, reduces current returns. We test these propositions in a set of prediction markets populated by two types of traders: forecasters who completed a required investing diary task and non-forecasters who did not. The portfolios of forecasters were significantly over-invested in securities associated with the forecaster's prediction. This is consistent with prior psychological research and a clear sign of investor over-confidence. We further find that forecasters with accurate predictions have higher returns than those with inaccurate predictions. However, the returns for forecasters with inaccurate predictions were generally no worse than the returns of the nonforecasters. Our results suggest that while keeping an investing diary may lead to biased portfolios, it does not have an overall negative effect on current returns. Therefore, contrary to expectations, there is not a trade-off between the longterm and short-term effects of an investing diary.
INTRODUCTION AND OBJECTIVES: As the general population continues to age and the number of practic... more INTRODUCTION AND OBJECTIVES: As the general population continues to age and the number of practicing urologists continues to decrease, advanced practice providers (APP) will be expected to play a larger role delivering urologic care. There is considerable debate regarding the role of APPs in urologic procedural care (UPC). The purpose of this study was to examine how APPs are currently being utilized to deliver UPC in a state where the density of urologists is considerably lower than the national average. METHODS: We analyzed data from the Iowa Hospital Association (IHA) database, which tracks all outpatient hospital procedural data within the state, for procedures being performed by APPs. The number and type of procedure was analyzed and then compared to the number of procedures being performed by urologists as well as the population over 65 over the corresponding time period. RESULTS: The number of APPs increased significantly (171 to 231) over the study period. A total of 5517 urologic procedures were performed by APPs from 2010-2013, and increased by 56% from 2010 to 2013 (Figure 1). This rise was statistically higher than the corresponding rise seen by urologists (16.6%), the rise in population over 65 (6%) and represented 6.7% of all procedures performed in the state. The most common procedures billed by APPs were catheter placement (78.5%), post-void residual measurement (7.6%), urodynamics (5.4%) and incision and drainage of wounds/abscesses (3.4%). More advanced/technically demanding procedures were performed less often (suprapubic tube placement (0.8%), cystoscopy (0.6%), ureteral stent placement (0.24%) and circumcision (0.11%)). CONCLUSIONS: APPs perform a significant percentage of the total UPC in our state. The numbers of procedures are increasing faster than those provided by urologists, though the procedures remain relatively non-complex in nature. In states with large rural populations and low urologic provider densities, we expect that the utilization of APPs for UPC will continue to increase as the demand increases. The implications of this shift for both providers and patients will need to be studied further.
Background and objectives: States are seeking ways to retain primary care physicians trained with... more Background and objectives: States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)-eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). Methods: Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression. A second model used rural location in Iowa as the dependent variable. Independent variables included graduation year cohort, IMG status, sex, undergraduate medical training in Iowa, medical degree, and residency location. Results: Undergraduate medical training in Iowa was strongly related to retention. Compared to graduates of the AMC residency, graduates of six of the seven community-based programs were significantly more likely to be practicing in Iowa. While the overall proportion of graduates practicing in rural Iowa was high (47.3%), women and IMGs were significantly less likely to practice in rural areas. Graduates of the Mason City program were significantly more likely to practice in a rural area after graduation. Conclusions: The experience of the IFMTN suggests that educating family physicians in community-based programs contributes significantly to in-state retention even 5 years after graduation. While all programs contribute to the rural FM workforce in Iowa, the residency program located in a rural community (Mason City) has a disproportionately positive impact.
The strong relationship between market share and other metrics (i.e., penetration rate, purchase ... more The strong relationship between market share and other metrics (i.e., penetration rate, purchase frequency, share of requirements) is well-documented in the marketing literature. However, there is no systematic meta-analysis of this important empirical generalization. This study quantifies the category-level correlations between market share and the aforementioned brand metrics. The category-level effects of promotional intensity, existence of sub-segments, purchase volume variation, and competition from private label and niche brands on these correlations are tested using grocery data from more than 400 categories. These factors have a negative effect all in three observed correlations with one exception. Promotional activity increases the correlation between market share and share of requirements. These results further generalize our knowledge of "Double Jeopardy" in FMCG markets and support the advice to brand managers to concentrate on increasing penetration rather than purchase frequency or share of requirements.
OBJECTIVE-To identify factors associated with nonmuscle invasive bladder cancer (NMIBC) American ... more OBJECTIVE-To identify factors associated with nonmuscle invasive bladder cancer (NMIBC) American Urological Association (AUA) guideline compliance in a rural state, to evaluate compliance rates over time, and to assess the impact of patient and provider rurality on delivery of NMIBC care. METHODS-We identified 847 Iowans in Surveillance, Epidemiology, and End Results-Medicare from 1992 to 2009 with high-grade NMIBC who survived 2 years and were not treated with cystectomy or radiation during this period. Compliance with AUA guidelines was assessed over time and compared to patient demographic, tumor, and treatment institution variables. Impact of rurality was analyzed using Surveillance, Epidemiology, and End Results ZIP code data travel distance of patient to nearest urologist practice location. RESULTS-Overall compliance with AUA guidelines was low (<1%), and did not markedly improve over the study period. In the multivariable model, only care at an academic medical center (OR 11.68, 95% CI 7.07-19.29) and tumor stage (Tis; OR 3.24, 95% CI 1.86-5.63) increased the odds of compliance. Patients living closer (<10 miles) to their urologists underwent more cystoscopies than patients living further (>30 miles) but distance did not affect compliance with other measures. Compliance was not associated with cancer-specific survival. CONCLUSION-Compliance with post-Transurethral Resection of Bladder Tumor (TURBT) NMIBC treatment guidelines has improved but remains suboptimal in our rural state, and is highly associated with treatment at an academic cancer center for reasons that could not be fully explained with these data. Bladder cancer represents the second most common urologic malignancy 1 and the most expensive cancer on a per patient basis. 2,3 Patients with high grade nonmuscle invasive
The aging of the US population, the obesity epidemic, and insurance reforms are increasing the de... more The aging of the US population, the obesity epidemic, and insurance reforms are increasing the demand for primary care services. 1,2 At the same time, the number of adult primary care physicians is not expected to grow at a pace sufficient to meet this expected increase. 3,4 High levels of professional burnout among family medicine physicians 5 and an increasing number of primary care doctors
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Endowment effect has typically been conceptualized as a phenomenon that occurs within a transacti... more Endowment effect has typically been conceptualized as a phenomenon that occurs within a transaction at a specific point in time wherein the buyer and seller have differing perspectives that result in different reservation prices: the buyer's willingness-to-pay (hereafter WTP) and the seller's willingness-to-accept (hereafter WTA). There is little in prospect theory to predict any carry-over of the endowment effect to another transaction. However, recent research (e.g., Nayakankuppam and Mishra 2005) has affirmed that the endowment effect is not due to shifts in response language (e.g., buy low, sell high) but reflect actual differences in mental representations of the item by sellers and buyers. Since mental representations are associative networks in memory (Anderson 1983), such associations that have been primed in memory are more accessible. Greater accessibility is likely to bias subsequent information processing and influence subsequent judgments (Houston and Fazio 1989). Therefore, we propose that an endowment, once experienced, can exert an influence the valuations of similar objects in a subsequent transaction. Recent research documents the differences in mental representations of the object in transaction (e.g., Carmon and Ariely 2000;
PurposeThe purpose of this paper is to examine the relationship of immediate workspace satisfacti... more PurposeThe purpose of this paper is to examine the relationship of immediate workspace satisfaction (IWS) and environmental workplace quality (EWQ) on perceived organizational support (POS), engagement and organizational citizenship behaviors (OCBs). In this paper, we draw on social exchange theory and environmental psychology to propose IWS and EWQ as drivers of employee OCBs.Design/methodology/approachA survey was conducted with 1,206 full-time employees. The EWQ measure was assessed with a randomly selected calibration sample (n = 603). Structural equation modeling was used to analyze the hypothesized model (n = 603).FindingsIWS and EWQ both are positively related to employees’ OCBs. For IWS, the effect was fully mediated by POS while POS and engagement partially mediated the EWQ–OCB relationship.Research limitations/implicationsThe survey was conducted at one point in time and may introduce common method variance.Practical implicationsHigh-quality, satisfying workspace and workp...
Customer loyalty is a key concern of marketing managers due to its potential impact on brand and ... more Customer loyalty is a key concern of marketing managers due to its potential impact on brand and firm performance. Share of category requirements (SCR) is one of the most widely used (and available) metrics of behavioural loyalty. We replicate existing research indicating that the Dirichlet model is an accurate predictor of a brand's SCR using a broad set of brands and categories in consumer packaged goods (CPG) markets across multiple retail channels in the United States. However, systematic deviations between the observed SCR and that predicted by the Dirichlet benchmark (i.e. "excess loyalty") remain. Excess loyalty is positively related to market share in most CPG categories (86%), a circumstance labelled by some authors as Triple Jeopardy. A cross-category analysis suggests that excess loyalty is significantly influenced by a brand's market share and average purchase volume while measures of the brand's marketing mix provide comparatively little explanatory power. By better understanding the drivers of excess loyalty, managers can more accurately evaluate a brand's performance with respect to SCR, a key behavioural loyalty metric.
This study examines the empirical relationship between four broad antecedents of brand equity (br... more This study examines the empirical relationship between four broad antecedents of brand equity (branding strategy, brand structure, brand positioning and target market) and two separate dimensions of revenue premium: price premium and volume premium. Our modeling framework aims to explain how different antecedents of brand equity influence the realized velocity and margin of branded product sales, key drivers of operating cash flow. Our generalizable empirical analyses are based on a representative dataset of over 6,500 brands, across 200 consumer-packaged goods categories, spanning three years. We find that only 20% of brands command revenue premiums, for which volume premiums are the critical determinant. Branding strategies and brand structure primarily impact volume premium. In contrast, brand positioning has little effect. Target market substantially affects both premiums. Overall, these four elements account for 73% and 69% of the explained variations in price and volume premiums, respectively. This study provides generalizable, important, and novel insights for the theory and practice of brand management regarding price positioning and extending brands into new categories.
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