Can supervise: YES
Applied Microeconomics: primarily in health, education, labour and public economics, with a focus on evaluating the effects of Australian government programs on economic outcomes and behaviours. Inequalty and inter-generational mobility is also a key theme in my work.
Atalay, K, Barrett, GF & Siminski, P 2018, 'Pension incentives and the joint retirement of couples: evidence from two natural experiments', Journal of Population Economics.View/Download from: Publisher's site
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Recent reforms to social security in many countries have sought to delay retirement. Given the family context in which retirement decisions are made, social security reforms have potentially important spillover effects on the labour force participation of spouses. This paper analyses two complementary Australian natural experiments: (i) the 1993 Age Pension reform that increased the eligibility age for social security benefits for women and (ii) the Vietnam veterans pension and compensation schemes, whereby eligibility was conditional on conscription lotteries. We find important within-family spillover effects that are symmetric by gender and independent of whether pension coverage is expanded or withdrawn. Taking account of such within-family spillover effects is important for understanding the behavioural effects of pension programs and for reform impacts on social welfare.
This paper considers the degree to which events that intensify partying increase sexual assault. Estimates are based on panel data from campus and local law enforcement agencies and an identification strategy that exploits plausibly random variation in the timing of Division 1 football games. The estimates indicate that these events increase daily reports of rape with 17-24-year-old victims by 28 percent. The effects are driven largely by 17-24-year-old offenders and by offenders unknown to the victim, but we also find significant effects on incidents involving offenders of other ages and on incidents involving offenders known to the victim.
© 2018 Economic Society of Australia We present the first Australian estimates of intergenerational mobility that draw on direct observations of income from two generations. Using panel data for three birth cohorts of young adults from the Household, Income and Labour Dynamics Australia Survey, the estimated intergenerational income elasticity is 0.28. Correcting for attenuation bias raises this to 0.41. We estimate the rank correlation to be 0.27. We show that Australia has greater mobility than the USA, and this is not sensitive to methodological choices. We also show that spousal selection and family structure may be important determinants of income persistence across generations.
Mendolia, S & Siminski, P 2017, 'Is education the mechanism through which family background affects economic outcomes? A generalised approach to mediation analysis', Economics of Education Review, vol. 59, pp. 1-12.View/Download from: UTS OPUS or Publisher's site
We seek to quantify the role of education as a mechanism through which family background affects economic outcomes. To this end, we generalise mediation analysis to allow for multidimensional treatments. This improves the validity of mediation analysis for our application, in which family background is exogenous and multidimensional. Our approach allows the mediating role of education to vary across background characteristics, whilst also estimating its overall mediating effect. We estimate that educational attainment explains 21%–37% of the family background effect on hourly earnings in Australia, and only 13%–19% of the effect on wealth. We argue that these estimates are likely upward-biased. Therefore the link between family background and economic outcomes operates mostly through other mechanisms.
Siminski, PM, Cousley, A & Ville, S 2017, 'The Causal Effects of World War II Military Service', Journal of Economic History, vol. 77, no. 3, pp. 838-865.View/Download from: UTS OPUS or Publisher's site
Outside of the United States, few studies have estimated the effects of World War II service. In Australia, general war-time conscription and minimal involvement in the Korean War led to large cohort differences in military service rates, which we use for identification. We find a small, temporary negative effect on employment and a substantial positive effect on post-school qualifications, but not at the university level. While service increased home ownership slightly, it greatly reduced outright home ownership, consistent with the incentives provided by veterans' housing benefits. We also find a positive effect on marriage, but only from 1971.
Johnston, DW, Shields, MA & Siminski, P 2016, 'Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries.', Journal of health economics, vol. 45, pp. 12-26.View/Download from: UTS OPUS or Publisher's site
This paper estimates the long-term health effects of Vietnam-era military service using Australia's National conscription lotteries for identification. Our primary contribution is the quality and breadth of our health outcomes. We use several administrative sources, containing a near-universe of records on mortality (1994-2011), cancer diagnoses (1982-2008), and emergency hospital presentations (2005-2010). We also analyse a range of self-reported morbidity indicators (2006-2009). We find no significant long-term effects on mortality, cancer or emergency hospital visits. In contrast, we find significant detrimental effects on a number of morbidity measures. Hearing and mental health appear to be particularly affected.
Lindo, JM, Siminski, P & Yerokhin, O 2016, 'Breaking The Link Between Legal Access To Alcohol And Motor Vehicle Accidents: Evidence From New South Wales.', Health economics, vol. 25, no. 7, pp. 908-928.View/Download from: UTS OPUS or Publisher's site
A large literature has documented significant public health benefits associated with the minimum legal drinking age in the USA, particularly because of the resulting effects on motor vehicle accidents. These benefits form the primary basis for continued efforts to restrict youth access to alcohol. It is important to keep in mind that policymakers have a wide variety of alcohol-control options available to them, and understanding how these policies may complement or substitute for one another can improve policy making moving forward. Towards this end, we propose that investigating the causal effects of the minimum legal drinking age in New South Wales, Australia, provides a particularly informative case study, because Australian states are among the world leaders in their efforts against drunk driving. Using an age-based regression discontinuity design applied to restricted-use data from several sources, we find no evidence that legal access to alcohol has effects on motor vehicle accidents of any type in New South Wales, despite having large effects on drinking and on hospitalizations due to alcohol abuse. Copyright © 2015John Wiley & Sons, Ltd.
© 2016 Economic Society of Australia We present new estimates of intergenerational earnings elasticity for Australia. We closely follow the methodology used by Leigh [BE Journal of Economic Analysis & Policy, 7 (2007) 1], but use considerably more data (12 waves of HILDA and four waves of PSID). Our adjusted estimates are intended to be comparable to those for other countries in Corak [Journal of Economic Perspectives, 27 (2013) 79]. Our preferred estimate (0.35) is considerably higher than implied by Leigh's study, and is less subject to sampling variation. In an international context, intergenerational mobility in Australia is not particularly high, and is consistent with its relatively high level of cross-sectional inequality.
Paloyo, AR, Rogan, S & Siminski, P 2016, 'The effect of supplemental instruction on academic performance: An encouragement design experiment', Economics of Education Review, vol. 55, pp. 57-69.View/Download from: UTS OPUS or Publisher's site
© 2016 Elsevier Ltd Supplemental Instruction (SI) or PASS (Peer Assisted Study Sessions) has been widely offered to students at tertiary institutions in many countries with the aim of improving academic performance. The SI/PASS evaluation literature is extensive, but it has not adequately addressed potential selection bias. We evaluate an SI/PASS program at an Australian university through a randomized-encouragement-design experiment. A randomly selected subgroup of students from first-year courses (N = 6954) was offered large incentives (worth AUD 55,000) to attend PASS which increased attendance by an estimated 0.47 hours each. This first-stage (inducement) effect did not vary with the size of the incentive and was larger (0.89) for students from disadvantaged backgrounds. Instrumental-variable estimates suggest that 1 hour of PASS improved grades by 0.065 standard deviations, which is consistent with the non-experimental literature. However, this estimate is not statistically significant, reflecting limited statistical power. The estimated effect is largest for students in their first semester at university.
Siminski, P, Ville, S & Paull, A 2016, 'Does the military turn men into criminals? New evidence from Australia's conscription lotteries', Journal of Population Economics, vol. 29, no. 1, pp. 197-218.View/Download from: UTS OPUS or Publisher's site
© 2014, Springer-Verlag Berlin Heidelberg. In this paper, we estimate the effect of military service on the perpetration of crime. Several hypothesized links exist between service and crime, but recent quasi-experimental studies on this subject have produced mixed results. Our contribution to this literature uses Australia's Vietnam era conscription lotteries for identification along with criminal court data from Australia's three largest states. We find no evidence that military service increases or decreases crime in any category. In our preferred specification, the 95 % confidence interval rules out positive (negative) effects larger than 11 % (10 %) relative to the mean crime rate.
Patulny, R, Siminski, P & Mendolia, S 2015, 'The front line of social capital creation - A natural experiment in symbolic interaction', Social Science and Medicine, vol. 125, pp. 8-18.View/Download from: UTS OPUS or Publisher's site
This paper offers theoretical and empirical contributions to understanding the micro-sociological processes behind the creation of social capital. Theoretically, we argue that the emotional and shared experience of participating in symbolic interaction rituals may affect social capital in four different ways, via: (i) a 'citizenship' effect, connecting participants symbolically to the broader, civic society; (ii) a 'supportive' effect, bonding participants with each other; (iii) an exclusive 'tribal' effect, which crowds-out connections with other groups and the wider society; and (iv) an 'atomising' effect, whereby intense experiences create mental health problems that damage social capital.
We illustrate this with a case study of Australian veterans of the Vietnam War. The randomness of the National Service conscription lotteries of that era translates into a high-quality natural experiment. We formulate several hypotheses about which of the four effects dominates for veterans who participated in the 'symbolic interaction' of training and deployment. We test these hypotheses using data from the 2006 Australian Census of Population and Housing, and the NSW 45 & Up Study.
We found that war service reduced 'bonding' social capital, but increased 'bridging' social capital, and this is not explained completely by mental health problems. This suggests that while the combined 'tribal' and 'atomizing' effects of service outweigh the 'supportive' effects, the 'citizenship' effect is surprisingly robust. Although they feel unsupported and isolated, veterans are committed to their community and country. These paradoxical findings suggest that social capital is formed through symbolic interaction. The emotional and symbolic qualities of interaction rituals may formulate non-strategic (perhaps irrational) connections with society regardless of the status of one's personal support networks.
Siminski, P 2013, 'Are low-skill public sector workers really overpaid? A quasi-differenced panel data analysis', Applied Economics, vol. 45, no. 14, pp. 1915-1929.View/Download from: UTS OPUS or Publisher's site
Public-private sectoral wage differentials have been studied extensively using quantile regression techniques. These typically find large public sector premiums at the bottom of the wage distribution. This may imply that low skill workers are 'overpaid', prompting concerns over efficiency. We note several other potential explanations for this result and explicitly test whether the premium varies with skill, using Australian data. We use a quasi-differenced Generalized Method of Moments (GMM) panel data model which has not been previously applied to this topic, internationally. Unlike other available methods, this technique identifies sectoral differences in returns to unobserved skill. It also facilitates a decomposition of the wage gap into components explained by differences in returns to all (observed and unobserved) skills and by differences in their stock. We find no evidence to suggest that the premium varies with skill. One interpretation is that the compressed wage profile of the public sector induces the best workers (on unobserved skills) to join the public sector in low wage occupations, vice versa in high wage occupations. We also estimate the average public sector premium to be 6% for women and statistically insignificant (4%) for men. © 2012 Copyright Taylor and Francis Group, LLC.
Siminski, P 2013, 'Employment effects of army service and veterans' compensation: Evidence from the australian vietnam-era conscription lotteries', Review of Economics and Statistics, vol. 95, no. 1, pp. 87-97.View/Download from: UTS OPUS or Publisher's site
Exploiting Australia's National Service lotteries of 1965 to 1972, I estimate the effect of army service on employment outcomes. Population data from military personnel records, tax returns, veterans' compensation records, and the Census facilitate a rich and precise analysis, identified by 53,000 complying conscripts. The estimated employment effect is -12 percentage points (95% CI: -13, -11) overall, -37 for those who served in Vietnam and 0 for those who served only in Australia. It emerged in the 1990s, mirrored by veterans' disability pension effects. These results contrast with those for the United States, possibly reflecting employment disincentives associated with Australia's veterans' compensation system. © 2013 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology.
Siminski, P & Ville, S 2012, 'I Was Only Nineteen, 45 Years Ago: What Can we Learn from Australia's Conscription Lotteries?', Economic Record, vol. 88, no. 282, pp. 351-371.View/Download from: UTS OPUS or Publisher's site
The Australian conscription lotteries of 1965-1972 are a unique and underutilised resource for studying the effects of army service and veterans' programs. Drawing on many data sources and 25 years of related US literature, we present a comprehensive analysis of this natural experiment, examining indicators of health, personal economic outcomes, family outcomes and educational attainment. We discuss the numerous potential mechanisms involved and the limitations of available data.
Siminski, P & Yerokhin, O 2012, 'Is the Age Gradient in Self-Reported Material Hardship Explained By Resources, Needs, Behaviors, or Reporting Bias?', Review of Income and Wealth, vol. 58, no. 4, pp. 715-741.View/Download from: UTS OPUS or Publisher's site
Older people report much less hardship than younger people in a range of contexts, despite lower
incomes. Hardship indicators are increasingly influential, so the source of this age gradient has considerable
policy implications. We propose a theoretical and empirical strategy to decompose the sources
of this relationship. We exploit a unique feature of the Household, Income and Labour Dynamics
Australia (HILDA) survey, which collects reports of hardship from all adult household members. This
facilitates within-couple estimates, allowing us to identify age-related reporting bias. The majority of
the raw age–hardship gradient is explained by observed resources, particularly wealth and home
ownership. One third of the relationship is explained by unobserved differences between households,
which we interpret as age-related behavioral choices. Reporting error does not appear to contribute to
the age gradient.
We analyze data from the Household, Income and Labour Dynamics in Australia (HILDA) survey waves 1–6, to investigate whether the housework and childcare contributions of coupled Australian men with one child affect the likelihood that their wives will have a second child. We find no evidence that the way housework or childcare is shared has an effect, nor that the amount of men's contribution to housework or childcare has an effect. In addition, the effect of men's housework and childcare time on fertility does not appear to be mediated through its effect on their wives' housework and childcare.
Livermore, T, Rodgers, J & Siminski, P 2011, 'The Effect of Motherhood on Wages and Wage Growth: Evidence for Australia', Economic Record, vol. 87, no. SUPPL. 1, pp. 80-91.View/Download from: UTS OPUS or Publisher's site
Labour market theory provides several reasons why mothers are likely to earn lower hourly wages than non-mothers. However, the size of any motherhood penalty is an empirical matter and the evidence for Australia is limited. This article examines the effect of motherhood on Australian women's wages and wage growth using a series of panel-data models. Based on data from the Household, Income and Labour Dynamics in Australia survey, an unexplained motherhood wage penalty of around 5 per cent for one child, and 9 per cent for two or more children, is found. Further analysis suggests that the wage penalty emerges over time through reduced wage growth, particularly when the youngest child is an infant, rather than through an immediate wage decline after the birth of a child. This reduction in wage growth is consistent with discrimination, but also with a reduction in mothers' work effort. © 2011 The Economic Society of Australia.
Siminski, P 2011, 'The price elasticity of demand for pharmaceuticals amongst highincome older Australians: A natural experiment', Applied Economics, vol. 43, no. 30, pp. 4835-4846.View/Download from: Publisher's site
Most high-income older Australians became eligible for a pharmaceutical concession through a 1999 policy change. I exploit this natural experiment to estimate their price elasticity of demand for pharmaceuticals. The preferred model is a nonlinear Instrumental Variable (IV) regression, estimated on nationally representative repeated cross-sectional survey data using the Generalized Method of Moments (GMM). No significant evidence is found for endogenous take-up, and so cross-sectional estimates are also considered. Taking all of the results into account, the 'headline' estimate is -0.1, implying that quantity demanded is not highly responsive to price. © 2011 Taylor & Francis.
Siminski, P & Ville, S 2011, 'Long-run mortality effects of Vietnam-era Army service: Evidence from Australia's conscription lotteries', American Economic Review, vol. 101, no. 3, pp. 345-349.View/Download from: UTS OPUS or Publisher's site
We estimate the effect of Vietnam-era Army service on mortality, exploiting Australia® conscription lotteries for identification. We utilize population data on deaths during 1994-2007 and military personnel records. The estimates are identified by over 51,000 compilers induced to enlist in the Army. We find no statistically significant effects on mortality overall, nor for any cause of death. The estimated relative risk (RR) of death associated with Army service is 1.03 (95% CI: 0.92,1.19). On the assumption that Army service affected mortality only for those who served in Vietnam, the estimated RR is 1.06 (95% CI: 0.81,1.51). © 2011 AEA. The American Economic Association is hosted by Vanderbilt University.
Ville, S & Siminski, P 2011, 'A fair and equitable method of recruitment? Conscription by ballot into the Australian army during the Vietnam war', Australian Economic History Review, vol. 51, no. 3, pp. 277-296.View/Download from: UTS OPUS or Publisher's site
Australia's commitment to the Vietnam War drew on the selective conscription of additional manpower through 16 biannual ballots. Twenty-year-old men were liable to serve if their date of birth was drawn out. The randomness of the ballot was seen as an equitable method of selection for a system of labour coercion that was potentially life-threatening. We investigate the various stages of conscription of these 'national servicemen' for army service in Vietnam from 1965 to 1972 and evaluate the extent to which the processes provided for fair and equitable selection. Comparisons are drawn with a similar process of Vietnam War era conscription in the US. © 2011 The Authors. Australian Economic History Review © 2011 Blackwell Publishing Asia Pty Ltd and the Economic History Society of Australia and New Zealand.
Is gender inequality in unpaid work within households implicated in falling fertility rates? This paper investigates whether the likelihood couples with one child will have more children is affected by: (i) the amount of household labor they each perform or (ii) the way they divide household labor between themselves. Drawing a sample of partnered couples with one child (n = 573) from the longitudinal Household, Income and Labor Dynamics in Australia survey, we conduct multivariate regression analysis and find the more housework that Australian women do, the less likely they are to have more children. Neither fathers' time allocation to housework, nor relative shares of housework, were found to have an effect on subsequent fertility. Thus, mothers' own domestic workloads negatively impacted upon fertility, but shares of housework did not. © 2010 The Author. Published by Oxford University Press. All rights reserved.
This article considers changes in poverty rates under the Howard government. We also make three methodological contributions. We consider the statistical significance of the estimated changes in poverty. We propose a decomposition technique that reconciles the trends in absolute and relative poverty. We also use 'poverty profiles', which illustrate sensitivity to alternative poverty lines. We find decreases in absolute poverty and increases in relative poverty, both of which are statistically significant over a range of poverty lines. At a poverty line equal to half of the median income, the increase in relative poverty is statistically significant for all people and borders on significance for children. © 2009 The University of Melbourne, Melbourne Institute of Applied Economic and Social Research.
The Commonwealth Seniors Health Card (CSHC) is a key element of a suite of benefits for Australia's 'self-funded retirees'. Its main component is a pharmaceutical concession, which is analysed as a form of public health insurance. The utility gain through risk-pooling is found to be negligible under conservative assumptions. The deadweight loss through moral hazard may be considerable. Finally, the CSHC may be seen as an inequitable transfer, because CSHC holders are a particularly wealthy population. © 2009 Economic Society of Australia.
Batteries of questions with identical response items are commonly used in survey research. This paper suggests that question order has the potential to cause systematic positive or negative bias on responses to all questions in a battery. Whilst question order effects have been studied for many decades, almost no attention has been given to this topic. The primary aim is to draw attention to this effect, to demonstrate its possible magnitude, and to discuss a range of mechanisms through which it might occur. These include satisficing, anchoring and cooperativeness. The effect seems apparent in the results of a recent survey. This was a survey of Emergency Department patients presenting to Wollongong Hospital (Australia) with apparently less urgent conditions in 2004. Two samples were taken. Question order was fixed in the first sample (n = 104; response rate RR2 = 94%), but randomised in the second sample (n = 46; response rate RR2 = 96%). Respondents were asked to indicate whether each of 18 reasons for presenting to the ED was a 'very important reason', a 'moderately important reason', or 'not a reason'. The mean number of very important reasons selected was 56% higher in the first sample as compared to the second sample. © 2006 Springer Science + Business Media B.V.
Siminski, P, Bezzina, A, Lago, L & Eagar, K 2008, 'Trends in primary care presentations at emergency departments in New South Wales (1999-2006)', Australian Journal of Primary Health, vol. 14, no. 3, pp. 35-42.
This paper examines trends in potential "primary care" presentations at emergency departments (ED), comparing these with other ED presentations and to primary care attendances in the community. The study draws on EDIS data (Emergency Department Information System), which, at December 2005, covered 76% of attendances in New South Wales, and from Medicare Australia MBS data. Annual counts of potential primary care presentations to EDs are compared with those of other ED presentations and to primary care presentations in the community. Changes in the percentage of ED presentations that are potentially for primary care are examined, as are changes in the percentage of total primary care presentations seen in EDs. Trends in age standardised presentation rates are also calculated for each of the three series. Primary care presentations at EDs increased marginally in the period under consideration, as did primary care presentations in the community. There was a substantial increase in other ED presentations. The proportion of ED presentations potentially for primary care decreased over the period. The proportion of primary care presentations seen in EDs and the proportion seen in the community changed little. Decline in the proportion of potential primary care presentations to EDs may have been impacted by new guidelines for the application of triage categories in 2001. However, trends over time do not show acute alterations and they continue to hold for the subsequent period after introduction of new guidelines. Primary care presentations at EDs are not responsible for recent changes to ED overcrowding in New South Wales, at least not for hospitals covered in the EDIS database. Future research might consider more specific trends in rural EDs.
Siminski, P, Bezzina, AJ, Lago, LP & Eagar, K 2008, 'Primary care presentations at emergency departments: rates and reasons by age and sex.', Australian health review : a publication of the Australian Hospital Association, vol. 32, no. 4, pp. 700-709.View/Download from: Publisher's site
Primary care presentations at emergency departments (EDs) have been the subject of much attention in recent years. This paper is a demographic analysis using administrative data from the Emergency Department Information System (EDIS) for 2005 of such presentations in New South Wales EDs and of self-reported reasons for presentation. Age and sex differences in the reasons given by patients for such presentations are analysed using data from a survey of patients conducted in a subset of EDs in 2004. The rate of "potential primary care" presentations varies greatly with age and to a lesser extent with sex. Almost half (47%) of these presentations are made by people under 25 years of age. Children aged 0-4 years account for 14% of the total. The pattern is distinctly different to the corresponding rate of ED presentations that do not fit the "potential primary care" definition. Reasons given for "potential primary care" presentations are consistent across all age groups, reflecting self-assessed urgency, access to diagnostics and self-assessed complexity. Older "primary care" patients are particularly unlikely to give reasons associated with GP affordability or availability for their presentations. Young adults' responses are consistent with the overall population, and children under the age of five seem most susceptible to availability issues.
Masso, M, Bezzina, AJ, Siminski, P, Middleton, R & Eagar, K 2007, 'Why patients attend emergency departments for conditions potentially appropriate for primary care: reasons given by patients and clinicians differ.', Emergency medicine Australasia : EMA, vol. 19, no. 4, pp. 333-340.View/Download from: Publisher's site
OBJECTIVES: To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. METHODS: Survey of staff and primary care patients in five ED in New South Wales, Australia using questionnaire based on reasons identified in published studies. RESULTS: Clinicians in the survey identify a broader spectrum of reasons for potential primary care cases presenting to the ED than the patients themselves report. Doctors reported on average 4.1 very important reasons and nurses 4.8 compared with patients 2.4 very important reasons. The main reasons identified by both doctors and nurses were similar and quite different to those identified by patients. Clinicians were more likely to emphasize cost and access issues rather than acuity and complexity issues. There was no difference within the clinician group between doctors and nurses nor by varying levels of experience. Furthermore doctors with significant experience in both primary care and emergency medicine did not differ from the overall clinicians' pattern. CONCLUSIONS: These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider - consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education.
Saunders, P & Siminski, P 2005, 'HOME OWNERSHIP AND INEQUALITY: IMPUTED RENT AND INCOME DISTRIBUTION IN AUSTRALIA', Economic Papers: A journal of applied economics and policy, vol. 24, no. 4, pp. 346-367.View/Download from: Publisher's site
Siminski, P, Chalmers, J & McHugh, M 2005, 'Foster carers in New South Wales: Profile and projections based on ABS Census data', Children Australia, vol. 30, no. 03, pp. 17-24.View/Download from: Publisher's site
Siminski, P, Cragg, S, Middleton, R, Masso, M, Lago, L, Green, J & Eagar, K 2005, 'Primary care patients' views on why they present to emergency departments: Inappropriate attendances or inappropriate policy?', Australian Journal of Primary Health, vol. 11, no. 2, pp. 87-95.View/Download from: Publisher's site
This study investigates why some patients with apparently less urgent conditions present to emergency departments (EDs). We report on a survey of "potential primary-care" ED patients, who were asked about their reasons for choosing the ED over GPs. The sample consisted of 397 patients (with a response rate of 99% = 397/400), recruited in the former Illawarra Health Area. The three main reasons selected were: self-assessed urgency; being able to see the doctor and having tests or X-rays done in the same place; and self-assessed seriousness or complexity. The results do not appear to be sensitive to two potential sources of bias (fixed question ordering and non-random sampling). The results suggest a number of potential policy levers for encouraging some people to present to GPs rather than EDs. However, the main conclusion is that the majority of "potential primary-care" patients appear to be presenting for appropriate reasons. Thus "inappropriate attendances" do not seem to be the cause of EDs being under stress. We also argue that the results are useful for drawing inferences more broadly than just in relation to the Illawarra.
Siminski, P 2003, 'Patterns of Disability and Norms of Participation through the Life Course: Empirical support for a social model of disability', Disability and Society, vol. 18, no. 6, pp. 707-718.View/Download from: Publisher's site
An attempt has been made in this article to empirically demonstrate the social derivation of disability using quantitative data, framed around the medical model. It would seem that people who are not convinced of the social derivation of disability, are likely to be influenced by findings made in such data. The term 'social derivation' is used to encompass both social construction and creation. The approach taken was to focus on one aspect of the social derivation of disability - investigating how the patterns of 'disabling conditions' vary over the course of life, specifically the schooling, working and retirement age. The observed patterns are not consistent with a medical model of disability that ignores social factors. Instead, the patterns are linked to social forces, both attitudinal and material. Socially-determined norms of participation, which vary between the life phases, seem to be a key determinant of the observed patterns of disability.