Dhiman Das | National University of Singapore (original) (raw)

Papers by Dhiman Das

Background and Purpose: As baby boomers reach retirement age, accessible, evidence-based programs... more Background and Purpose: As baby boomers reach retirement age, accessible, evidence-based programs to promote healthy aging and prevent or delay onset of chronic conditions in communities will be essential. New York City, one of the most racially/ethnically, culturally and economically diverse cities in the world, is expecting a 44% increase in the older adult (65 +) population over the next 25 years. The Healthy Indicators Project (HIP) is an initiative to design, deliver, and evaluate effective programs for older adults that support personal choice and communal interdependence. The 3-year study uses representative survey data to design and implement evidence based practices, and evaluate their effectiveness. The first year consisted of a survey of a representative sample of senior center participants' functional, social, health, demographic and socioeconomic characteristics for baseline measurement and to design targeted, evidence-based interventions. This paper presents an ana...

Journal of health care finance, 2013

This article examines the implications of revenue changes on the financial condition of nonprofit... more This article examines the implications of revenue changes on the financial condition of nonprofit hos pitals. I examine these implications empirically by studying the effect of changes in Medicare payments in the Balanced Budget Act of 1997. Using data from the Healthcare Cost Report Information System maintained by the Centers for Medicare & Medicaid Services between 1996 and 2004, I show that even though revenue fell significantly, resulting in a decline in profitability, hospitals did not significantly change their capital structure and use of capital. An important implication of this is a higher cost of borrowing for these hospitals, which can affect future capital accumulation and viability. Nonprofit hospitals are a very important part of the healthcare delivery system in the United States. Medicare patients constitute the single largest segment of their revenue sources. Understanding the consequences of the changes in Medicare reimbursement on hospital finances is useful in f...

Computing in Economics and Finance 2004, 2004

Paper provided by Society for Computational Economics in its series Computing in Economics and Fi... more Paper provided by Society for Computational Economics in its series Computing in Economics and Finance 2004 with number 30. ... , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate ...

In the context of growing female labour migration in Southeast Asia, it has been argued that migr... more In the context of growing female labour migration in Southeast Asia, it has been argued that migration represents an important livelihood strategy for poverty alleviation amongst
migrants and their families. Using the case study of Indonesian women migrating as domestic workers to Singapore, this paper draws on a quantitative survey (n=201) and qualitative in-depth interviews (n=30) to examine the migration trajectories of these women — in particular, their experiences of recruitment and placement in Indonesia and Singapore
respectively, as well as remittance-sending behaviours — concerning whether or not there are significant discrepancies between the costs of migration and benefits of employment
through remittances (both economic and in-kind). It also examines the mediating role of communication technologies in reducing the transaction costs of migration and remittance sending, as well as contributing to the maintenance of family ties across borders.
In the survey, we found that the majority of respondents (nearly 90 per cent) did not pay any recruitment fees to a training centre or intermediary prior to their arrival in Singapore, but instead paid them via monthly salary deductions once they started work. Although this route of migration might appear attractive, particularly amongst those with little access to capital, it was observed that these fees often fluctuated, with the majority (64 per cent) taking between seven and nine months to complete their salary deduction period. During this time, workers received a nominal monthly sum of S$10 to S$20 to cover the most basic expenses. It was reported that approximately two-thirds (61 per cent) of respondents received a meagre S$10 or less, whilst 16 respondents (8 per cent) received no allowance at all. This practice has served to hinder women’s ability to remit for a significant period of their initial contract whilst reinforcing their lack of mobility, both physically and financially.
Along a similar vein, the monthly salaries of respondents ranged substantially between S$150 and S$750 (median=S$450). The salary women received did not seem to correlate with any previous experience, such as one’s educational background, occupation, or marital status, apart from prior experience of working in Singapore. It is evident from these findings that recruitment and placement procedures exhibited a certain homogenising effect on workers’ salaries and employment conditions. Although the majority (79 per cent) reported having received a salary increase since the time of first arrival, it was observed that these increments tended to be highly subjective and often at the behest of employers in the absence of formally stipulated guidelines. Through the interviews, we found that workers were often hesitant to broach the issue despite acknowledging the possibility of being able to do so. This further highlights the inherent power imbalance at play between employers, agents, and workers. Concerning remittances, we found that respondents remitted an average of 55 per cent of their monthly incomes upon completion of their debt deduction periods. These remittances went primarily towards paying for basic needs and children’s education. In the interviews, some workers reported that family members found difficulty coping with everyday expenses despite receiving remittances, noting how salary levels for domestic work in Singapore have not increased in tandem with rising living expenses in Indonesia. The often uncertain nature of domestic work as a livelihood strategy is seen in the protracted nature of women’s migration trajectories, with many finding it necessary to undertake multiple two-year contracts to fulfil their financial goals. It was observed that women tended to remit more during the early stages of their migration period (to finance children’s education or household assets such as agricultural land or houses), after which emphasis is placed on acquiring capital to fund future business ventures back home.
It is important to note that women in this survey have higher than average levels of education. Moreover around two-thirds were employed (albeit in often poorly paid forms of employment) prior to migrating. While these women do not represent ‘the poorest of the poor’, the fact that they are going into debt to finance their overseas migration suggests that they are financially disadvantaged and as such remittances were important for potentially creating future forms of livelihood for themselves and their children.
The research shows that despite the precarious and unregulated nature of recruitment and employment processes, with employers and agents exercising a great deal of power over workers, 66 per cent of the migrants in the sample said that remittances had contributed to the education of their children. Other productive and livelihood enhancing use of remittances, such as investing in land and housing (39 per cent), health (10 per cent), enterprise (9 per cent) and debt repayment (3 per cent) were also reported in addition to improved consumption (73 per cent). All of these outcomes have the potential to reduce poverty and improve well-being in the longer term. However, the impacts of such migration on poverty would be significantly faster and greater if the industry could be better regulated and the study offers a number of policy recommendations to this end.
Although a large proportion of survey respondents (nearly 90 per cent) owned a mobile phone, no significant relationship was found between ICT (information and communications
technology) use and the reduction of costs concerning remittance-sending. Instead, access to ICTs played an important role in the maintenance of family ties, as well as aided in the monitoring of the use and receipt of remittances for about half the respondents (51 per cent). In some cases, social media platforms such as Facebook served as useful channels of communication to repair strained relationships with loved ones at home. For others, ICTs facilitated access to information and resources concerning relevant policies affecting their work and daily lives in Singapore, as well as available skills training courses that offer the potential to translate into sustainable employment opportunities upon return.
The paper concludes with a list of policy recommendations to help reduce the costs and risks of migration for domestic work, whilst increasing its benefits for individual migrants and their families. Building upon recent reforms introduced by the Indonesian and Singapore governments to enhance the regulatory framework for training, recruitment, and employment practices concerning migrant domestic work, we suggest the following as a potential way forward: a) encouraging skills differentiation within the industry by incentivising skills acquisition based on higher remuneration and/or reduced levies; b) enhance workers’ access to information about basic rights and entitlements through ICTs; c) ensure greater transparency and accountability in placement procedures to curb the risks of contract substitution and exploitation; d) establish proper channels for workers to seek redress in cases of employment difficulties; and e) reform the current sponsorship system to ensure better access to job mobility.

Health Economics, Policy and Law, 2007

Cross-national comparisons that assess dimensions of health system performance indicate that the ... more Cross-national comparisons that assess dimensions of health system performance indicate that the US provides higher rates of revascularization procedures than France and other developed nations, but we believe these findings are misleading. In this paper, we compare the use of these procedures in the US, France and their two world cities, Manhattan and Paris. In doing so, we address a number of limitations associated with existing cross-national comparisons of heart disease treatment. After adjusting for the prevalence of disease in these nations and cities, we found that residents of France aged 45-64 years receive more revascularization procedures than residents of the US and that Parisians receive more revascularizations than residents of Manhattan. Older residents 65 years and over (65+) in the US receive more of these procedures than their French counterparts, but the differences are not nearly as great as previous studies suggest. Moreover, our data on Manhattan and Paris where the population and level of health resources are more comparable, indicate that older Parisians obtain more revascularization procedures than older Manhattanites. Finally, we found that the use of revascularization procedures is significantly lower in Manhattan among persons without private health insurance and among racial and ethnic minorities.

Journal of Nutrition Education and Behavior, 2010

Objective: This paper presents the reliability and validity of a ''competing food choice'' constr... more Objective: This paper presents the reliability and validity of a ''competing food choice'' construct designed to assess whether factors related to consumption of less-healthful food were perceived to be barriers to fruit and vegetable consumption in college freshmen. Design: Cross-sectional, self-administered survey. Setting: An urban public college with a large, diverse student population. Participants: A convenience sample of 408 college freshmen. Variables Measured: A ''competing food choice'' construct and fruit and vegetable intake. Analyses: Factor analysis, Cronbach a, and correlation coefficients were used to determine the reliability and validity of the construct. Results: Three factors were produced from the factor analysis of the 11-item competing food choice construct: ''competitive food'' barriers (Cronbach a ¼ 0.73), fruit and vegetable-related ''time'' barriers (Cronbach a ¼ 0.67), and ''quality'' barriers (Cronbach a ¼ 0.64). Construct validity assessments revealed significant inverse correlations between fruit and vegetable consumption and competitive food barriers (r ¼ -0.15, P < .01 current and r ¼ -0.25, P < .01 prior) and time barriers (r ¼ -0.12, P < .05 current and r ¼ -0.10, P < .05 prior). Conclusions and Implications: This ''competing food choice'' construct demonstrated satisfactory reliability and construct validity among college freshmen.

Exploiting changes in welfare policy across states and over time and comparing relevant populatio... more Exploiting changes in welfare policy across states and over time and comparing relevant population subgroups within an econometric difference-in-differences framework, we estimate the causal effects of welfare reform on adult women's illicit drug use from 1992 to 2002, the period during which welfare reform unfolded in the U.S. The analyses are based on all available and appropriate national datasets, each offering unique strengths and measuring a different drug-related outcome. We investigate self-reported illicit drug use (from the National Surveys on Drug Use and Health), drug-related prison admissions (from the National Corrections Reporting Program), drug-related arrests (from the Uniform Crime Reports), drug-related treatment admissions (from the Treatment Episode Data Set), and drug-related emergency room episodes (from the Drug Abuse Warning Network). We find robust and compelling evidence that welfare reform led to declines in illicit drug use and increases in drug treatment among women at risk for relying on welfare, and some evidence that the effects operate, at least in part, through both TANF drug sanctions and work incentives.

Preventive Medicine, 2008

Economics of Education Review, 2011

Exploiting variation in welfare reform across states and over time and using relevant comparison ... more Exploiting variation in welfare reform across states and over time and using relevant comparison groups, this study estimates the effects of welfare reform on an important source of human capital acquisition among women at risk for relying on welfare: vocational education and training. The results indicate that welfare reform reduced enrollment in full-time vocational education and had no significant effects on part-time vocational education or participation in other types of work-related courses, though there is considerable heterogeneity across states with respect to the strictness of educational policy and the strength of work incentives under welfare reform. In addition, we find heterogeneous effects by prior educational attainment. We find no evidence that the previously-observed negative effects of welfare reform on formal education (including college enrollment), which we replicated in this study, have been offset by increases in vocational education and training.

Journal of health care finance, 2009

Markov switching GARCH models have been developed in order to address the statistical regularity ... more Markov switching GARCH models have been developed in order to address the statistical regularity observed in financial time series such as strong persistence of conditional variance. However, Maximum Likelihood Estimation faces a implementation problem since the ...

Journal of evidence-based social work, 2012

Journal of Urban Health-bulletin of The New York Academy of Medicine, 2007

Households and workplaces are the predominant location for exposure to secondhand smoke. The purp... more Households and workplaces are the predominant location for exposure to secondhand smoke. The purpose of this study is to examine the association between health status and smoking restrictions at home and work and to compare the relative effect of household and workplace smoking restrictions on health status. This study uses data from a cross sectional representative probability sample of 2,537 Chinese American adults aged 18-74 living in New York City. The analysis was limited to 1,472 respondents who work indoors for wages. Forty-three percent of respondents reported a total smoking ban at home and the workplace, 20% at work only, 22% home only, and 15% reported no smoking restriction at home or work. Smokers who live under a total household smoking ban only or both a total household and total workplace ban were respectively 1.90 and 2.61 times more likely to report better health status compared with those who reported no smoking ban at work or home. Before the NYC Clean Indoor Air Act second-hand smoke (SHS) exposure among this immigrant Chinese population at home and work was high. This study finds that household smoking restrictions are more strongly associated with better health status than workplace smoking restrictions. However, better health status was most strongly associated with both a ban at work and home. Public health efforts should include a focus on promoting total household smoking bans to reduce the well-documented health risks of SHS exposure.

Perspectives on Sexual and Reproductive Health, 2012