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on Health Economics |
| By: | BEJEAN, Sophie (LEG - CNRS UMR 5118 - Université de Bourgogne); PEYRON, Christine (LEG - CNRS UMR 5118 - Université de Bourgogne); URBINELLI, Renaud |
| Abstract: | The objective of this study is to identify the practice profiles of different GPs in order to test the hypothesis of heterogeneity in physician behaviour. We have established an extensive database consisting of about 4 700 GPs from two regions in France (Aquitaine and Burgundy) for the year 2000. Variables describe the volume as well as the structure of the physicians' medical activity, income level, personal characteristics, practice characteristics, socioeconomic and geographical environment. We used two complementary methods to test the heterogeneity of the behaviour of private physicians: a cluster analysis to identify different practice profiles and econometric tests to display the determinants of the physicians' multidimensional activity. Our results show that four different homogeneous groups can be identified, each one associating a physician's level of activity to his socioeconomic status. Econometric tests clearly distinguish the main determinants between the multidimensional medical activity of rural and urban GPs. We conclude with the finding that there is no uniformity in the way GPs practice medicine. The level and type of medical activity vary greatly among physicians mainly due to the characteristics of the socioeconomic environment and other individual factors. An immediate consequence is that any cost-containment measure, such as regulating fees, which applies uniformly to all GPs, inevitably results in different outcomes according to the physicians' category type. |
| Keywords: | medical activity, practice profiles, general practitioner, cluster analysis, econometric test |
| Date: | 2006–01 |
| URL: | http://d.repec.org/n?u=RePEc:lat:legeco:2006-01&r=hea |
| By: | Alan M. Garber; Charles I. Jones; Paul M. Romer |
| Abstract: | This paper studies the interactions between health insurance and the incentives for innovation. Although we focus on pharmaceutical innovation, our discussion applies to other industries producing novel technologies for sale in markets with subsidized demand. Standard results in the growth and productivity literatures suggest that firms in many industries may possess inadequate incentives to innovate. Standard results in the health literature suggest that health insurance leads to the overutilization of health care. Our study of innovation in the pharmaceutical industry emphasizes the interaction of these incentives. Because of the large subsidies to demand from health insurance, limits on the lifetime of patents and possibly limits on monopoly pricing may be necessary to ensure that pharmaceutical companies do not possess excess incentives for innovation. |
| JEL: | I1 O30 |
| Date: | 2006–03 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:12080&r=hea |
| By: | Patricia Born; W. Kip Viscusi; Tom Baker |
| Abstract: | Whereas the literature evaluating the effect of tort reforms has focused on reported incurred losses, this paper examines the long run effects using a comprehensive sample by state of individual firms writing medical malpractice insurance from 1984-2003. The long run effects of reforms are greater than insurers' expected effects, as five year developed losses and ten year developed losses are below the initially reported incurred losses for those years following reform measures. The quantile regressions show the greatest effects of joint and several liability limits, noneconomic damages caps, and punitive damages reforms for the firms that are at the high end of the loss distribution. These quantile regression results show stronger, more concentrated effects of the reforms than do the OLS and fixed effects estimates for the entire sample. |
| JEL: | K13 G22 |
| Date: | 2006–03 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:12086&r=hea |
| By: | Junmin Wan (Osaka School of International Public Policy, Osaka University) |
| Abstract: | Japan has implemented a number of anti-smoking policies; these include information disclosures, taxation, and smoking bans. These measures have increased the information available to consumers, as well as tax rates on tobacco products. First, this paper shows, theoretically, the association between a lack of information and over-consumption of cigarettes, and then examines the effects of smoking policies using monthly data from 1951 to 1999. Long-term policies have had greater effects than short-term policies. Taxation has reduced consumption, but income differences have had no significant effect. Following health disclosures in 1964 and 1967, many consumers switched to filtered cigarettes and low-nicotine and low-tar products, respectively. The move to lower tar and nicotine products was further accelerated by the "harmful to health" label applied to cigarettes in 1972, although many smokers then raised the number of cigarettes they smoked to keep up their intake of nicotine. Other policies have decreased cigarette, nicotine, and tar consumption since 1972. |
| Keywords: | anti-smoking, health information, nicotine-tar, compensative behavior, rational addiction |
| JEL: | I18 D11 D12 |
| Date: | 2004–06 |
| URL: | http://d.repec.org/n?u=RePEc:osk:wpaper:0412r&r=hea |
| By: | Jennifer Franz; Felix Fitzroy |
| Keywords: | Child mortality, environmental health, Central Asian Republics, multivariate analysis. |
| JEL: | Q18 Q28 Q32 Q56 |
| URL: | http://d.repec.org/n?u=RePEc:san:wpecon:0518&r=hea |
| By: | L.Guarcello; S.Lyon; F.Rosati |
| Abstract: | This paper looks in detail at the relationship between the intensity of children's work (i.e., children's weekly working hours) and children's health outcomes, making use of household survey data from Bangladesh, Brazil, and Cambodia. The paper focuses only on the subset of children at work in economic activity. It relies on two sets of measures: self-reported health problems and injuries.The analysis points to a causal relationship between working hours and children's health outcomes. |
| Date: | 2004–09 |
| URL: | http://d.repec.org/n?u=RePEc:ucw:worpap:12&r=hea |