nep-hea New Economics Papers
on Health Economics
Issue of 2006‒05‒13
seventeen papers chosen by
Yong Yin
SUNY at Buffalo, USA
  1. The Economics of Obesity-Related Mortality Among High Income Countries By Huffman, Wallace; Huffman, Sonya K.; Tegene, Abebayehu; Rickertsen, Kyrre
  2. Changing Economic Incentives in Long-Term Care By R. Tamara Konetzka
  3. Rational Alcohol Addiction: Evidence from the Russian Longitudinal Monitoring Survey By Badi H. Baltagi; Ingo Geishecker
  4. Intensive Medical Care and Cardiovascular Disease Disability Reductions By David M. Cutler; Mary Beth Landrum; Kate A. Stewart
  5. The Effects of Health on Health Insurance Status in Fragile Families By Hope Corman; Anne Carroll; Kelly Noonan; Nancy E. Reichman
  6. The Effects of State Medicaid Policies on the Dynamic Savings Patterns of the Elderly By Lara Gardner; Donna Gilleskie
  7. Risk Factor Study - How to reduce the burden of harm from poor nutrition, tobacco smoking, physical inactivity and alcohol misuse: cost-utility analysis of 9 multi-risk factor interventions By Kim Dalziel; Leonie Segal; Duncan Mortimer
  8. Risk Factor Study - How to reduce the burden of harm from poor nutrition, tobacco smoking, physical inactivity and alcohol misuse: cost-utility analysis of 4 physical inactivity interventions By Kim Dalziel; Leonie Segal; Duncan Mortimer
  9. Risk Factor Study - How to reduce the burden of harm from poor nutrition, tobacco smoking, physical inactivity and alcohol misuse: cost-utility analysis of 8 nutrition interventions By Kim Dalziel; Leonie Segal; Duncan Mortimer
  10. Risk Factor Study - How to reduce the burden of harm from poor nutrition, tobacco smoking, physical inactivity and alcohol misuse: cost-utility analysis of 5 interventions to discourage tobacco smoking By Duncan Mortimer; Leonie Segal; Kim Dalziel
  11. Risk Factor Study - How to reduce the burden of harm from poor nutrition, tobacco smoking, physical inactivity and alcohol misuse: cost-utility analysis of 6 interventions to promote safe use of alcohol By Duncan Mortimer; Leonie Segal; Kim Dalziel
  12. Neglected equity issues in cost effectiveness analysis - part 1: severity of pre-treatment of potential for health, concentration and dispersion of health benefits, and age-related social preferences By John McKie; Jeff Richardson
  13. Neglected equity issues in cost effectiveness analysis - part 2: direct and indirect costs, the preservation of hope, the rule of rescue, patient adaptation, and the Ex Ante/Ex Post distinction By John McKie; Jeff Richardson
  14. Global Health Governance: Conflicts on Global Social Rights By Wolfgang Hein; Lars Kohlmorgen
  15. Contingent Valuation of Mortality Risk Reduction in Developing Countries: A Mission Impossible? By Minhaj Mahmud
  16. Using Choice Experiments to Measure Relative Values of Statistical Lives: Evidence from Bangladesh By Minhaj Mahmud
  17. Non-pecuniary returns to higher education: The effect on smoking intensity in the UK By Alfonso Miranda; Massimiliano Bratti
  1. By: Huffman, Wallace; Huffman, Sonya K.; Tegene, Abebayehu; Rickertsen, Kyrre
    Abstract: This paper establishes the econometric underpinning of an aggregate household health production function and an aggregate household heath supply function for developed countries. The conceptual model builds on productive household models for health. A pooled time series cross sectional model of obesity-related mortality is fitted to annual data for 18 high income countries over 1971-2001. In the health production function, we show that obesity-related mortality is related to diet, socialized medicine, and trend dominated factors such as medical knowledge and technology. In the health supply function, we show that cheap food increases obesity-related mortality and a modest level of socialized medicine reduces it. The results for labor market variables imply that individuals who are in the labor force burn more calories in their daily activities than do those who do not work in the market and have lower obesity-related mortality.
    Keywords: health, household production, health production function, health supply function, obesity-related mortality, high income countries
    JEL: D1 I1 Q1
    Date: 2006–05–01
    URL: http://d.repec.org/n?u=RePEc:isu:genres:12604&r=hea
  2. By: R. Tamara Konetzka (Department of Health Studies, University of Chicago, 5841 S. Maryland Avenue, MC2007, Chicago, IL 60637)
    Abstract: Just as managed care has changed utilization and incentives in other parts of health care, there is a whole set of incentives built around long-term care that really matter. For example, if nursing homes have a financial incentive to hospitalize people with certain health conditions, then in the long run they are not going to develop the programs and invest in the resources to treat those people in the facility. Instead they're going to use those resources to stay in business or to provide other types of care. And while we can assume that policymakers do not create regulations that they expect will lead to poor quality, efforts to increase access or efficiency sometimes have the unintended consequence of reducing quality. Health care sectors in which spending is rising particularly rapidly or in which access seems to be problematic may be prone to regulations that fail to take into account potential effects on quality. There's a lot of money spent on nursing homes; there's certainly a lot of interest from public funders in nursing homes; and nursing homes have a long history of quality-of-care problems. Not surprisingly, then, some of the most interesting sets of bad incentives for quality can be found in nursing homes.
    Keywords: nursing home, Medicare, Medicaid, long-term care, elderly, social welfare.
    JEL: I11 I18 J14
    Date: 2006–04
    URL: http://d.repec.org/n?u=RePEc:max:cprpbr:32&r=hea
  3. By: Badi H. Baltagi (Center for Policy Research, Maxwell School, Syracuse University, Syracuse, New York 13244-1020); Ingo Geishecker (Institute for East European Studies, Free University Berlin)
    Abstract: Alcohol consumption in Russia is legendary and has been reported to be the third leading cause of death in the former Soviet Union after heart disease and cancer. Are Russian alcohol consumers rational addicts? This paper uses eight rounds of a nationally representative Russian survey spanning the period 1994-2003 to estimate a rational addiction (RA) model for alcohol consumption. This is done in a panel data setting as well as on a wave by wave basis. Theprofile of the Russian drinker finds a huge difference between males and females and the model is estimated by gender. We do not find support for the RA model in Russia for women. For men, although we find that some implications of the RA model are satisfied, we fail to endore the model impirically on grounds of implausible negative estimates of the discount rate.
    Keywords: panel data, liquor consumption, rational addiction
    JEL: C23 D12 I10
    Date: 2006–05
    URL: http://d.repec.org/n?u=RePEc:max:cprwps:81&r=hea
  4. By: David M. Cutler; Mary Beth Landrum; Kate A. Stewart
    Abstract: There is little empirical evidence to explain why disability declined among the elderly over the past 20 years. In this paper, we explore the role of improved medical care for cardiovascular disease on health status improvements over time. We show that the incidence of cardiovascular disease hospitalizations remained relatively constant between 1984 and 1999 at the same time that post-event survival improved and disability declined. We find that use of appropriate therapies, including pharmaceuticals such as beta-blockers, aspirin, and ace-inhibitors, and invasive procedures, explains up to 50% and 70% of the reductions in disability and death over time, respectively. Elderly patients living in regions with high use of appropriate medical therapies had better health outcomes than patients living in low-use areas. Finally, we estimate that preventing disability after an acute event can add as much as 3.7 years of quality-adjusted life expectancy, or $316,000 of value.
    JEL: I1 J1
    Date: 2006–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:12184&r=hea
  5. By: Hope Corman; Anne Carroll; Kelly Noonan; Nancy E. Reichman
    Abstract: We use data from the Fragile Families and Child Wellbeing study to estimate the effects of poor infant health, pre-pregnancy health conditions of the mother, and the father's health status on health insurance status of urban, mostly unmarried, mothers and their one-year-old children. Virtually all births were covered by health insurance, but one year later about one third of mothers and over 10 percent of children were uninsured. We separately examine births that were covered by public insurance and those that were covered by private insurance. The child's health status had no effect, for the most part, on whether the mother or child became uninsured. For publicly insured births, a maternal physical health condition made it less likely that both the mother and child became uninsured, while maternal mental illness made it more likely that both the mother and child lost insurance coverage. For privately insured births, the father's suboptimal physical health made it more likely that the mother, but not the child, became uninsured.
    JEL: I1 I3
    Date: 2006–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:12197&r=hea
  6. By: Lara Gardner; Donna Gilleskie
    Abstract: States have considerable flexibility in determining Medicaid policies such as financial eligibility criteria, subsidies for home- and community-based services, and reimbursements rates to skilled nursing facilities, among other things. An understanding of how differences in Medicaid programs across states and time affect the elderlys' demand for Medicaid coverage of long-term care is necessary for evaluating future changes in the Medicaid program structure. We use data from the 1993, 1995, 1998, and 2000 waves of the Asset and Health Dynamics of the Elderly and variation in state Medicaid policies over time to estimate our dynamic framework capturing the sequential asset and gift decisions that determine eligibility for Medicaid. We also model the long-term care decisions of married and single individuals conditional on endogenous insurance coverage and health transitions. To control for the impact of unobserved heterogeneity in all outcomes, the structural equations of the empirical model are estimated jointly, allowing for correlation in the error structure across equations and over time. In this paper we focus on the asset and gifting decisions of the elderly over time. We find that many of the Medicaid policy variables that differ across states have a significant but small effect on the savings decisions of the elderly, with single elderly individuals exhibiting more response than married elderly individuals.
    JEL: I1 I3
    Date: 2006–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:12208&r=hea
  7. By: Kim Dalziel (Centre for Health Economics, Monash University); Leonie Segal (Centre for Health Economics, Monash University); Duncan Mortimer (Centre for Health Economics, Monash University)
    Date: 2005–04
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-2&r=hea
  8. By: Kim Dalziel (Centre for Health Economics, Monash University); Leonie Segal (Centre for Health Economics, Monash University); Duncan Mortimer (Centre for Health Economics, Monash University)
    Date: 2005–04
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-3&r=hea
  9. By: Kim Dalziel (Centre for Health Economics, Monash University); Leonie Segal (Centre for Health Economics, Monash University); Duncan Mortimer (Centre for Health Economics, Monash University)
    Date: 2005–04
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-4&r=hea
  10. By: Duncan Mortimer (Centre for Health Economics, Monash University); Leonie Segal (Centre for Health Economics, Monash University); Kim Dalziel (Centre for Health Economics, Monash University)
    Date: 2005–04
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-5&r=hea
  11. By: Duncan Mortimer (Centre for Health Economics, Monash University); Leonie Segal (Centre for Health Economics, Monash University); Kim Dalziel (Centre for Health Economics, Monash University)
    Date: 2005–04
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-6&r=hea
  12. By: John McKie (Centre for Health Economics, Monash University); Jeff Richardson (Centre for Health Economics, Monash University)
    Date: 2005–07
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-7&r=hea
  13. By: John McKie (Centre for Health Economics, Monash University); Jeff Richardson (Centre for Health Economics, Monash University)
    Date: 2005–07
    URL: http://d.repec.org/n?u=RePEc:mhe:cherps:2005-8&r=hea
  14. By: Wolfgang Hein (GIGA German Institute of Global and Area Studies); Lars Kohlmorgen (GIGA German Institute of Global and Area Studies)
    Abstract: This paper analyses the impact of new institutional structures in global health governance on the realization of social rights in poor countries. Meanwhile, health is broadly seen as an import precondition for social and economic development. This leads to an integration of the “diseases of the poor” (basically infectious diseases) into strategies of fighting poverty. Considering the example of global HIV/AIDS politics, the paper argues that new governance modes increase the participation of civil society groups and affected communities, but that they are also frequently instrumentalised by powerful actors to pursue their particular interests. In fact, increasing resources are mobilized for the fight against poverty related diseases. The paper concludes that global health governance is characterized by a combination of moral values and material interests which does not guarantee a comprehensive realization of social rights, but which allows some progress in the fight against poverty-related diseases – a precondition of the possible further realization of social rights.
    Keywords: Global Health Governance; New Governance Modes, International Organizations, Social Rights, Global Social Justice, Developing Countries, HIV/AIDS Politics
    Date: 2005–08
    URL: http://d.repec.org/n?u=RePEc:gig:wpaper:07&r=hea
  15. By: Minhaj Mahmud (Keele University, Centre for Economic Research and School of Economic and Management Studies)
    Abstract: We examine the effect of training the respondents regarding probabilities and risk reductions, in addition to using visual aids to communicate risk and risk reductions, in a contingent valuation survey of mortality risk reduction in Bangladesh. We elicit individuals’ risk perception and find that people on average overestimate the mortality risk at younger ages and underestimate it at older ages. Our results indicate a significantly higher WTP for the trained sub-sample, and WTP is sensitive to the magnitude of risk reduction both with and without the training.
    Keywords: Contingent valuation; risk reduction; WTP; sensitivity to scope; training respondents; Bangladesh
    JEL: I1 D6 D8 H4
    Date: 2006–01
    URL: http://d.repec.org/n?u=RePEc:kee:kerpuk:2006/01&r=hea
  16. By: Minhaj Mahmud (Keele University, Centre for Economic Research and School of Economic and Management Studies)
    Abstract: By assuming that an individual has preferences concerning different states of the world and these preferences can be described by an individual social welfare function, we explore the relative value of statistical life using survey data from Bangladesh. We apply a pair-wise choice experiment on life-saving programs to elicit individuals’ preferences regarding differences in the values of statistical lives related to age. We find that the relative value decreases strongly with age and that people have strong preferences for saving more life-years, rather than lives per se. Moreover, in specific follow-up questions, it is again elicited that a majority of the respondents believe that it is better, from a social point of view, to save younger individuals.
    Keywords: Social preference; choice experiment; life-saving programs; relative value of life; Bangladesh.
    JEL: D63 I18 J17
    Date: 2006–01
    URL: http://d.repec.org/n?u=RePEc:kee:kerpuk:2006/02&r=hea
  17. By: Alfonso Miranda (Keele University, Centre for Economic Research and School of Economic and Management Studies); Massimiliano Bratti (Department of Economics, Business and Statistics, University of Milan)
    Abstract: In this paper we investigate whether higher education (HE) produces non-pecuniary returns via a reduction in the consumption of health-damaging substances. In particular, the paper focuses on studying the smoking intensity of British individuals. We use data on current smokers from the 1970 British Cohort Study and estimate endogenous switching count models for cigarette consumption. Results show that HE is endogenous with smoking. Once endogeneity is controlled for, HE is found to have a higher negative effect on smoking than in models where it is treated as exogenous.
    Keywords: Endogenous switching, count data, higher education, smoking, UK
    JEL: C35 I12 I21
    Date: 2006–04
    URL: http://d.repec.org/n?u=RePEc:kee:kerpuk:2006/04&r=hea
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