|
on Health Economics |
| By: | José M. Martínez-Carrión (Universidad de Murcia, Madrid, Spain); Javier Puche-Gil (Universidad de Zaragoza, Zaragoza, Spain); José Cañabate-Cabezuelos (Universidad de Murcia, Madrid, Spain) |
| Abstract: | Child labour has been considered a health risk affecting physical growth. Together with income, diets, diseases and environmental hygiene, child labour is one of the determinants of height. This paper examines whether child labour affected the stature of young workers during the spread of industrialization. With military recruitment heights it is analyzed the impact that child labour might have on physical health and nutritional status. After reporting on what happened during the Industrial Revolution in Britain, France and other industrialized countries, it is highlighted the contribution made by Spanish hygienists, whose importance has increased since the 1880´s. The following sections provide results of height evolution at the beginning of Spanish industrialization in major industrial and mining districts. Our findings emphasize the stature deterioration resulting from child labour, and the remarkable role that anthropometric history plays within economic and social history, and labour history too. |
| Keywords: | Child labour, height, health, nutrition, labour productivity |
| JEL: | I18 J28 J81 N33 |
| Date: | 2013–05 |
| URL: | http://d.repec.org/n?u=RePEc:ahe:dtaehe:1306&r=hea |
| By: | Ji Yan; Sally Brocksen |
| Abstract: | This paper studies whether adolescents who are more aware of the risks on substance use in the early teenage years are later less likely to turn into binge drinkers or smokers. It also examines if reduction in substance use, due to high risk perception among adolescents, consequently improves their educational achievement. This research is important for two reasons. First, enhancing risk perception of substance use is an important strategy to prevent the youth from binge drinking and smoking. Second, adolescent substance use and educational achievement are key predictors of adulthood outcomes. We apply a bivariate probit model to a large representative dataset which codes youth risk perception, substance use, and educational attainment. The analysis shows high risk perception lowers the likelihood of substance use among the high school seniors. The resulting low alcohol use increases the chance of attending college and decreases the probability of dropping out of high school. The reduction in cigarette use caused by high risk perception has a similar effect on such two educational outcomes. It also increases high school graduation by 22 percent. Overall, this study suggests that enhancing recognition on the hazards of substance use is an effective policy intervention to reduce adolescent binge drinking and smoking, as well as improve educational attainment. Key Words: adolescent risk perception; binge drinking; cigarette smoking; educational attainment |
| JEL: | I12 I18 J24 |
| Date: | 2013 |
| URL: | http://d.repec.org/n?u=RePEc:apl:wpaper:13-12&r=hea |
| By: | Jenna Libersky; Allison Hedley Dodd; Shinu Verghese |
| Abstract: | This article uses 2005 and 2008 Medicaid Analytic eXtract (MAX) data to present spending and enrollment trends for adults with disabilities who are dually eligible for Medicare and Medicaid. Nationwide, the proportion of adult duals in managed care increased from 2005 to 2008, with the expansion of prepaid health plans (PHPs), particularly behavioral health PHPs, driving the increase. Although overall use of managed care has increased, there has been little expansion in the use of comprehensive managed care among adult dual eligible beneficiaries, particularly when compared with their Medicaid-only disabled adult peers. This imbalance suggests room to remove barriers preventing dually eligible adults, from enrolling in comprehensive, integrated managed care. |
| Keywords: | Medicaid, Dual Eligibles, Managed Care, Disability |
| JEL: | I J |
| Date: | 2013–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7741&r=hea |
| By: | Debbie Peikes; Dana Petersen; Aparajita Zutshi; David Meyers; Janice Genevro |
| Keywords: | PCMH, Patient-Centered Medical Home Models, Methods, Health |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7749&r=hea |
| By: | Jelena Zurovac; Deborah Peikes; Aparajita Zutshi; Randy Brown |
| Keywords: | Comparative Effectiveness, Orthogonal Designs, Patient-Centered Medical Home, Health |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7750&r=hea |
| By: | Kristin Geonnotti; Deborah Peikes; Winnie Wang; Jeffrey Smith |
| Keywords: | Patient-Centered Medical Home, Interventions, Adaptations, Refinements, PCMH |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7751&r=hea |
| By: | Marcus Thygeson; Deborah Peikes; Aparajita Zutshi |
| Keywords: | Patient-Centered Medical Home Models, Comparative Method, Qualitative Comparative Analysis, PCMH |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7752&r=hea |
| By: | Laura Damschroder; Deborah Peikes; Dana Petersen |
| Keywords: | PCMH, Patient-Centered Medical Home Models, Implementation Research, Adaptation, Dissemination |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7753&r=hea |
| By: | Dana Petersen; Erin Fries Taylor; Deborah Peikes |
| Keywords: | Patient-Centered Medical Home Models, Logic Model, PCMH, Health |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7754&r=hea |
| By: | Deborah Peikes; Kristin Geonnotti; Winnie Wang |
| Keywords: | Patient-Centered Medical Home Models, Pragmatic Clinical Trials, Effectiveness, Health |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7755&r=hea |
| By: | Rutger P. Daems PhD (Planet Strategy Group, Brussels, Belgium); Edith L. Maes DBA (Maastricht School of Management, PO Box 1203, 6201 BE Maastricht, The Netherlands); Guy Nuyts, PhD (Janssen, Pharmaceutical Companies of Johnson & Johnson) |
| Abstract: | This paper describes an innovation framework that fosters public-private partnership as a means to overcoming the barriers of developing medicines to combat neglected diseases. We define neglected diseases as those therapeutic areas for which a great unmet need exists but for which market demand is lacking so that innovation-driven companies cannot recoup their investments in product research, development and large-scale manufacturing. Tropical infectious diseases like malaria represent an enormous burden of illness but are poverty related because the majority of people affected by them live in poor resource settings making affordability the main issue. On the other hand, rare diseases in advanced economies like cystic fibrosis affect few people so the volume-related demand is low despite the fixed cost of R&D. In addition, problems with access to medicines against widespread diseases persist due to a lack of awareness and financial constraints within the health care system resulting in under diagnosis which in turn leads to slow adoption and drug utilization. The common thread running through this disease category is that pharmaceutical companies cannot on their own address the specific challenges posed by neglected diseases. This paper provides insight into how a number of push and pull incentive systems that foster innovation may overcome the problem, and how the related corporate strategy and public policy can be aligned. |
| Keywords: | pharmaceutical R&D, neglected diseases, push mechanism, pull mechanism, innovation, investment risk incentive |
| Date: | 2013–04 |
| URL: | http://d.repec.org/n?u=RePEc:msm:wpaper:2013/11&r=hea |
| By: | Tomas J. Philipson; George Zanjani |
| Abstract: | We review and extend the economic analysis of risk and uncertainty as it relates to behavior mitigating health shocks. We summarize some central aspects of the vast positive and normative literature on the role of various forms of insurance that attempt to smooth consumption, which can be uneven due to medical spending induced by health shocks. Much of this literature has been concerned with the barriers that prevent full insurance and the role of the government eliminating their adverse consequences. We argue that this large literature is limited in that it is focused largely on consumption smoothing rather than smoothing of health itself. However, a problem with insuring health itself is that human capital cannot be traded; a person diagnosed with an incurable cancer cannot be made whole through reallocation of someone else’s health. This lack of tradability in human capital implies that pooling of health risks, through private or public insurance, is infeasible except in rare instances such as transplantations. We argue that medical innovation can be interpreted as an insurance mechanism for a population’s health. By enabling treatment of a harmful disease, it completes the previously incomplete market for risk-sharing in health by pooling the health care spending risk. In a sense, medical innovation involves a current certain R&D payment for a reduced future price of health, which is directly comparable to traditional health care insurance where a current premium is paid for a future reduced price of health care. We explore the positive and normative implications of this “health insurance” view of medical R&D and stress the ex ante value of new medical innovations, sometimes for patients that may never even use them. Given the potentially large value of smoothing health itself rather than consumption, we argue that more explicit analysis is needed on the relative value of public programs stimulating medical innovation versus health care reforms largely aimed at enabling consumption-smoothing. |
| JEL: | I0 I11 |
| Date: | 2013–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19005&r=hea |
| By: | Dipanwita Sarkar; Jayanta sarkar |
| Abstract: | The positive impact of early childhood intervention on child’s cognitive, behavioural and schooling outcomes is now well-recognized in the developed countries. However, little is known whether preschools in the developing countries confer similar dividends. This paper focuses on the effect of preschool attendance on childhood health outcomes in the Indian state of Andhra Pradesh. We employ difference-in-difference method to control for selection on unobservables. Furthermore, allowing for possible heterogeneity in health outcomes across the distribution of health outcomes using quantile treatment effects, we find a significant negative causal effect of preschool attendance that varies across the distribution of a variety of child health outcomes. The result seems to be more pronounced among the male children. |
| Date: | 2013–05–01 |
| URL: | http://d.repec.org/n?u=RePEc:qut:qubewp:wp013&r=hea |
| By: | Soojin Kim (University of Pennsylvania); Dirk Krueger (University of Pennsylvania); Harold Cole (University of Pennsylvania) |
| Abstract: | This paper constructs a dynamic model of health insurance to evaluate the short- and long run effects of policies that prevent firms from conditioning wages on health conditions of their workers, and that prevent health insurance companies from charging individuals with adverse health conditions higher insurance premia. Our study is motivated by recent US legislation that has tightened regulations on wage discrimination against workers with poorer health status (Americans with Disability Act of 2009, ADA, and ADA Amendments Act of 2008, ADAAA) and that will prohibit health insurance companies from charging different premiums for workers of different health status starting in 2014 (Patient Protection and Affordable Care Act, PPACA). In the model, a tradeoff arises between the static gains from better insurance against poor health induced by these policies and their adverse dynamic incentive effects on household efforts to lead a healthy life. Using household panel data from the PSID we estimate and calibrate the model and then use it to evaluate the static and dynamic consequences of no-wage discrimination and no-prior conditions laws for cross-sectional consumption dispersion, the evolution of the cross-sectional health distribution of a cohort of households as well as ex-ante lifetime welfare of a typical member of this cohort. We find that although a combination of both policies is effective in providing full consumption insurance in the short run, it lowers social welfare since it induces a more rapid deterioration of the cohort health distribution over time. Interestingly, introducing each law in isolation has limited adverse dynamic incentive effects, but a combination of both laws severely undermines the incentives to lead healthier lives. The resulting negative effects on health outcomes in society more than offset the static gains from better consumption insurance so that social welfare, measured in terms of the expected discounted lifetime utility, declines as a result of introducing both policy measures in conjunction. |
| Date: | 2012 |
| URL: | http://d.repec.org/n?u=RePEc:red:sed012:609&r=hea |
| By: | Sergi Jiménez-Martín; Cristina Vilaplana Prieto |
| Abstract: | This paper analyses the effect of unmet formal care needs on informal caregiving hours in Spain using the two waves of the Informal Support Survey (1994, 2004). Testing for double sample selection from formal care receipt and the emergence of unmet needs provides evidence that the omission of either one of these two variables would causes underestimation of the number of informal caregiving hours. After controlling for these two factors the number of hours of care increases with both the degree of dependency and unmet needs. In the presence of unmet needs, the number of informal caregiving hours increases when some formal care is received. This result refutes the substitution model and supports complementarity or task specificity between both types of care. For the same combination of formal care and unmet needs, informal caregiving hours increased between 1994 and 2004. Finally, in the model for 2004, the selection term associated with the unmet needs equation is larger than that of the formal care equation, suggesting that using the number of formal care recipients as an indicator of the goodness of the long-term care system may be confounding, if we do not complete this information with other quality indicators. |
| Keywords: | double sample selection, unmet need, informal care, caregiver, formal care |
| JEL: | H41 I10 I11 |
| Date: | 2013–04 |
| URL: | http://d.repec.org/n?u=RePEc:upf:upfgen:1366&r=hea |