|
on Health Economics |
| By: | Manuela Alcañiz (Faculty of Economics, University of Barcelona); Montserrat Guillén (Faculty of Economics, University of Barcelona); Daniel Sánchez-Moscona (Catalan Traffic Authority); Miguel Santolino (Faculty of Economics, University of Barcelona); Oscar Llatje (Catalan Traffic Authority); Lluís Ramon (Catalan Traffic Authority) |
| Abstract: | Sobriety checkpoints are not usually randomly located by traffic authorities. As such, information provided by non-random alcohol tests cannot be used to infer the characteristics of the general driving population. In this paper a case study is presented in which the prevalence of alcohol-impaired driving is estimated for the general population of drivers. A stratified probabilistic sample was designed to represent vehicles circulating in non-urban areas of Catalonia (Spain), a region characterized by its complex transportation network and dense traffic around the metropolis of Barcelona. Random breath alcohol concentration tests were performed during spring 2012 on 7,596 drivers. The estimated prevalence of alcohol-impaired drivers was 1.29%, which is roughly a third of the rate obtained in non-random tests. Higher rates were found on weekends (1.90% on Saturdays, 4.29% on Sundays) and especially at night. The rate is higher for men (1.45%) than for women (0.64%) and the percentage of positive outcomes shows an increasing pattern with age. In vehicles with two occupants, the proportion of alcohol-impaired drivers is estimated at 2.62%, but when the driver was alone the rate drops to 0.84%, which might reflect the socialization of drinking habits. The results are compared with outcomes in previous surveys, showing a decreasing trend in the prevalence of alcohol-impaired drivers over time. |
| Keywords: | Breath alcohol concentration, blood alcohol content, drunk driving, sampling analysis, weights, substance abuse. JEL classification: |
| Date: | 2013–07 |
| URL: | http://d.repec.org/n?u=RePEc:ira:wpaper:201313&r=hea |
| By: | Avdic, Daniel (Uppsala University); Johansson, Per (IFAU) |
| Abstract: | Women are on average more absent from work for health reasons than men. At the same time, they live longer. This conflicting pattern suggests that part of the gender difference in health-related absenteeism arises from differences between the genders unrelated to actual health. An overlooked explanation could be that men and women's preferences for absenteeism differ, for example because of gender differences in risk preferences. These differences may originate from the utility-maximizing of households in which women's traditional dual roles influence household decisions to invest primarily in women's health. Using detailed administrative data on sick leave, hospital visits and objective health measures we first investigate the existence of gender-specific preferences for absenteeism and subsequently test for the household investment hypothesis. We find evidence for the existence of gender differences in preferences for absence from work, and that a non-trivial part of these preference differences can be attributed to household investments in women's health. |
| Keywords: | sickness absence, gender norms, health investments |
| JEL: | J22 D13 |
| Date: | 2013–06 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp7480&r=hea |
| By: | Jean-Denis Garon; Alix Masse; Pierre-Carl Michaud |
| Abstract: | Using a unique dataset on health club attendance from Quebec, we look at the relationship between actual and expected attendance and how these relate to measures of self-control. We find that a large majority of contract choices appear inconsistent if we do not take into account the commitment value of long-term contracts for attendees with self-control problems: 41% of members would be better off paying the fee for a single visit each time they go to the gym rather than signing a long-term contract. We then find that almost all members have made the right decision once we use subjectives expectations on the number of visits per week at the time of contract choice. We estimate that the median total cost is $229 for those making a mistake. Next, we study how actual attendance following contract choice is related to measures of self-control. We find that reports of self-control problems at baseline are associated with low future attendance and that attendance decreases faster, in particular after New Year, for those expressing such problems. Quite interestingly, those expressing self-control problems do not expect at baseline to attend less often. We show that these results are consistent with a model where agents underestimate the severity of their self-control problems and estimate this degree of underestimation. |
| Keywords: | Self-control, gym attendance, expectations, obesity |
| JEL: | D00 D12 D91 |
| Date: | 2013 |
| URL: | http://d.repec.org/n?u=RePEc:lvl:lacicr:1317&r=hea |
| By: | Groneck, Max; Ludwig, Alexander; Zimper, Alexander (Munich Center for the Economics of Aging (MEA)) |
| Abstract: | On average, "young" people underestimate whereas "old" people overestimate their chances to survive into the future. We adopt a Bayesian learning model of ambiguous survival beliefs which replicates these patterns. The model is embedded within a non-expected utility model of life-cycle consumption and saving. Our analysis shows that agents with ambiguous survival beliefs (i) save less than originally planned, (ii) exhibit undersaving at younger ages, and (iii) hold longer on to their assets than their rational expectations counterparts who correctly assess survival probabilities. Our ambiguity-driven model therefore simultaneously accounts for three important empirical fi…ndings on household saving behavior. |
| JEL: | D91 D83 E21 |
| Date: | 2013–07–02 |
| URL: | http://d.repec.org/n?u=RePEc:mea:meawpa:13270&r=hea |
| By: | Catherine M. DesRoches; Michael W. Painter; Ashish K. Jha |
| Keywords: | HIT, Health Information Technology, Health Care, United States |
| JEL: | I |
| Date: | 2013–07–02 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7825&r=hea |
| By: | Catherine M. DesRoches; Dustin Charles; Michael F. Furukawa; Maulik S. Joshi; Peter Kralovec; Farzad Mostashari; Chantal Worzala; Ashish K. Jha |
| Abstract: | This article measured current hospital use of electronic health record (EHR) systems using data from the 2012 health IT supplement to the American Hospital Association’s annual survey. According to the data, 44 percent of hospitals report having at least a basic EHR system, a 17 percent increase from 2011 and a near-tripling of the 2010 adoption rate. Also, large urban hospitals continued to outpace rural and nonteaching hospitals. Although 42.2 percent of all hospitals met all the stage 1 meaningful-use criteria, only 5.1 percent had advanced to stage 2. While considerable progress has been made, findings suggest a need for a focus on hospitals still trailing behind, notably small and rural institutions. This focus is especially important as stage 2 meaningful-use criteria become the rule, and positive incentives are replaced by penalties for noncompliance. |
| Keywords: | Electronic Health Records, EHRs, Health Information Technology, HIT |
| JEL: | I |
| Date: | 2013–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7826&r=hea |
| By: | Erdal Tekin; Chandler McCellan; Karen Jean Minyard |
| Abstract: | While previous studies have shown that recessions are associated with better health outcomes and behaviors, the focus of these studies has been on the relatively milder recessions of the late 20th century. In this paper, we examine if the previously established counter-cyclical pattern in health and heath behaviors is held during the Great Recession. Using data from the Behavioral Risk Factor Surveillance System (BRFSS) between 2005 and 2011 and focusing on a wide range of outcomes capturing health and health behaviors, we show that the association between economic deterioration and these outcomes has weakened considerably during the recent recession. In fact, majority of our estimates indicate that the relationship has practically become zero, though subtle differences exist among various sub-populations. Our results are consistent with the evidence emerging from several recent studies that suggests that the relationship between economic activity and health and health behaviors has become less noticeable in the recent years. |
| JEL: | E32 I00 I10 I12 I14 I15 |
| Date: | 2013–07 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19234&r=hea |
| By: | Erin M. Johnson; M. Marit Rehavi |
| Abstract: | This paper provides new evidence on the interaction between patient information and financial incentives in physician induced demand (PID). Using rich microdata on childbirth, we compare the treatment of physicians when they are patients with that of comparable non-physicians. We exploit a unique institutional feature of California to determine how inducement varies with obstetricians' financial incentives. Consistent with PID, physicians are almost 10 percent less likely to receive a C-section, with only a quarter of this effect attributable to differential sorting of patients to hospitals or obstetricians. Financial incentives have a large effect on C-section probabilities for non-physicians, but physician-patients are relatively unaffected. Physicians also have better health outcomes, suggesting overuse of C-sections adversely impacts patient health. |
| JEL: | I10 |
| Date: | 2013–07 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19242&r=hea |
| By: | Margaret S. McMillan; William A. Masters; Harounan Kazianga |
| Abstract: | This paper addresses the role of tropical disease in rural demography and land use rights, using data from Onchocerciasis (river blindness) control in Burkina Faso. We combine a new survey of village elders with historical census data for 1975-2006 and geocoded maps of treatment under the regional Onchocerciasis Control Program (OCP). The OCP ran from 1975 to 2002, first spraying rivers to stop transmission and then distributing medicine to help those already infected. Controlling for time and village fixed effects, we find that villages in treated areas acquired larger populations and also had more cropland transactions, fewer permits required for cropland transactions, and more regulation of common property pasture and forest. These effects are robust to numerous controls and tests for heterogeneity across the sample, including time-varying region fixed effects. Descriptive statistics suggest that treated villages also acquired closer access to electricity and telephone service, markets, wells and primary schools, with no difference in several other variables. These results are consistent with both changes in productivity and effects of population size on public institutions. |
| JEL: | I00 Q0 Q00 |
| Date: | 2013–07 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19245&r=hea |
| By: | Gul, Ejaz |
| Abstract: | The number of road traffic casualties is still very lofty and the trend shows a boost with each passing day. The road traffic accidents involve fatalities due to which economic resources are damaged and the productivity of the economy is correspondingly impaired. Costs resulting from traffic accidents represent the largest single part of the overall cost of traffic to the economy. Knowledge about the harm of these traffic accidents to the economy is essential if measures to reduce road traffic accidents are to be identified and initiated. Once an economic assessment of road safety measures has been made, work on improving safety in accordance with economic criteria can be organized as efficiently as possible. Towards this end, it is necessary to opt for measures that are likely to be successful in a given situation. Current research is regarding the evaluation of road traffic safety measures in Pakistan and its economical effects based on available data. The research reveals that road accidents have key influence on the economic statistics of the country. The study presents a valuable tool for policy formulation on the road safety regulations in the country. |
| Keywords: | Economic, Evaluation, Traffic, Safety, Accidents, Statistical Analysis. |
| JEL: | D61 O18 R41 R42 |
| Date: | 2013–07–16 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:48350&r=hea |
| By: | Gul, Ejaz |
| Abstract: | The number of road traffic casualties is still very lofty and the trend shows a boost with each passing day. The road traffic accidents involve fatalities due to which economic resources are damaged and the productivity of the economy is correspondingly impaired. Costs resulting from traffic accidents represent the largest single part of the overall cost of traffic to the economy. Knowledge about the harm of these traffic accidents to the economy is essential if measures to reduce road traffic accidents are to be identified and initiated. Once an economic assessment of road safety measures has been made, work on improving safety in accordance with economic criteria can be organized as efficiently as possible. Towards this end, it is necessary to opt for measures that are likely to be successful in a given situation. Current research is regarding the evaluation of road traffic safety measures in Pakistan and its economical effects based on available data. The research reveals that road accidents have key influence on the economic statistics of the country. The study presents a valuable tool for policy formulation on the road safety regulations in the country. |
| Keywords: | Economic, Evaluation, Traffic, Safety, Accidents, Statistical Analysis. |
| JEL: | R41 R42 |
| Date: | 2013–07–16 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:48373&r=hea |
| By: | Sabina Nuti (Istituto di Management - Scuola Superiore Sant’Anna, Pisa); Sara Barsanti (Istituto di Management - Scuola Superiore Sant’Anna, Pisa) |
| Abstract: | This paper analyses migrant access to health care through the Italian legal framework and the use of health care services. In both analyses, an underlying gap and critical issues are demonstrated for migrants regarding their knowledge of the health care system as well as the accessibility and use of health services. In particular, immigrants have a lower hospitalisation rate than the native population. However, hospitalisation for some events (i.e., injuries, infectious disease) is higher for migrants than for natives. The results suggest that the health care system is unable to ensure an equitable use of the same services between populations with identical needs (horizontal equity) or accessibility for specific conditions prevalent in the migrant population (vertical equity).Moreover, the main entry point for migrants to the health care system(the maternal pathway and women’s health services)could be the first step for a more comprehensive process of integration and communication. In Italy, the immigrant population is growing and the differences in access to care are demonstrated. Consequently, it is necessary to rethink a possible model of integration and welfare for the migrant population, where access to the healthcare system is not only a desired result but also an opportunity for integration and inclusion. |
| Keywords: | healthcare performance; performance evaluation system; migrant; equity; integration |
| JEL: | I18 |
| Date: | 2013–04–01 |
| URL: | http://d.repec.org/n?u=RePEc:sse:wpaper:201304&r=hea |
| By: | Pipit Pitriyan (Department of Economics, Padjadjaran University); Adiatma Y.M Siregar (Department of Economics, Padjadjaran University) |
| Abstract: | Indonesia significant progress in health outcomes is followed by significant issues, among them are the issues of inequities and inequalities. These two issues are known to be an important part in achieving plausible health outcome. This study attempts to observe disparity reduction and its acceleration rate in selected health indicators (i.e. access to improved water source and sanitation facility, first-child birth attended by health care worker) over a period of the last 15 years. We analyze the health indicators by clusters of expenditure quintile and regions (urban - rural, Java - non Java, KTI - non KTI). Our analyses have shown some key observations. First, the national figures show improvement for all indicators except for the percentage of population suffering from diarrhea (seemed worsening). However, the rate of improvement remained stagnant and there was no acceleration. Second, the gap reduction between the rich and the poor in terms of health access and status seemed to slow down or even widened during the post reformation era. Third, the health indicators movement trend by region did not seem to have a pattern and the gap between richer and poorer areas exist in some indicators and nonexistent in others (the widest gap is found between urban and rural areas.). Where it existed, however, the condition persisted along the period of observation. |
| Keywords: | inequality, inequity, health, Indonesia |
| JEL: | I14 I15 |
| Date: | 2013–07 |
| URL: | http://d.repec.org/n?u=RePEc:unp:wpaper:201316&r=hea |