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on Health Economics |
By: | Manuel Flores (University of Santiago de Compostela, IDEGA); Adriaan Kalwij (Utrech University School of Economics) |
Abstract: | This paper adds to the empirical literature on health as an important determinant of employment at older ages by exploring the role in the health-employment nexus of the wage rates of 50 to 64-year-old workers. To do so, we use individual-level panel data from the Survey of Health, Ageing and Retirement in Europe to estimate a system of equations for health, wages and employment. Our model also takes into account both the potential for measurement error in the health variable and selectivity issues related to the wage equation. We find that for men (women) a one-unit (one standard deviation) increase in health yields, on average, a 7 (8) percentage higher hourly wage rate, resulting in a 2 (4) percentage point higher employment probability. We also show a direct impact of health on employment: a similar increase in health raises the employment probability of men (women) by 16 (13) percentage points. As regards differences between European countries, our findings suggest that for all country groups, the mediating role of wages in the health-employment nexus is relatively small while the direct impact of health on employment is relatively large and rather similar. Overall, our findings indicate only a minor role for disability income policies likes wage subsidies to encourage the employment of (older) workers with health limitations, but an instrumental role for policy aimed at helping employers accommodate these workers on the job and keep them employed at older ages. |
Keywords: | Health, wages, employment |
JEL: | D00 I10 J14 J20 J30 |
Date: | 2013–07 |
URL: | http://d.repec.org/n?u=RePEc:edg:anecon:0054&r=hea |
By: | Michèle Belot (University of Edinburgh), Jonathan James (University of Bath) and Patrick Nolen (University of Essex) |
Abstract: | We conduct a field experiment in 31 primary schools in England to test whether incentives to eat fruit and vegetables help children develop healthier habits. The intervention consists of rewarding children with stickers and little gifts for a period of four weeks for choosing a portion of fruit and vegetables at lunch. We compare the effects of two incentive schemes (competition and piece rate) on choices and consumption over the course of the intervention as well as once the incentives are removed and six months later. We find that the intervention had positive effects, but the effects vary substantially according to age and gender. However, we find little evidence of sustained long term effects, except for the children from poorer socio-economic backgrounds. |
Keywords: | Incentives, Health, Habits, Child nutrition, Field experiment. |
JEL: | J13 I18 I28 H51 H52 |
Date: | 2013–08–02 |
URL: | http://d.repec.org/n?u=RePEc:edn:esedps:219&r=hea |
By: | Sophie Mitra (Fordham University); Usha Sambamoorthi (West Virginia University) |
Abstract: | Objectives: We estimated disability prevalence among adults at global, regional and country levels using internationally comparable disability data and measure. Methods: We conducted a retrospective analysis of data from the World Health Survey (WHS) (2002--2004) for nationally representative samples of civilian, non-institutionalized populations in 54 countries. A disability was measured as having at least one severe or extreme difficulty with bodily functions (seeing, concentrating) and activities (moving around, self--care) based on an individual’s self-reports. Results: In the 54 countries under study, severe or extreme functional or activity difficulties are highly prevalent. For all countries, disability prevalence is estimated at 14% for all adults. Low and middle income countries have higher disability prevalence compared to high income countries. Among subgroups, disability prevalence stands at 12% amon working age adults and 39% among the elderly. Women have higher prevalence than men. Conclusions: Disability is found to be highly prevalent among adults, with an estimated global prevalence at 14%. Disability deserves enhanced policy attention and resources in public health and international development. |
Keywords: | Disability prevalence, Development |
JEL: | I1 J14 |
Date: | 2013 |
URL: | http://d.repec.org/n?u=RePEc:frd:wpaper:dp2013-06&r=hea |
By: | Hiroaki Matsuura (University of Oxford) |
Abstract: | A number of studies have evaluated the effect of a right to health as a mechanism for achieving desirable health outcomes, yet no study has sought institutional conditions that make this mechanism more effective at population level.I hypothesise whether a right to health is only an effective instrument for improving health in countries that demonstrate good governance in which effective mechanisms for enforcing the right to health, as well as controlling government behaviour, exist. Annual data from 1970 to 2007 was obtained for a panel of 157 countries, to study the effects of introducing into national constitutions an explicit, enforceable, right to health and democratic governance on infant and under-five mortality rates. The introduction of a right to health in a national constitution was significantly associated with reductions in both mean infant and under-five mortality rates. The effect was large in countries with high scores for democratic governance, whereas in countries with low scores for democratic governance, approximately half of the effect of introducing a constitutional right to health was present. The results suggest that introducing a constitutional right to health is likely to be an effective mechanism for improving health in countries that have a high level of democratic governance. However, whereas a right to health is likely to be less effective in countries with low scores for democratic governance in the short run, there can be a longer term health benefits if governance subsequently improves, the right to health remains in the constitution. |
Keywords: | Population health, Constitutional right to health, Democratic governance |
Date: | 2013–07 |
URL: | http://d.repec.org/n?u=RePEc:gdm:wpaper:10613&r=hea |
By: | Bénédicte Apouey (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - École des Hautes Études en Sciences Sociales [EHESS] - Ecole des Ponts ParisTech - Ecole normale supérieure de Paris - ENS Paris - Institut national de la recherche agronomique (INRA)); Jacques Silber (Department of Economics - Bar-Ilan University, CEPS/INSTEAD - Centre d'Etudes de Populations, de Pauvreté et de Politiques Socio-Economiques / International Networks for Studies in Technology, Environment, Alternatives, Development - Centre d'Etudes de Populations, de Pauvreté et de Politiques Socio-Economiques / International Networks for Studies in Technology, Environment, Alternatives, Development) |
Abstract: | Traditional indices of bi-dimensional inequality and polarization were developed for cardinal variables and cannot be used to quantify dispersion in ordinal measures of socioeconomic status and health. This paper develops two approaches to the measurement of inequality and bi-polarization using only ordinal information. An empirical illustration is given for 24 European Union countries in 2004-2006 and 2011. Results suggest that inequalities and bi-polarization in income and health are especially large in Estonia and Portugal, and that inequalities have significantly increased in recent years in Austria, Belgium, Finland, Germany, and the Netherlands, whereas bi-polarization significantly decreased in France, Portugal, and the UK. |
Keywords: | Inequality ; Bi-polarization ; Ordinal variables ; Self-assessed health |
Date: | 2013–08–05 |
URL: | http://d.repec.org/n?u=RePEc:hal:psewpa:halshs-00850014&r=hea |
By: | Stefania Albanesi (Federal Reserve Bank of New York and CEPR); Claudia Olivetti (Boston University and NBER) |
Abstract: | U.S. fertility rose from a low of 2.27 children for women born in 1908 to a peak of 3.21 children for women born in 1932. It dropped to a new low of 1.74 children for women born in 1949, before stabilizing for subsequent cohorts. We propose a novel explanation for this boom-bust pattern, linking it to the huge improvements in maternal health that started in the mid 1930s. Our hypothesis is that the improvements in maternal health contributed to the mid-twentieth century baby boom and generated a rise in women's human capital, ultimately leading to a decline in desired fertility for subsequent cohorts. To examine this link empirically, we exploit the large cross-state variation in the magnitude of the decline in pregnancy-related mortality and the differential exposure by cohort. We find that the decline in maternal mortality is associated with a rise in fertility for women born between 1921 and 1940, with a rise in college and high school graduation rates for women born in 1933-1950 relative to previous cohorts, and with a decline in fertility for women born in 1941-1950 relative to those born in 1921-1940. The analysis provides new insights on the determinants of fertility in the U.S. and other countries that experienced similar improvements in maternal health. |
Keywords: | Maternal mortality, Fertility choice, Baby boom, human capital |
JEL: | J11 J13 N12 N3 |
Date: | 2013–05 |
URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2013-003&r=hea |
By: | Stefania Albanesi (Federal Reserve Bank of New York and CEPR) |
Abstract: | This paper examines the impact of the decline in maternal mortality on fertility and women's human capital. Fertility theory suggests that a permanent decline in maternal mortality initially increases fertility and generates a permanent rise in women's human capital, relative to men. The resulting rise in the opportunity cost of children leads to a subsequent decline in desired fertility, generating a boom-bust response. We assess these predictions using newly digitized data on maternal mortality for 25 advanced and emerging economies for the time period 1900-2000. The empirical estimates suggest that the decline in maternal mortality contributed significantly to the baby booms and subsequent baby busts experi- enced by these economies in the twentieth century, and that the female-male differential in education attainment grew more in those countries that experience a sizable maternal mortality decline. |
Keywords: | Maternal mortality decline, fertility choice, baby boom, women's, human capital |
JEL: | J11 J13 J16 N3 |
Date: | 2013–05 |
URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2013-005&r=hea |
By: | Averett, Susan L. (Lafayette College); Terrizzi, Sabrina (Moravian College); Wang, Yang (Lafayette College) |
Abstract: | Eating disorders affect 12-25% of college women. Previous research established a positive correlation between sorority membership and eating disorders. We investigate a possible causal link between sororities and weight-related behaviors and eating disorders using data from the American College Health Association. Using Propensity Score Matching and Instrumental Variable methods, we confirm that sororities exert a negative effect on the weight-related behaviors of their members. However, females who are more resilient to these outcomes self-select into sororities, implying that females in sororities are less adversely affected by them than a female who was randomly selected to join a sorority would be. |
Keywords: | obesity, underweight, BMI, sorority, anorexia, bulimia, eating disorders, weight control |
JEL: | I12 I18 |
Date: | 2013–07 |
URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp7512&r=hea |
By: | Erin Fries Taylor; Janice Genevro; Deborah Peikes; Kristin Geonnotti; Winnie Wang; David Meyers |
Keywords: | Primary Care, Quality Improvement, Patient-Center Medical Homes, Health |
JEL: | I |
Date: | 2013–04–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7851&r=hea |
By: | Erin Fries Taylor; Deborah Peikes; Janice Genevro; David Meyers |
Keywords: | Primary Care, Quality Improvement, Patient-Center Medical Homes, Health |
JEL: | I |
Date: | 2013–04–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7852&r=hea |
By: | Erin Fries Taylor; Lyndee Knox; Dana Petersen; Kristin Geonnotti; Rachel Machta |
Keywords: | Primary Care, Practice Facilitation, Quality Improvement, Patient-Centered Medical Homes |
JEL: | I |
Date: | 2013–01–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7853&r=hea |
By: | Lyndee Knox; Erin Fries Taylor |
Keywords: | Patient-Centered Medical Homes, Primary Care, Practice Facilitation, North Carolina |
JEL: | I |
Date: | 2013–01–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7854&r=hea |
By: | Rachel M. Machta; Erin Fries Taylor |
Keywords: | Patient-Centered Medical Homes, Practice Facilitation, Primary Care Practice, Oklahoma |
JEL: | I |
Date: | 2013–01–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7855&r=hea |
By: | Dana Petersen; Erin Fries Taylor; Kristin Geonnotti |
Keywords: | Patient-Centered Medical Homes, Practice Facilitation, Primary Care Practice, Safety Net |
JEL: | I |
Date: | 2013–01–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7856&r=hea |
By: | Lyndee Knox; Erin Fries Taylor |
Keywords: | Patient-Centered Medical Homes, Primary Care, Practice Facilitation, Vermont |
JEL: | I |
Date: | 2013–01–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7857&r=hea |
By: | Erin Fries Taylor; Lyndee Knox; Dan Petersen; Kristin Geonnotti; Rachel Machta |
Keywords: | Patient-Centered Medical Homes, Practice Facilitation, Primary Care Practice, Health |
JEL: | I |
Date: | 2013–01–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7858&r=hea |
By: | Brenda Natzke; Maggie Colby; Erin Taylor |
Keywords: | Medicaid, CHIP, Performance Measures, Health |
JEL: | I |
Date: | 2013–04–30 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7861&r=hea |
By: | Asia Friedman; Jesse C. Crosson; Jenna Howard; Elizabeth C. Clark; Maria Pellerano; Ben-Tzion Karsh; Benjamin Crabtree; Carlos Roberto Jaén; Deborah J. Cohen |
Keywords: | Electronic Health Records, Primary Care, EHR, HIT |
JEL: | I |
Date: | 2013–08–01 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7863&r=hea |
By: | Matthew Kehn; Jody Schimmel |
Keywords: | Medicaid , disability, employment, Medicaid Buy-In |
JEL: | I |
Date: | 2013–05–14 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7865&r=hea |
By: | Committee on Evaluating Progress of Obesity Prevention Effort; Food; Nutrition Board; Institute of Medicine; of which Ronette Briefel is a member |
Keywords: | Obesity Prevention, IOM, Nutrition |
JEL: | I0 I1 |
Date: | 2013–08–02 |
URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7866&r=hea |
By: | Yuko Ito (National Graduate Institute for Policy Studies); Hiroshi Nagano (National Graduate Institute for Policy Studies) |
Abstract: | Since National and public research and development institutions, including those that are set up under the Act on General Rules for Independent Administrative Agency, are funded by taxation, they are in-creasingly required to contribute research outcomes to society. Society’s needs for research outcomes are high in medicine, and in this case, publicly funded research institutions need to collaborate with hospitals in conducting research. This article analyzes collaboration between publicly funded research institutions and hospitals using two clinical cases in the area of cell therapy research, which is at the translational re-search stage. The analysis shows that factors that have probably promoted collaboration between publicly funded research institutions and hospitals include: (a) the cutting-edge nature of the research theme, which cannot be pursued by hospitals only, (b) the existence of a locally focused policy framework for institutional collaboration, and (c) the existence of core researchers and their migration between institutions. In addition, it is necessary to amend the law and system for streamlining the process of medical research and clinical trials in order to realize medical treatment based on outcome of translational research. |
Date: | 2013–08 |
URL: | http://d.repec.org/n?u=RePEc:ngi:dpaper:13-15&r=hea |
By: | OECD |
Abstract: | This report presents the findings of a research project to investigate the drivers and criteria shaping the application of genomic biotechnology to health in different national settings, and the barriers to implementation nationally and internationally. A case study approach was adopted for the project. The findings are based on the active participation in the survey of seven self-selected countries, including both OECD member and non-member countries (Finland, Israel, Luxembourg, Mexico, the United Kingdom, China and South Africa). The report outlines a number of potentially important patterns that are seen to emerge when the country case studies are set alongside one another and viewed in transnational perspective. The data, albeit based on limited evidence from a small sample of countries, suggest a significant divergence in the way that different countries are tending to adopt genomics for public health, which may have important implications for thinking about how genomic science and technology might best be employed in the interests of global public health. |
Date: | 2013–08–02 |
URL: | http://d.repec.org/n?u=RePEc:oec:stiaac:8-en&r=hea |
By: | Bontile, Honey Loveleen R. |
Abstract: | The national government has been aiming for the provision of essential health services that are accessible, affordable, and equitable. With the LGU Code of 1991, DOH retained 45 hospitals nationwide and in 2011, with the exclusion of drug abuse treatment and rehabilitation centers, 21 renationalized and 4 new hospitals were added to the list: 51 hospitals were classified as general and 19 are specialty hospitals. Aside from accessibility, people seek quality health care when getting medical attention while health providers use quality care to increase their market share. However, perception of quality differs between patients and health providers. Since one of the functions of the NCHFD is to provide technical assistance, an assessment of the 2011 hospital performance during the first year implementation of the KP thrust is beneficial. The study may determine areas for improving levels of performance and provide evidence for policy development. Results can serve as basis in ranking DOH hospitals in the PBB implementation. Furthermore, application of hospital performance specific indicators can be used in the planned hospital scorecard. The study focused its analysis on the 51 general DOH hospitals. Data were based on the annual hospital statistics reports submitted to the BHFS and NCHFD. Indirect indicators were used as recommended and agreed upon by the hospital information management team since the direct measures of quality care cannot be used. Generated results were compared to the standards proposed by McGibony (1969) and used as reference by the DOH (A.O. 147 s.2004). |
Keywords: | Philippines, Department of Health (DOH), general hospitals, performance assessment |
Date: | 2013 |
URL: | http://d.repec.org/n?u=RePEc:phd:dpaper:dp_2013-36&r=hea |
By: | Puyat, Maria Elizabeth Angeline D. |
Abstract: | According to the 2008 National Demographic and Health Survey (NDHS) report, children under 5 are more likely to use in-patient care than other age groups. These children are not only more vulnerable to getting sick, but are also at risk of incurring high health expenditures if they are without health insurance. Using the 2008 NDHS dataset, this study focused on the coverage and in-patient benefit utilization of children under 5, who are dependents of the Philippine Health Insurance Corporation (PhilHealth). Unique to this analysis was the shift in focus of coverage and utilization from the traditional angle of primary members to the dependents. Descriptive analyses revealed that PhilHealth covered only 33.93 percent of the under-5 population, and of those PhilHealth dependents who were confined in a hospital, 67.59 percent used PhilHealth as a source of payment. Logistic regression analysis determined that age and educational attainment of the household head, region, and wealth index were significant factors that influenced coverage. Moreover, it was found that confinement in a private facility and for longer periods of time increased the probability of in-patient benefit utilization for PhilHealth dependents. These results will be useful for PhilHealth as they create evidence-based initiatives to attain Universal Health Coverage. |
Keywords: | health insurance, Philippines, children, insurance coverage, benefit utilization |
Date: | 2013 |
URL: | http://d.repec.org/n?u=RePEc:phd:dpaper:dp_2013-37&r=hea |
By: | Reyes-Lao, Issa |
Abstract: | The Philippines is one of the few countries where the prevalence of HIV/AIDS remains relatively small. However, recent data show that while other countries have shown a decrease in the incidence rate for this disease, the Philippines has experienced a 25 percent increase in incidence rate for HIV infection. While the proportion of people living with HIV/AIDS accounts for less than 1 percent of the population, the country is clearly falling behind in attaining the Millennium Development Goal for this disease. Moreover, it is still evident that Filipinos continue to experience inequity and unequal access to health services for HIV/AIDS even with different interventions already in place. The Philippine Health Insurance Corporation (PHIC) launched the Outpatient HIV/AIDS Treatment (OHAT) package in 2010 to improve accessibility and affordability of HIV/AIDS treatment. With already three years underway and continued growth in people infected with HIV/AIDS, an assessment of this benefit package looked into issues that hinder the utilization of this package. The benefit coverage, support value, and utilization rate for this benefit package were evaluated through a review of literature, costing analysis, and key informant interviews. The results of this study show that there is a need to enhance the OHAT package, as this is not fully utilized despite the increasing number of people living with HIV/AIDS who are in need of treatment. Addressing underutilization and retention among PHIC members will involve expanding coverage benefits to patients at different stages of the disease, increasing patient awareness, and improving claims processes. However, expanding access to treatment must also be coupled with preventive programs for HIV at the primary care level to maximize the benefits of this intervention and minimize financial out-of-pocket. |
Keywords: | PHIC, Philippines, Outpatient HIV/AIDS Treatment package, benefit coverage, support value, package utilization |
Date: | 2013 |
URL: | http://d.repec.org/n?u=RePEc:phd:dpaper:dp_2013-38&r=hea |
By: | Ulep, Valerie Gilbert T.; Aldeon, Melanie; Dela Cruz, Nina Ashley |
Abstract: | This report is a continuation of the discussion paper of the Philippine Institute for Development Studies entitled "Inequalities in Noncommunicable Diseases in the Philippines". The first technical paper is an analysis of the current status and social determinants of noncommunicable diseases (NCD). This report, on the other hand, focuses on potential NCD prevention and control strategies of the Department of Health (DOH) with wider multisector involvement. This report is divided into five chapters. Chapters I and II discuss the current status of noncommunicable diseases and existing policies and programs of the DOH. Chapter III introduces the potential roadmap of the NCD prevention and control program of the DOH. Chapter IV defines the roles and responsibilities of different bureaus within the health sector. Chapter V outlines the potential framework of the multisector strategy of the DOH. |
Keywords: | Philippines, noncommunicable diseases, multisector collaboration, health system approach, supply and demand-side interventions |
Date: | 2013 |
URL: | http://d.repec.org/n?u=RePEc:phd:dpaper:dp_2013-40&r=hea |
By: | Hendrik Schmitz; Matthias Westphal |
Abstract: | This paper estimates the effect of informal care provision on female caregiver’s health. We use data from the German Socio-economic Panel and assess effects up to seven years after care provision. A simulation-based sensitivity analysis scrutinizes the sensitivity of the results with respect to potential deviations from the conditional independence assumption in the regression adjusted matching approach. The results suggest that there is a considerable short-term eff ect of informal care provision on mental health which fades out over time. Five years after care provision there are no signifi cant effects left. Both short- and medium-term effects on physical health are much smaller and insignificant throughout. |
Keywords: | Informal care; regression adjusted matching; propensity score matching; mental health; physical health |
JEL: | I10 I18 C21 J14 |
Date: | 2013–07 |
URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0426&r=hea |
By: | Jose I. Silva (University Of Kent); Judit Vall-Castello (Universitat de Girona) |
Abstract: | Although partially disabled individuals in Spain are allowed to combine the receipt of disability benefits with a job, the empirical evidence shows that employment rates for this group of individuals are very low. Therefore, in this paper we construct labor market model with search intensity and matching frictions in order to identify the incentives and disincentives to work provided by the partial disability system in Spain from the point of view of both disabled individuals and employers. According to the model, the high employment rate gap observed between nondisabled and disabled workers can be partially explained by the presence of a lower level of productivity and higher searching costs among disabled individuals that discourage them from looking for jobs. Moreover, the design of the Spanish Disability System also contributes in explaining this gap. We also analyze the role of business cycle conditions in shaping the labor market transitions of disabled individuals. |
Keywords: | disability system, job search intensity, flow analysis |
JEL: | I18 J64 J68 |
Date: | 2013–07 |
URL: | http://d.repec.org/n?u=RePEc:upj:weupjo:13-201&r=hea |
By: | Das Gupta, Monica; Dalpatadu, K. C. S.; Shanmugarajah, C. K.; Herath, H. M. S. S. D. |
Abstract: | What can other developing countries learn from Sri Lanka on achieving good health at low cost? While its well-organized medical and maternal-child health services have been documented elsewhere, this paper fills a gap in documenting how it organizes services to reduce the population's exposure to disease -- a pure public good. The key factors underlying the effectiveness of these services are (1) strong focal points in the central Health Ministry for supporting preventive services; (2) pro-active outreach by the health line agency to collaborate with other sectors / agents whose work influences public health outcomes; and (3) community-level delivery institutions with well-trained multivalent Public Health Inspectors -- all underpinned by (4) assured tax-based financing. This paper describes this system in some detail such that other countries can learn from Sri Lanka's successful approach to improving population health. It also makes some recommendations for strengthening the system in response to changing conditions. |
Keywords: | Health Monitoring&Evaluation,Disease Control&Prevention,Population Policies,Health Systems Development&Reform,Gender and Health |
Date: | 2013–08–01 |
URL: | http://d.repec.org/n?u=RePEc:wbk:wbrwps:6558&r=hea |